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Development of a test of cognitive bias in medical decision making

P J Hershberger1, H M Part, R J Markert

  • 1Department of Veterans Affairs Medical Center (DVAMC), Dayton, OH 45428.

Academic Medicine : Journal of the Association of American Medical Colleges
|October 1, 1994
PubMed

Insights

Cognitive biases significantly impact medical decision-making, with both students and faculty making statistically incorrect choices in over half of scenarios. The Inventory of Cognitive Biases in Medicine (ICBM) can help identify and address these biases.

Area of Science:

  • Medical Education
  • Cognitive Psychology
  • Clinical Decision-Making

Background:

  • Cognitive biases are systematic errors in thinking that can influence professional judgment.
  • Understanding the impact of these biases is crucial for improving medical decision-making and patient outcomes.

Purpose of the Study:

  • To develop and validate the Inventory of Cognitive Biases in Medicine (ICBM), a tool designed to measure the influence of cognitive biases on medical decisions.
  • To assess the performance of medical students, residents, and faculty on tasks prone to cognitive biases.

Main Methods:

  • The Inventory of Cognitive Biases in Medicine (ICBM) was developed, featuring 22 medical scenarios with bias-prone and statistically based decision alternatives.
  • The ICBM was administered to 102 medical students and residents and 318 physician faculty at Wright State University School of Medicine between 1992 and 1993.

Main Results:

  • Statistically correct decisions were made in less than half of the ICBM scenarios for both students/residents (41%) and faculty (49%).
  • Faculty performance was significantly better than chance, and the ICBM demonstrated acceptable reliability (KR 20 = .62 for faculty) and item discrimination (mean = .49).
  • Evidence suggests the ICBM possesses both content and construct validity.

Conclusions:

  • Poor performance on the ICBM by medical trainees and faculty highlights the significant detraction of cognitive biases from logical and statistical reasoning in medicine.
  • The ICBM shows potential as a valuable tool for both educational interventions and research aimed at minimizing and understanding cognitive biases in healthcare professionals.
Abstract

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