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Cognitive biases in Mohs micrographic surgery.

Faisal Dubash1, Andrew Affleck1, Marese O'Reilly1

  • 1Department of Dermatology Ninewells Hospital and Medical School Dundee UK.

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|December 3, 2024
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Summary

Cognitive biases can influence Mohs micrographic surgery (MMS) decision-making. Awareness and mitigation strategies for these biases can enhance surgeon performance and reduce clinical errors.

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Area of Science:

  • Dermatology
  • Cognitive Psychology
  • Surgical Education

Background:

  • Mohs micrographic surgery (MMS) relies on precise decision-making.
  • Surgeon fallibility in MMS can lead to clinical errors.
  • The role of cognitive biases in MMS errors is understudied.

Purpose of the Study:

  • To explore the influence of cognitive biases on heuristic decision-making in MMS.
  • To identify specific cognitive biases affecting pre-operative, intraoperative, and reconstruction phases.
  • To propose strategies for mitigating cognitive biases in Mohs surgeons.

Main Methods:

  • Literature review of established cognitive biases.
  • Application of bias concepts to MMS decision-making stages.
  • Analysis of potential impact on clinical judgment and errors.

Main Results:

  • Cognitive biases are relevant to heuristic decision-making in MMS.
  • Biases can contribute to errors in clinical judgment during MMS.
  • Metacognitive strategies can help mitigate bias.

Conclusions:

  • Mohs surgeons should be aware of cognitive biases.
  • Implementing bias mitigation strategies can enhance surgical performance.
  • Reframing errors as learning opportunities promotes metacognition.