Abstract
Research into human cognition exploded in the 1970s. A dual system of reasoning was outlined by Nobel Prize winner Daniel Kahneman and Amos Tversky. System 1 is the instinctual limbic pattern recognition that integrates senses, feelings and gut instincts. System 2 is the more logical hypothetico-deductive style with differential diagnoses and testing of various hypotheses. System 1 improves as you gain experience in the rich tapestry of the clinical practice of medicine. Most clinical decisions are made in the System 1 arena and this has tremendous benefit as it allows us to process a vast amount of clinical information quickly. However, certain cognitive biases may lead to a discrete pattern of errors in System 1 thinking. An understanding of these biases will help improve your safety in the practice of medicine and provide a cognitive toolkit for better care.
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References
Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. Washington, DC: The National Academies Press; 2000.
Berner ES, Graber ML. Overconfidence as a cause of diagnostic error in medicine. Am J Med. 2008;121(5 Suppl):S2–23.
Newman-Toker DE, Pronovost PJ. Diagnostic errors—the next frontier for patient safety. JAMA. 2009;301(10):1060–2. doi:10.1001/jama.2009.249.
Graber ML, Franklin N, Gordon R. Diagnostic error in internal medicine. Arch Intern Med. 2005;165(13):1493–9.
Groopman J. How doctors think. New York: Houghton Mifflin; 2007.
Graber ML, Gordon R, Franklin N. Reducing diagnostic error – what’s the goal? Acad Med. 2002;77:981–92.
Kahneman D. Thinking, fast and slow. New York: Farrar, Straus and Giroux; 2011.
Sloman S. The empirical case for two systems of reasoning. Psychol Bull. 1996;119(1):3–22.
Lehrer J. How we decide. Boston: Houghton Mifflin Harcourt; 2009.
Croskerry P. Clinical cognition and diagnostic error: applications of a dual process model of reasoning. Adv Health Sci Educ Theory Pract. 2009;14 Suppl 1:27–35. doi:10.1007/s10459-009-9182-2.
Coderre S, Mandin H, Harasym PH, Fick GH. Diagnostic reasoning strategies and diagnostic success. Med Educ. 2003;37(8):695–703.
Stiegler MP, Neelankavil JP, Canales C, Dhillon A. Cognitive errors detected in anaesthesiology: a literature review and pilot study. Br J Anaesth. 2012;108(2):229–35. doi:10.1093/bja/aer387.
Croskerry P, Abbass A, Wu AW. Emotional influences in patient safety. J Patient Saf. 2010;6(4):199–205.
Croskerry P. The cognitive imperative: thinking about how we think. Acad Emerg Med. 2000;7:1223–31.
Gawande A. The checklist manifesto – how to get things right. New York: Metropolitan Books; 2009.
Kahol K, Smith M, Brandenberger J, Ashby A, Ferrara JJ. Impact of fatigue on neurophysiologic measures of surgical residents. J Am Coll Surg. 2011;213(1):29–34.
Gleitman H. Some trends in the study of cognition. In: Koch S, Leary DE, editors. A century of psychology as science. New York: McGraw-Hill; 1985. p. 420–36.
Crosskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med. 2003;78(8):775–80.
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Boyle, D.J. (2014). Cognitive Errors. In: Stahel, P., Mauffrey, C. (eds) Patient Safety in Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4369-7_3
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DOI: https://doi.org/10.1007/978-1-4471-4369-7_3
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