Decision-Making Errors During Recognizing and Responding to Clinical Deterioration: Gaze Path-Cued Retrospective Think-Aloud

Published:September 28, 2022DOI:


      • Eye tracker combined with simulated patient help researchers to gain a better understanding of how information is processed in decision-making by nurses.
      • Cognitive bias can influence nurses’ decision-making and patient safety.
      • Time pressure, complexity and uncertainty may contribute to the presence of cognitive biases.



      Using individuals... own eye gaze path and mouse click tracks has proven to be a valuable technique for identifying a broad range of underlying cognitive processes and lapses of decision-making.


      The study aims to investigate nurses... decision-making errors in clinical deterioration.


      Tobii eye tracker(R) was used to collect eye movements and mouse clicks of eighteen participants followed by gaze path retrospective interview.


      Thematic analysis revealed several forms of cognitive bias including anchoring, availability and confirmation bias, commission error and Yin-yang out. A distraction effect was apparent in nurses' ability to perceive, process data and to intervene.


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