Interprofessional collaborative reasoning by residents and nurses in internal medicine: Evidence from a simulation...

Area of Science:

• Medical Education
• Clinical Reasoning
• Interprofessional Collaboration

Background:

• Clinical reasoning research often focuses on individual practitioners.
• Interprofessional collaboration is increasingly important but poorly understood in practice.
• Collaborative reasoning between residents and nurses requires further investigation.

Purpose of the Study:

• To explore resident-nurse collaborative reasoning in a simulation setting.
• To identify dimensions of collaborative reasoning in clinical teams.
• To understand how interprofessional differences impact team performance.

Main Methods:

• Mixed methods study involving 14 resident-nurse teams.
• Management of acute case scenarios in a simulation.
• Qualitative analysis of stimulated-recall sessions and quantitative performance assessment.

Main Results:

• Five dimensions of collaborative reasoning were identified: diagnostic reasoning, patient management, monitoring, patient communication, and team communication.
• Team communication enhanced situational awareness and efficiency.
• Resident and nurse reasoning processes differed, impacting overall team assessment.

Conclusions:

• Collaborative reasoning is a distinct construct not reducible to individual performance.
• Improving situational awareness and understanding interprofessional differences are key for effective collaboration.
• Findings offer insights for interprofessional education and clinical practice.