Constructing case vignettes for evaluating clinical judgment

Heverly, Mary Ann; Fitt, David; Newman, Frederick L.

doi:10.1016/0149-7189(84)90024-7

Cited by 59 publications

(46 citation statements)

References 8 publications

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“…We also piloted a range of behavioural scenarios to examine whether behavioural intentions could be assessed and measured. These were created jointly by the research team, health professionals, and CUG and were developed in line with empirical guidance on effective vignette development ([44, 45]; see Appendix 3). They presented a range of situations that young people might find themselves in with regard to their asthma symptoms and physical activity and asked them to express their behavioural intentions in these situations.…”

Section: Resultsmentioning

confidence: 99%

A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar

Murray

Williams

Hoskins

et al. 2016

Pilot Feasibility Stud

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BackgroundVisualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma. We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing.ResultsOur final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions.ConclusionsWe have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However, attention needs to be paid to the potential ambiguity associated with images and thus the concept of visual literacy among patients. Our revised model may be helpful as a guide to aid development, acceptability, and ultimately effectiveness.

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Section: Resultsmentioning

confidence: 99%

A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar

Murray

Williams

Hoskins

et al. 2016

Pilot Feasibility Stud

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show abstract

“…First, our paper patients' written descriptions were not wordfor-word identical to the spoken words of our standardized patients. However, the core clinical elements were the same for both paper patients and standardized patients, paper patients were developed based on an empirical model [40] and we addressed all four areas of study design considered important when assessing the criterion validity of paper patients [27]. Second, standardized patients brought their own X-rays to each visit, whereas paper patients included a written description of the radiographic evidence of OA.…”

Section: Discussionmentioning

confidence: 99%

“…The standardized patients' spoken words and the paper patients' written descriptions were identical in pertinent clinical history. An empirical model was used to construct the paper patient scenarios [40]. The primary presenting problem (chronic right knee pain) and symptoms consistent with moderate knee OA were the constant factors across all paper patients.…”

Section: Paper Patient Scenariosmentioning

confidence: 99%

Patients' gender affected physicians' clinical decisions when presented with standardized patients but not for matching paper patients

Borkhoff¹,

Hawker²,

Kreder³

et al. 2009

Journal of Clinical Epidemiology

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“…Second, vignettes are useful in desensitising and depersonalising responses to sensitive topics. Asking participants to respond to hypothetical situations encountered by other people is found to be effective in lessening any sensitivity which the participants might feel when responding to delicate topics (Heverly, Fitt, and Newman 1984). Thus, vignettes have been applied in both qualitative and quantitative research, particularly to investigate sensitive issues (Sleed et al 2002;Grønhøj and Bech-Larsen 2010), such as racial integration in neighbourhood areas, and abusive and violent behaviour.…”

Section: Introductionmentioning

confidence: 98%

‘I have Just Understood it from the Story …’: using vignettes in educational research to investigate cultural tolerance

Sadi

Basit

2016

Research Papers in Education

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Constructing case vignettes for evaluating clinical judgment

Cited by 59 publications

References 8 publications

A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar

A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar

Patients' gender affected physicians' clinical decisions when presented with standardized patients but not for matching paper patients

‘I have Just Understood it from the Story …’: using vignettes in educational research to investigate cultural tolerance

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