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Cognitive Debiasing Strategies: A Faculty Development Workshop for Clinical Teachers in Emergency Medicine.

ABSTRACT: Introduction:Medical decision-making is a cornerstone of clinical care and a key contributor to diagnostic accuracy. Medical decision-making occurs via two primary pathways: System 1, pattern recognition, is fast, intuitive, and heuristically driven and occurs largely unconsciously. System 2, analytic thinking, is slow, deliberate, and under conscious control. Biases are systematic errors that can impact reasoning via either pathway but predominantly affect decisions made by pattern recognition. Debiasing strategies involve the deliberate switching from pattern recognition to analytic thinking triggered by a stimulus. This resource describes a faculty development workshop designed to train emergency medicine educators about common biases and debiasing strategies, to improve teaching of diagnostic reasoning to trainees. Methods:This workshop was implemented at the 2017 Society for Academic Emergency Medicine Annual Meeting. The workshop consisted of a brief didactic, followed by small-group case-based learning. A retrospective survey and qualitative evaluation were administered to attendees. Results:The participants' self-assessment showed significant improvements (p < .001) in their abilities to recognize how pattern recognition can lead to bias, identify common types of bias in the emergency department, teach trainees about common types of bias, and apply cognitive debiasing strategies to improve diagnostic reasoning. Strengths of the workshop included the interactive case-based format, discussions of bias-mitigation strategies, and take-home resources. Suggestions for improvement included lengthening the discussion time and providing more cases. Discussion:Cognitive biases can negatively impact patient care. Faculty development is needed to improve instruction about bias and debiasing strategies for all levels of trainees.

SUBMITTER: Daniel M

PROVIDER: S-EPMC6338148 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Cognitive Debiasing Strategies: A Faculty Development Workshop for Clinical Teachers in Emergency Medicine.

Daniel Michelle M Carney Michele M Khandelwal Sorabh S Merritt Chris C Cole Michael M Malone Matthew M Hemphill Robin R RR Peterson Will W Burkhardt John J Hopson Laura L Santen Sally A SA

MedEdPORTAL : the journal of teaching and learning resources 20171023

<h4>Introduction</h4>Medical decision-making is a cornerstone of clinical care and a key contributor to diagnostic accuracy. Medical decision-making occurs via two primary pathways: System 1, pattern recognition, is fast, intuitive, and heuristically driven and occurs largely unconsciously. System 2, analytic thinking, is slow, deliberate, and under conscious control. Biases are systematic errors that can impact reasoning via either pathway but predominantly affect decisions made by pattern reco ...[more]

PMID: 30800847

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Project description:BackgroundAlthough clinical teachers can often identify struggling learners readily and reliably, they can be reluctant to act upon their impressions, resulting in failure to fail. In the absence of a clear process for identifying and remediating struggling learners, clinical teachers can be put off by the prospect of navigating the politically and personally charged waters of remediation and potential failing of students.MethodsTo address this gap, we developed a problem-solving algorithm to support clinical teachers from the identification through the remediation of learners with clinical reasoning difficulties, which have significant implications for patient care. Based on this algorithm, a mobile application (Pdx) was developed and assessed in two emergency departments at a Canadian university, from 2015 to 2016, using interpretive description as our research design. Semi-structured interviews were conducted before and after a three-month trial with the application. Interviews were analysed both deductively, using pre-determined categories, and inductively, using emerging categories.ResultsTwelve clinical teachers were interviewed. Their experience with the application revealed their need to first validate their impressions of difficulties in learners and to find the right words to describe them before difficulties could be addressed. The application was unanimously considered helpful regarding both these aspects, while the mobile format appeared instrumental in allowing clinical teachers to quickly access targeted information during clinical supervision.ConclusionsThe value placed on verifying impressions and finding the right words to pinpoint difficulties should be further explored in endeavours that aim to address the failure to fail phenomenon. Moreover, just-in-time mobile solutions, which mirror habitual clinical practices, may be used profitably for knowledge transfer in medical education, as an alternative form of faculty development.

Dataset Information

Cognitive Debiasing Strategies: A Faculty Development Workshop for Clinical Teachers in Emergency Medicine.

Publications

Cognitive Debiasing Strategies: A Faculty Development Workshop for Clinical Teachers in Emergency Medicine.

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