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探索改善整脊诊所临床决策的策略:病例系列

Exploring strategies to improve clinical decision making in a chiropractic office: a case series.

作者信息

Plener Joshua, Assimakopoulos Demetry, Chung Chadwick, Hains François, Mior Silvano

机构信息

Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON.

Department of Medicine, Mount Sinai Hospital, Toronto, ON.

出版信息

J Can Chiropr Assoc. 2024 Aug;68(2):113-121.

Abstract

BACKGROUND

Clinicians make clinical decisions using the dual process theory. The dual process theory comprises two approaches, System 1, based on heuristics, and System 2, involving an analytical and effortful thought process. However, there are inherent limitations to the dual process theory, such as relying on inaccurate memory or misinterpreting cues leading to inappropriate clinical management. As a result, clinicians may utilize mental shortcuts, termed heuristics, and be susceptible to clinical errors and biases that may lead to flawed decision making and diagnosis.

METHODS

This case series describes four clinical cases whereby the clinicians use distinct strategies to assess and manage complex clinical presentations.

DISCUSSION

Through the use of self-reflection and acknowledging diagnostic uncertainty, the clinicians were able to reduce common cognitive biases and provide effective and timely patient care. We discuss strategies that clinicians can implement in their daily practice to improve clinical decision-making processes and deliver quality care.

摘要

背景

临床医生运用双加工理论做出临床决策。双加工理论包含两种方式,即基于启发式的系统1和涉及分析性及费力思维过程的系统2。然而,双加工理论存在固有局限性,比如依赖不准确的记忆或错误解读线索,从而导致不恰当的临床管理。因此,临床医生可能会采用被称为启发式的心理捷径,并且容易出现临床错误和偏差,这可能导致有缺陷的决策和诊断。

方法

本病例系列描述了四个临床案例,其中临床医生使用不同策略来评估和处理复杂的临床表现。

讨论

通过自我反思和承认诊断的不确定性,临床医生能够减少常见的认知偏差,并提供有效且及时的患者护理。我们讨论了临床医生在日常实践中可以实施的策略,以改善临床决策过程并提供高质量护理。

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