Paper
Tuesday, November 6, 2007

687
This presentation is part of : The Nurse's Role in Leadership Development
Similarity Discernments in General and Nursing Representations
Sharie L. Falan, School of Nursing, University of Michigan, Ann Arbor, MI, USA
Learning Objective #1: identify components of a the shared understanding framework necessary for clinical practice.
Learning Objective #2: articulate that shared understanding in clinical practice cannot be assumed.
The ability to discern similarities in clinical practice is critical for nurses who develop, implement, and evaluate patient care.  It is assumed that knowledge and experience affect this ability.
Hypotheses: patterns and expressions in four levels of similarity would occur between general and nursing images based on education. Additionally, it was hypothesized that years of clinical experience would produce different patterns of similarity.
The study used a comparative descriptive design. The level of similarities was measured through written descriptions produced when subjects compared two general and two nursing knowledge images.  
Similarity was measured as the presence, quantity, and patterns of analogy, thematic, literal, and surface-level responses. 
A convenience sample of eighty nurses was recruited from four hospitals.  Fifty-nine percent had an ADN.  Of the entire sample, 65% had less than ten years experience.

All levels of similarity were used, yet the highest and most complex level of similarity, analogy, was used least.  Subjects with a BSN used significantly more similarity descriptions; these were at the literal level for general images, and surface and literal levels for nursing.  Subjects with less than ten years experience used significantly more surface (for general) and thematic (for nursing) similarity descriptions.  There was a strong correlation surface and literal similarity.  Correlations were found for analogy and thematic for BSN, and subjects with 10 or more years experience.  Correlations were found between analogy and literal levels for subjects with less than 10 years experience.  The BSN cohort used literal and thematic levels in the same manner across image sets. Findings revealed unexpected differences among subject groups in the ability to discern similarities.  This study informs our knowledge base regarding how nurses think about what they observe.   Further, it is important to nursing because it adds to our understanding of how differences in patient care might occur.

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