Jan Kiesewetter1, Frank Fischer, Martin R Fischer. 1. Dr. Jan Kiesewetter: Research Associate for the Institut für Didaktik und Ausbildungsforschung in der Medizin des Klinikums der Ludwig-Maximilian-Universität München, München, Germany. Prof. Dr. Frank Fischer: Psychologist and Full Professor of Education and Educational Psychology at the Ludwig-Maximilians University of Munich, München, Germany. Prof. Dr. Martin Fischer: Internist, Endocrinologist, and Master of Medical Education and works as a Full Professor for Medical Education for the Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikums der Ludwig-Maximilian-Universität München, München, Germany.
Abstract
INTRODUCTION: Health care delivery involves multiple health professions, and increasingly, diagnostic and therapeutic decisions are made through interprofessional teamwork. We define collaborative clinical reasoning (CCR) as the process in which two or more health care team members negotiate diagnostic, therapeutic, or prognostic issues of an individual patient resulting in an illness or treatment plan (and to reduce uncertainty). In a systematic review, we aimed to answer the following research question: Which empirically observable factors are considered crucial influences on performance in CCR in current empirical research? METHODS: A systematic literature review was conducted. We included empirical studies taking place in a hospital setting, with a clear focus on CCR and published between January 1990 and September 2014. The studies were only included when at least one physician was part of the team. Nine articles were included in the review. RESULTS: The factors crucially influencing the CCR performance (ie, diagnosis or treatment plan of patients) are (1) the initial distribution of information over team members, (2) clinical experience of physicians within a team, (3) information exchange within a team, and (4) individual retrieval of information from the team or information representation. DISCUSSION: Despite the sparse empirical evidence on CCR, four factors influencing performance were extracted from the literature. Overall, there is little evidence though how each of these factors actually influences CCR performance. Thus, we need more empirical studies to better understand and foster CCR performance.
INTRODUCTION: Health care delivery involves multiple health professions, and increasingly, diagnostic and therapeutic decisions are made through interprofessional teamwork. We define collaborative clinical reasoning (CCR) as the process in which two or more health care team members negotiate diagnostic, therapeutic, or prognostic issues of an individual patient resulting in an illness or treatment plan (and to reduce uncertainty). In a systematic review, we aimed to answer the following research question: Which empirically observable factors are considered crucial influences on performance in CCR in current empirical research? METHODS: A systematic literature review was conducted. We included empirical studies taking place in a hospital setting, with a clear focus on CCR and published between January 1990 and September 2014. The studies were only included when at least one physician was part of the team. Nine articles were included in the review. RESULTS: The factors crucially influencing the CCR performance (ie, diagnosis or treatment plan of patients) are (1) the initial distribution of information over team members, (2) clinical experience of physicians within a team, (3) information exchange within a team, and (4) individual retrieval of information from the team or information representation. DISCUSSION: Despite the sparse empirical evidence on CCR, four factors influencing performance were extracted from the literature. Overall, there is little evidence though how each of these factors actually influences CCR performance. Thus, we need more empirical studies to better understand and foster CCR performance.
Authors: Jan Kiesewetter; Inga Hege; Michael Sailer; Elisabeth Bauer; Claudia Schulz; Manfred Platz; Martin Adler Journal: JMIR Med Educ Date: 2022-07-28
Authors: Jan Kiesewetter; Michael Sailer; Valentina M Jung; Regina Schönberger; Elisabeth Bauer; Jan M Zottmann; Inga Hege; Hanna Zimmermann; Frank Fischer; Martin R Fischer Journal: BMC Med Educ Date: 2020-03-14 Impact factor: 2.463