Cognitive Debiasing Strategies: A Faculty Development Workshop for Clinical Teachers in Emergency Medicine.
Michelle Daniel, Michele Carney, Sorabh Khandelwal, Chris Merritt, Michael Cole, Matthew Malone, Robin R Hemphill, Will Peterson, John Burkhardt, Laura Hopson, Sally A Santen
Author Information
Michelle Daniel: Assistant Dean of Curriculum, University of Michigan Medical School. ORCID
Michele Carney: Program Director, Pediatric Emergency Medicine Fellowship Program, University of Michigan Medical School.
Sorabh Khandelwal: Residency Program Director, Department of Emergency Medicine, Ohio State University College of Medicine.
Chris Merritt: Residency Program Director, Department of Pediatrics, Alpert Medical School of Brown University.
Michael Cole: Assistant Professor, Department of Emergency Medicine, University of Michigan Medical School.
Matthew Malone: Resident Physician, Emergency Medicine Residency Program, University of Michigan Medical School.
Robin R Hemphill: Chief Patient Safety Officer, Veterans Health Administration.
Will Peterson: Resident Physician, Emergency Medicine Residency Program, University of Michigan Medical School.
John Burkhardt: Assistant Professor, Department of Emergency Medicine, University of Michigan Medical School.
Laura Hopson: Residency Program Director, University of Michigan Medical School.
Sally A Santen: Assistant Dean for Educational Research and Quality Improvement, University of Michigan Medical School.
Introduction: Medical decision-making is a cornerstone of clinical care and a key contributor to diagnostic accuracy. Medical decision-making occurs via two primary pathways: System 1, pattern recognition, is fast, intuitive, and heuristically driven and occurs largely unconsciously. System 2, analytic thinking, is slow, deliberate, and under conscious control. Biases are systematic errors that can impact reasoning via either pathway but predominantly affect decisions made by pattern recognition. Debiasing strategies involve the deliberate switching from pattern recognition to analytic thinking triggered by a stimulus. This resource describes a faculty development workshop designed to train emergency medicine educators about common biases and debiasing strategies, to improve teaching of diagnostic reasoning to trainees. Methods: This workshop was implemented at the 2017 Society for Academic Emergency Medicine Annual Meeting. The workshop consisted of a brief didactic, followed by small-group case-based learning. A retrospective survey and qualitative evaluation were administered to attendees. Results: The participants' self-assessment showed significant improvements ( < .001) in their abilities to recognize how pattern recognition can lead to bias, identify common types of bias in the emergency department, teach trainees about common types of bias, and apply cognitive debiasing strategies to improve diagnostic reasoning. Strengths of the workshop included the interactive case-based format, discussions of bias-mitigation strategies, and take-home resources. Suggestions for improvement included lengthening the discussion time and providing more cases. Discussion: Cognitive biases can negatively impact patient care. Faculty development is needed to improve instruction about bias and debiasing strategies for all levels of trainees.
