Statement of Study Purpose
Two independent studies were undertaken examining the use of vignettes for nurse judgement and decision making when caring for complex or vulnerable patient groups. Patient groups included older people with long term care needs and women undergoing or planned medical termination of pregnancy (MTOP). Both patient groups were targeted in health care transition: older people from acute to community care and MTOP from acute to nurse-led settings.

Methods
Based on case site studies, simulated clinical scenarios were constructed for each patient group. In study 1, written scenarios were used and nurses set priorities for two different patient caseloads; surgical or gynaecology patients. Nurses ranked patients in each caseload firstly, in the order in which they proposed to attend them and secondly, in order of planned tasks and interventions for each patient. In study 2, scenarios involved the use of an actor (who took on the role of the patient) supplemented by written material. While engaged in the judgement and decision making task of pressure ulcer risk assessment, nurses verbalised their thoughts using the Think Aloud method.

Results
Providing that efforts have been made to ensure that validity and reliability of the vignettes have been addressed to reflect the context in which the judgement and decision making task takes place in, the results suggest that vignettes are an ideal way to examine the judgement and decision making of nurses who are involved in the care of complex or vulnerable patient groups.

Conclusion
The use of vignettes to examine nurse judgement and decision making can be considered a reliable and sensible method of data collection, whilst also safeguarding patients from harm and intrusion of personal privacy. Vignettes are pertinent when conducting research prior to, during, or after periods of transition in health care organizations. Both studies also highlight implications for nurse education.