Integrating cognitive ethnography and phenomenology: rethinking the study of patient safety in healthcare organisations

Lebahn-Hadidi, Malte; Abildgren, Lotte; Hounsgaard, Lise; Steffensen, Sune Vork

doi:10.1007/s11097-021-09780-9

Cited by 6 publications

(6 citation statements)

References 44 publications

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“…In analyzing the ethnographic data, we rely on the phenomenological-hermeneutic tradition 82 and thematic analysis, used in traditional ethnography. 83 , 84 In the analysis of videodata we rely both on multimodal interaction analysis 81 , 85 and on cognitive event analysis (CEA) used in CE 86 , 87 to capture the real-time unfolding of events, as well as the changes and transitions that emerge around learning. 80 CEA is a qualitative and cognitive method for analyzing video recordings, particularly used for investigating how humans adapt to and modify their environment in order to get things done.…”

Section: Methodsmentioning

confidence: 99%

“…The methodological procedure of CEA is described in Steffensen et al and Lebahn-Hadidi et al and consists of 5 steps spanning from event identification to interpretation. 87 , 89 In analyzing the video data, we looked more specifically at how the communication trajectory of the HCPs exposed to intervention changed over time. The purpose was to determine how and to what extent the HCPs applied the communicative skills introduced through e-learning modules in their clinical practice, and to identify any significant changes in the HCPs’ behavior over time: What worked well, and what were the challenges.…”

Section: Methodsmentioning

confidence: 99%

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Communication, Cognition and Competency Development in Healthcare: A Model for Integrating Cognitive Ethnography and Communication Skills Training in Clinical Interventions

Schwalbe,

Timmermann,

Gregersen

et al. 2024

Journal of Medical Education and Curricular Development

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OBJECTIVES The aim of this study was to conduct and evaluate the Blended Learning communication skills training program. The key objective was to investigate (i) how clinical intervention studies can be designed to include cognitive, organizational, and interactive processes, and (ii) how researchers and practitioners could work with integrated methods to support the desired change. METHODS The method combined design and implementation of a 12-week Blended Learning communication skills training program based on the Calgary-Cambridge Guide. The training was implemented in a patient clinic at a Danish university hospital and targeted all healthcare professionals at the clinic. Cognitive ethnography was used to document and evaluate healthcare professionals’ implementation and individual competency development, and support the design of in-situ simulation training scenarios. RESULTS Thirteen participants completed the program. The synergy within the teams, as well as the opportunities for participants to coordinate, share, discuss, and reflect on the received knowledge with a colleague or on-site researcher, affected learning positively. The knowledge transfer process was affected by negative feedback loops, such as time shortages, issues with concept development and transfer, disjuncture between the expectations of participants and instructors of the overall course structure, as well as participant insecurity and a gradual loss of motivation and compliance. CONCLUSION We propose a novel 3-step model for clinical interventions based on our findings and literature review. This model will effectively support the implementation of educational interventions in health care by narrowing the theory-practice gap. It will also stimulate desired change in individual behavior and organizational culture over time. Furthermore, it will work for the benefit of the clinic and may be more suitable for the implementation of communication projects than, for example, randomized setups.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Communication, Cognition and Competency Development in Healthcare: A Model for Integrating Cognitive Ethnography and Communication Skills Training in Clinical Interventions

Schwalbe,

Timmermann,

Gregersen

et al. 2024

Journal of Medical Education and Curricular Development

Self Cite

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“…However, so far it has largely been a theoretical affair (but see e.g. Carel et al (2020); Maiese & Hanna (2019); Ratcliffe (2019); Zahavi & Martiny (2019); Heft & Chawla (2006); Protevi (2009b/b); Slaby & Von Scheve (2019); Lebahn-Hadidi (2021); Kaaronen (2017)). The Change-Ability Conceptual Framework (CAF) starts from the idea that individuals and communities are situated in the same rich landscape of affordances and suggests that making communities more change-able entails transforming the material ‘grooves’ in this landscape of affordances.…”

