EFFECTS OF INFORMATION DISPLAY ON THE CONSTRUCTION OF CLINICIAN MENTAL MODELS

Objective: To determine how a clinician’s background knowledge, their tasks, and displays of information interact to affect the clinician’s mental model. Design: Repeated Measure Nested Experimental Design Population, Sample, Setting: Populations were gastrointestinal/internal medicine physicians and nurses within the greater Houston area. A purposeful sample of 24 physicians and 24 nurses were studied in 2003. Methods: Subjects were randomized to two different displays of two different mock medical records; one that contained highlighted patient information and one that contained non-highlighted patient information. They were asked to read and summarize their understanding of the patients aloud. Propositional analysis was used to understand their comprehension of the patients. Findings: Different mental models were found between physicians and nurses given the same display of information. The information they shared was very minor compared to the variance in their mental models. There was additionally more variance within the nursing mental models than the physician mental models given different displays of the same information. Statistically, there was no interaction effect between the display of information and clinician type. Only clinician type could account for the differences in the clinician comprehension and thus their mental models of the cases. Conclusion: The factors that may explain the variance within and between the clinician models are clinician type, and only in the nursing group, the use of highlighting.

The construction of aging and health in older African American women

Persistence of racial and ethnic health disparities and governmental policies based on outdated ideas of aging call for inclusive approaches to the study of elder African Americans. The lived experiences of aging among urban, poor African American women, who comprise a vulnerable population, are not well known, as most studies focus on mainstream populations. Gerontological studies have tended to employ methods that collapse contextual information for ease of analysis, thus failing to capture nuanced information critically relevant to health of marginalized groups. Few researchers have been successful highlighting the importance of local knowledge, resilience, and resources for health by using participatory methods with older Black women. This study utilizes participatory principles to gather discursive data from nine older African American women, engaged in three generational cohorts: those born around World War II, women born after the great depression, and those born before the great depression. Videotaped and transcribed conversations of cohorts were analyzed in search of contextual factors that influence their experience of aging and health. As women responded to general themes that provoked their talk about their lives, they helped answer the study's questions: How do older African American women make sense of their aging experience? What are some of the important social and cultural influences that shape the construction of aging and health by these women? Are generational discourse groups an effective tool for exploring changes in the experiences of aging? A key finding demonstrated rich heterogeneity of experiences with strong generational influences on the construction of aging and health. The participants' moral orders comprised of traditional values of family, reinforced by personal experiences and the church, have guided their lives through oppression and stress but appear to be failing younger women who have greater exposure to new environmental pressures. Limited time and the size of the study were weaknesses although the women's interest in the study and their participation were gratifying. The participants served to highlight the importance of recognizing generational and other contextual factors in formation of ideas of aging and likelihood of additional challenges to the experience of old age among older, poorer, African Americans. ^