scholarly journals Widening the lens on teaching and assessing clinical reasoning: from “in the head” to “out in the world”

Diagnosis ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. 181-190 ◽  
Author(s):  
Dario Torre ◽  
Steven J. Durning ◽  
Joseph Rencic ◽  
Valerie Lang ◽  
Eric Holmboe ◽  
...  
Keyword(s):  
Clinical Reasoning ◽  
Distributed Cognition ◽  
Social Cognitive ◽  
Traditional Teaching ◽  
Educational Approach ◽  
Performance Simulation ◽  
Stimulated Recall ◽  
The Individual ◽  
Design Of Learning Environments ◽  
Social Cognitive Theories

AbstractTraditional teaching and assessment of clinical reasoning has focused on the individual clinician because of the preeminence of the information processing (IP) theory perspective. The clinician’s mind has been viewed as the main source of effective or ineffective reasoning, and other participants, the environment and their interactions have been largely ignored. A social cognitive theoretical lens could enhance our understanding of how reasoning and error and the environment are linked. Therefore, a new approach in which the clinical reasoning process is situated and examined within the context may be required. The theories of embodied cognition, ecological psychology, situated cognition (SitCog) and distributed cognition (DCog) offer new insights to help the teacher and assessor enhance the quality of clinical reasoning instruction and assessment. We describe the teaching and assessment implications of clinical reasoning and error through the lens of this family of theories. Direct observation in different contexts focused on individual and team performance, simulation (with or without enhancement of technology), stimulated recall, think-aloud, and modeling are examples of teaching and assessment strategies grounded in this family of social cognitive theories. Educators may consider the instructional design of learning environments and educational tools that promote a situated educational approach to the teaching and assessment of clinical reasoning.

Situativity: a family of social cognitive theories for understanding clinical reasoning and diagnostic error

Diagnosis ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. 169-176 ◽  
Author(s):  
Jerusalem Merkebu ◽  
Michael Battistone ◽  
Kevin McMains ◽  
Kathrine McOwen ◽  
Catherine Witkop ◽  
...  
Keyword(s):  
Clinical Reasoning ◽  
Distributed Cognition ◽  
Social Cognitive ◽  
Diagnostic Error ◽  
Dynamic Interactions ◽  
Clinical Encounters ◽  
Cognitive Theories ◽  
Context Specific ◽  
Social Cognitive Theories ◽  
Physician Patient

AbstractThe diagnostic error crisis suggests a shift in how we view clinical reasoning and may be vital for transforming how we view clinical encounters. Building upon the literature, we propose clinical reasoning and error are context-specific and proceed to advance a family of theories that represent a model outlining the complex interplay of physician, patient, and environmental factors driving clinical reasoning and error. These contemporary social cognitive theories (i.e. embedded cognition, ecological psychology, situated cognition, and distributed cognition) can emphasize the dynamic interactions occurring amongst participants in particular settings. The situational determinants that contribute to diagnostic error are also explored.

Teamwork in clinical reasoning – cooperative or parallel play?

Diagnosis ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. 307-312 ◽  
Author(s):  
Andrew P.J. Olson ◽  
Steven J. Durning ◽  
Carolina Fernandez Branson ◽  
Brian Sick ◽  
Kathleen P. Lane ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Reasoning ◽  
Distributed Cognition ◽  
Social Cognitive ◽  
Diagnostic Process ◽  
Clinical Context ◽  
High Quality ◽  
Cognitive Theories ◽  
Parallel Play ◽  
Social Cognitive Theories

AbstractTeamwork is fundamental for high-quality clinical reasoning and diagnosis, and many different individuals are involved in the diagnostic process. However, there are substantial gaps in how these individuals work as members of teams and, often, work is done in parallel, rather than in an integrated, collaborative fashion. In order to understand how individuals work together to create knowledge in the clinical context, it is important to consider social cognitive theories, including situated cognition and distributed cognition. In this article, the authors describe existing gaps and then describe these theories as well as common structures of teams in health care and then provide ideas for future study and improvement.

scholarly journals A situated cognition model for clinical reasoning performance assessment: a narrative review

Diagnosis ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. 227-240 ◽  
Author(s):  
Joseph Rencic ◽  
Lambert W.T. Schuwirth ◽  
Larry D. Gruppen ◽  
Steven J. Durning
Keyword(s):  
Performance Assessment ◽  
Conceptual Model ◽  
Clinical Reasoning ◽  
Social Cognitive ◽  
Contextual Factors ◽  
Situated Cognition ◽  
Context Specificity ◽  
Cognitive Theories ◽  
Social Cognitive Theories ◽  
The Impact

AbstractBackgroundClinical reasoning performance assessment is challenging because it is a complex, multi-dimensional construct. In addition, clinical reasoning performance can be impacted by contextual factors, leading to significant variation in performance. This phenomenon called context specificity has been described by social cognitive theories. Situated cognition theory, one of the social cognitive theories, posits that cognition emerges from the complex interplay of human beings with each other and the environment. It has been used as a valuable conceptual framework to explore context specificity in clinical reasoning and its assessment. We developed a conceptual model of clinical reasoning performance assessment based on situated cognition theory. In this paper, we use situated cognition theory and the conceptual model to explore how this lens alters the interpretation of articles or provides additional insights into the interactions between the assessee, patient, rater, environment, assessment method, and task.MethodsWe culled 17 articles from a systematic literature search of clinical reasoning performance assessment that explicitly or implicitly demonstrated a situated cognition perspective to provide an “enriched” sample with which to explore how contextual factors impact clinical reasoning performance assessment.ResultsWe found evidence for dyadic, triadic, and quadratic interactions between different contextual factors, some of which led to dramatic changes in the assessment of clinical reasoning performance, even when knowledge requirements were not significantly different.ConclusionsThe analysis of the selected articles highlighted the value of a situated cognition perspective in understanding variations in clinical reasoning performance assessment. Prospective studies that evaluate the impact of modifying various contextual factors, while holding others constant, can provide deeper insights into the mechanisms by which context impacts clinical reasoning performance assessment.

