Collaborative Clinical Reasoning: a scoping review

Abstract

AbstractIntroductionTeam approaches in healthcare highlight the importance and benefits of collaboration on maximising clinical outcomes and patient safety. Based on extant literature, the authors aimed to explore collaborative clinical reasoning (CCR) among healthcare professionals.MethodsA scoping review was undertaken to examine CCR related studies in healthcare. Medline, PsychInfo, SciVerse Scopus, and Web of Science were searched. Inclusion criteria included full-text articles published between 2011 to 2020. Search terms included cooperative, collaborative, shared, team, collective, reasoning, problem solving, decision making, combined with clinical or medicine or medical, but excluded shared decision making.ResultsA total of 24 articles were identified in the review. Analysis of the articles resulted in four major content themes: (1) Decision-making process (n=14); (2) Quality assessment by MDTs-MODe (Multidisciplinary Team-Metric for the Observation of Decision Making; n=5) (3) CCR theory and definitions(n=3); and (4) Problem-solving process (n=2). Most articles focused on communication associated with collaborative decision-making processes. The discussion of team impacts among all studies was merely the notion of clinical reasoning as an essential component of the collaborative or interprofessional practice. None provided direct evidence on the process of CCR or its impact on clinical outcomes. Only two articles provided specific definitions on CCR.DiscussionWe illuminate the necessity of further research in CCR, specifically with a focus on cognitive components of CCR. A better understanding of current CCR research in healthcare may inform future discussions around establishing strategies to enhance CCR development, and hence provide positive influence on medical education and patient safety.