Exploring the role of salient distracting clinical features in the emergence of diagnostic errors and the mechanisms through which reflection counteracts mistakes.

Silvia Mamede; Ted A W Splinter; Tamara Van Gog; Remy M J P Rikers; Henk G. Schmidt

Study

Exploring the role of salient distracting clinical features in the emergence of diagnostic errors and the mechanisms through which reflection counteracts mistakes.

March 21, 2012

Mamede S, Splinter TAW, Van Gog T, et al. BMJ Qual Saf. 2012;21(4):295-300.

View more articles from the same authors.

This study described the role of reflection in preventing physicians from being overly influenced by salient clinical features that may misdirect diagnostic reasoning. The authors advocate for deliberate reflection as a tool to prevent diagnostic errors.

PubMed citation

Available at

Related Resources From the Same Author(s)

Exposure to media information about a disease can cause doctors to misdiagnose similar-looking clinical cases.

March 12, 2014

Diagnostic errors and reflective practice in medicine.

March 21, 2007

Effect of availability bias and reflective reasoning on diagnostic accuracy among internal medicine residents.

October 6, 2010

Why do doctors make mistakes? A study of the role of salient distracting clinical features.

December 11, 2013

Improving diagnostic decision support through deliberate reflection: a proposal.

November 9, 2022

Improving medical residents’ self-assessment of their diagnostic accuracy: does feedback help?

February 2, 2022

Improving handoff by deliberate cognitive processing: results from a randomized controlled experimental study.

April 28, 2021

Do patients' disruptive behaviours influence the accuracy of a doctor's diagnosis? A randomised experiment.

March 23, 2016

The causes of errors in clinical reasoning: cognitive biases, knowledge deficits, and dual process thinking.

November 16, 2016

Factors underlying suboptimal diagnostic performance in physicians under time pressure.

January 16, 2019

Think twice: effects on diagnostic accuracy of returning to the case to reflect upon the initial diagnosis.

September 23, 2020

Does time pressure have a negative effect on diagnostic accuracy?

March 2, 2016

Cognitive diagnostic error in internal medicine.

April 24, 2013

'Immunising' physicians against availability bias in diagnostic reasoning: a randomised controlled experiment.

March 18, 2020

Do malpractice claim clinical case vignettes enhance diagnostic accuracy and acceptance in clinical reasoning education during GP training?

September 20, 2023

Identifying and prioritizing educational content from a malpractice claims database for clinical reasoning education in the vocational training of general practitioners.

October 4, 2023

Cognitive debiasing; part 1 and part 2.

September 18, 2013

Effect on diagnostic accuracy of cognitive reasoning tools for the workplace setting: systematic review and meta-analysis.

September 14, 2022

Impact of diagnostic checklists on the interpretation of normal and abnormal electrocardiograms.

May 31, 2023

Adverse events associated with sedatives, analgesics, and other drugs that provide patient comfort in the intensive care unit.

June 8, 2005

Perspectives on patient and family engagement with reduction in harm: the forgotten voice.

August 15, 2018

Developing an intervention to reduce harm in hospitalized patients: patients and families in research.

December 5, 2018

Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?

June 27, 2007

Effect of medication reconciliation with and without patient counseling on the number of pharmaceutical interventions among patients discharged from the hospital.

August 19, 2009

Medication errors with the use of allopurinol and colchicine: a retrospective study of a national, anonymous Internet-accessible error reporting system.

March 8, 2006

To tell the truth, the whole truth, may do patients harm: the problem of the nocebo effect for informed consent.

May 16, 2012

Changes in adverse event rates in hospitals over time: a longitudinal retrospective patient record review study.

February 13, 2013

Essential elements nurses have to address to promote a safe discharge in paediatrics: a systematic review and narrative synthesis.

February 21, 2024

Alarm algorithms in critical care monitoring.

July 5, 2006

Longitudinal medication reconciliation at hospital admission, discharge and post-discharge.

August 26, 2020

Advancing the future of patient safety in oncology: implications of patient safety education on cancer care delivery.

June 10, 2015

Patient safety strategies targeted at diagnostic errors: a systematic review.

March 13, 2013

Advancing nursing home quality through quality improvement itself.

January 20, 2010

No shortcuts to safer opioid prescribing.

May 8, 2019

Reviewing the impact of computerized provider order entry on clinical outcomes: the quality of systematic reviews.

March 7, 2012

January 19, 2011

Temporal trends in patient safety in the Netherlands: reductions in preventable adverse events or the end of adverse events as a useful metric?

August 5, 2015

Identifying adverse events: reflections on an imperfect gold standard after 20 years of patient safety research.

