Croskerry P, Nimmo G R
Department of Emergency Medicine and Division of Medical Education, Faculty of Medicine, Dalhousie University, QE II-Health Sciences Centre, Halifax Infirmary, 1796 Summer Street, Halifax, Nova Scotia, Canada.
J R Coll Physicians Edinb. 2011 Jun;41(2):155-62. doi: 10.4997/JRCPE.2011.208.
A major amount of our time working in clinical practice involves thinking and decision making. Perhaps it is because decision making is such a commonplace activity that it is assumed we can all make effective decisions. However, this is not the case and the example of diagnostic error supports this assertion. Until quite recently there has been a general nihilism about the ability to change the way that we think, but it is now becoming accepted that if we can think about, and understand, our thinking processes we can improve our decision making, including diagnosis. In this paper we review the dual process model of decision making and highlight ways in which decision making can be improved through the application of this model to our day-to-day practice and by the adoption of de-biasing strategies and critical thinking.
我们在临床实践中花费的大量时间都涉及思考和决策。也许正是因为决策是如此平常的活动，所以人们认为我们都能做出有效的决策。然而，情况并非如此，诊断错误的例子就支持了这一观点。直到最近，人们对改变思维方式的能力普遍持虚无主义态度，但现在人们逐渐接受，如果我们能够思考并理解自己的思维过程，就可以改善包括诊断在内的决策。在本文中，我们回顾了决策的双过程模型，并强调了通过将该模型应用于日常实践以及采用去偏策略和批判性思维来改善决策的方法。
