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Clinical Judgement Analysis: An innovative approach to explore the individual decision-making processes of pharmacists

Waghorn, J; Bates, I; Davies, JG; Jubraj, B; Rakow, T; Stevenson, JM; (2021) Clinical Judgement Analysis: An innovative approach to explore the individual decision-making processes of pharmacists. Research in Social and Administrative Pharmacy 10.1016/j.sapharm.2021.05.006.

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Abstract

Background Pharmacy stands increasingly on the frontline of patient care, yet current studies of clinical decision-making by pharmacists only capture deliberative processes that can be stated explicitly. Decision-making incorporates both deliberative and intuitive processes. Clinical Judgement Analysis (CJA) is a method novel to pharmacy that uncovers intuitive decision-making and may provide a more comprehensive understanding of the decision-making processes of pharmacists. Objectives This paper describes how CJA potentially uncovers the intuitive clinical decision-making processes of pharmacists. Using an illustrative decision-making example, the application of CJA will be described, including: Method An illustrative study was used, applying an established method for CJA. The decision to initiate anticoagulation, alongside appropriate risk judgements, was chosen as the context. Expert anticoagulation pharmacists were interviewed to define and then refine variables (cues) involved in this decision. Decision tasks with sixty scenarios were developed to explore the effect of these cues on pharmacists’ decision-making processes and distributed to participants for completion. Descriptive statistical and regression analyses were conducted for each participant. Results The method produced individual judgement models for each participant, for example, demonstrating that when judging stroke risk each participant’s judgements could be accurately predicted using only 3 or 4 out of the possible 11 cues given. The method also demonstrated that participants appeared to consider multiple cues when making risk judgements but used an algorithmic approach based on one or two cues when making the clinical decision. Conclusion CJA generates insights into the clinical decision-making processes of pharmacists not uncovered by the current literature. This provides a springboard for more in-depth explorations; explorations that are vital to the understanding and ongoing development of the role of pharmacists.

Type: Article
Title: Clinical Judgement Analysis: An innovative approach to explore the individual decision-making processes of pharmacists
DOI: 10.1016/j.sapharm.2021.05.006
Publisher version: https://doi.org/10.1016/j.sapharm.2021.05.006
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Clinical decision-making, clinical judgement analysis, pharmacists, intuition, risk judgement, anticoagulation
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/10127900
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