Contextualizing care: An essential and measurable clinical competency

PATIENT EDUCATION AND COUNSELING

卷:105

Article

Weiner, Saul J.^1,2 

[1] Jesse Brown VA Med Ctr, Vet Affairs VA Ctr Innovat Complex Chron Healthca, Chicago, IL 60612 USA

[2] Univ Illinois, Coll Med, Dept Med, 840 South Wood St,CSN 450,M-C 718, Chicago, IL 60612 USA

关键词: Contextualizing care;    Contextual error;    Competency;    Medical education;    Clinical decision making;    Patient-centered care;   

DOI  :  10.1016/j.pec.2021.06.016

来源: Elsevier

【 摘 要 】

Contextualizing care is the process of adapting research evidence to patient life context. The failure to do so, when it results in a care plan that is not likely to achieve its intended aim, is a contextual error. There is substantial evidence that contextual errors are common, adversely affect patient outcomes and health care costs, and are preventable. This evidence comes from over 5000 mostly incognito recordings of physician-patient encounters over a range of practice settings that have been analyzed along with the medical records of each encounter utilizing a specialized coding algorithm. Educational and practice improvement inter-ventions have been tested at the medical student, resident, and attending level, each with evidence of benefits and limitations. The author argues that contextualizing care is an essential clinician competency and proposes an evidence-informed strategy for building and reinforcing the requisite skills across the continuum of medical education and professional development. Published by Elsevier B.V.

【 授权许可】

Free