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

Author:

Merkebu Jerusalem1,Battistone Michael2,McMains Kevin1,McOwen Kathrine3,Witkop Catherine4,Konopasky Abigail5,Torre Dario1,Holmboe Eric6,Durning Steven J.1

Affiliation:

1. Uniformed Services University of the Health Sciences (USUHS) , Bethesda , USA

2. George E. Wahlen Veterans Affairs Salt Lake City Health Care System USA, Department of Medicine, Division of Rheumatology, University of Utah Health Sciences Center , Salt Lake City , USA

3. Association of American Medical Colleges (AAMC) , Uniformed Services University of the Health Sciences (USUHS) , Bethesda , USA

4. Obstetrics/Gynecology and Preventive Medicine , Uniformed Services University of the Health Sciences (USUHS) , Bethesda , USA

5. Henry M. Jackson Foundation for the Advancement of Military Medicine, Uniformed Services University of the Health Sciences (USUHS) , Bethesda , USA

6. Accreditation Council for Graduate Medical Education (ACGME), Uniformed Services University of the Health Sciences (USUHS) , Chicago, IL , USA

Abstract

Abstract The 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.

Publisher

Walter de Gruyter GmbH

Subject

Biochemistry (medical),Clinical Biochemistry,Public Health, Environmental and Occupational Health,Health Policy,Medicine (miscellaneous)

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