Five psychological mechanisms that might bias learning from neurosurgical complications: case discussions and a narrative review

Abstract

Purpose:The ability of neurosurgeons to analyze and reflect on their complications in a constructive way is important both for professional development and for patient safety. The purpose of the present paper is to highlight some psychological factors that might impair or bias the ability of the neurosurgeon to do this successfully. Methods: Five fictitious cases, loosely inspired by real events and situations, are used as a basis for a discussion of some of the most important potential sources of psychological bias in the context of understanding neurosurgical complications. Results: The issues of a) self-serving bias and the actor-observer effect; b) heuristics and biases in interpreting probabilistic events; c) emotional avoidance and denial; d) limitations of attention (dual systems theory) and e) errors of memory, are discussed. Conclusion: There are a number of psychological factors, that are well known to science that may be ubiquitous sources of influence on the ability of neurosurgeons to grow by reflection on their own complications. Exactly how these factors can and should be efficiently adressed by the individual neurosurgeon and/or the organisation and team in which the neurosurgeon works may vary according to type of bias, context and circumstances. However, being aware of these issues and addressing them on an individual and organizational level remains important to the quality of our craft.

Brain stimulation and elicited memories

“…Source attribution theory has during the latest decades become an important tool for understanding how false memories may be created not only during simple cognitive testing but also in the context of clinical decision-making, forensic interviewing, or psychotherapy [5,20,30,31,53]. The theory has even been shown to be consistent with what is known about how false memories of having been kidnapped by Satanists were created in child witnesses during the period of early modern European witch persecutions [46,49].…”