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.

scholarly journals Clinical reasoning performance assessment: using situated cognition theory as a conceptual framework

Diagnosis ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. 241-249 ◽  
Author(s):  
Joseph Rencic ◽  
Lambert W.T. Schuwirth ◽  
Larry D. Gruppen ◽  
Steven J. Durning
Keyword(s):  
Performance Assessment ◽  
Clinical Reasoning ◽  
Contextual Factors ◽  
Situated Cognition ◽  
Assessment Method ◽  
Complex Interactions ◽  
Valid Assessment ◽  
Linear Statistical Models ◽  
The Impact ◽  
And Task

AbstractDeveloping valid assessment approaches to clinical reasoning performance has been challenging. Situated cognition theory posits that cognition (e.g. clinical reasoning) emerges from interactions between the clinician and situational (contextual) factors and recognizes an opportunity to gain deeper insights into clinical reasoning performance and its assessment through the study of these interactions. The authors apply situated cognition theory to develop a conceptual model to better understand the assessment of clinical reasoning. The model highlights how the interactions between six contextual factors, including assessee, patient, rater, and environment, assessment method, and task, can impact the outcomes of clinical reasoning performance assessment. Exploring the impact of these interactions can provide insights into the nature of clinical reasoning and its assessment. Three significant implications of this model are: (1) credible clinical reasoning performance assessment requires broad sampling of learners by expert raters in diverse workplace-based contexts; (2) contextual factors should be more explicitly defined and explored; and (3) non-linear statistical models are at times necessary to reveal the complex interactions that can impact clinical reasoning performance assessment.

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.

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

scholarly journals Possible cognitive processes underlying competency assessment

2003 ◽  
Vol 29 (3) ◽  
Author(s):  
A. B. Boshoff ◽  
R. Van Wyk ◽  
C. L. Bester
Keyword(s):  
Cognitive Processes ◽  
Social Cognitive ◽  
Frame Of Reference ◽  
Competency Assessment ◽  
New Paradigm ◽  
Cognitive Evaluation ◽  
Cognitive Theories ◽  
Cognitive Choice ◽  
Theoretical Frame ◽  
Social Cognitive Theories

Indications are that research on competency assessment lacks a theoretical frame of reference. An attempt is made to explore cognitive processes taking place during assessment explaining the large percentage of rater variance. The principles of five different cognitive theories are discussed in the search for possible explanations namely: cognitive choice-, cognitive evaluation-, social cognitive theories, metacognitive- and the new paradigm approaches.

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