Cognitive Underpinnings of Diagnostic Error

Gordon, Ruthanna; Franklin, Nancy

doi:10.1097/00001888-200308000-00005

Cited by 13 publications

(7 citation statements)

References 5 publications

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“…The information‐procession model is rooted in medical decision making (Joseph & Patel 1990). This model uses a scientific or hypothetico‐deductive approach to assist metacongitive reasoning that is essential to medical diagnosis (Graber 2003, Gordon & Franklin 2003). Nurses adopted this hypothetico‐deductive approach to assist clinical decision making using decision trees to assess potential outcomes numerically.…”

Section: The Information‐processing Modelmentioning

confidence: 99%

A review of clinical decision making: models and current research

Banning

2007

Journal of Clinical Nursing

212

225

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This version is available at:Access to and use of the material held within the Brunel University Research Archives, is based on your acceptance of the BURA End User Licence Agreement (EULA) Relevance to clinical practice: It is proposed that clinical decision-making improves as the nurse gains experience of nursing patients within a specific speciality and with experience, nurses gain a sense of saliency in relation to decision making.BanningExperienced nurses may use all three forms of clinical decision making both independently and concurrently to solve nursing-related problems. It is suggested that O.Neill's clinical decision making model could be tested by educators and experienced nurses to assess the efficacy of this hybrid approach to decision-making.

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Section: The Information‐processing Modelmentioning

confidence: 99%

A review of clinical decision making: models and current research

Banning

2007

Journal of Clinical Nursing

212

225

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“…This is because there is a large body of research demonstrating that stimulus familiarity and domain-specific knowledge acquired through extensive and deliberate practice underlie the superior performance of experts relative to their less skilled counterparts (for a review see Ericsson and Charness, 1994 ). However, experts are not immune to the negative impact of prior experience and stimulus familiarity as demonstrated in studies of expertise in medicine ( de Graaff, 1989 ; Croskerry, 2003 ; Gordon and Franklin, 2003 ) and chess ( Saariluoma, 1992 ; Reingold et al, 2001b ; Bilalić et al, 2008a , b , 2010 ; Sheridan and Reingold, 2013 ; Bilalić and McLeod, 2014 ). For example, Bilalić et al (2008a) employed eye movement monitoring to study the Einstellung effect in chess experts.…”

Section: Introductionmentioning

confidence: 99%

The Einstellung effect in anagram problem solving: evidence from eye movements

Ellis

Reingold

2014

Front. Psychol.

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The Einstellung effect is the counterintuitive finding that prior experience or domain-specific knowledge can under some circumstances interfere with problem solving performance. This effect has been demonstrated in several domains of expertise including medicine and chess. In the present study we explored this effect in the context of a simplified anagram problem solving task. Participants solved anagram problems while their eye movements were monitored. Each problem consisted of six letters: a central three-letter string whose letters were part of the solution word, and three additional individual letters. Participants were informed that one of the individual letters was a distractor letter and were asked to find a five-letter solution word. In order to examine the impact of stimulus familiarity on problem solving performance and eye movements, the central letter string was presented either as a familiar three-letter word, or the letters were rearranged to form a three-letter nonword. Replicating the classic Einstellung effect, overall performance was better for nonword than word trials. However, participants’ eye movements revealed a more complex pattern of both interference and facilitation as a function of the familiarity of the central letter string. Specifically, word trials resulted in shorter viewing times on the central letter string and longer viewing times on the individual letters than nonword trials. These findings suggest that while participants were better able to encode and maintain the meaningful word stimuli in working memory, they found it more challenging to integrate the individual letters into the central letter string when it was presented as a word.

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“…Although a resident may learn diagnostic criteria, a vast array of other information is transmitted, intentionally or unintentionally, including the following: that we possess much medical knowledge; that our dogmatic views are not entirely shared by many other equally dogmatic attending pathologists; how we deal with ignorance and uncertainty; how we deal with errors [8][9][10]; how we communicate with colleagues, secretaries, and students; and much about our behavior and attitudes (ie, most of the Accreditation Commission for Graduate Medical Education core competencies relating to interpersonal skills, communication, and professionalism). It is likely that most of the communication at a sign-out is nonverbal, and often, it is subconscious.…”

Section: What Does a Resident Actually Learn From Us At Sign-out?mentioning

confidence: 99%