Social psychology and Clinical decision making

Question 1

Define conformity

Answer 1

Adjustment of individual behaviours, attitudes and beliefs to a group standard

Question 2

What factors influence conformity

Answer 2

Group size : Conforming increase with group size, but this stops at 5 members and doesn’t increase past this
Presence of dissenter : One person disagreeing will decrease conforming
Culture : Increase in collectivistic cultures

Question 3

Describe a key study on conformity

Answer 3

Asch conformity experiment
A test of line length is given to the group with one being a test subject and the rest being part of the experimental team, when the experimental team said a wrong answer the test subject went along with what they were saying even though they could see that the group was wrong

Question 4

Define obedience

Answer 4

Compliance with commands given by an authority figure

Question 5

What are the influencing factors of obedience

Answer 5

Remoteness of the victim
Closeness/legitimacy of the authority figure
Diffusion of responsibility : obedience increases when someone else takes the blame

Question 6

Describe the Milgram obedience study

Answer 6

One learner and one teacher
An actor is placed in a fake electric chair and asked memory questions
The participant is asked to administer electric shocks whenever they get a question wrongs with increasingly worse shocks
They were told to perform the shocks in different ways first “you can shock them” proceeding up to “Shock them or you’ll die”
Even at lethal doses/when the actor appeared unconscious or dead they kept going

Question 7

Define social loafing

Answer 7

Social loafing is a tendency for people to expend less individual effort when part of a team than when alone

Question 8

What are the influencing factors of social loafing

Answer 8

More likely to occur if:
- Person thinks they’re not being monitored
- Task/group has less meaning for the person
- The person isn’t very motivated
- The person expects that they will be carried by the other members
Depends on:
- Gender: Occurs more in all-male groups
- Culture: Occurs more in individualistic cultures
Disappears when:
- Individual performance is monitored
- Members value their goal a lot

Question 9

Define groupthink

Answer 9

The tendency for a group to not think critically because they are trying to reach a decision

Question 10

What are the influencing factors of group think

Answer 10

Most likely to occur when a group:

• Is under stress to reach a decision
• Is isolated from outside input
• Has a directive leader
• Has a lot of cohesiveness

Question 11

Define group polarisation

Answer 11

The tendency for people to make decisions that are extreme just because they’re in a group

Question 12

What are the steps to the process of the bystander effect

Answer 12

Notice event
Decide if it’s an emergency (Social comparison to see how others react)
Assume responsibility to intervene OR diffuse responsibility
Self-efficacy to deal with situation (so lack thereof = less likely to help)
Decision to help (occurs based on a cost-benefit analysis)

Question 13

How do you overcome the bystander effect

Answer 13

Reduce restraints on helping
- Reduce ambiguity and increase responsibility
- Enhance guilt and concern for self image
Social altruism:
- Teaching moral inclusion
- Modelling helpful behaviour
- Attributing helpful behaviours to altruistic motive

Question 14

What are the 3 styles of leadership and what are the advantages and disadvantages

Answer 14

Autocratic - All decision making is done by one person
- Pros : Enables quick decision making and a clear hierarchy of responsibilty
- Cons : Can be demotivating and lead to errors
Democratic - Favours group decision making, with leader instructing after consulting the group
- Pros : Can win cooperation and motivate team and can improve quality of decision making
- Cons : Time-consuming and can lead to disagreements
Laissez-Faire - “Free-reign” style where a leader doesn’t lead but allows others to make decisions
- Pros : Allows autonomous working and allows expertise to be utilised
Cons : Can lead to lack of direction and lack of ultimate responsibility holder

Question 15

What is conformity bias

Answer 15

The tendency to search for, interpret and recall info in a way that confirms pre-existing beliefs often leading to errors

Question 16

What is the sunk cost fallacy

Answer 16

The more you have invested in something (time, money, etc) the more you want to prove it and the harder it is to abandon

Question 17

What is representativeness heuristics

Answer 17

Putting someone/thing in a category that fits the prototype we have in our head of what it should be like and ignore facts that contradict this
Clinically this can result in neglect and error in diagnosis

Question 18

What is availability heuristics

Answer 18

Probabilities are estimated on the basis of how easily we can recall cases
e.g. if you’ve just seen a rare disease you’re more likely to look for it again in a similar presentation

Question 19

What are the strategies for improving clinical decision making

Answer 19

Education and training :
- Integrate teaching about cognitive error and diagnostic error into med school curriculum
- Recognise heuristics and biases may affect our judgement even though we may not be conscious of them
Feedback :
- Increase number of autopsies
- Conduct regular and systemic audits
- Follow up patients
Accountability :
- Establish clear accountability and follow-up for decisions made
Generating alternatives :
- Establish forced consideration of alternative possibilities (e.g. differential diagnoses)
Consultation :
- Seek second opinions, use algorithms (provides best answer based on evidence) and clinical decision-making support systems