This classic article should be on everyone’s reading list.
The Bottom Line: Clinicians engaging in metacognition, that is thinking about our reasoning process, can avoid making some critical errors and falling victim to cognitive biases.
Diagnostic errors are common in clinical medicine and particularly common in situations in which the clinician is faced with a novel circumstance and cannot, therefore easily apply heuristics or rules. There are also certain classic situations in which cognitive errors often occur (e.g., mistaking intracranial injury for intoxication). Through a process of active consideration of one’s diagnostic approach, many errors and cognitive biases (particularly availability bias and anchoring bias) can be avoided.
Take-home message: This article is worth reading in its entirety. Applying these principles can protect both patients and clinicians from the consequences of diagnostic errors.
References
Croskerry, P. Cognitive forcing strategies in clinical decision-making. Ann Emerg Med 2003;41:110-120
