Case Study Shows Collaborative Clinical Reasoning Extends Beyond Individual Expertise

Collaborative clinical reasoning extends beyond the integration of individual clinical expertise to operate as a sociocognitive process shaped by organisational, communicative, and relational conditions, according to an exploratory qualitative case study conducted at an interprofessional paediatric outpatient centre in Geneva, Switzerland.

Collaborative clinical reasoning is defined as the process through which two or more healthcare team members negotiate diagnostic, therapeutic, or prognostic issues concerning an individual patient to generate an illness or treatment plan. While this collaborative practice has grown increasingly important in interprofessional healthcare and health professions education, how healthcare professionals collectively construct clinical reasoning in authentic clinical settings, particularly within longitudinal patient care, has remained under-researched.

To explore how collaborative clinical reasoning is enacted and understand the interactions through which clinicians contribute to collective thinking, the research team examined an interdisciplinary case conference using video-recorded observations. The observational records were paired with semi-structured stimulated recall interviews involving six healthcare professionals, and preliminary findings were subsequently discussed with participants during a feedback session.

The study analysed the observational and interview materials as distinct yet complementary sources using a combined deductive and inductive thematic framework. The deductive component was guided by the clinical reasoning framework of Charlin and colleagues, whereas inductive analysis was employed to identify collaborative dimensions that were not adequately captured by that existing model.

Deductive analysis demonstrated that healthcare professionals were able to retrospectively recognise the reasoning processes described by Charlin and colleagues during interviews. In contrast, direct video observation of the case conference yielded more limited evidence that transitions between these clinical reasoning processes were explicitly coordinated at the team level.

Inductive analysis identified three interrelated dimensions that shape collaborative clinical reasoning: organisational conditions, communication processes that render reasoning visible and shareable, and professional identities and relational dynamics influencing collective sense-making. The study observed that information sharing did not necessarily entail reasoning sharing; collaborative reasoning became more accessible when observations, interpretations, hypotheses, and proposed actions were articulated, questioned, and reformulated.

The investigation also established that leadership, hierarchy, and perceived interpersonal safety shaped team participation and the integration of complementary clinical expertise. To support health professions education, the authors concluded that training programmes must help learners and teams make reasoning accessible, engage with alternative interpretations, coordinate transitions across reasoning stages, and navigate tensions between leadership and horizontality, psychological safety and cognitive challenge, and individual expertise and collective sense-making.

Subject of Research: Collaborative clinical reasoning in interprofessional healthcare teams

Article Title: Negotiating the paradoxes of collaborative clinical reasoning: insights from a qualitative case study in longitudinal patient care

Article References: Emilie, G., Vitória, P. D. S., & Marie-Claude, A. (2026). Negotiating the paradoxes of collaborative clinical reasoning: insights from a qualitative case study in longitudinal patient care. BMC Medical Education. https://doi.org/10.1186/s12909-026-10708-7

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10708-7

Keywords: collaborative clinical reasoning, interprofessional healthcare, health professions education, longitudinal patient care, qualitative case study, paediatric outpatient care, interdisciplinary case conference, stimulated recall interviews, thematic analysis, Charlin clinical reasoning framework, sociocognitive process, interpersonal safety, team hierarchy, collective sense-making, information sharing, reasoning sharing, Geneva Switzerland