Learning to Reflect Together: A Video Reflexive Ethnography and Linguistic Analysis of Collaborative Clinical Reasoning in Intensive Care

Background Collaborative clinical reasoning (CCR) is essential to safe and effective practice in intensive care units, where decisions are shaped by uncertainty, high cognitive load, and interprofessional dynamics. Although CCR is widely recognised as a collective cognitive process, little is known about how clinicians learn to reason together or how reflective educational interventions influence the language and social organisation through which CCR is enacted. Methods This mixed-methods Groundwork study examined the impact of a Video Reflexive Ethnography (VRE) intervention on CCR within a multidisciplinary neuro-intensive care unit in Taiwan. Twelve clinicians (physicians, nurses, and a respiratory therapist) were video-recorded during routine bedside rounds. Transcripts of team interactions before and after the VRE intervention were analysed using Linguistic Inquiry and Word Count (LIWC-22) to examine markers of analytical thinking, clout, authenticity, cognitive processing, and social interaction. Quantitative linguistic trends were interpreted alongside qualitative data from retrospective reflective think-aloud sessions in which participants reviewed and discussed selected video excerpts of their own practice. Results No statistically significant differences were observed across LIWC categories following the intervention. However, consistent linguistic trends suggested shifts toward more reflective and collaborative reasoning. Post-intervention interactions demonstrated increased use of language associated with analytical thinking, insight, tentativeness, and authenticity, alongside a decrease in clout-related language. During reflective sessions, participants described heightened awareness of their own communicative habits, greater openness to uncertainty, and increased willingness to invite and consider alternative perspectives from other team members. Conclusions By integrating video-reflexive inquiry with computational linguistic analysis, this study provides insight into how reflection may reshape the cognitive and social dimensions of collaborative clinical reasoning. The findings suggest that VRE can support communicative equity and epistemic humility in interprofessional teams, even when changes are subtle and not readily captured by traditional outcome measures. This work highlights the value of combining qualitative and linguistic approaches to examine learning processes in authentic clinical environments and informs the design of reflective faculty development and interprofessional education initiatives.