Medical Decision Making Flashcards

1
Q

What are the 2 approaches to human error?

A

Person Approach

Systemic Approach

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2
Q

What is the person approach to human error?

A
  • health professional responsible

- active errors include forgetfulness/negligence/poor motivation/carelessness/inattention

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3
Q

What are the weaknesses of person approach to human error?

A
  • prevents analysis of what went wrong
  • failure to recognise patterns of mistakes
  • suggests mistakes only made by bad doctors
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4
Q

What is the systemic approach of human error?

A
  • assumes mistakes are inevitable because humans are fallible
  • errors are consequences rather than causes
  • best prevention in a system defending against human error
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5
Q

How may errors be consequences rather than causes?

A
  • unworkable procedures
  • inadequate equipment
  • fatigue
  • understaffing
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6
Q

What is heuristics?

A

cognitive shortcuts/decisional shortcuts

  • educated guess, common sense, rule of thumb
  • can lead to cognitive biases
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7
Q

What are cognitive biases?

A

Systemic and predictable errors in judgement due to reliance on heuristics

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8
Q

What are some examples of cognitive biases?

A
  • availability (readily comes to mind = seems more likely, dramatic, recently seen)
  • representativeness (seems more likely as typical characteristics present)
  • anchoring (first impression)
  • diagnosis momentum (labels attached to patients so hard to go back and chane)
  • fundamental attribution error (blaming people for illness rather than circumstances)
  • commissioning bias (tendency to act rather than inact, perhaps unnecessarily)
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9
Q

What is the difference between informed decision making and shared decision making?

A

Informed = responsibility lies with patient, patient decides on treatment, doctor just provides

Shared = both doctor and patient involved, doctor gives expert opinion, decide on treatment together

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10
Q

What is the inductive clinical reasoning model?

A

Inductive clinical reasoning:

  • for novices
  • collection information from history and exam -> problem solving steps -> diagnosis
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11
Q

What is the hypothetico-deductive model?

A
  • collect information from history and examination
  • generate hypothesis
  • analyse information to confirm or refute hypothesis
  • diagnose
  • for experts
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12
Q

What are the 2 systems to making decisions?

A
  • pattern recognition/quick/intuitive/based on experience
    vs.
  • heuristics
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