Exploring Intraoperative Cognitive Biases in Cardiac Surgery Teams

Area of Science:

• Medical Decision Making
• Cognitive Psychology in Medicine
• Surgical Team Performance

Background:

• Intraoperative decision-making in cardiac surgery is complex and high-stakes.
• Cognitive biases can influence clinical reasoning and potentially compromise patient safety.
• Understanding these biases is essential for improving surgical outcomes.

Purpose of the Study:

• To investigate the prevalence and impact of cognitive biases in cardiac surgery teams.
• To identify specific cognitive biases affecting intraoperative decision-making.
• To explore how these biases influence patient safety and outcomes.

Main Methods:

• A mixed-methods approach combining quantitative ratings and qualitative interviews.
• 32 cognitive biases were rated for likelihood of occurrence and potential for patient harm.
• Semi-structured interviews were conducted with surgeons, anesthesiologists, and perfusionists.

Main Results:

• A significant presence of cognitive biases was found, notably confirmation bias and overconfidence.
• Six cognitive biases were rated above the 75th percentile for both likelihood and harm potential.
• These biases were identified as influencing decision-making and posing risks to patients.

Conclusions:

• Cognitive biases are prevalent in cardiac surgery and can negatively impact intraoperative decisions and patient safety.
• Further research is needed to explore the link between biases and surgical outcomes.
• Metacognition strategies, such as debiasing training, warrant investigation for improving performance.