The AHRQ PSNet Collection comprises an extensive selection of resources relevant to the patient safety community. These resources come in a variety of formats, including literature, research, tools, and Web sites. Resources are identified using the National Library of Medicine’s Medline database, various news and content aggregators, and the expertise of the AHRQ PSNet editorial and technical teams.
Sibbald M, Abdulla B, Keuhl A, et al. JMIR Hum Factors. 2022;9:e39234.
Electronic differential diagnostic support (EDS) are decision aids that suggest one or more differential diagnoses based on clinical data entered by the clinician. The generated list may prompt the clinician to consider additional diagnoses. This study simulated the use of one EDS, Isabel, in the emergency department to identify barriers and supports to its effectiveness. Four themes emerged. Notably, some physicians thought the EDS-generated differentials could reduce bias while others suggested it could introduce bias.
Brush JE, Sherbino J, Norman GR. BMJ. 2022;376:e064389.
Misdiagnosis of heart failure can lead to serious patient harm. This article reviews the cognitive psychology of diagnostic reasoning in cardiology. Strategies for educators, students, and researchers to reduce cardiovascular misdiagnosis are presented.
Kandasamy S, Vanstone M, Colvin E, et al. J Eval Clin Pract. 2021;27:236-245.
Physicians often experience considerable emotional distress, shame, and self-doubt after being involved in a medical error. Based on in-depth interviews with emergency, internal, and family medicine physicians, this qualitative study explores how physicians experience and learn from preventable medical errors. In addition to exploring themes around the physician’s emotional growth and professional development, the authors discuss the value of sharing and learning from these experiences for colleagues and trainees.
Cook DA, Sherbino J, Durning SJ. JAMA. 2018;319:2267-2268.
This commentary reviews five differences between diagnostic reasoning and patient management reasoning, such as the changing nature of management over time and the team-based nature of the activity. The authors recommend areas of research needed to further understand patient management reasoning.
Norman GR, Monteiro SD, Sherbino J, et al. Acad Med. 2017;92:23-30.
Decision making is typically either intuitive or analytical. This commentary discusses the two types of decision making, how heuristics and cognitive biases affect diagnostic reasoning, and strategies to reduce diagnostic error.
Zwaan L, Monteiro SD, Sherbino J, et al. BMJ Qual Saf. 2016;26.
Providing eight ambiguous clinical vignettes to generalist physician members of the Society to Improve Diagnosis in Medicine, this study found participants did not agree on whether cognitive biases were or were not present. When the outcome of the vignette implied an incorrect diagnosis, respondents reported twice as many biases, suggesting that physician judgments are strongly influenced by hindsight bias.
Monteiro SD, Sherbino J, Patel A, et al. J Gen Intern Med. 2015;30:1270-4.
This medical education study found that self-reflection only minimally improved diagnostic accuracy among medical residents in a simulation setting. These results suggest that a more robust cognitive debiasing curriculum may be needed to enhance diagnostic decision making.
This study used written medical cases to examine whether simulated time pressure or interruptions affect diagnostic accuracy among resident and attending emergency medicine physicians. While the experienced physicians answered the questions more quickly and accurately compared to resident physicians, diagnostic accuracy was not compromised by time pressure or interruptions for either group in this study.
Norman GR, Sherbino J, Dore KL, et al. Acad Med. 2014;89:277-84.
Resident physicians instructed to be "careful, thorough, and reflective" when answering clinical vignette questions took 30% more time with each case but did not have better diagnostic accuracy compared with residents who were told to answer as quickly as possible. These results suggest diagnostic errors are not simply related to insufficient attention or time.