Section: Discussionmentioning

confidence: 99%

“…Bruineberg & Rietveld 2014; Rietveld et al 2018), we have focused on skilled agents with the aim of understanding embodied cognition in everyday, real-life situations (Van Dijk & Rietveld 2018; Bruineberg et al 2021; cf. Merleau-Ponty 1945/2002; Wittgenstein 1953; Dreyfus & Kelly 2007; Sutton 2010; Abramova & Slors, 2015; Gallagher & Ransom 2016; Zahavi 2019; Gallagher 2020; Lebahn-Hadidi 2021). People are generally able to skilfully adjust what they do to fit the particularities of the situation (Rietveld 2008a; Rietveld et al, 2018; Van den Herik & Rietveld 2021).…”

Section: Introductionmentioning

confidence: 99%

Change-Ability for a World in Flux

Rietveld

2022

Adaptive Behavior

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This article aims to sketch a new integrative perspective on what I call change-ability. I define change-ability as skilled ways of coordinating with a rapidly changing world. Many urgent societal challenges – from climate change to obesity, from the mass extinction of species to fraying social cohesion – require people to collectively change everyday patterns of behaviour they take for granted. The key insight I start from is that to durably change undesirable patterns of behaviour, we could start by changing the affordances the environment offers – the possibilities for action offered to us by the living environment. The aim of this article is to sketch an integrative conceptual framework for understanding change-ability in terms in terms of a dynamical ‘brain ↔ body ↔ community ↔ landscape of affordances’ system. This Change-Ability Conceptual Framework starts from the idea that individuals and communities are situated in the same rich landscape of affordances and suggests that making communities more change-able entails transforming the material ‘grooves’ that have formed in this landscape of affordances.

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“…A more encompassing framework is found in human factors, e.g., presented in the SHELL model, which considers a broader spectrum of human interaction, incorporating social skills, cognitive abilities, and decision-making. Moreover, it emphasises the interplay between the environment, organisation, and human psychology (15). In light of this perspective, this article implements the term human factors skills (HFS) to denote the skills under examination.…”

Section: Introductionmentioning

confidence: 99%

Transferring Health Personnel's Human Factor Skills to competency in clinical practice: Key Findings from a Qualitative Investigation

Abildgren,

Lebahn-Hadidi,

Mogensen

et al. 2024

Preprint

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Background: Research shows that simulation-based training can increase knowledge and skills among pregraduate healthcare students, that simulation-based training of technical skills places the participants higher on the learning curve in practice, and that simulation-based training can improve participants’ human factor skills. Nevertheless, how cognitive and social knowledge and skills are transferred into clinical practice competency remains unknown. This study aims to explore qualified in-hospital health personnel’s transfer of human factor skills from a simulation-based training course to competency in everyday clinical practice. Method: A qualitative phenomenological-hermeneutic methodology and an ethnographic study investigate qualified health personnel’s transfer of human factor skills before, during, and after a simulation-based training course. The data collection comprises three phases: a clinical phase, a simulation-based training phase and a transfer phase; each phase is based on a subsequent analysis of the previous phase. Data consist of approximately 107 hours of video recordings, field notes and reflections within the research team. Data are analysed with RICEA, a qualitative hybrid method of a Ricɶur-Inspired Analysis and Cognitive Event Analysis. Findings: The analysis reveals three key themes: Individual transfer of learning, Intercollegiate transfer of learning and Organisational transfer of learning. The findings imply that transfer of human factor skills happens on an individual and intercollegiate level. Still, transfer needs to be scaffolded on an organisational level so that cognitive and social knowledge becomes competency in clinical practice. Further, the findings imply that transferring human factor skills needs another focus than transferring technical skills. Transfer, internalisation and retention of human factor skills are inadequate because of insufficient organisational focus on transferring human factor skills. Conclusion: Findings suggest a need for a broader and more profound focus on transferring human factor skills to competency in clinical practice. Involving local ambassadors and increased collaboration between simulation centres and organisations around the transfer phase could optimise the transfer of human factor skills. However, further research is needed in this area. Trial registration: N/A

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Integrating cognitive ethnography and phenomenology: rethinking the study of patient safety in healthcare organisations

Cited by 6 publications

References 44 publications

Communication, Cognition and Competency Development in Healthcare: A Model for Integrating Cognitive Ethnography and Communication Skills Training in Clinical Interventions

Communication, Cognition and Competency Development in Healthcare: A Model for Integrating Cognitive Ethnography and Communication Skills Training in Clinical Interventions

Change-Ability for a World in Flux

Transferring Health Personnel's Human Factor Skills to competency in clinical practice: Key Findings from a Qualitative Investigation

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