Exploring Knowledge of Cognitive Disposition to Respond in Clinical Decision-Making among Early Clinical Learners.

Introduction: Background: Errors in clinical medicine are a constant occurrence leading to litigations. Cognitive disposition to respond (CDR) was considered the underlying cause of errors in the decision-making process. The rapid thinking system used by early clinical learners leads to cognitive errors. The scenario gets compounded by a limited awareness and lack of exposure to cognitive dispositions to respond (CDRs) in the formal medical graduate curriculum. Variation in the frequency of occurrence in a real-life context, contradictory claims over the influence of clinical expertise, specialty, and methods of teaching about cognitive biases led to this exploratory study among early clinical learners. Methods:In the present research, subjects' recruitment was based on voluntary participation of medical graduates, interns, and residents, who were assigned to equal groups of 30. All study groups were first exposed to six commonly occurring CDRs as role-play-based videos, followed by a case scenario-based exposure to 13 uncommon CDRs in the clinical setting. Participants were then asked to reflect on the experience. Data was analyzed by descriptive and thematic analysis. Results:Among the 19 tested biases, 75.6% of participants identified Hindsight bias. The sunk cost was found out by 34.4% of participants only. Information processing bias was identified more frequently than psychological processing bias. Intergroup variability showed that residents were not identifying biases as frequently as medical graduates and interns. The role play video with reflective writing was voiced as the suitable training method for cognitive bias. Conclusion:The study concludes that medical graduates must be sensitized to CDRs using role-play-based reflection methods.

Citation

N Vinaykumar, T S Gugapriya, S Kalaiselvi. Exploring Knowledge of Cognitive Disposition to Respond in Clinical Decision-Making among Early Clinical Learners. Maedica. 2023 Jun;18(2):317-322

PMID: 37588819

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