Distributed cognition: Theoretical insights and practical applications to health professions education: AMEE Guide No. 159

Abstract

Distributed cognition (DCog) is a member of the family of situativity theories that widens the lens of cognition from occurring solely inside the head to being socially, materially and temporally distributed within a dynamic system. The concept of extending the view of cognition to outside the head of a single health professional is relatively new in the healthcare system. DCog has been increasingly used by researchers to describe many ways in which health professionals perform in teams within structured clinical environments to deliver healthcare for patients. In this Guide, we expound ten central tenets of the macro (grand) theory of DCog (1. Cognition is decentralized in a system; 2. The unit of analysis is the system; 3. Cognitive processes are distributed; 4. Cognitive processes emerge from interactions; 5. Cognitive processes are interdependent; 6. Social organization is a cognitive architecture; 7. Division of labour; 8. Social organization is a system of communication; 9. Buffering and filtering; 10. Cognitive processes are encultured) to provide theoretical insights as well as practical applications to the field of health professions education.

Keywords:

• Clinical reasoning
• diagnosis
• distributed cognition
• error
• health professions education
• medical education
• situated cognition
• situativity theory

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The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

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Notes on contributors

James G. Boyle

James G. Boyle, MBChB, MD, MSc, FRCP, is associate professor and year director, Undergraduate Medical School, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.

Matthew R. Walters

Matthew R. Walters, MBChB, MSc, MD, is professor and head, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.

Susan Jamieson

Susan Jamieson, BSc (Hons), PhD, EdD, is professor and director, Health Professions Education Programme, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.

Steven J. Durning

Steven J. Durning, MD, PhD, is professor and director, Center for Health Professions Education, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.