Background: This article illustrates how cognitive, organizational, and communicative/interactive processes can be included into the design of micro-skills interventions in healthcare. We present a model for integrating methods of cognitive ethnography and in situ simulation into clinical communication intervention studies to support the implementation process.
Methods: A twelve-week Blended Learning communication training course based on the Calgary-Cambridge guide and supported by in situ simulation is conducted among healthcare professionals at an outpatient clinic at a Danish university hospital. Cognitive ethnography is used to document and evaluate implementation and competency development: How learning is absorbed and translated into clinical practice.
Results/Discussion: Clinical intervention studies can be designed to include cognitive, organizational, and communicative/interactive processes. The proposed model can effectively support implementation of communicative skills interventions in healthcare. The integration of cognitive ethnography supports documentation of change processes and organizational challenges that arise during the implementation and allows to evaluate whether the intervention is flexible enough to accommodate in “real-time.” Integration of cognitive ethnography can also secure necessary and timely adaptability of the program, stimulating the desired change on individual and organizational levels. In situ simulation training provides a further opportunity to train and review communicative skills in the clinic, which may help to better retain the introduced skills, thus promoting sustainable change.
Conclusions: The proposed design can narrow the theory-practice gap, c and knowledge transfer, and has the potential to generate a positive cultural change, all of which are necessary to improve organizational processes and better patient care. The model works for the benefit of the clinic and may be more suitable for implementation of communication projects than, say, randomized setups. Adopting the integration of cognitive ethnography with clinical interventions as a way of understanding change processes can ensure adaptable activities and secure quality optimization and change in individual behavior and organizational culture over time. Improvement of health communication and communicative skills of healthcare providers can create pace for patient-involvement and reduce inequalities, and hence provide better and safer healthcare.