Graduation Year


Document Type




Degree Granting Department


Major Professor

Mary Webb, Ph.D., R.N.


Decision-making, Social judgment theory, Clinical assessment, Nursing, Patients


Coronary heart disease (CHD) is the single largest killer of American males and females in the United States. According to the American Heart Association, (2005) approximately 41% of Americans that experience a coronary attack in a given year will die from it (AHA, 2005). To combat this growing problem, strategies need to be evaluated to assess how the identification of actual and potential CHD risks are made. This study utilized the Social Judgment Theory to gain insight into nurse practitioner's decision-making strategies. Sixty family or adult specialty nurse practitioners affiliated with the University of South Florida (USF) College of Nursing volunteered to take part in a pretest-posttest experimental design. They were randomly assigned to one of three conditions. Condition 1 and 2 received educational interventions and Condition 3 served as the control group, which received no education.

This design was used to assess the effects of educational feedback on improving judgment accuracy, achievement, and insight. The findings indicated nurse practitioners agreement with the Framingham prediction model of CHD risk did improve significantly for the two intervention groups from Time 1 to Time 2 (p <.05). the participants also showed a relatively high degree of cognitive control when judging and performing the policy-capturing task (average Rs = .88) as compared to Framingham (Re = .96). Significant amount of unconditional bias (F(2, 57) = 9.85, p < .01) and conditional bias (F(2, 57). 5.42), p < .05) was present in this sample. Nurse practitioners overall performed well when compared with the Framingham Heart Study risk equation, however, nurse practitioners showed little insight into their judgment process. The results of this study may provide the opportunity for nurse practitioners to offer patients more appropriate medicinal and diagnostic treatments.

Future cardiac events may be avoided through evidenced-based CHD education for nurse practitioners.