Cognitive models in training health professionals to protect patients' confidential information

Recent advances in theories of learning and knowledge acquisition in cultur ally-situated environments have illuminated the role of cognition in changi ng behavior, and in turn on influencing performance for the long term. One such advance focuses on the relationship between explicit formal training a nd implicit knowledge acquired through daily interactive activities in scho ols and organizations. The former relates more to instruction regarding the policy issues whereas the latter is tied closely to cultural, moral and or ganizational values. In this paper, we draw on these theories of cognition and learning to show the shift in thinking that is needed regarding educati on of health professionals, including steps required to assure that the pro tection of confidential information becomes part of their routine practices . Illustrative examples are used to show the nature of conceptual change in the health professional's knowledge organization and reasoning strategies that is necessary for more sustained behavior change with regards to protec ting data confidentiality and privacy of individual patients. This re-conce ptualization is intended to be reflected at various levels of training and education for health professionals, including influences on personal and or ganizational practices as well as revisions in medical-school and graduate- medical curricula. (C) 2000 Elsevier Science Ireland Ltd. All rights reserv ed.