BSSR Resources, Methods, and Measures

Assessing Alignment of Thinking Between Health Professionals and Health Consumers

Medicine of the person recognizes that illness may be perceived as a threat. Illness is a threat that may undermine hope and that may force confrontation with mortal fears. Achieving the aim of clinical care that focuses on medicine of the person requires first and foremost the alignment of thinking among healthcare providers and the alignment of shared objectives between the healthcare provider and the patient. This is central to both the therapeutic and the research alliance. Put another way, confronting dread is at the interface between 'medicine of the person' and 'medicine of the disease'. Unfortunately, teaching alignment of thinking is a marginalized competency in medical training. But, by the same token, measuring alignment of thinking is one mechanism to assess both critical thinking and emotional intelligence. If the therapeutic alliance can be strengthened through improved management of expectations, then feelings of exploitation or betrayal may be ameliorated. The teaching methods for transformational learning in this regard are mature within the field of adult education. It starts by asking: "How do we think and feel about trust?" and "What behaviors are not entrustable in the patient-provider alliance?" One way to operationalize the behaviors that lead to entrustability during the clinical encounter is to employ the statistical method of random forests classification analysis for purposes of capturing the strength of alignment of thinking between health care provider and patient expectations (PMID: 20142443).

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Idea No. 281