Creating a common trajectory: Shared decision making and distributed cognition in medical consultations

The growing literature on shared decision making and patient centered care emphasizes the patient’s role in clinical care, but research on clinical reasoning almost exclusively addresses physician cognition. In this article, we suggest clinical cognition is distributed between physicians and patient...

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Autores principales:	Katherine Lippa, Valerie Shalin
Formato:	article
Lenguaje:	EN
Publicado:	The Beryl Institute 2016
Materias:	shared decision making patient centered care medical consultation multiple sclerosis patient experience Medicine (General) R5-920 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/838f0614bfdc408889ea33ac471e98dd
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spelling	oai:doaj.org-article:838f0614bfdc408889ea33ac471e98dd2021-11-15T04:21:49ZCreating a common trajectory: Shared decision making and distributed cognition in medical consultations2372-0247https://doaj.org/article/838f0614bfdc408889ea33ac471e98dd2016-11-01T00:00:00Zhttps://pxjournal.org/journal/vol3/iss2/12https://doaj.org/toc/2372-0247The growing literature on shared decision making and patient centered care emphasizes the patient’s role in clinical care, but research on clinical reasoning almost exclusively addresses physician cognition. In this article, we suggest clinical cognition is distributed between physicians and patients and assess how distributed clinical cognition functions during interactions between medical professionals and patients with Multiple Sclerosis (MS). A combination of cognitive task analysis and discourse analysis reveals the distribution of clinical reasoning between 24 patients and 3 medical professionals engaged in MS management. Findings suggest that cognition was distributed between patients and physicians in all major tasks except for the interpretation of MRI results. Otherwise, patients and physicians collaborated through discourse to develop a common trajectory to guide clinical reasoning. The patients’ role in clinical cognition expands the concept of patient-centered care and suggests the need to optimize physician-patient distributed cognition rather than physician cognition in isolation.Katherine LippaValerie ShalinThe Beryl Institutearticleshared decision makingpatient centered caremedical consultationmultiple sclerosispatient experienceMedicine (General)R5-920Public aspects of medicineRA1-1270ENPatient Experience Journal (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	shared decision making patient centered care medical consultation multiple sclerosis patient experience Medicine (General) R5-920 Public aspects of medicine RA1-1270
spellingShingle	shared decision making patient centered care medical consultation multiple sclerosis patient experience Medicine (General) R5-920 Public aspects of medicine RA1-1270 Katherine Lippa Valerie Shalin Creating a common trajectory: Shared decision making and distributed cognition in medical consultations
description	The growing literature on shared decision making and patient centered care emphasizes the patient’s role in clinical care, but research on clinical reasoning almost exclusively addresses physician cognition. In this article, we suggest clinical cognition is distributed between physicians and patients and assess how distributed clinical cognition functions during interactions between medical professionals and patients with Multiple Sclerosis (MS). A combination of cognitive task analysis and discourse analysis reveals the distribution of clinical reasoning between 24 patients and 3 medical professionals engaged in MS management. Findings suggest that cognition was distributed between patients and physicians in all major tasks except for the interpretation of MRI results. Otherwise, patients and physicians collaborated through discourse to develop a common trajectory to guide clinical reasoning. The patients’ role in clinical cognition expands the concept of patient-centered care and suggests the need to optimize physician-patient distributed cognition rather than physician cognition in isolation.
format	article
author	Katherine Lippa Valerie Shalin
author_facet	Katherine Lippa Valerie Shalin
author_sort	Katherine Lippa
title	Creating a common trajectory: Shared decision making and distributed cognition in medical consultations
title_short	Creating a common trajectory: Shared decision making and distributed cognition in medical consultations
title_full	Creating a common trajectory: Shared decision making and distributed cognition in medical consultations
title_fullStr	Creating a common trajectory: Shared decision making and distributed cognition in medical consultations
title_full_unstemmed	Creating a common trajectory: Shared decision making and distributed cognition in medical consultations
title_sort	creating a common trajectory: shared decision making and distributed cognition in medical consultations
publisher	The Beryl Institute
publishDate	2016
url	https://doaj.org/article/838f0614bfdc408889ea33ac471e98dd
work_keys_str_mv	AT katherinelippa creatingacommontrajectoryshareddecisionmakinganddistributedcognitioninmedicalconsultations AT valerieshalin creatingacommontrajectoryshareddecisionmakinganddistributedcognitioninmedicalconsultations
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Creating a common trajectory: Shared decision making and distributed cognition in medical consultations

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