Cognitive interventions to reduce diagnostic error: a narrative review

Graber, Mark L.; Kissam, Stephanie; Payne, Velma L.; Meyer, Ashley N. D.; Sorensen, Asta; Lenfestey, Nancy; Tant, Elizabeth; Henriksen, K; LaBresh, Kenneth A.; Singh, Hardeep

doi:10.1136/bmjqs-2011-000149

Cited by 353 publications

(288 citation statements)

References 158 publications

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“…Contributors to diagnostic error include gaps in provider knowledge or memory (e.g., the ability to recall a similar case), mistakes in judgment, fatigue, poor referral choices, incomplete history-taking, misinterpretation of laboratory tests, and provider overconfidence [36,[38][39][40][41][42]. Cognitive [43] and system-related interventions [44] to reduce the likelihood of diagnostic errors have also been examined.…”

Section: Discussionmentioning

confidence: 99%

Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics

et al. 2014

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Background: An estimated 1.2 million people in the US have an acute myocardial infarction (AMI) each year. An estimated 7% of AMI hospitalizations result in death. Most patients experiencing acute coronary symptoms, such as unstable angina, visit an emergency department (ED). Some patients hospitalized with AMI after a treatand-release ED visit likely represent missed opportunities for correct diagnosis and treatment. The purpose of the present study is to estimate the frequency of missed AMI or its precursors in the ED by examining use of EDs prior to hospitalization for AMI. Methods: We estimated the rate of probable missed diagnoses in EDs in the week before hospitalization for AMI and examined associated factors. We used Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases for 2007 to evaluate missed diagnoses in 111,973 admitted patients aged 18 years and older. Results: We identified missed diagnoses in the ED for 993 of 112,000 patients (0.9% of all AMI admissions). These patients had visited an ED with chest pain or cardiac conditions, were released, and were subsequently admitted for AMI within 7 days. Higher odds of having missed diagnoses were associated with being younger and of Black

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Section: Discussionmentioning

confidence: 99%

Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics

et al. 2014

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“…Reflection is linked to elements that are fundamental to meaningful learning and cognitive development. 13 Reflective practice assures development of Metacognition amongst the students. Metacognition is capacity of the students to improve their ability to think about their thinking; ability to self-evaluate; the capacity for students to judge the quality of their work based on evidence and explicit criteria for doing better work; development of critical thinking, problem-solving, and decision-making; and an enhancement of teacher understanding of the learner.…”

Section: Discussionmentioning

confidence: 99%

Reflective practice as a method of learning in medical education: history and review of literature

Jorwekar

2017

Int J Res Med Sci

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Modern medical education and profession needs innovative methods to improve learning among the students. Reflective practice is one of the time-tested tool to improve students’ learning following a teaching encounter. Reflective practice is an analytical practice in which an individual adds a personal reflection about the action, incident, situation or thought. Purpose of this article is to review the literature to find out history, various models, genesis and application of reflective practice in medical education. Through the present paper, attempt has been made to focus on role of reflective practice in present medical education and profession.

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“…Narrative and systematic reviews have focused on cognitive [40], system [41], and organizational [42] approaches. One review identified 109 strategies that targeted diagnostic error, sorting them into six organizational categories: personnel changes, educational interventions, technique (e.g.…”

Section: Strategies and Interventionsmentioning

confidence: 99%

Challenges and opportunities from the Agency for Healthcare Research and Quality (AHRQ) research summit on improving diagnosis: a proceedings review

et al. 2017

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Background: The Improving Diagnosis in Health Care report from the National Academies of Sciences, Engineering and Medicine (NASEM) provided an opportunity for many groups to reflect on the role they could play in taking actions to improve diagnostic safety. As part of its own process, AHRQ held a research summit in the fall of 2016, inviting members from a diverse collection of organizations, both inside and outside of Government, to share their suggestions regarding what is known about diagnosis and the challenges that need to be addressed. Content: The goals of the summit were to learn from the insights of participants; examine issues associated with definitions of diagnostic error and gaps in the evidence base; explore clinician and patient perspectives; gain a better understanding of data and measurement, health information technology, and organizational factors that impact the diagnostic process; and identify potential future directions for research. Summary and outlook: Plenary sessions focused on the state of the new diagnostic safety discipline followed by breakout sessions on the use of data and measurement, health information technology, and the role of organizational factors. The proceedings review captures many of

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Cognitive interventions to reduce diagnostic error: a narrative review

Cited by 353 publications

References 158 publications

Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics

Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics

Reflective practice as a method of learning in medical education: history and review of literature

Challenges and opportunities from the Agency for Healthcare Research and Quality (AHRQ) research summit on improving diagnosis: a proceedings review

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