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Assessing the association between thinking dispositions and clinical error.

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Clinicians often make intuitive decisions, but a cognitive puzzle did not predict clinical errors. This study highlights the high prevalence of errors and intuitive thinking in healthcare professionals.

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Area of Science:

  • Cognitive Psychology
  • Medical Education
  • Clinical Decision-Making

Background:

  • Dual-process theory differentiates intuitive (Type 1) and rational (Type 2) thinking.
  • Individual differences exist in rationalization, ranging from careful to cursory.
  • A preference for cursory rationalization may lead to decision-making errors.

Purpose of the Study:

  • To assess clinicians' propensity for 'quick and casual' decision-making using a cognitive puzzle.
  • To investigate the association between cognitive puzzle performance and self-reported clinical errors.
  • To determine the predictive capability of a cognitive puzzle for clinical error.

Main Methods:

  • Clinicians (n=153) completed a cognitive puzzle with an obvious incorrect answer.
  • Participants reported clinical errors committed in the prior two weeks.
  • Statistical analysis (chi-squared test) examined the relationship between puzzle answers and error reporting.

Main Results:

  • 59% of clinicians reported clinical errors; 67% provided the incorrect intuitive answer to the puzzle.
  • No statistically significant association was found between committing errors and answering the puzzle incorrectly.
  • The cognitive puzzle did not predict which clinicians were more likely to commit errors.

Conclusions:

  • The study observed a high prevalence of clinical errors and intuitive decision-making among clinicians.
  • The cognitive puzzle used was not a reliable predictor of individual clinical error.
  • Further research is needed to develop effective predictive models for clinical error.