Introduction

Question 1

Clinical reasoning types

Answer 1

• probabilistic
• causal
• case-based
• narrative

Question 2

Probabilistic reasoning

Answer 2

assessing likelihood of a clinical hypothesis

Question 3

Causal Reasoning

Answer 3

cause and effect relationships of variables.

Question 4

Case-based Reasoning

Answer 4

based on experience + research literature (script)

Question 5

Narrative

Answer 5

what does the pt tell you?

Question 6

Experts rely on what type of problem solving method?

Answer 6

Intuitive

Question 7

Novice clinicians rely on what type of problem solving method?

Answer 7

Analytical

Question 8

Reducing uncertainty methods

Answer 8

• Bayes theorem + Fagan’s Nomogram
• QUADAS tool
• Elimination strategy
• Confirmation strategy
• Discrimination strategy
• Ockham’s razor
• Hickam’s Dictum

Question 9

Elimination Strategy

Answer 9

Seeking data to reduce suspicion of unlikely hypotheses

Question 10

Confirmation Strategy

Answer 10

Seeking data to support a highly likely hypotheses

Question 11

Discrimination strategy

Answer 11

seeking information to discriminate between likely hypotheses

Question 12

A diagnosis requires…

Answer 12

• Coherency
• Adequacy
• Parsimonous nature

Question 13

No-fault error

Answer 13

errors in which no clinician could have made the diagnosis

Question 14

System Errors

Answer 14

occur due to technical failures or organizational failures

Question 15

Cognitive errors

Answer 15

subconscious errors in our thinking processes

Question 16

Aggregate Bias

Answer 16

belief that aggregated data (CPGs) don’t apply to your pt population

Question 17

Anchoring

Answer 17

lock into salient features in pt’s initial presentation too early in diagnostic process.

Question 18

Commission Bias

Answer 18

belief that pt requires intervention to heal

Question 19

Omission Bias

Answer 19

Belief that no intervention is more beneficial

Question 20

Confirmation bias

Answer 20

tendency to look for confirming evidence to support a diagnosis

Question 21

Outcome bias

Answer 21

opt for diagnosis with better prognosis

Question 22

Overconfidence Bias

Answer 22

a universal tendency to believe we know more than we do.

Question 23

Premature closure

Answer 23

tendency to apply premature closure to decision making process once diagnosis is verified

Question 24

Search satisfying

Answer 24

universal tendency to stop search once diagnosis is found.

Question 25

Emotional-based practice

Answer 25

Clinician elects to use a test/intervention despite evidence to the contrary

Question 26

Base-Rate Neglect

Answer 26

tendency to ignore the true prevalence of a disease

Question 27

Playing the Odds

Answer 27

tendency to opt for benign diagnosis on the basis that it is significantly more likely than a serious one.

Question 28

Faulty Causation

Answer 28

falsely assumes that one event causes another.

Question 29

Ascertainment bias

Answer 29

physician’s thinking is shaped by prior expectation (stereotyping/gender)

Question 30

Availability Bias

Answer 30

belief that something is more likely if it readily comes to mind.

Question 31

Representativeness Restraint

Answer 31

diagnostician looks for prototypical manifestations of disease: ‘‘If it looks like a duck, walks like a duck, quacks like a duck, then it is a duck.’ and restraints decision-making

Question 32

Metacognition

Answer 32

the ability to detect inconsistencies or links between the data gathered, the experience and a critique of reasoning processes.

Question 33

What allows a therapist to have decreased reliance on their memory when treating a patient?

Answer 33

CPGs
Clinical algorithms
Established test item clusters

Question 34

Cognitive forcing strategies

Answer 34

strategies to avoid bias with targeted or general strategies

Question 35

What assumptions are made with cognitive forcing strategies?

Answer 35

• Clinicans are able to become aware of their CDRs
• Cognitive biases can be avoided with effort.