Training Induces Cognitive Bias

Park, Christine; Stojiljković, Ljuba; Miličić, Biljana; Lin, Bingyi; Dror, Itiel E.

doi:10.1097/sih.0b013e3182a90304

Cited by 17 publications

(3 citation statements)

References 38 publications

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“…Studies have shown that residents tend to exhibit training induced cognitive bias, implying they will preferentially choose a technique on which they received formal instruction. [25] As there is currently no standard way that we teach OOOR airway management, our findings were not surprising. Our study also showed that residents who felt they were more familiar with the content of the DAA, did not actually perform better than those who felt they were less familiar.…”

Section: Discussionmentioning

confidence: 72%

“…[17, 25, 26] The scenario described a situation wherein the resident had just transferred a post-operative patient to the trauma-burn intensive care unit (ICU), and was now being asked by an ICU nurse to evaluate a different patient in the unit. The patient was described as a 25 year old male who was involved in a motorcycle accident earlier that day.…”

Section: Methodsmentioning

confidence: 99%

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Assessing anesthesiology residents’ out-of-the-operating-room (OOOR) emergent airway management

et al. 2017

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BackgroundAt many academic institutions, anesthesiology residents are responsible for managing emergent intubations outside of the operating room (OOOR), with complications estimated to be as high as 39%. In order to create an OOOR training curriculum, we evaluated residents’ familiarity with the content and correct adherence to the American Society of Anesthesiologists’ Difficult Airway Algorithm (ASA DAA).MethodsResidents completed a pre-simulation multiple-choice survey measuring their understanding and use of the DAA. Residents then managed an emergent, difficult OOOR intubation in the simulation center, where two trained reviewers assessed performance using checklists. Post-simulation, the residents completed a survey rating their behaviors during the simulation. The primary outcome was comprehension and adherence to the DAA as assessed by survey responses and behavior in the simulation.ResultsSixty-three residents completed both surveys and the simulation. Post-survey responses indicated a shift toward decreased self-perceived familiarity with the DAA content compared to pre-survey responses. During the simulation, 22 (35%) residents were unsuccessful with intubation. Of these, 46% placed an LMA and 46% prepared for cricothyroidotomy. Nineteen residents did not attempt intubation. Of these, only 31% considered LMA placement, and 26% initiated cricothyroidotomy.ConclusionsMany anesthesiology residency training programs permit resident autonomy in managing emergent intubations OOOR. Residents self-reported familiarity with the content of and adherence to the DAA was higher than that observed during the simulation. Curriculum focused on comprehension of the DAA, as well as improving communication with higher-level physicians and specialists, may improve outcomes during OOORs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-017-0387-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 72%

Section: Methodsmentioning

confidence: 99%

Assessing anesthesiology residents’ out-of-the-operating-room (OOOR) emergent airway management

et al. 2017

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“…9 Prior works demonstrated the value of both low-and high-fidelity exercises as mediums for exploring and reproducing cognitive biases. 10,11 Within MedEdPORTAL there was a paucity of simulation experiences that dealt directly with cognitive biases, with a small number oriented specifically towards emergency medicine (EM) trainees. [12][13][14][15][16] This represented a clear deficit in educational resources given the aforementioned interest in metacognitive skills in recent decades.…”

Section: Citationmentioning

confidence: 99%

Occult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents

Weil

Cassara

2020

MedEdPORTAL

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Introduction: There is a paucity of simulation literature and curricula addressing cognitive bias and the skills necessary to overcome this common source of clinical error. We designed a scenario for emergency medicine (EM) residents with the intent to trigger an anchoring bias as a nidus for conversation about metacognition. Methods: We implemented this case for teams of two to three PGYs 1-5, including both EM and EM/internal medicine residents within a longitudinal simulation curriculum. The case was designed to simulate a major trauma wherein evaluation according to standard advanced trauma life support principles failed to identify a traumatic injury to explain the patient's hemodynamic instability. Residents had to reorient their thought process towards other etiologies of shock, ultimately identifying sepsis as the driving force behind the trauma. The scenario ran over 10-15 minutes followed by a 30-minute debrief. Case satisfaction and the success of various learning objectives were assessed via a postsimulation survey. Results: Forty-four EM and combined EM/IM residents ranging from PGY 1-5 participated in the simulation over a 5-week period. Nearly 82% of respondents expressed an overall satisfaction with the case. About 76% felt the case succeeded in contributing to their understanding of cognitive biases. Discussion: The implementation of misdirection in this simulation was an effective means by which to engage learners in education about cognitive biases.

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