A Cooperative Inquiry Investigation of Transport Nurses Decision Making and Expertise
Abstract
by
ANDREW P. REIMER
Investigating expertise has proven difficult and successful inquiry into nursing
expertise has been limited. The purpose of this dissertation is (1) to describe the
development of a program of research related to flight nursing practice, (2) to describe
the development of the Middle Range Theory of Flight Nursing Expertise, (3) to explore
the usefulness of applying complex system characteristics in investigating expertise, and
(4) to report the findings of a cooperative inquiry investigation that provided the initial
exploration of the Middle Range Theory of Flight Nursing Expertise.
Three manuscripts related to flight nursing practice and expertise was developed.
The three manuscripts for publication are: (1) Flight Nursing Expertise: Toward a
Middle-range Theory, (2) The Contribution of Complex System Characteristics to
Naturalistic Decision Making in an Investigation of Flight Nursing Practice, and (3) An
Exploration of the Middle Range Theory of Flight Nursing Expertise in Clinical Practice.
We choose complexity science as a theoretical approach to this investigation.
Several complexity science characteristics (open system, non-linearity, self-organization,
and emergence) influenced the choice of a methodological approach - cooperative
inquiry. Two rounds of inquiry were conducted. The first round consisted of the creation
and completion of a post-flight questionnaire to assess expertise in flight nursing. The
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second round entailed the conduction of individual interviews (critical decision method),
and identified three themes which were: anticipating future events, expanded decision
making, and partner cuing. The results of both rounds of inquiry provided support for the
inclusion of each concept identified in the theory and provided initial support for each
proposition.
The results of this investigation provide initial support for the Middle-range
Theory of flight Nursing Expertise. Additional exploration of the theory will include
possible revision of the theory to incorporate the concept of partner cuing, and the
expansion of the theory to include additional flight team compositions and modes of
transport. An additional application of this theory may include the expansion of the
theory into an interdisciplinary conceptual framework applicable to each profession
involved in patient transport.