Theses and Dissertations at Montana State University (MSU)
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/733
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Item Understanding the relationship culture between physicians and nurses and their effects on perceived clinical outcomes and nursing outcomes(Montana State University - Bozeman, College of Engineering, 2014) Waliullah, Md.; Co-chairpersons, Graduate Committee: Nicholas Ward and Bill SchellThe US healthcare industry faces a variety of complex challenges. Simultaneously, pressures continue to mount with regard to the expectation for lower costs with improved quality of care. These problems have drawn the attention of many researchers seeking ways to improve healthcare delivery. These efforts regularly identify two key issues requiring solutions: 1) Improving clinical outcomes by reducing adverse patient conditions due to medical errors, and 2) Improving care delivery by reducing staffing shortages and turnover within the nursing profession. Several studies have shown that workplace culture and incivility can be a material contributor to both of these issues. While many researchers have investigated the nature of nurse-physician interaction, and their effects on clinical and nursing outcomes, they mostly focus on the 'perception' of nurses and not physicians. Perhaps more importantly, these studies generally did not distinguish between descriptive and injunctive norms suggested by Social Norms Theory (SNT). This study seeks to close both of these gaps. This study developed a new survey instrument to measure these norms and performed a sample survey of the physicians and nurses of Montana and Denver area. This study used SNT to identify any gaps between descriptive and injunctive norms of RNs and MDs regarding their relationship culture and their effects behaviors on perceived nursing outcomes (e.g. job satisfaction, retention, etc.) and perceived clinical outcomes (e.g. medical errors, quality of care). The study sought to investigate these gaps because SNT suggests that people tend to behave in the way they believe is most typical of and accepted by their peers (perceived norms). Unfortunately, perceptions of others' behaviors are quite frequently inaccurate, with views of problematic behaviors tending to be overestimated and healthy behaviors tending to be underestimated. SNT offers an innovative approach for addressing such situations by changing perceptions. The findings of the study suggest significant differences between the perceived norms of physicians and nurses when compared to their actual norms. The findings are expected to be helpful for developing an intervention program to improve the relationship culture between physicians and nurses which can contribute to improve quality of patient care and nursing retention.Item The effect of simulation attributes on driver perception and behavior(Montana State University - Bozeman, College of Engineering, 2010) Durkee, Shaun Michael; Chairperson, Graduate Committee: Nicholas WardTransportation systems in today's world are complex, diverse, and dangerous. Drivers execute many tasks in order to safely and efficiently maneuver their vehicles in these systems. Evaluation of vehicle speed (ego motion) and inter-vehicle distance (egocentric distance) are crucial skills and constant demands while operating a motor vehicle. Common maneuvers such as braking, obstacle avoidance, and overtaking rely heavily on such skills. Driving skills and transportation safety concerns in general have been studied over the years by many research methodologies. One such methodology, the driving simulator, has emerged as a leading research tool to help understand driver behavior and mitigate traffic safety concerns. The overall effectiveness of driving simulation as a research tool is linked to how accurately modern technology can model reality. Therefore determining how valid simulators are in representing reality is a chief concern among researchers, as validity ensures accuracy and credibility of research efforts. Simulation validity is established both physically and behaviorally. The objective of this project was to conduct a driving simulator experiment to examine the perceptual and behavioral effects of various parameters of the simulation deemed relevant from theories of ego motion. Twenty drivers completed speed and following distance perception tasks (absolute production, fixed-increase production, and ratio production) while driving through rural road scenarios that varied in the presentation of motion, field of view, and optic flow. Tasks and dependent variables assessed driver perception of speeds (25-65 MPH) and following distances (150-300 ft) common in everyday driving. The study concluded that field of view (FOV) and optic flow simulation parameters were significant to the perception of absolute speed, with high levels of each parameter (large FOV, high optic flow) resulting in more accurate perception than low levels (small FOV, low optic flow). Also, participants perceived a high level of field of view as significantly more natural than a low level of field of view. The results of this study will add to the existing simulator body of knowledge and will also allow the researchers to quantify the relative importance of simulation parameters as a basis for future behavioral validation of the driving simulator.