Enhancing collaborative clinical reasoning among multidisciplinary healthcare teams in a neurosurgery ICU: insights from video-reflexive ethnography

Abstract Background Clinical reasoning is a critical skill for healthcare professionals, vital for making accurate diagnoses and effective treatment decisions. This study focuses on enhancing collaborative clinical reasoning (CCR) among multidisciplinary healthcare teams in a neurosurgery intensive...

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Main Authors: Ching-Yi Lee, Ching-Hsin Lee, Sze-Yuen Yau, Hung-Yi Lai, Po-Jui Chen, Mi-Mi Chen
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Medical Education
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Online Access:https://doi.org/10.1186/s12909-025-06782-y
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author Ching-Yi Lee
Ching-Hsin Lee
Sze-Yuen Yau
Hung-Yi Lai
Po-Jui Chen
Mi-Mi Chen
author_facet Ching-Yi Lee
Ching-Hsin Lee
Sze-Yuen Yau
Hung-Yi Lai
Po-Jui Chen
Mi-Mi Chen
author_sort Ching-Yi Lee
collection DOAJ
description Abstract Background Clinical reasoning is a critical skill for healthcare professionals, vital for making accurate diagnoses and effective treatment decisions. This study focuses on enhancing collaborative clinical reasoning (CCR) among multidisciplinary healthcare teams in a neurosurgery intensive care unit (NICU) in Taiwan. The study utilizes video-reflexive ethnography (VRE) to examine the factors influencing CCR, the cognitive processes involved, and the efficacy of VRE in promoting CCR. Methods The study employed a qualitative research design, utilizing VRE. Participants included 17 healthcare professionals from a NICU, comprising attending physicians, residents, nurses, and respiratory therapists. Data collection involved video recordings of daily ward rounds, field observations, and reflexive interviews where participants reviewed video clips of their interactions. Thematic analysis was conducted on the transcripts of video recordings and interview. Results Thematic analysis revealed seven key themes in CCR: information sharing, active verbal and behavioral information gathering, information processing and recall, modification and discussion, short-term indications, and management plans and goals. Information sharing was fundamental, with team members frequently exchanging patient data to ensure a common understanding. Active information gathering, both verbal and behavioral, was crucial for obtaining real-time patient insights. Cognitive processing involved synthesizing data to form initial hypotheses, while modification and discussion highlighted the iterative nature of CCR. Conclusions This study underscores the importance of effective communication, active information gathering, and iterative discussions in enhancing CCR. VRE proved to be a valuable tool for promoting self-awareness and continuous improvement among healthcare teams. The findings suggest that education programs should focus on developing teamwork and communication skills, and interventions should aim to optimize information flow and foster a culture of open communication. By enhancing CCR, healthcare teams can improve patient outcomes and ensure safer healthcare delivery. Clinical trial number Not required, as this is not a clinical trial and does not involve any healthcare interventions with human participants.
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spelling doaj-art-4d6f10ad8eb14b86b785c74d46946f1e2025-02-09T12:42:25ZengBMCBMC Medical Education1472-69202025-02-0125111210.1186/s12909-025-06782-yEnhancing collaborative clinical reasoning among multidisciplinary healthcare teams in a neurosurgery ICU: insights from video-reflexive ethnographyChing-Yi Lee0Ching-Hsin Lee1Sze-Yuen Yau2Hung-Yi Lai3Po-Jui Chen4Mi-Mi Chen5Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of MedicineDepartment of Radiation Oncology, Proton and radiation therapy center, Chang Gung Memorial Hospital at Linkou(CG-MERC) Chang Gung Medical Education Research CentreDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of MedicineDepartment of Radiation Oncology, Proton and radiation therapy center, Chang Gung Memorial Hospital at LinkouDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of MedicineAbstract Background Clinical reasoning is a critical skill for healthcare professionals, vital for making accurate diagnoses and effective treatment decisions. This study focuses on enhancing collaborative clinical reasoning (CCR) among multidisciplinary healthcare teams in a neurosurgery intensive care unit (NICU) in Taiwan. The study utilizes video-reflexive ethnography (VRE) to examine the factors influencing CCR, the cognitive processes involved, and the efficacy of VRE in promoting CCR. Methods The study employed a qualitative research design, utilizing VRE. Participants included 17 healthcare professionals from a NICU, comprising attending physicians, residents, nurses, and respiratory therapists. Data collection involved video recordings of daily ward rounds, field observations, and reflexive interviews where participants reviewed video clips of their interactions. Thematic analysis was conducted on the transcripts of video recordings and interview. Results Thematic analysis revealed seven key themes in CCR: information sharing, active verbal and behavioral information gathering, information processing and recall, modification and discussion, short-term indications, and management plans and goals. Information sharing was fundamental, with team members frequently exchanging patient data to ensure a common understanding. Active information gathering, both verbal and behavioral, was crucial for obtaining real-time patient insights. Cognitive processing involved synthesizing data to form initial hypotheses, while modification and discussion highlighted the iterative nature of CCR. Conclusions This study underscores the importance of effective communication, active information gathering, and iterative discussions in enhancing CCR. VRE proved to be a valuable tool for promoting self-awareness and continuous improvement among healthcare teams. The findings suggest that education programs should focus on developing teamwork and communication skills, and interventions should aim to optimize information flow and foster a culture of open communication. By enhancing CCR, healthcare teams can improve patient outcomes and ensure safer healthcare delivery. Clinical trial number Not required, as this is not a clinical trial and does not involve any healthcare interventions with human participants.https://doi.org/10.1186/s12909-025-06782-yCollaborative clinical reasoningVideo-reflexive ethnographyQualitative analysisHealthcare education
spellingShingle Ching-Yi Lee
Ching-Hsin Lee
Sze-Yuen Yau
Hung-Yi Lai
Po-Jui Chen
Mi-Mi Chen
Enhancing collaborative clinical reasoning among multidisciplinary healthcare teams in a neurosurgery ICU: insights from video-reflexive ethnography
BMC Medical Education
Collaborative clinical reasoning
Video-reflexive ethnography
Qualitative analysis
Healthcare education
title Enhancing collaborative clinical reasoning among multidisciplinary healthcare teams in a neurosurgery ICU: insights from video-reflexive ethnography
title_full Enhancing collaborative clinical reasoning among multidisciplinary healthcare teams in a neurosurgery ICU: insights from video-reflexive ethnography
title_fullStr Enhancing collaborative clinical reasoning among multidisciplinary healthcare teams in a neurosurgery ICU: insights from video-reflexive ethnography
title_full_unstemmed Enhancing collaborative clinical reasoning among multidisciplinary healthcare teams in a neurosurgery ICU: insights from video-reflexive ethnography
title_short Enhancing collaborative clinical reasoning among multidisciplinary healthcare teams in a neurosurgery ICU: insights from video-reflexive ethnography
title_sort enhancing collaborative clinical reasoning among multidisciplinary healthcare teams in a neurosurgery icu insights from video reflexive ethnography
topic Collaborative clinical reasoning
Video-reflexive ethnography
Qualitative analysis
Healthcare education
url https://doi.org/10.1186/s12909-025-06782-y
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