重症监护室决策制定在不确定和充满压力的条件下第 2 部分：认知错误、去偏策略和提高批判性思维。

Intensive Care Unit Decision-Making in Uncertain and Stressful Conditions Part 2: Cognitive Errors, Debiasing Strategies, and Enhancing Critical Thinking.

机构信息

Department of Medicine, Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI 53045, USA.

出版信息

Crit Care Clin. 2022 Jan;38(1):89-101. doi: 10.1016/j.ccc.2021.08.003.

DOI:10.1016/j.ccc.2021.08.003

PMID:34794633

Abstract

Diagnostic errors are considered a blind spot of health care delivery and occur in up to 15% of patient cases. Cognitive failures are a leading cause of diagnostic error and often occur as a result of overreliance on system 1 thinking. This narrative review describes why diagnostic errors occur by shedding additional light on systems 1 and 2 forms of thinking, reviews literature on debiasing strategies in medicine, and provides a framework for teaching critical thinking in the intensive care unit as a strategy to promote learner development and minimize cognitive failures.

摘要

诊断错误被认为是医疗服务的一个盲点，在多达 15%的患者病例中都会发生。认知失误是导致诊断错误的主要原因，通常是由于过度依赖系统 1 思维所致。本叙述性评论通过进一步阐明系统 1 和系统 2 思维形式，解释诊断错误发生的原因，回顾医学中去偏倚策略的文献，并提供一个在重症监护病房中教授批判性思维的框架，作为促进学习者发展和最小化认知失误的策略。