Cognitive dissonance: how self-protective distortions can undermine clinical judgement
Jill Klein1,2, Geoff McColl3
1Department of Medical Education, Melbourne Medical School, University of Melbourne, Carlton, Victoria, Australia.
Medical Education
|August 10, 2019
Summary
Cognitive dissonance, an uncomfortable tension from conflicting beliefs, can impede error recognition and learning in healthcare. Understanding and managing this psychological effect is crucial for improving clinical practice and medical education.
Area of Science:
- Social Psychology
- Clinical Practice
- Medical Education
Background:
- Errors in clinical settings require prompt, non-defensive recognition for corrective action and learning.
- Cognitive dissonance, a psychological construct, creates tension from conflicting beliefs, potentially hindering optimal responses to errors.
Purpose of the Study:
- To describe the effects of cognitive dissonance in clinical settings.
- To discuss circumstances leading to dissonance, its influence on clinical practice, and potential remedies.
- To suggest future research for testing remedies in clinical contexts.
Main Methods:
- Applying social psychology research on cognitive dissonance to clinical settings.
- Examining factors that increase the likelihood of dissonance occurrence.
- Illustrating dissonance with historical and ongoing medical examples.
- Exploring moderators to identify potential remedies for dissonance.
Main Results:
- Cognitive dissonance can significantly distort judgments, delay optimal responses, and hinder learning in clinical environments.
- A model of cognitive dissonance phases is presented, offering strategies for prevention and reduction of distortions.
- Methods to inhibit dissonance-induced escalation of commitment are suggested.
Conclusions:
- Cognitive dissonance, though well-studied in social psychology, has limited influence in medical education research.
- The construct is highly relevant to clinical contexts and medical education, impacting learning, error management, and change acceptance.
- Negative impacts of cognitive dissonance in clinical practice can be mitigated through targeted interventions.
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