Review

Question 1

Describe the importance of history taking in reaching a diagnosis

Answer 1

We take a history to make a diagnosis, to establish working and trusting relationships, and to reassure the patient.

There are three commonly used methods of reaching a diagnosis: inductive, hypothetico-deductive and pattern recognition. In the inductive method, the trainee is encouraged to take a comprehensive history irrespective of presenting a complaint. It is time consuming.

In the hypothetico-deductive model, there is further questioning and we reach possible diagnostic hypotheses. In the pattern recognition process, a recognition of the pattern of the symptoms can lead to a swift diagnosis.

Question 2

To define cognitive bias

Answer 2

A cognitive bias is a systematic error in thinking that occurs when people are processing and interpreting information in the world around them and affects the decisions and judgments that they make.

Question 3

To list four types of bias that can affect medical care

Answer 3

Availability Bias:
Availability bias or the availability heuristic refers to the human tendency to judge an event by the ease with which examples of the event can be retrieved from your memory or constructed anew. The availability bias happens when we overestimate the likelihood of something happening because a similar event has either recently happened or because we feel very emotional about a previous similar event.

Groupthink:
Groupthink enables non-evidence-based and bad organisational practice to continue and can increase clinical risk.

Search Satisfying Bias:
Ceasing to look for further information or alternative answers when the first plausible solution is found.

Blindspot Bias:
Blindspot Bias is the tendency to see oneself as less biased than other people, or to be able to identify more cognitive biases in others than in oneself.

Question 4

To list 5 ways to reduce the potential for biases in your medical decisions

Answer 4

• Being aware and taught about bias
• Metacognition- being aware to critically think and ‘work-up’ patients
• Slowing down
• Checklists
• Looking at statistics

Question 5

To understand who and what to report in adult and child safeguarding cases

Answer 5

Safeguarding is an important part of being a doctor and a medical student, some patients do not have a voice, if you are worried or concerned share these with a member of the doctor or nursing team immediately.