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MedEdPORTAL. 2017 Oct 23;13:10646. doi: 10.15766/mep_2374-8265.10646.

Cognitive Debiasing Strategies: A Faculty Development Workshop for Clinical Teachers in Emergency Medicine.

Daniel M1,2,3, Carney M4,5,6, Khandelwal S7,8, Merritt C9,10,11, Cole M2,12, Malone M13, Hemphill RR14,15, Peterson W13, Burkhardt J2,3, Hopson L16,2, Santen SA17,18,19.

Author information

1
Assistant Dean of Curriculum, University of Michigan Medical School.
2
Assistant Professor, Department of Emergency Medicine, University of Michigan Medical School.
3
Assistant Professor, Department of Learning Health Sciences, University of Michigan Medical School.
4
Program Director, Pediatric Emergency Medicine Fellowship Program, University of Michigan Medical School.
5
Clinical Assistant Professor, Department of Emergency Medicine, University of Michigan Medical School.
6
Clinical Assistant Professor, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School.
7
Residency Program Director, Department of Emergency Medicine, Ohio State University College of Medicine.
8
Samuel Kiehl III MD Professor in Emergency Medicine, Ohio State University College of Medicine.
9
Residency Program Director, Department of Pediatrics, Alpert Medical School of Brown University.
10
Assistant Professor, Department of Emergency Medicine, Alpert Medical School of Brown University.
11
Assistant Professor, Department of Pediatrics, Alpert Medical School of Brown University.
12
Co-Director, Clinical Reasoning Course, University of Michigan Medical School.
13
Resident Physician, Emergency Medicine Residency Program, University of Michigan Medical School.
14
Chief Patient Safety Officer, Veterans Health Administration.
15
Director, VA National Center for Patient Safety.
16
Residency Program Director, University of Michigan Medical School.
17
Assistant Dean for Educational Research and Quality Improvement, University of Michigan Medical School.
18
Professor, Department of Emergency Medicine, University of Michigan Medical School.
19
Professor, Department of Learning Health Sciences, University of Michigan Medical School.

Abstract

Introduction:

Medical decision-making is a cornerstone of clinical care and a key contributor to diagnostic accuracy. Medical decision-making occurs via two primary pathways: System 1, pattern recognition, is fast, intuitive, and heuristically driven and occurs largely unconsciously. System 2, analytic thinking, is slow, deliberate, and under conscious control. Biases are systematic errors that can impact reasoning via either pathway but predominantly affect decisions made by pattern recognition. Debiasing strategies involve the deliberate switching from pattern recognition to analytic thinking triggered by a stimulus. This resource describes a faculty development workshop designed to train emergency medicine educators about common biases and debiasing strategies, to improve teaching of diagnostic reasoning to trainees.

Methods:

This workshop was implemented at the 2017 Society for Academic Emergency Medicine Annual Meeting. The workshop consisted of a brief didactic, followed by small-group case-based learning. A retrospective survey and qualitative evaluation were administered to attendees.

Results:

The participants' self-assessment showed significant improvements (p < .001) in their abilities to recognize how pattern recognition can lead to bias, identify common types of bias in the emergency department, teach trainees about common types of bias, and apply cognitive debiasing strategies to improve diagnostic reasoning. Strengths of the workshop included the interactive case-based format, discussions of bias-mitigation strategies, and take-home resources. Suggestions for improvement included lengthening the discussion time and providing more cases.

Discussion:

Cognitive biases can negatively impact patient care. Faculty development is needed to improve instruction about bias and debiasing strategies for all levels of trainees.

KEYWORDS:

Clinical Reasoning; Cognitive Debiasing; Dual Processing Theory; Faculty Development

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