Cognitive disposition to respond amongst junior doctors
Several patients die each year as a result of human errors, which predominantly involve cognitive factors.
These involve faulty thought processes and subconscious biases [cognitive disposition to respond (CDR)] and have been shown to contribute to patient injury by means of missed/wrong diagnoses and treatment.
There is currently no data around occurrence of various different types of CDRs amongst junior doctors, how they are associated with good and bad outcomes and how junior doctors can be taught to mitigate the harmful effects of these CDRs.
The project aimed to address some of these questions. As a first step, we reviewed the video recordings of over 70 simulation sessions, wherein the junior doctors were involved in management of acutely sick patients in a high fidelity simulation lab.
The project then progressed to a prospective study of junior doctors' management of acutely sick patients in a simulated environment with detailed assessment of CDRs, and associated factors such as cognitive load.
Simultaneously, a literature review was conducted on various theories of clinical judgment and decision-making, exploring the various ways in which an intervention could be designed in order to help doctors recognize and mitigate the harmful effects of these CDRs.