Annals Clinical Decision Making: Avoiding Cognitive Errors in Clinical Decision Making

2020 ◽  
Vol 172 (11) ◽  
pp. 747-751 ◽  
Author(s):  
Daniel Restrepo ◽  
Katrina A. Armstrong ◽  
Joshua P. Metlay
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cognitive Errors

Virtual patients and clinical decision-making skills: How students learn to diagnose depending on their psychological characteristics (Preprint)

2020 ◽  
Author(s):  
Bartosz Zalewski ◽  
Maciej Walkiewicz ◽  
Mateusz Guziak
Keyword(s):  
Decision Making ◽  
Negative Affect ◽  
Clinical Psychology ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Psychology Students ◽  
Psychological Characteristics ◽  
Cognitive Errors ◽  
Clinical Psychology Students ◽  
Academic Knowledge

BACKGROUND The process of conducting a clinical assessment is a highly complex task. Virtual Patient (VP) technology may be a useful tool to complement educational activities based on real patients and it is widely used in medical education. OBJECTIVE The goal of this exploratory study is to analyse which psychological characteristics of clinical psychology students are related to the effectiveness of learning clinical decision-making skills with the use of VP. METHODS Authors’ VP was used for measuring the ability to learn the decision-making in 29 last-year clinical psychology students by: negative vs positive aspects of a patient’s functioning, reactance, coping, stage of change, cognitive errors, adequacy of assessment data, and the quality of assessment. Psychological questionnaires were used for measuring student’s: need for cognitive closure; ability to achieve closure; beliefs of changeability on human traits; the level of hope, intelligence, positive vs negative affect, and academic knowledge. RESULTS Developing clinical decision-making with the use of VP is effective for students who have a higher ability to tolerate ambiguity and complexity of data. Students convinced of the changeability of human traits take into consideration more diverse data and the process of diagnosis requires the analysis of complex phenomena. Students with dominant negative affect seem to build diagnoses more carefully and make fewer cognitive errors than those with positive affect. CONCLUSIONS Our study indicates which properties of students support and which weaken the acquisition of the ability to make a diagnosis.

scholarly journals Virtual Patients and Clinical Decision-making Skills: How Students Learn to Diagnose Depending on Their Psychological Characteristics

2020 ◽  
Author(s):  
Bartosz Zalewski ◽  
Maciej Walkiewicz ◽  
Mateusz Guziak
Keyword(s):  
Decision Making ◽  
Negative Affect ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Dominant Negative ◽  
Psychological Characteristics ◽  
Cognitive Errors ◽  
Clinical Psychology Students ◽  
Academic Knowledge ◽  
Complex Phenomena

Abstract Background:The goal of this exploratory study is to analyse which psychological characteristics of clinical psychology students are related to the effectiveness of learning clinical decision-making skills with the use of virtual patient (VP).Methods: Authors’ VP was used for measuring the ability to learn the decision-making: negative vs positive aspects of a patient’s functioning, reactance, coping, stage of change, cognitive errors, adequacy of assessment data, and the quality of assessment. Psychological questionnaires were used for measuring student’s: need for cognitive closure; ability to achieve closure; beliefs of changeability on human traits; the level of hope, intelligence, positive vs negative affect, and academic knowledge. Results: Developing clinical decision-making with the use of VP is effective for students who have a higher ability to tolerate ambiguity and complexity of data. Students convinced of the changeability of human traits take into consideration more diverse data and the process of diagnosis requires the analysis of complex phenomena. Students with dominant negative affect seem to build diagnoses more carefully and make fewer cognitive errors than those with positive affect.Conclusions:Our study indicates which properties of participants support and which weaken the acquisition of the ability to make a diagnosis.

How Residents Think and Make Medical Decisions: Implications for Education and Patient Safety

2007 ◽  
Vol 73 (6) ◽  
pp. 548-553 ◽  
Author(s):  
Jeffrey S. Young ◽  
Robert L. Smith ◽  
Stephanie Guerlain ◽  
Barbara Nolley
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cognitive Errors ◽  
Care Experience ◽  
First Case ◽  
Total Data ◽  
Data Points ◽  
Preliminary Study

Medical errors are a major cause of morbidity and mortality, and cognitive errors account for many of these events. This study examined the basic science of the cognitive performance of trainees. We created a low-intensity medical simulator to perform a preliminary study of the ability of residents to recall and process patient information presented verbally. The subjects were separated into three categories based on critical care experience: novice (≤8 weeks of critical care experience), intermediate (8–16 weeks of critical care experience), and expert (>16 weeks of critical care experience). The subjects were presented with three clinical cases. In the first case, the presentation contained 55 separate data points and subject recall was analyzed. In the second and third cases, a patient report was given, and the subjects were asked by a “medical student” to outline and explain their treatment decisions. Fifteen subjects completed the experiment (five novices, six intermediates, and four experts). Case 1 (recall): No significant differences among groups with regard to errors or total data points recalled (however, subjects who chose not to take notes had significantly poorer recall and committed more errors). Cases 2 and 3 (cognition and decision making): Intermediates and experts made significantly fewer errors. More importantly, the reasoning process (forward hypothesis based) of the more experienced residents differed from novices. This preliminary study demonstrates that the cognitive processes used by residents experienced in critical care are quantitatively and qualitatively different from those used by novices. These processes were also associated with far fewer cognitive errors in clinical decision making.

Avoiding Cognitive Errors in Clinical Decision Making

2020 ◽  
Vol 173 (8) ◽  
pp. 679
Author(s):  
Daniel Restrepo ◽  
Katrina A. Armstrong ◽  
Joshua P. Metlay
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cognitive Errors

Avoiding Cognitive Errors in Clinical Decision Making

2020 ◽  
Vol 173 (8) ◽  
pp. 678-679
Author(s):  
Robert L. Trowbridge ◽  
Joseph J. Rencic ◽  
Thilan P. Wijesekera ◽  
Andrew P.J. Olson
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cognitive Errors

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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