Vygotskian education psychology places a high priority on mediational artifacts or cognitive tools; things like knowledge, concepts, criteria, schemas, etc . . .. These tools act as cognitive mediation and are instrumental to activity as subjects work on an object to produce an outcome.
I spoke here about how unity of the 3 elements and the central unit of analysis is the activity. Lets consider an activity example relevant to evidence-based practice.
A clinician (the subject) uses the idea of evidence-based practice (the mediating artifact) to examine routine aspects of their practice (the object) with the goal of changing their practice to improve their patience’s health (the outcome). If you find that evidence-based changes are not being made in a field, where would you look for a problem? Many analysis have implied that there is a problem with the subjects, they’re just not using the available evidence or that their knowledge based is deficient. I would say that it is much more likely that the solution can be found by developing an appropriate mediating artifact that can support clinicians in examining their practice.
This was the focus of Gal’perin, a prominate follower of Vygotsky. He said that not all (cognitive tools (mediators) are of sufficient quality and that the quality of development (like the development of evidence-based practice) is most dependent on the quality of the cognitive tools. Specifically, he thought that cognitive tools should be organized around and support the psychological functioning of the subject. So, what are the psychological functions around which you might organize the concept of evidence-based practice?
- First, don’t focus on the evidence, focus on the practice and use a tool that brings evidence to a practice focus. An example might be a checklist used by a surgical team as they prepare for surgery. The checklist reflects the available evidence and allows the team to bring that evidence to their practice focus, but still allows their cognitive load for addressing important aspect of their practice.
- Second, use cognitive tools to organize information and to orient evidence toward action. A research finding may represent important evidential information, but they are seldom oriented to practice in a way that naturally leads to action. An example is a network security assessment I developed. It reflect HIPPA security requirements (the evidence) in a series of 46 questions. The questions were structured not only to assess security status, to clarify an action plan that would improve the security status. This again would reduce the cognitive load needed to include an enormous amount of information in a short time span.
Vygotsky developed this idea of mediational tools or cognitive artifacts during the 1920’s, but with the increasing importance of knowledge and other cognitive artifacts, it has never been as relevant or important. Vygotsky was thinking mainly of children’s development, but his theory is also relevant to adults and their cognitive functioning in their work life.