Correcting biases in psychiatric diagnostic practice in Northwest Russia: Comparing the impact of a general educational program and a specific diagnostic training program

Rezvyy, Grigory; Parniakov, Alexander; Fedulova, Elena; Olstad, Reidun

doi:10.1186/1472-6920-8-15

Cited by 4 publications

(7 citation statements)

References 15 publications

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“…56 The use of a structured diagnostic system (i.e., International Statistical Classification of Diseases and Related Health Problems-10 codes) was intended to help overcome the cultural biases known to affect diagnostic decision-making in psychiatry. 55 The cognitive forcing training aimed to encourage participants to use analytic, or System 2, thinking during diagnostic reasoning, which means that they would self-monitor after an initial diagnosis and "force" themselves to consider any alternative, nonobvious diagnoses. 56 At the preintervention stage, each training program needed to be designed appropriately in terms of curriculum and pedagogy and participants needed to be given time to attend the training.…”

Section: Resultsmentioning

confidence: 99%

“…All logic models use the generic term “clinician” to denote any healthcare professional or staff member involved in making a diagnosis at any stage in the diagnostic pathway. To generate the logic model shown in Figure 3, we drew on two specific interventions in this error-cause–type combination, a training program in diagnostic coding for psychiatric disorders ( International Statistical Classification of Diseases and Related Health Problems-10 ) trialed in a simulated setting 55 and cognitive forcing strategy training trialed with medical students in a simulated emergency medicine setting 56 . The use of a structured diagnostic system (i.e., International Statistical Classification of Diseases and Related Health Problems-10 codes) was intended to help overcome the cultural biases known to affect diagnostic decision-making in psychiatry 55 .…”

Section: Resultsmentioning

confidence: 99%

“…56 Sherbino et al 56 suggested a number of reasons why their intervention was ineffective, including insufficiently complex cases that did not require System 2 thinking, a lack of transfer of learning to new cases, and an insufficiently strong training program to counter existing cognitive biases. For the intervention found to be effective, 55 it would still be necessary to show longer-term retention and transfer to real-life clinical practice if patient-level outcomes are to be improved.…”

Section: Resultsmentioning

confidence: 99%

“…FIGURE 3. Logic model for errors in diagnostic decision-making caused by cognitive bias and addressed with education and feedback interventions 55,56. …”

mentioning

confidence: 99%

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A Library of Logic Models to Explain How Interventions to Reduce Diagnostic Errors Work

et al. 2018

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Objectives:We aimed to create a library of logic models for interventions to reduce diagnostic error. This library can be used by those developing, implementing, or evaluating an intervention to improve patient care, to understand what needs to happen, and in what order, if the intervention is to be effective. Methods:To create the library, we modified an existing method for generating logic models. The following five ordered activities to include in each model were defined: preintervention; implementation of the intervention; postimplementation, but before the immediate outcome can occur; the immediate outcome (usually behavior change); and postimmediate outcome, but before a reduction in diagnostic errors can occur. We also included reasons for lack of progress through the model. Relevant information was extracted about existing evaluations of interventions to reduce diagnostic error, identified by updating a previous systematic review.Results: Data were synthesized to create logic models for four types of intervention, addressing five causes of diagnostic error in seven stages in the diagnostic pathway. In total, 46 interventions from 43 studies were included and 24 different logic models were generated. Conclusions:We used a novel approach to create a freely available library of logic models. The models highlight the importance of attending to what needs to occur before and after intervention delivery if the intervention is to be effective. Our work provides a useful starting point for intervention developers, helps evaluators identify intermediate outcomes, and provides a method to enable others to generate libraries for interventions targeting other errors.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…FIGURE 3. Logic model for errors in diagnostic decision-making caused by cognitive bias and addressed with education and feedback interventions 55,56. …”

mentioning

confidence: 99%

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A Library of Logic Models to Explain How Interventions to Reduce Diagnostic Errors Work

et al. 2018

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“…In the process of learning, academic performance will rise rapidly at an early stage and slow down, or even become stagnant, in the late stage; this is called the plateau phenomenon in education psychology [24]. The plateau phenomenon is related to multiple factors, one of which is that the difficulty of learning increases gradually [25].…”

Section: Discussionmentioning

confidence: 99%

The effect of a web-based training for improving primary health care providers’ knowledge about diabetes mellitus management in rural China: A pre-post intervention study

et al. 2019

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BackgroundThe performance of primary health care providers regarding DM management is poor in rural China, and effective training methods for providers are urgently needed. This study aimed to evaluate the effect of web-based training for improving knowledge about DM management among primary health care providers in rural China and to further compare the effects of the training effect between primary health care providers with different backgrounds.MethodsA pre-post intervention study was conducted from April to August 2014. In this study, a total of 901 primary health care workers were recruited from six counties in Hubei province. To evaluate the effect of the web-based training, the knowledge achievement of participants was measured with multiple choice questions (MCQ) at baseline, at the end of two weeks of training and at three months after training. A mixed linear model (MLM) was used to measure group differences in the mean scores at baseline and follow-up.ResultsAfter the web-based training, the knowledge scores of the village doctors increased from 73.58 at baseline to 89.98 at posttest and to 84.57 three months after the training. For township health workers, we observed an upward trend in scores from 78.87 at the pre-test to 91.72 at the second test, and at the three months after the training, the scores increased to 94.91. For village doctors, greater knowledge achievement was observed between the scores at baseline and after two weeks of training(adjusted difference: 3.55, P = 0.03) compared to that observed for the township health workers, while decreased their knowledge achievement between baseline and the third-test compared with that of township health workers (adjusted difference: 5.05, P = 0.01).ConclusionsThis study suggested that web-based training was an effective method for improving the knowledge of primary health care providers about management of DM in remote areas. Compared with the effect of the training on village doctors, the training had a poor short-term effect on township health workers but a better long-term effect.

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Diagnostic Errors and the Bedside Clinical Examination

Clark

Derakhshan

Desai

2018

Medical Clinics of North America

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Correcting biases in psychiatric diagnostic practice in Northwest Russia: Comparing the impact of a general educational program and a specific diagnostic training program

Cited by 4 publications

References 15 publications

A Library of Logic Models to Explain How Interventions to Reduce Diagnostic Errors Work

A Library of Logic Models to Explain How Interventions to Reduce Diagnostic Errors Work

The effect of a web-based training for improving primary health care providers’ knowledge about diabetes mellitus management in rural China: A pre-post intervention study

Diagnostic Errors and the Bedside Clinical Examination

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