March 25, 2020

Pediatric rapid response teams in the academic medical center.

January 3, 2007

CDC guideline for prescribing opioids for chronic pain—United States, 2016.

March 30, 2016

Overdiagnosis of coronary artery disease detected by coronary computed tomography angiography: a teachable moment.

November 23, 2016

Using performance improvement to enhance time-out compliance and prevent wrong-site surgery.

August 11, 2021

Improving patient safety: moving beyond the "hype" of medical errors.

October 26, 2005

The 5th anniversary of the "Universal Protocol": pitfalls and pearls revisited.

July 29, 2009

Evaluation of laboratory monitoring alerts within a computerized physician order entry system for medication orders.

September 20, 2006

Adverse incidents, patient flow and nursing workforce variables on acute psychiatric wards: the Tompkins Acute Ward Study.

February 28, 2007

Risky procedures by nurses in hospitals: problems and (contemplated) refusals of orders by physicians, and views of physicians and nurses: a questionnaire survey.

September 28, 2005

Impact of opioid administration in the intensive care unit and subsequent use in opioid-naïve patients.

June 9, 2021

Automated dispensing cabinet overrides-an evaluation of necessity in a pediatric emergency department.

May 25, 2022

Exploring care left undone in pediatric nursing.

September 28, 2022

1,300 days and counting: a risk model approach to preventing retained foreign objects (RFOs).

May 23, 2018

Medication errors in hospitals: a literature review of disruptions to nursing practice during medication administration.

September 23, 2015

Accuracy of infection reporting in US nursing home ratings.

August 9, 2023

Dynamic pocket card for implementing ISBAR in shift handover communication.

October 23, 2019

Measuring patient safety culture: an assessment of the clustering of responses at unit level and hospital level.

August 26, 2009

SBAR improves nurse–physician communication and reduces unexpected death: a pre and post intervention study.

October 23, 2013

Safety perceptions of health care leaders in 2 Canadian academic acute care centers.

June 7, 2017

Cultivating a culture of medication safety in prelicensure nursing students.

April 8, 2015

Implementation of the Josie King Care Journal in a pediatric intensive care unit: a quality improvement project.

November 21, 2012

Implementation of Condition Help: family teaching and evaluation of family understanding.

October 26, 2011

Safe use of cellular telephones in hospitals: fundamental principles and case studies.

November 16, 2005

Combining ratings from multiple physician reviewers helped to overcome the uncertainty associated with adverse event classification.

August 29, 2007

Nurse interrupted: development of a realistic medication administration simulation for undergraduate nurses.

August 26, 2015

Interventions to improve safe sleep among hospitalized infants at eight children's hospitals.

May 4, 2016

Effects of the introduction of the WHO "Surgical Safety Checklist" on in-hospital mortality: a cohort study.

January 30, 2005

Interunit handoffs from emergency department to inpatient care: a cross-sectional survey of physicians at a university medical center.

August 5, 2015

Effect of cognitive aids on adherence to best practice in the treatment of deteriorating surgical patients: a randomized clinical trial in a simulation setting.

January 8, 2020

The reliability of AHRQ Common Format Harm Scales in rating patient safety events.

October 23, 2013

Simulation exercises as a patient safety strategy: a systematic review.

March 20, 2013

Clinically missed cancer: how effectively can radiologists use computer-aided detection?

May 16, 2012

Critical events in the lives of interns.

November 19, 2008

Should all duty hours be the same? Results of a national survey of surgical trainees.

July 29, 2009

Intensive care unit alarms—how many do we need?

February 3, 2010

Limited health literacy is a barrier to medication reconciliation in ambulatory care.

October 31, 2007

Crew resource management in the intensive care unit: a prospective 3-year cohort study.

July 1, 2015

Implementing the World Health Organization surgical safety checklist: a model for future perioperative initiatives.

December 7, 2011

Failure to rescue as a patient safety indicator for neurosurgical patients: are we there yet?

November 1, 2023

A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours.

April 27, 2005

An evaluation of hand hygiene in an intensive care unit: are visitors a potential vector for pathogens?

June 24, 2015

Does Nursing Home Compare reflect patient safety in nursing homes?

November 28, 2018

Addressing systemic racism in nursing homes: a time for action.

April 14, 2021

System planning for modern-day Just Culture to mitigate worker distress and second victim response.

November 29, 2023

The value of adding a verbal report to written handoffs on early readmission following prolonged respiratory failure.

December 22, 2010

Analysis of deaths related to anesthesia in the period 1996-2004 from closed claims registered by the Danish Patient Insurance Association.

May 30, 2007

Family-centered rounds on pediatric wards: a PRIS network survey of US and Canadian hospitalists.

