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411: EXPLORING THE EFFECT OF RISK-TAKING, STRESS OF UNCERTAINTY ON THE DIFFERENT CLINICAL DECISION-MAKING

Learning Objectives: Making appropriate decision choices regarding the care of the individual is one of the integral factors that contribute to safe, efficient, and cost effective care. Much of the education provided in schools aims toward building the analytical thought processes to help with decision making. The goal ultimately is to help the students to improve their decision making process but analytical processes are considered most appropriate. Therefore, the purpose of this study is to examine the different clinical decision making styles in end of life care situations among Sophomore, Junior, and Senior undergraduate nursing students as guided by the dual process theory as the theoretical framework for analytical and intuitive process. More specifically, this study will examine the effect of risk taking behaviors and stress of uncertainty on decision making styles. Methods: This is a cross sectional and a longitudinal crossover survey study. We approached undergraduate (Sophomore, Junior, and Senior) nursing students at Widener University and the University of Pennsylvania. The total number of students enrolled in study was 210. Participants completed the demographic information, Decision Score Scale, Risk and Tolerance of Ambiguity Scale Behavior subscales. Participants were asked to indicate their support for aggressive treatment (SC) in two different clinical vignettes pertaining to end of life care. Results: We found that there was significant variation in support to continue aggressive life support when student where presented with futile palliative care vignettes. Sophomore supported a decision to place feeding tube and tracheostomy much more frequently than junior or senior (SCjunior=27 ± 13; SCsophomore=57 ± 26; SCsenior=31 ± 15; p=0.0016). There was no difference in risk taking score or intuitive versus rational decision-making score between year group of the students. However, there was positive correlation between rationality and GPA score ((=0.23; p+0.005). Clinical experience differed between studied group but correlations between SC for any vignette and clinical experience were low. Conclusions: Our study suggests that rationality and decision making styles are traits and are not modified by the experience of nursing school. However, we found interesting variation of support to engage in aggressive medical treatment among the sophomore students only suggesting that experience of RN have profound effect on clinical judgment among nursing students.