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Cognitive debiasing 2: impediments to and strategies for change
Pat Croskerry1, Geeta Singhal, Sílvia Mamede
1Division of Medical Education, Dalhousie University, , Halifax, Nova Scotia, Canada.
BMJ Quality & Safety
|September 3, 2013
Summary
Cognitive debiasing, a skill to improve clinical reasoning and reduce diagnostic errors, involves understanding cognitive change and overcoming individual biases. Strategies include education, workplace interventions, and forcing functions to enhance decision-making quality.
Area of Science:
- Cognitive Psychology
- Medical Education
- Clinical Reasoning
Background:
- Cognitive biases contribute to diagnostic failure in clinical reasoning.
- Understanding cognitive change and debiasing mechanisms is crucial.
- Individual factors can impede cognitive change and effective debiasing.
Purpose of the Study:
- To outline a schema for cognitive change and its constraints.
- To examine strategies for cognitive and affective debiasing.
- To propose interventions for improving clinical decision-making.
Main Methods:
- Review of cognitive change theories.
- Examination of individual factors impeding change.
- Analysis of debiasing strategies from social sciences and medicine.
Main Results:
- Identified individual biases as impediments to cognitive change.
- Highlighted the variety of debiasing strategies, including forcing functions.
- Emphasized the role of ambient and contextual influences on decision-making.
Conclusions:
- Ongoing cognitive debiasing is key for critical thinking and a well-calibrated mind.
- Proposed interventions: educational, workplace, and forcing functions.
- Advocated for integrating critical thinking and debiasing training in medical education.
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