Bringing team science to the ambulatory diagnostic process: how do patients and clinicians develop shared mental models?

IF 2.2 Q2 MEDICINE, GENERAL & INTERNAL
Diagnosis Pub Date : 2024-10-21 DOI:10.1515/dx-2024-0115
Aubrey Samost-Williams, Eric J Thomas, Olivia Lounsbury, Scott I Tannenbaum, Eduardo Salas, Sigall K Bell
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引用次数: 0

Abstract

The ambulatory diagnostic process is potentially complex, resulting in faulty communication, lost information, and a lack of team coordination. Patients and families have a unique position in the ambulatory diagnostic team, holding privileged information about their clinical conditions and serving as the connecting thread across multiple healthcare encounters. While experts advocate for engaging patients as diagnostic team members, operationalizing patient engagement has been challenging. The team science literature links improved team performance with shared mental models, a concept reflecting the team's commonly held knowledge about the tasks to be done and the expertise of each team member. Despite their proven potential to improve team performance and outcomes in other settings, shared mental models remain underexplored in healthcare. In this manuscript, we review the literature on shared mental models, applying that knowledge to the ambulatory diagnostic process. We consider the role of patients in the diagnostic team and adapt the five-factor model of shared mental models to develop a framework for patient-clinician diagnostic shared mental models. We conclude with research priorities. Development, maintenance, and use of shared mental models of the diagnostic process amongst patients, families, and clinicians may increase patient/family engagement, improve diagnostic team performance, and promote diagnostic safety.

将团队科学引入门诊诊断过程:患者和临床医生如何建立共同的心理模型?
门诊诊断过程可能非常复杂,导致沟通不畅、信息丢失和缺乏团队协调。患者和家属在门诊诊断团队中具有独特的地位,他们掌握着有关其临床状况的重要信息,同时也是连接多个医疗机构的纽带。虽然专家们主张让患者作为诊断团队成员参与其中,但患者参与的可操作性一直是个难题。团队科学文献将团队绩效的提高与共享心智模式联系在一起,共享心智模式这一概念反映了团队对所要完成任务的共同认知以及每个团队成员的专业知识。尽管共享心智模式在其他环境中已被证明具有提高团队绩效和成果的潜力,但在医疗保健领域仍未得到充分探索。在本手稿中,我们回顾了有关共享心智模式的文献,并将这些知识应用到门诊诊断过程中。我们考虑了患者在诊断团队中的角色,并对共享心理模式的五因素模型进行了调整,从而为患者-医师诊断共享心理模式制定了一个框架。最后,我们提出了研究重点。在患者、家属和临床医生之间开发、维护和使用诊断过程的共享心理模型,可以提高患者/家属的参与度,改善诊断团队的表现,促进诊断安全。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diagnosis
Diagnosis MEDICINE, GENERAL & INTERNAL-
CiteScore
7.20
自引率
5.70%
发文量
41
期刊介绍: Diagnosis focuses on how diagnosis can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors. The journal welcomes both fundamental and applied works, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality.  Topics: -Factors that promote diagnostic quality and safety -Clinical reasoning -Diagnostic errors in medicine -The factors that contribute to diagnostic error: human factors, cognitive issues, and system-related breakdowns -Improving the value of diagnosis – eliminating waste and unnecessary testing -How culture and removing blame promote awareness of diagnostic errors -Training and education related to clinical reasoning and diagnostic skills -Advances in laboratory testing and imaging that improve diagnostic capability -Local, national and international initiatives to reduce diagnostic error
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