Communicating and Learning Clinical Reasoning during Handover: a Multi-Professional Study

Clinical reasoning is applied while health care professionals make decision for the diagnosis and treatment during their clinical work. The ability of clinical reasoning determines the right or wrong of the clinical practice and medical behaviours. It also affects the patient’s safety and the occurrence of malpractice.Although clinical reasoning is very important, there have been few educational courses known as “clinical reasoning” during the training of health care professionals in the past in Taiwan. Most medical staff learn basic medical knowledge and skills at the college of medicine, then learn clinical reasoning through “learning by doing” and “learning by seeing” in the clinical setting. It is the “seeing”, or rather, “hearing” of clinical reasoning that we focus upon in this programme of research. Handover is an important and necessary activity in routine of clinical practice. It is a process of the transfer of professional responsibility and accountability for some or all aspects of care for patients to another professional on a temporary or permanent basis. During the handover process, health care professionals discuss patients’ condition and the decision-making which demonstrate their clinical reasoning ability. As such, the context of handover lends itself well for us to understand the cognitive process, and the transference, of clinical reasoning.This study intends to observe and evaluate the process of communicating and learning clinical reasoning during handover of multi-professional medical staff by applying focused ethnography and video-reflexivity. In doing so, alongside the advancement of theory, we will develop practical guidelines for expressing clinical reasoning in handover in order to facilitate the learning of clinical reasoning with the aim of reducing the malpractice and improving patient safety.

Project ID:PF10708-0906
External Project ID:MOST107-2511-H182-015