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Acad Med. 2010 May;85(5):894-901. doi: 10.1097/ACM.0b013e3181d7427c.

Perspective: redefining context in the clinical encounter: implications for research and training in medical education.

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  • 1Department of Medicine (NEP), F. Edward H├ębert School of Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland 20814, USA.


Physician training and practice occur in complex environments. These complex environments, or contexts, raise important challenges and opportunities for research and training in medical education. The authors explore how studies from fields outside medicine can assist medical educators with their approach to the notion of context in the clinical encounter. First, they discuss the use of the term context in the clinical encounter as it relates to medical education. They then detail the meaning and use of the term in diverse fields outside medicine, such as mathematics, physics, and psychology, all of which suggest a nonlinear approach to the notion of context. Next, the authors highlight two inclusive theories, situated cognition and ecological psychology, that propose factors that relate to context and that suggest some potential next steps for research and practice. By redefining context as it relates to the clinical encounter (by linking it to theory and research from several diverse fields), the authors hope to move the field forward by providing guidance for the theory, research, and practice of medical education.

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