Collaborative clinical reasoning: a scoping review

Team approaches in healthcare settings is beneficial for maximising clinical outcomes and patient safety. A scoping review was undertaken to examine collaborative clinical reasoning (CCR) related studies in healthcare. Medline, PsychInfo, SciVerse Scopus, and Web of Science were searched to include full-text articles published between 2011 to 2020. Search terms included cooperative, collaborative, shared, team, collective, reasoning, problem solving, decision making, combined with clinical or medicine or medical, but excluded shared decision making. A total of 24 articles were identified in the review. Analysis of the articles resulted in four major content themes: (1) Decision-making process (n=14); (2) Quality assessment by MDTs-MODe (Multidisciplinary Team-Metric for the Observation of Decision Making; n=5) (3) CCR theory and definitions(n=3); and (4) Problem-solving process (n=2). Most articles focused on communication associated with collaborative decision-making processes. None provided direct evidence on the process of CCR or its impact on clinical outcomes. CCR describes the process of reaching a shared mental model where members in a healthcare team can arrive at a solution more efficiently by anticipating other members’ responses and needs. This evidence also suggests that team-based care has important implications for medical diagnosis and decision-making. Our results illuminate the necessity of further research in CCR, specifically with a focus on cognitive components of CCR. A better understanding of current CCR research in healthcare may inform future discussions around establishing strategies to enhance CCR development, and hence provide positive influence on medical education and patient safety.