Role and Experience Determine Decision Support Interface Requirements in a Neonatal Intensive Care Environment.

The aim of this paper is to describe a novel approach to the analysis of data obtained from card-sorting experiments. The card-sorting experiments were performed as a part of the initial phase of a project, called NEONATE, which has an aim to develop decision support tools for the neonatal intensive care environment. Physical card-sorts were performed using clinical “action ” and patient “descriptor” words. Thirty-two staff (8 junior nurses, 8 senior nurses, 8 junior doctors and 8 senior doctors) participated in the actions cards sorts and 32 staff (of similar classifications) participated in separate descriptors card-sorting experiments. The card-sorts were replicated for all staff in the descriptor experiments, but only for nurses during the action card-sorts. The card-sort data were analysed using conventional cluster analysis to produce treediagrams or dendrograms. Differences were shown in the way various classes of staff with different levels of experience mentally map clinical concepts. Clinical actions were grouped more loosely by nurses and by those with less experience with a polarisation between senior doctors and junior nurses. Descriptors were classed more definitively and similarly by nurses and senior doctors but in a less structured way and quite differently by junior doctors. This paper presents a graphical method of summarising the differences in the card-sort data for the various staff categories. It was shown that concepts are used differently by various staff groups in a neonatal unit and this may impact on the effectiveness of computerised decision aids unless it is explored during their development