THE EFFECT OF OTTAWA DECISION SUPPORT FRAMEWORK TRAINING IN AN INTERACTIVE WORKSHOP WITH AND WITHOUT STANDARDIZED PATIENTS ON CLINICAL DECISIONMAKING OF NURSES IN AN INTENSIVE CARE UNIT

The complexity of the clinical status of patients in the ICU and the role of nurse’s
decisions on clinical outcomes of patients makes the education of nurses an essential task in the wards.
This study determined the effect of education based on the Ottawa Decision Support Framework using
interactive workshops on clinical decision-making skills of nurses in an intensive care unit (ICU).
Materials and Methods: In this quasi experimental study, 58 nurses from the ICU of Shahid Kamyab
Hospital in the city of Mashhad in Iran were randomly-assigned to one of the two workshops either with
standardized patients (n = 28) or without standardized patients (n = 30). Each workshop session lasted
6 hours, and it had identical educational content and clinical scenarios. Both groups completed a clinical
decision-making questionnaire before intervention, and 45 days post-intervention. Data analysis was
done using the t-test, paired test, Mann-Whitney, and chi-square tests in SPSS (v. 16). Results were
considered significant at p = 0.05.
Results: There was no significant difference in decision-making (p = 0.120) between groups before
intervention. The results of the paired-test indicated that the mean plus standard deviation scores were
significantly different (p < 0.001) for the group with standardized patients from pre-intervention (97.7
± 28.4) to post-intervention (152.5 ± 16.1), and in the group without standardized patients from preintervention (85.7 ± 29.2) to post-intervention (121.3 ± 24.6). The mean difference pre- and postintervention between the group with standardized patients (54.7 ± 22.3) and without standardized
patients (35.5 ± 28.2) was also significant (p = 0.002).
Conclusion: The results showed that a training program based on the Ottawa Decision Support
Framework promoted nurses participation in clinical decision-making in both groups, but the workshop
with standardized patients was more effective in the development of this clinical skill. Applying this
educational method in service training programs to improve nurse decision-making is recommended,
particularly with the use of standardized patients