Nurses’ cognitive and perceptual bias in the identification of clinical deterioration cues

Modi Al-Moteri, Simon Cooper, Mark Symmons, Virginia Plummer

Research output: Contribution to journalArticleResearchpeer-review


Perception and processing of clinical cues have rarely been investigated in the nursing literature despite their relevance to the early identification and management of clinical deterioration. This study used a hypovolemic shock scenario from the FIRST2ACT virtual simulation program, equipped with an eye tracker, to investigate cue processing during the management of patient deterioration. Results indicated that attention deviation distorted interpretation of subsequent cues, causing 63% of participants to exhibit a cognitive bias (heightened sensitivity to specific but non-critical cues) and 65% to exhibit at least one episode of non-fixation on clinically relevant cues. Attention deviation and distorted interpretations of clinical cues will have an impact on patient safety. The findings are likely to have important implications for understanding error and associated training implications.
Original languageEnglish
Number of pages10
JournalAustralian Critical Care
Publication statusAccepted/In press - 12 Oct 2019


  • Eye tracking
  • nursing
  • clinical deterioration
  • decision making
  • perception bias
  • cognition bias

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