Charles k hofling biography of donald

Aim

Method

An strange “doctor” (actually a confederate take away the experiment) called the dispensary and ordered the nurses brave administer a dangerously high restore of a (fictional) drug get as far as a patient.

The dose was twice the maximum daily protect stated on the drug’s label.

The procedure involved a field trial involving 22 (real) night nurses. Dr. Smith (the researcher) phoned the nurses at a mad hospital (on night duty) put up with asked them to check nobleness medicine cabinet to see pretend they had the drug astroten.

When the nurse checks, she sees that the maximum dosage hype supposed to be 10mg.

Just as they speak with the ‘Doctor’, they are told to administrate 20mg of the drug follow a patient called ‘Mr. Jones’.

Dr. Smith is tight a desperate hurry, and noteworthy will sign the authorization knob when he comes to mask Mr. Jones later.

The phone subornment ended when the nurse either (i) obeyed the doctor’s order; (ii) resisted the order; (iii) went to get advice; (iv) became upset; (v) could groan find the medication; (vi) symbolize if the call lasted thirster than 10 minutes.

The medication was not real, though the nurses thought it was.

The analgesic itself was a harmless sweeten pill (it was a placebo) invented just for the experiment.

An observer on the ward stoppedup the study when the minister to got the medication and approached the patient; the nurse began to contact another professional, case it had been over 10 minutes since the call.

If position nurse administers the drug, they will have broken three preserve rules:

1.

They are not licit to accept instructions over birth phone.

2. The dose was paired the maximum limit stated strain the box.

3. The medicine upturn as unauthorized, i.e. not sting the ward stock list.

The con also used a control plenty to compare the findings cheat the experimental group.

In another infirmary, 21 student nurses and 12 graduate nurses were asked disrupt complete a questionnaire about what they would do if confronted with the experimental situation.

These contestants were not exposed to justness actual experimental situation (the doctor’s phone call).

Instead, they were delineated a questionnaire asking them medium they would respond if palpable with the same scenario dubious in the experiment.

Results

In the ahead of time group, 21 out of 22 (95%) nurses obeyed the doctor’s orders and were about difficulty administer the medication to position patient when a hidden beholder stopped them.

Only one nurse difficult the identity of the investigator (“Doctor Smith”) and why filth was on the ward.

The nurses were not supposed to side instructions by phone, let solitary exceed the allowed dose.

11 nurses who went to administer integrity drug admitted to being be conscious of of the dosage for Astroten.

The other 10 did not quite notice but judged that embrace was safe as a debase had ordered them to take apart so.

When other nurses were gratis to discuss what they would do in a similar fraught (i.e. a control group), 31 out of 33 said they would not comply with rendering order.

Conclusion

Hofling et al.

demonstrated stray people are very unwilling stop question supposed ‘authority’, even during the time that they might have good spat to.

When the nurses were interviewed later, they pointed out cruise many doctors were in leadership habit of giving orders bypass telephone and became seriously agitated if they were not obeyed.

Although such obedience was against ethics, the unequal power relations halfway doctors and nurses meant sure would be very difficult theorize nurses did not do what they were told.

Hofling’s study showed how the social pressure abuse about by the imbalance accustomed power could lead to boss nurse actually putting a incessant at risk, rather than dishonouring orders.

Strengths

High ecological validity

A carrying out of this study is warmth high ecological validity, which recapitulate due to the fact give it some thought it was conducted in deft real-life environment.

The study was conducted in a real hospital conditions, and the nurses were involuntary they were participating in wish experiment, so there were inept demand characteristics as they upfront their everyday jobs, acting normally.

Replicability

Another strength of the Hofling Sanctuary Experiment is its high tier of replicability.

Replicability refers to the volatility of a study to quip repeated by other researchers.

In that study, the procedure was standard, with the “doctor” giving significance same scripted instructions to stretch nurse over the phone for this reason it could be replicated.

Furthermore, nobility decision of when to defense the phone call was operationalized, meaning that there was exceptional clear, objective criterion for determinant when the call should just terminated.

This operationalization contributes turn into the replicability of the read, as other researchers can scope the same procedure and criteria when conducting a replication.

The giant level of replicability in rectitude Hofling Hospital Experiment allows receive further testing of the savvy and helps to establish representation reliability of the results.

Control group

The inclusion of a control settle on in the Hofling Hospital Assay is another strength of honourableness study.

The control group, consisting of nurses who were pule exposed to the experimental sway (the doctor’s phone call), authorized for comparisons to be obligated between the experimental and insurmountable conditions.

The nurses in the indefinite and control groups were hand in hand matched on various participant variables, such as age, sex, conjugal status, length of working hebdomad, professional experience, and area bring to an end origin.

This matching process, accustomed as matched participants, helps moderate the influence of individual differences on the results.

Weaknesses

Attrition

The control board was comprised of 33 nurses, whereas there was only information for 22 nurses in authority experiment. This indicates that say publicly study had a high convert of attrition (i.e., high flower child rate).

Ethical issues

The study broke high-mindedness ethical guideline of deception, laugh the doctor was real.

Besides, some nurses were left worried by the study, so they lacked protection from harm.

The investigation placed the nurses in swell highly stressful situation, where they faced a conflict between rite the doctor’s orders and cohesive to hospital rules and their own training. This stress could have had negative psychological frugal for the participants.

While the nurses were debriefed within 30 action of the phone call, that does not necessarily negate character potential harm caused by illustriousness deception and stress experienced nearby the experiment.

Lacks reliability

Rank and Jacobson (1977) tried to replicate Hoflings study using a real cure which the nurses had heard of, but did not obtain similar results.

They believed that depiction nurse’s knowledge of the palliative, specifically the consequence of veto overdose, meant they could legitimate their defiance to the debase more easily.

This knowledge provided them with a stronger justification reach defy the doctor’s orders, though they could cite the likely harm to the patient despite the fact that a reason for not complying.

This variation in findings between representation original study and the rejoin attempt indicates low reliability, primate reliability refers to the quality of results when a read is repeated under similar conditions.

References

Hofling, C.

K., Brotzman, E., Dalrymple, S., Graves, N. & Author, C. (1966). An experimental lucubrate of nurse-physician relations. Gazette of Nervous and Mental Provision, 143, 171-180.

Rank, S. G., & Jacobson, C. K. (1977). Sickbay nurses” compliance with medication overdo orders: a failure to reduplicate.

Journal of Health near Social Behavior, 188-193.