Abstract:
An integrated method was constructed for the study of in situ clinical reasoning. A meta-analysis of existing theories and an exploratory case
study were performed. Twelve physicians at the department of otorhinolaryngology,
and three physicians and three biomedical technologists at the clinical microbiological
laboratory of an 800-bed university hospital were involved in the evaluation of the
method. The meta-analysis identified situations where practitioners face assignments
for which they follow no routine strategy as suitable starting points for the development
of the method, in which organizational processes are presented as workflow graphs.
Using the critical incident technique, problem situations in the processes are identified,
and stimulated recall interviews are employed to construct a model of the situation-dependent
logic used in decision-making. The case study showed thatthe first levels of the method
could easily be used by physicians without training in organizational development
or cognitive psychology. It is concluded that the method can be a means for case construction
in problem-oriented learning programs that have an empirical background. It can also
be used in the development of clinical organization, where training is combined with
the establishment of critical paths and computer support.
Keywords:
Clinical Cognition - Methodology Design - Meta-analysis - Case Study - Case-based
Learning
