Communication, Cognition and Competency Development in Healthcare – A model for integrating cognitive ethnography and communication skills training in clinical interventions
Bibliographic record
Abstract
Abstract Background: This article illustrates how cognitive, organizational, and communicative/interactive processes can be included into the design of micro-skills interventions in healthcare. We present a model for integrating methods of cognitive ethnography and in situ simulation into clinical communication intervention studies to support the implementation process. Methods: A twelve-week Blended Learning communication training course based on the Calgary-Cambridge guide and supported by in situ simulation is conducted among healthcare professionals at an outpatient clinic at a Danish university hospital. Cognitive ethnography is used to document and evaluate implementation and competency development: How learning is absorbed and translated into clinical practice. Results/Discussion: Clinical intervention studies can be designed to include cognitive, organizational, and communicative/interactive processes. The proposed model can effectively support implementation of communicative skills interventions in healthcare. The integration of cognitive ethnography supports documentation of change processes and organizational challenges that arise during the implementation and allows to evaluate whether the intervention is flexible enough to accommodate in “real-time.” Integration of cognitive ethnography can also secure necessary and timely adaptability of the program, stimulating the desired change on individual and organizational levels. In situ simulation training provides a further opportunity to train and review communicative skills in the clinic, which may help to better retain the introduced skills, thus promoting sustainable change. Conclusions: The proposed design can narrow the theory-practice gap, c and knowledge transfer, and has the potential to generate a positive cultural change, all of which are necessary to improve organizational processes and better patient care. The model works for the benefit of the clinic and may be more suitable for implementation of communication projects than, say, randomized setups. Adopting the integration of cognitive ethnography with clinical interventions as a way of understanding change processes can ensure adaptable activities and secure quality optimization and change in individual behavior and organizational culture over time. Improvement of health communication and communicative skills of healthcare providers can create pace for patient-involvement and reduce inequalities, and hence provide better and safer healthcare.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.012 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".