Similarity discernment in general and nursing representations.

Ability to discern similarities is critical for nurses who develop, implement, and evaluate patient care. It was assumed that knowledge and experience affect this ability. This study tested the hypotheses that subjects with an Associate Degree in Nursing (ADN), a Baccalaureate Degree in Nursing, (BSN) and those with varying years of medical-surgical experience (MSE) would differ in their similarity descriptions of general and nursing images. A comparative descriptive design was used. Similarity was measured as the presence, quantity, and patterns of analogy, thematic, literal, and surface-level responses. The level of similarities was measured through written descriptions produced when subjects compared two general and two nursing images. A convenience sample of eighty nurses was recruited from four hospitals. Of the sample, 65% had less than ten years' experience. Fifty-nine percent had an ADN. All levels of similarity were used, but analogy, the highest and most complex form, was used least. For general images, BSN subjects used significantly more literal level (p = .033); for nursing images, use of surface (p = .031) and literal levels (p = .008) was higher than the ADN cohort. For general images, subjects with less than ten years' experience used significantly more surface level (p = .046); thematic descriptions were higher (p = .004) for nursing descriptions. For all four groups, there was a strong correlation (p &le; .003) between use of literal and surface levels in describing nursing images. There was also a strong correlation between the presence of analogy and thematic levels in BSN subjects and the &ge; 10 MSE group (p = .037, p = .047). Subjects with an ADN or < 10 yrs' MSE showed a strong correlation in use of analogy and literal levels (p = .000, p = .014). Unexpected differences appeared in subject groups' ability to discern similarities. This study informs our knowledge base regarding how nurses think about what they observe and adds to our understanding of how differences in patient care might occur.Ph.D.Health and Environmental SciencesNursingUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/126416/2/3253265.pd