Applying the Zone of Proximal Development when Evaluating Clinical Decision Support Systems: A Case Study.

Area of Science:

• Medical Informatics
• Educational Technology
• Human-Computer Interaction

Background:

• Clinical decision-support systems (CDSS) can integrate continuing medical education (CME).
• Evaluating the effectiveness of CDSS in skill development is crucial.
• Activity Theory and Zone of Proximal Development offer frameworks for analysis.

Purpose of the Study:

• To develop and evaluate a methodology for assessing clinician knowledge and skill acquisition using a CDSS.
• To analyze clinician activity within a CDSS environment.
• To inform the design of future CDSS for enhanced CME.

Main Methods:

• Activity Theory was used to analyze the system-supported activity.
• A structured protocol was developed for assessment.
• Four clinicians were observed during their initial use of the CDSS.
• Clinician activity was assessed using the Zone of Proximal Development concept.

Main Results:

• The study demonstrated how the CDSS was utilized by clinicians with varying skill levels.
• Initial findings provide insights into the practical application of the assessment methodology.
• Observed differences in system usage highlight the impact of individual skill levels.

Conclusions:

• The developed methodology shows promise for evaluating skill development in CDSS.
• The findings have implications for refining both the CDSS and the evaluation approach.
• Further research can build upon this framework to optimize CDSS for medical education.