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Assessment of management reasoning: Design considerations drawn from analysis of simulated outpatient encounters.

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Title: Assessment of management reasoning: Design considerations drawn from analysis of simulated outpatient encounters.
Authors: Cook, David A.1,2 cook.david33@mayo.edu, Durning, Steven J.3, Stephenson, Christopher R.2, Gruppen, Larry D.4, Lineberry, Matt5
Source: Medical Teacher. Feb2025, Vol. 47 Issue 2, p218-232. 15p.
Subject Terms: *Intellect, *Qualitative research, *Decision making, *Clinical competence, *Communication, *Comparative studies, Medical logic, Research funding, Research evaluation, Simulated patients, Outpatients, Physician-patient relations, Patients' attitudes
Abstract: Purpose: Management reasoning is a distinct subset of clinical reasoning. We sought to explore features to be considered when designing assessments of management reasoning. Methods: This is a hybrid empirical research study, narrative review, and expert perspective. In 2021, we reviewed and discussed 10 videos of simulated (staged) physician-patient encounters, actively seeking actions that offered insights into assessment of management reasoning. We analyzed our own observations in conjunction with literature on clinical reasoning assessment, using a constant comparative qualitative approach. Results: Distinguishing features of management reasoning that will influence its assessment include management scripts, shared decision-making, process knowledge, illness-specific knowledge, and tailoring of the encounter and management plan. Performance domains that merit special consideration include communication, integration of patient preferences, adherence to the management script, and prognostication. Additional facets of encounter variation include the clinical problem, clinical and nonclinical patient characteristics (including preferences, values, and resources), team/system characteristics, and encounter features. We cataloged several relevant assessment approaches including written/computer-based, simulation-based, and workplace-based modalities, and a variety of novel response formats. Conclusions: Assessment of management reasoning could be improved with attention to the performance domains, facets of variation, and variety of approaches herein identified. [ABSTRACT FROM AUTHOR]
Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Assessment of management reasoning: Design considerations drawn from analysis of simulated outpatient encounters.
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  Data: Purpose: Management reasoning is a distinct subset of clinical reasoning. We sought to explore features to be considered when designing assessments of management reasoning. Methods: This is a hybrid empirical research study, narrative review, and expert perspective. In 2021, we reviewed and discussed 10 videos of simulated (staged) physician-patient encounters, actively seeking actions that offered insights into assessment of management reasoning. We analyzed our own observations in conjunction with literature on clinical reasoning assessment, using a constant comparative qualitative approach. Results: Distinguishing features of management reasoning that will influence its assessment include management scripts, shared decision-making, process knowledge, illness-specific knowledge, and tailoring of the encounter and management plan. Performance domains that merit special consideration include communication, integration of patient preferences, adherence to the management script, and prognostication. Additional facets of encounter variation include the clinical problem, clinical and nonclinical patient characteristics (including preferences, values, and resources), team/system characteristics, and encounter features. We cataloged several relevant assessment approaches including written/computer-based, simulation-based, and workplace-based modalities, and a variety of novel response formats. Conclusions: Assessment of management reasoning could be improved with attention to the performance domains, facets of variation, and variety of approaches herein identified. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1080/0142159X.2024.2337251
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      – TitleFull: Assessment of management reasoning: Design considerations drawn from analysis of simulated outpatient encounters.
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              Text: Feb2025
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