psychology Flashcards
clinical reasoning and decision making: define common errors in decision making and how the use of heuristics can lead to clinical errors; recall ways to improve clinical decision making
define medical error
failure of a planned action to
be completed as intended (i.e., error of execution) or the
use of a wrong plan to achieve an aim (i.e. error of
planning)
4 main causes of medical errors in order of prevalence
both system-related and cognitive errors > cognitive error only > system-related only > no-fault factors only
what are heuristics
combination of intuitive understanding of probabilities and cognitive processes, often referred to as rules of thumb, educated guesses, or mental shortcuts
what do heuristics involve and rely on
involve pattern recognition and rely on a subconscious integration of patient data
with prior experience
2 systems for decision making
hot (emotional) and cold (cognitive)
define confirmatory bias
tendency to search for or seek, interpret, and recall information in a way that confirms one’s preexisting beliefs or hypotheses, often
leading to errors (using cognitive thinking to justify emotional response, partially explaining overconfidence)
what are sunk costs
any costs that have been spent on a project that are
irretrievable, such as money spent on expensive drugs used to treat a patient with a rare disease
what is the sunk cost fallacy
where future cost/benefit ratio is not the only factor affecting future action, as often the more one has invested in the past, the more they are prepared to invest in a
problem in the future
what is anchoring
poor ability at adjusting estimates from a given starting point (probabilities and values), with adjustments crude and imprecise e.g. dismissing or excusing conflicting data compared to initial diagnosis
examples of probability judgements
two or more competing
diagnoses, alternative treatments which may be effective
what is the representativeness heuristic
subjective probability that a stimulus belongs to a particular class based on how ‘typical’ of that class it appears to be (regardless of base rate probability), resulting in neglect of relevant base rates and other errors e.g. older women feeling well now but had symptoms of heart attack excluding chest pain, and saying it doesn't match typical profile but being unwise to dismiss possibility as MI common among women of that age with variable presentations
what are conditional probabilities
probability of one event occurring with some relationship to one or more other events e.g. false negatives and positives
how does aversion to loss influence framing
gain-framing more powerful than loss-framing (e.g. when describing surgical options)
what is the availability heuristic
how easily and/or vividly they can be called to mind (overestimate the frequency
of occurrence of catastrophic, dramatic events) e.g, rare case seen in unlikely patient, so now screen all similar patients even though remains very unlikely
5 ways decision making can be improved
education and training, feedback, accountability, generating alternatives, consultation