July 14, 2010

Interventions to improve team effectiveness: a systematic review.

November 18, 2009

Accuracy of pediatric trauma field triage: a systematic review.

May 30, 2018

Inappropriate prescriptions of direct oral anticoagulants (DOACs) in hospitalized patients: a narrative review.

May 10, 2023

Program director perceptions of surgical resident training and patient care under flexible duty hour requirements.

September 7, 2016

Exploring the causes of adverse events in hospitals and potential prevention strategies.

February 24, 2010

Diffusing aviation innovations in a hospital in the Netherlands.

August 4, 2010

Safety of using a computerized rounding and sign-out system to reduce resident duty hours.

July 14, 2010

Adverse events detected by clinical surveillance on an obstetric service.

November 15, 2006

Comparison of potential risk factors for medication errors with and without patient harm.

August 18, 2010

Emergency diagnosis of cancer and previous general practice consultations: insights from linked patient survey data.

August 2, 2017

Bringing the clinical laboratory into the strategy to advance diagnostic excellence.

September 22, 2021

Prescribing decision making by medical residents on night shifts: a qualitative study.

November 9, 2022

Effect of a pharmacy-based centralized intravenous admixture service on the prevalence of medication errors: a before-and-after study.

August 10, 2022

Using prospective clinical surveillance to identify adverse events in hospital.

March 30, 2011

Clinical diagnoses vs. autopsy findings in early deceased septic patients in the intensive care: a retrospective cohort study.

July 28, 2021

Related Resources

Annual Perspective

Equity in Patient Safety

March 27, 2024

Effect on diagnostic accuracy of cognitive reasoning tools for the workplace setting: systematic review and meta-analysis.

September 14, 2022

Learning from patient safety incidents involving acutely sick adults in hospital assessment units in England and Wales: a mixed methods analysis for quality improvement.

August 25, 2021

Improving diagnosis by feedback and deliberate practice: one-on-one coaching for diagnostic maturation.

June 2, 2021

The Cognitive Autopsy: A Root Cause Analysis of Medical Decision Making.

January 27, 2021

Misdiagnosis, mistreatment, and harm - when medical care ignores social forces.

April 8, 2020

A randomized experimental study to assess the effect of language on medical students' anxiety due to uncertainty.

August 21, 2019

Recommendations for using the Revised Safer Dx instrument to help measure and improve diagnostic safety.

August 21, 2019

Analysis of human performance deficiencies associated with surgical adverse events.

August 14, 2019

Walking the plank: an experimental paradigm to investigate safety voice.

July 31, 2019

Animated stories of medical error as a means of teaching undergraduates patient safety: an evaluation study.

July 24, 2019

Health Professions Education.

June 12, 2019

Patient Safety.

May 1, 2019

Saving without compromising: teaching trainees to safely provide high value care.

April 17, 2019

Teaching novice clinicians how to reduce diagnostic waste and errors by applying the Toyota Production System.

April 10, 2019

Mortality and morbidity rounds (MMR) in pathology: relative contribution of cognitive bias vs. systems failures to diagnostic error.

March 27, 2019

A cognitive forcing tool to mitigate cognitive bias—a randomised control trial.

February 20, 2019

The role of purple pens in learning to prescribe.

February 13, 2019

Fatal flaws in clinical decision making.

January 30, 2019

Artificial intelligence, bias and clinical safety.

January 23, 2019

Case-based simulation empowering pediatric residents to communicate about diagnostic uncertainty.

January 16, 2019

Safety work and risk management as burdens of treatment in primary care: insights from a focused ethnographic study of patients with multimorbidity.

November 14, 2018

Adaptive expertise in medical decision making.

October 17, 2018

Ten principles for more conservative, care-full diagnosis.

October 10, 2018

Does the perception of severity of medical error differ between varying levels of clinical seniority?

October 3, 2018

Overdiagnosis in primary care: framing the problem and finding solutions.

September 12, 2018

Between demarcation and discretion: the medical-administrative boundary as a locus of safety in high-volume organisational routines.

August 1, 2018

Interview

In Conversation With… Gordon Schiff, MD

July 1, 2018

Imitating incidents: how simulation can improve safety investigation and learning from adverse events.

June 27, 2018

Cognitive bias in clinical practice—nurturing healthy skepticism among medical students.

June 6, 2018

See More About The Topic

Exploring the role of salient distracting clinical features in the emergence of diagnostic errors and the mechanisms through which reflection counteracts mistakes.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Exploring the role of salient distracting clinical features in the emergence of diagnostic errors and the mechanisms through which reflection counteracts mistakes.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site