Indirect Assessment of Attitudes with Response-Time-Based Measures

2006 ◽  
Vol 37 (3) ◽  
pp. 131-139 ◽  
Author(s):  
Juliane Degner ◽  
Dirk Wentura ◽  
Klaus Rothermund
Keyword(s):  
Social Cognitive ◽  
Incremental Validity ◽  
Self Report ◽  
Small Scale ◽  
Implicit Measures ◽  
Scale Theory ◽  
Starting Point ◽  
Self Reports ◽  
Predicting Behavior ◽  
Social Cognitive Theories

Abstract: We review research on response-latency based (“implicit”) measures of attitudes by examining what hopes and intentions researchers have associated with their usage. We identified the hopes of (1) gaining better measures of interindividual differences in attitudes as compared to self-report measures (quality hope); (2) better predicting behavior, or predicting other behaviors, as compared to self-reports (incremental validity hope); (3) linking social-cognitive theories more adequately to empirical research (theory-link hope). We argue that the third hope should be the starting point for using these measures. Any attempt to improve these measures should include the search for a small-scale theory that adequately explains the basic effects found with such a measure. To date, small-scale theories for different measures are not equally well developed.

Recovery in the Clubhouse Environment: Applying Ecological and Social Cognitive Theories

2013 ◽  
Vol 7 (2) ◽  
pp. 151-165 ◽  
Author(s):  
Francesca Pernice-Duca ◽  
Barry Markman ◽  
Heather Chateauvert
Keyword(s):  
Social Cognitive ◽  
Cognitive Theories ◽  
Social Cognitive Theories

Examining Racial Discrimination’s Association With Depressive Symptoms Through Metadehumanization Among African Americans: Does Racial Identity Matter?

2020 ◽  
pp. 009579842098366
Author(s):  
Yara Mekawi ◽  
Natalie N. Watson-Singleton
Keyword(s):  
Depressive Symptoms ◽  
Racial Identity ◽  
African Americans ◽  
Racial Discrimination ◽  
Indirect Effect ◽  
Social Cognitive ◽  
Empirical Work ◽  
The United States ◽  
Racial Groups ◽  
Social Cognitive Theories

Though considerable empirical work has documented the ways in which African Americans are dehumanized by other racial groups, there is no research examining how perceiving dehumanization (i.e., metadehumanization) is associated with the mental health of African Americans. In this study, we examined the indirect effect of racial discrimination on depressive symptoms through metadehumanization and explored whether this indirect effect was contingent on racial identity (i.e., centrality, private regard). African American students completed measures in a university lab located in the Midwestern region of the United States ( N = 326; Mage = 19.7, 72.4% women). We found that the degree to which racial discrimination was indirectly associated with depressive symptoms through metadehumanization was contingent on racial identity dimensions. Specifically, the indirect effect of racial discrimination on depressive symptoms through metadehumanization was only significant for individuals who were relatively higher on centrality and private regard. This research suggests that the role of metadehumanization is stronger among African Americans who strongly identify with and have positive views of their racial group. We discuss these results in the context of social cognitive theories.

scholarly journals Understanding the clinical reasoning processes involved in the management of multimorbidity in an ambulatory setting: study protocol of a stimulated recall research

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M.-C. Audétat ◽  
S. Cairo Notari ◽  
J. Sader ◽  
C. Ritz ◽  
T. Fassier ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Reasoning ◽  
Primary Care Physicians ◽  
Video Sequence ◽  
Structured Interview ◽  
Ambulatory Setting ◽  
Structured Interviews ◽  
Stimulated Recall ◽  
Study Results

Abstract Background Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. Methods A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a “button camera” (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. Conclusion Study results will contribute to the scientific community’s overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient’s care and treatments.

scholarly journals A Framework for Implementing OER-Based Lesson Design Activities for Pre-Service Teachers

2018 ◽  
Vol 19 (4) ◽  
Author(s):  
Dongho Kim
Keyword(s):  
Teacher Education ◽  
Distributed Cognition ◽  
Open Educational Resources ◽  
Teacher Education Programs ◽  
Unified Framework ◽  
Lesson Design ◽  
Web Resource ◽  
Design Activities ◽  
The Individual ◽  
Pedagogical Knowledge And Skills

The demand for qualified teachers with sufficient pedagogical knowledge and skills is high. However, existing teacher education programs do not provide adequate experiences through which to develop pre-service teachers’ professional foundations. This study recognized Open Educational Resources (OER) as a means by which to address the issue of enhancing teacher education. The purpose of this study was to propose a framework to be used to integrate OER into lesson design activities for pre-service teachers. In this study, a focused literature review investigated the frameworks of distributed cognition and example-based learning. This review process resulted in a unified framework that provides a description of how pre-service teachers learn with OER at both the individual and cognitive system levels. Four principles and 10 guidelines are provided to guide the implementation of OER-based lesson design activities in real settings. The new framework has the potential to enhance pre-service teachers’ Web resource-based professional development.

Sign in / Sign up

Export Citation Format

Share Document