Cognitions associated with nurse performance: a comparison of concurrent and retrospective verbal reports of nurse performance in a simulated task environment.

BACKGROUND: Cognitions represent the computations associated with human thought processes. Verbal protocols offer a method by which to record these processes. While concurrent and retrospective verbal reporting of cognitions have been used extensively within nursing and other domains, the use of this methodology in nursing has been characterized by inconsistencies in its application. OBJECTIVES: The primary objective of this study was to describe and compare the content of concurrent and retrospective verbal reports provided by nurses during and after administering care in a simulated task environment. DESIGN: The study utilized a laboratory based quasi-experimental research design. SETTING: The study was based in a simulation laboratory designed specifically for use in studies designed to measure nursing performance. The laboratory integrated extensive instrumentation that facilitated the comprehensive audio and video recording of participant actions. PARTICIPANTS: The participants (N=15) were recruited from a College of Nursing at a large university in the Southeastern United States. METHODS: Research participants were asked to admit a patient experiencing an acute exacerbation of congestive heart failure in a simulated task environment, during which they were required to prioritize and provide care. Participants were trained in the method for providing verbal reports of thoughts, and concurrent and retrospective report data were collected during and after the simulation exercise. The data were then coded for the purposes of descriptive analysis. RESULTS: The results indicated that the concurrent verbal reports provide a more complete representation of the cognitions of research participants providing care in a simulated task environment. However, the results reflect that additional unique data is present in the retrospective reports, exclusive of the concurrent reports. CONCLUSIONS: The findings support the utility of concurrent and retrospective verbal reports as a method of gathering data in studies that address nursing performance in a clinical context.