A simulation-based intelligent tutoring system (ITS) was designed for nurses working in a Surgical Intensive Care Unit (SICU). A cognitive task analysis approach was used to identify the cognitive components of clinical decision making of “expert” surgical nurses. Quantitative analyses revealed that expert nurses reached the same decisions. However, a qualitative analysis of the verbal protocols revealed great variability in how the nurses arrived at their clinical decisions. Differences were observed in: hypothesis generation, planning of medical interventions, actions performed, results of evidence gathering, interpretation of the results, heuristics, and the overall solution paths. The results of these analyses were used to design a prototype ITS. The tutoring environment (SICUN) is described in terms of the cognitive tools it provides, and the assessment opportunities it presents. Implications for the evaluation of this system are discussed.
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