title: Learning support for the consultation: information support and decision support should be placed in an educational framework.
abstract: BACKGROUND
  Advances in information technology mean that it is now possible to provide contextually relevant, evidence-based information during the course of the consultation. As a consequence, the practitioner has to consider the new information (from the computer) in the situation of the present consultation and in the light of his or her own experience. This task has to be carried out in a short time, in the presence of the patient.
  
  
  METHODS
  Drawing on experience of the development of one decision support system, this paper places that task for the practitioner in an educational framework. We begin by reviewing theories of professional experience and knowledge and go on to look at schema theory and the role of cognitive dissonance and reflection in learning.
  
  
  CONCLUSIONS
  This paper considers the provision of real time decision support in the light of learning and the experienced practitioner. We conclude that framing the implementation of decision support in this way provides useful insights. The key process is learning by the practitioner, in the course of the consultation. This process should be supported by decision support and information support software. There are implications here for the design of such software, and also for the way in which practitioners are trained to use it.
authors.affiliation: Sowerby Centre for Health Informatics, University of Newcastle, UK. p.j.robinson@ncl.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Robinson
authors.forename: Ian
authors.initials: I
authors.lastname: Purves
authors.forename: Rob
authors.initials: R
authors.lastname: Wilson
mesh_terms: D003073:Cognitive Dissonance; D003658:Decision Making, Computer-Assisted; D004502:Education, Medical, Continuing / Q000379:methods* / Q000592:standards; D006801:Humans; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000193:education; D011364:Professional Practice / Q000592:standards*