Examining the Role of Context Specificity in Task-Based Clinical Reasoning

• In Event: Reasoning

Abstract

Arriving at a diagnosis and treatment plan requires physicians to employ a variety of clinical reasoning processes that interact with specific contextual, or situational, factors. Context specificity refers to the phenomenon whereby a physician arrives at two different diagnoses for two patients with the same symptoms, findings, and underlying diagnosis, due to the differing situation in each case. Using 26 clinical reasoning tasks established by Juma and Goldszmidt, we investigated the types of tasks clinicians engage in as they come up against context specificity. Analysis of think-aloud transcripts revealed that these contextual factors play a role in physician engagement in key diagnostic and self-reflective tasks. These findings expand the vocabulary for discussing, teaching, and studying reasoning during patient encounters.

Authors

• Michael Soh, The Uniformed Services University of the Health Sciences (USUHS)

• Abigail W Konopasky, Geisel School of Medicine at Dartmouth

• Elexis McBee, Uniformed Services University of the Health Sciences

• Temple Ratcliffe, University of Texas Health Science Center at San Antonio

• Jerusalem Merkebu, Uniformed Services University of the Health Sciences

• Divya Ramani, Uniformed Services University of the Health Sciences

• Steven J. Durning, The Uniformed Services University of the Health Sciences