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Dropping the baton: Cognitive biases in emergency physicians
Mingwei Ng1, Evelyn Wong1, Guek Gwee Sim2
1Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore.
Plos One
|January 2, 2025
Summary
Sociocultural pressures and team cognition issues cause cognitive biases and medical errors in emergency physicians. Addressing these team-based factors is crucial for improving patient safety across all medical specialties.
Area of Science:
- Clinical Medicine
- Cognitive Psychology
- Healthcare Management
Background:
- Healthcare complexity necessitates team-based approaches.
- Distributed cognition highlights the importance of out-in-the-world context for understanding errors.
- Limited qualitative research exists on team-based cognitive biases in clinical settings.
Purpose of the Study:
- To explore how sociocultural influences and team cognition impact cognitive biases and errors in emergency physicians (EPs).
Main Methods:
- Constructivist paradigm and reflexive thematic analysis.
- Seven focus group discussions with 25 purposively sampled EPs.
- Qualitative methodological guidance from academics.
Main Results:
- Sociocultural pressures compel EPs to blindly trust colleagues.
- Cultural norms encourage EPs to oversimplify cases during handovers.
- Pressure to conform to conventional wisdom and protocols hinders challenging specialists.
Conclusions:
- Lapses in distributed team cognition contribute to cognitive biases and clinical errors.
- Findings are relevant across all medical specialties, not just emergency medicine.
- The hyperacute nature of emergency medicine amplifies these team-based cognitive challenges.
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