title: A tool for the consensual analysis of decision-making scenarios.
abstract: The authors believe there is a need for novel ways of enhancing professional judgment and discretion in the contemporary healthcare environment. The objective is to provide a framework to guide a discursive analysis of an ongoing clinical scenario by a small group of healthcare professionals (4-12) to achieve consensual understanding in the decision-making necessary to resolve specific healthcare inadequacies and promote organisational learning. REPVAD is an acronym for the framework's five decision-making dimensions of reasoning, evidence, procedures, values, attitudes and defences. The design is set out in terms of well-defined definitions of the dimensions, a rationale for using REPVAD, and explications of dimensions one at a time. Furthermore, the REPVAD process of application to a scenario is set out, and a didactic scenario is given to show how REPVAD works together with a sample case. A discussion is fleshed out in four real life student cases, and a conclusion indicates strengths and weaknesses and the possibility of further development and transferability. In terms of findings, the model has been tried, tested and refined over a number of years in the development of advanced practitioners at university healthcare faculties in two European countries. Consent was obtained from the four participating students.
authors.affiliation: University of Surrey, UK.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Hunt
authors.forename: Christine
authors.initials: C
authors.lastname: Merzeder
authors.affiliation: Kalaidos University of Applied Sciences, Switzerland.
authors.forename: Iren
authors.initials: I
authors.lastname: Bischofberger
mesh_terms: D002983:Clinical Competence / Q000592:standards; D003657:Decision Making / Q000941:ethics*; D006801:Humans; D007858:Learning / Q000941:ethics
keywords: Clinical reasoning; consensus; decision-making; defences; ethical values; evidence based; learning organisation