Cognitive elements in clinical decision-making: Toward a cognitive model for medical education and understanding clinical reasoning

Physician cognition, metacognition and affect may have an impact upon the quality of clinical reasoning. The purpose of this study was to examine the relationship between measures of physician metacognition and affect and patient outcomes in obstetric practice. Reflective coping (RC), proactive copi...

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Bibliographic Details
Published in:Advances in health sciences education : theory and practice 2010-05, Vol.15 (2), p.229-250
Main Authors: Dunphy, Bruce C., Cantwell, Robert, Bourke, Sid, Fleming, Mark, Smith, Bruce, Joseph, K. S., Dunphy, Stacey L.
Format: Article
Language:English
Subjects:
Clinical Competence
Cognition
Decision Making
Education
Education, Medical - methods
Female
Humans
Male
Medical Education
Models, Educational
Obstetrics - education
Obstetrics - methods
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Summary:Physician cognition, metacognition and affect may have an impact upon the quality of clinical reasoning. The purpose of this study was to examine the relationship between measures of physician metacognition and affect and patient outcomes in obstetric practice. Reflective coping (RC), proactive coping, need for cognition (NFC), tolerance for ambiguity, state-trait anxiety and metacognitive awareness were assessed for obstetricians ( n  = 12) who provided intra-partum care to 4,149 women. Outcome measures included delivery mode and intrapartum asphyxia. Analysis was carried out using logistic regression and tree-based classification. Obstetricians with high RC scores were more likely to perform a caesarean section (OR 1.59, p  
ISSN:1382-4996
1573-1677
DOI:10.1007/s10459-009-9194-y