Dual Processing in Clinical Reasoning: Collaborative Decision Making among Multidisciplinary Healthcare Professionals

Clinical reasoning is a central component of physician competence. It occurs when health care professionals make decision for the diagnosis and treatment during clinical activities. Clinical reasoning performance may greatly influence the quality of clinical outcomes. Past studies have focused on assessments and learning of clinical reasoning skills in an attempt to shape up physicians’ competence and improve the healthcare services. Also, recent studies have shown that teamwork is largely beneficial for clinical situations as it helps identify, reduce subjective biases and leads to efficient decision-making during diagnostic processes through team effort and communication The conventional discussion of team impacts on healthcare professional competences has primarily focused on individualist discourse. Little is known about how clinical reasoning can be communicated in a collaborative effort through shared cognition. Both systems 1 and 2 thinking of clinical reasoning process are constantly adopted and interchangeable during decision-making among healthcare professionals. However, it is generally recognised that system 1 thinking which favors pattern-recognition costs less effort than system 2 thinking that demands more mental searches. In a busy clinical setting, it is impractical for an individual healthcare professional to stay in system 2 thinking continuously, however, this type of thinking is often crucial and less prone to error. Collaborative clinical reasoning allows cognitive load sharing in a complex clinical situation where multiple healthcare professionals are involved. Our study aims to observe and evaluate the details about the process of collaborative clinical reasoning among multidisciplinary healthcare professionals in an intensive care unit. In this study, we collect all published research in the past ten years and perform a scoping review to understand the current status of researches on collaborative clinical reasoning. Followed by the observation and interview with multidisciplinary healthcare professionals using focused ethnography, we can investigate the process and factors associated with this practice of collaborative clinical reasoning. Our finding can provide further evidence that collaborative clinical reasoning is one crucial practice of team communication which has received increasing attention in healthcare system. It has the potential to improve professional competence and patient safety.

Project ID:PF10907-1891
External Project ID:MOST109-2511-H182-002