Journal Article

Hindsight ≠ foresight: the effect of outcome knowledge on judgment under uncertainty.

Fischoff B

This article presents three psychology experiments examining how knowledge of an outcome affects the perception of the past. In the end, subjects suffered from “creeping determinism,” the tendency to perceive reported outcomes as having been relatively inevitable in hindsight. That is, when subjects were informed an outcome had occurred, it biased their hindsight view of events. A commentary extrapolates these findings to medical errors and postulates that we must be aware of our “hindsight bias” in trying to identify the causes of errors, and that we cannot accurately reconstruct the past. The author argues that we should apply a “safety management approach” that integrates past experiences to inform the future and anticipates outcomes and errors.