Study Conclusion: NP diagnostic reasoning in a complex case scenario compared favorably with that of physicians.

Robert Bell rmsbell200 at YAHOO.COM
Thu Aug 13 15:49:20 UTC 2015


And what are the issues when we have advanced computer programs that almost anyone with reasonable technology and medical diagnostic understanding can operate?

In England from the 1600s on some of the physicians became pharmacists and some of the pharmacists physicians!

Rob Bell

Sent from my iPad

On Aug 13, 2015, at 6:02 AM, Maureen Cahill <MCahill at NCSBN.ORG> wrote:

> We, in the nursing and APRN community, are very interested in learning where there may be diagnostic challenges in our care and especially tools and resources that enable us to have greater diagnostic accuracy with improved patient outcomes.  This is one of the areas of continued competency for which there is great interests, but as yet, little data.
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> Maureen
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> Maureen Cahill [Associate] 312.525.3646 (D) mcahill at ncsbn.org
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> From: Mark Graber [mailto:mark.graber at IMPROVEDIAGNOSIS.ORG] 
> Sent: Wednesday, August 12, 2015 6:20 PM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Subject: Re: [IMPROVEDX] Study Conclusion: NP diagnostic reasoning in a complex case scenario compared favorably with that of physicians.
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> Its hard to know what to make of a small study using a single case, but I’m delighted to see ANY data that tried to look at relative diagnostic competency.  This is going to be one of the most interesting questions we face going forward, as more and more diagnoses are rendered by PA’s, NP’s, nurses in outreach and storefront clinics, etc.  Even if there is a small difference in diagnostic competency, which would not be surprising, the improved access to someone to help with diagnosis might offset any such difference in terms of improving overall diagnostic accuracy and timeliness.
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> On Aug 11, 2015, at 5:07 PM, Julianne Nemes Walsh <nemeswalsh at gmail.com> wrote:
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> Hello Ruth,
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> I think the commentary makes a great point about each profession being independently licensed but the importance of making complex decisions as a team.  The Ontario Health Professions Act of 1991 addresses the need for each profession to set the standards and regulate its own profession for the sole purpose of protecting the public.  
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> Thanks for sending the link.  I enjoyed reading.  
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> Julianne Nemes Walsh, DNP(c), MS, PNP-BC
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> On Tue, Aug 11, 2015 at 4:23 PM, Ruth Ryan <ruthryan at cox.net> wrote:
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> In Medscape at http://www.medscape.com/viewarticle/848710?nlid=86363_785&src=wnl_edit_medp_nurs&uac=9733BN&spon=24src=wnl_edit_medp_nurs&uac=9733BN&spon=24&impID=789938&faf=1
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> I think you have to register to access it, but it’s free of charge.
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> The methodology was interesting, worth a read. Participants were given a complex inpatient case presentation, and instructed to use a "think aloud" protocol. Judgement of correct dx was by an expert panel.
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> It must have been complex case indeed: MDs made the correct diagnosis 61.9% of the time. NPs made the correct diagnosis 54.7% of the time. The differences were not statistically significant. Participants who took longer to complete the case scenario were more accurate.
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> Pirret AM, Neville SJ, La Grow SJ. Nurse Practitioners Versus Doctor Diagnostic Reasoning in a Complex Case Presentation to an Acute Tertiary Hospital: A Comparative Study. Int J Nurs Stud. 2015;52:716-726.
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> Ruth
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> Ruth Ryan RN, BSN, MSW, CPHRM
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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