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Effects of Information Display on the Construction of Clinician Mental Models

Author: Constance M. Johnson, MS, RN (2003)

Primary Advisor: Todd R. Johnson, PhD

Committee Members: Jiajie Zhang, PhD; James Turley, PhD; Christopher Amos, PhD

PhD Thesis, The University of Texas School of Health Information Sciences at Houston.


Objective: To determine how a clinician’s background knowledge, their tasks, and displays of information interact to affect the clinician’s mental model.
Design: Repeated Measure Nested Experimental Design.
Population, Sample, Setting: Populations were gastrointestinal/internal medicine physicians and nurses within the greater Houston area. A purposeful sample of 24 physicians and 24 nurses were studied in 2003.

Methods: Subjects were randomized to two different displays of two different mock medical records; one that contained highlighted patient information and one that contained non-highlighted patient information. They were asked to read and summarize their understanding of the patients aloud. Propositional analysis was used to understand their comprehension of the patients.

Findings: Different mental models were found between physicians and nurses given the same display of information. The information they shared was very minor compared to the variance in their mental models. There was additionally more variance within the nursing mental models than the physician mental models given different displays of the same information. Statistically, there was no interaction effect between the display of information and clinician type. Only clinician type could account for the differences in the clinician comprehension and thus their mental models of the cases.

Conclusion: The factors that may explain the variance within and between the clinician models are clinician type, and only in the nursing group, the use of highlighting.