gms | German Medical Science

Introduction: Clinical reasoning (CR) can be seen as a form of scientific reasoning and argumentation (SRA), a competency critical to successful clinical practices and patient outcomes [1]. Although SRA can be influenced by various factors (e.g. prior knowledge), education and psychology research suggests a mutually influential relationship between SRA and epistemic beliefs (EB); that is, individual perceptions related to the nature of knowledge and knowing [2]. EB research primarily seeks to improve the learning of SRA-related skills by assessing the EB/SRA relationship both directly and through moderating factors. Unfortunately, EB research in clinical contexts specifically is sparse and current consensus suggests that EB is ultimately contextualized and domain-specific [3]. This places higher value on the cumulative implications of existing clinical EB research as well as to moderators that may be more prominent within clinical contexts.

Objectives: The purpose of this study is to systematically assess and synthesize empirical investigations of EB within clinical contexts. On that basis, suggestions for future research and instructional practices on fostering the EB/CR relationship will be provided.

Methods: This poster will present the first meta-analytical results between EB and CR from primary studies conducted in clinical contexts: A systematic literature review of EB was conducted in academic databases (≥5; e.g. PsycINFO) via EBSCOhost, resulting in >1,000 citations. Upon passing two phases of screening (title & abstract; full-text) per the inclusion/exclusion criteria, the final literature set will be analyzed for the cumulative main effects and indirect effects of various moderators described in the primary studies. Such moderators will include general factors, such as the social structure of CR (social vs. individual) and the format of CR (oral vs. written), as well as factors characteristic of clinical settings (e.g. the balance of epistemic authority vs. epistemic agency).

Expected results: The available literature is expected to demonstrate similar results to those hypothesized for non-clinical EB/SRA research: a bi-directional relationship between EB and CR in which each exhibits reciprocal effects on one another, and positive moderating effects on the EB/CR relationship for settings in which CR is conducted socially versus individually and orally versus written. In contrast to non-clinical EB research, a distinct emphasis on hierarchical aspects of the context is generally expected. Further, contexts with both high epistemic authority and high epistemic agency (contrast: e.g. contexts with high epistemic authority but low epistemic agency) are hypothesized to exhibit positive moderating effects on the EB/CR relationship.