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Making Decision-Making Visible-Teaching the Process of Evaluating Interventions.

Angela Benfield1, Robert B Krueger2

  • 1Occupational Therapy Program, Department of Health Professions, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA.

International Journal of Environmental Research and Public Health
|April 3, 2021
PubMed
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Teaching clinicians the complex cognitive processes behind intervention selection is key. Making this decision-making visible improves the judicious adoption of evidence-based practice (EBP) in healthcare.

Keywords:
causal modelclinical reasoningconcept mappingevidence-based practiceintervention theory

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Area of Science:

  • Healthcare professional education
  • Clinical decision-making
  • Evidence-based practice implementation

Background:

  • Decades of efforts to teach evidence-based practice (EBP) have yielded limited sustained improvements in clinical settings.
  • Many new interventions lacking strong evidence are adopted, suggesting openness to change is not the primary barrier.
  • Intervention selection is a complex, often invisible cognitive process influenced by problem representation.

Purpose of the Study:

  • To review the cognitive processes involved in selecting health interventions.
  • To highlight the critical analysis skills needed for judicious intervention adoption.
  • To advocate for explicit teaching of intervention selection decision-making.

Main Methods:

  • Literature review of intervention selection processes.
  • Analysis of cognitive factors influencing clinical decision-making.
  • Exploration of methods to make complex selection processes visible to clinicians.

Main Results:

  • Limited success of traditional EBP implementation strategies.
  • The critical role of cognitive processes in intervention selection.
  • The potential of making decision-making processes explicit to enhance skill acquisition.

Conclusions:

  • Current EBP implementation approaches are insufficient for sustained practice change.
  • Explicitly teaching the cognitive and analytical skills for intervention selection is crucial.
  • Making these complex decision-making processes visible can improve the appropriate adoption of new interventions.