Reducing Cognitive Skill Decay and Diagnostic Error: Theory-Based Practices for Continuing Education in Health Care

Weaver, Sallie J.; Newman‐Toker, David E.; Rosen, Michael A.

doi:10.1002/chp.21155

Cited by 28 publications

(19 citation statements)

References 67 publications

(128 reference statements)

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“…The dual-process theory of reasoning has emerged as the dominant theoretic model for cognitive processing during human decision making in real-world settings [24]. This model proposes two general classes of cognitive operations and suggests causal explanations of where and how diagnostic errors occur in clinical reasoning [25].…”

Section: Cognitive Errors In Radiologymentioning

confidence: 99%

Cognitive and System Factors Contributing to Diagnostic Errors in Radiology

Lee

Nagy

Weaver

et al. 2013

American Journal of Roentgenology

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210

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Every radiologist worries about missing a diagnosis or giving a false-positive reading. The retrospective error rate among radiologic examinations is approximately 30%, with real-time errors in daily radiology practice averaging 3-5%. Nearly 75% of all medical malpractice claims against radiologists are related to diagnostic errors. As medical reimbursement trends downward, radiologists attempt to compensate by undertaking additional responsibilities to increase productivity. The increased workload, rising quality expectations, cognitive biases, and poor system factors all contribute to diagnostic errors in radiology. Diagnostic errors are underrecognized and underappreciated in radiology practice. This is due to the inability to obtain reliable national estimates of the impact, the difficulty in evaluating effectiveness of potential interventions, and the poor response to systemwide solutions. Most of our clinical work is executed through type 1 processes to minimize cost, anxiety, and delay; however, type 1 processes are also vulnerable to errors. Instead of trying to completely eliminate cognitive shortcuts that serve us well most of the time, becoming aware of common biases and using metacognitive strategies to mitigate the effects have the potential to create sustainable improvement in diagnostic errors.

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Section: Cognitive Errors In Radiologymentioning

confidence: 99%

Cognitive and System Factors Contributing to Diagnostic Errors in Radiology

Lee

Nagy

Weaver

et al. 2013

American Journal of Roentgenology

Self Cite

300

210

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“…Regardless of whether continuing education and professional development is mandatory, voluntary, formal or informal, the positive outcomes are many and range from personal satisfaction to professional competency which optimizes safe contemporary evidence-informed practice and quality health services for individuals and their families. In turn, continuing education and professional development mitigates outdated practice and protects the public [9]. …”

Section: Introductionmentioning

confidence: 99%

Approaches to health-care provider education and professional development in perinatal depression: a systematic review

Legere

Wallace

Bowen

et al. 2017

BMC Pregnancy Childbirth

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BackgroundPerinatal depression is the most common mental illness experienced by pregnant and postpartum women, yet it is often under-detected and under-treated. Some researchers suggest this may be partly influenced by a lack of education and professional development on perinatal depression among health-care providers, which can negatively affect care and contribute to stigmatization of women experiencing altered mood. Therefore, the aim of this systematic review is to provide a synthesis of educational and professional development needs and strategies for health-care providers in perinatal depression.MethodsA systematic search of the literature was conducted in seven academic health databases using selected keywords. The search was limited to primary studies and reviews published in English between January 2006 and May/June 2015, with a focus on perinatal depression education and professional development for health-care providers. Studies were screened for inclusion by two reviewers and tie-broken by a third. Studies that met inclusion criteria were quality appraised and data extracted. Results from the studies are reported through narrative synthesis.ResultsTwo thousand one hundred five studies were returned from the search, with 1790 remaining after duplicate removal. Ultimately, 12 studies of moderate and weak quality met inclusion criteria. The studies encompassed quantitative (n = 11) and qualitative (n = 1) designs, none of which were reviews, and addressed educational needs identified by health-care providers (n = 5) and strategies for professional development in perinatal mental health (n = 7). Consistently, providers identified a lack of formal education in perinatal mental health and the need for further professional development. Although the professional development interventions were diverse, the majority focused on promoting identification of perinatal depression and demonstrated modest effectiveness in improving various outcomes.ConclusionsThis systematic review reveals a lack of strong research in multi-disciplinary, sector, site, and modal approaches to education and professional development for providers to identify and care for women at risk for, or experiencing, depression. To ensure optimal health outcomes, further research comparing diverse educational and professional development approaches is needed to identify the most effective strategies and consistently meet the needs of health-care providers.Trial registrationA protocol for this systematic review was registered on PROSPERO (Protocol number: CRD42015023701), June 21, 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1431-4) contains supplementary material, which is available to authorized users.

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“…Deterioration of cognitive diagnostic skills can have a severe impact on patients, providers, and the entire health care system. 35 …”

Section: Discussionmentioning

confidence: 99%

Regulatory Considerations for Physiological Closed-Loop Controlled Medical Devices Used for Automated Critical Care: Food and Drug Administration Workshop Discussion Topics

Parvinian

Scully

Wiyor³

et al. 2018

Anesthesia &Amp; Analgesia

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Part of the mission of the Center for Devices and Radiological Health (CDRH) at the US Food and Drug Administration is to facilitate medical device innovation. Therefore, CDRH plays an important role in helping its stakeholders such as manufacturers, health care professionals, patients, patient advocates, academia, and other government agencies navigate the regulatory landscape for medical devices. This is particularly important for innovative physiological closed-loop controlled (PCLC) devices used in critical care environments, such as intensive care units, emergency settings, and battlefield environments. CDRH’s current working definition of a PCLC medical device is a medical device that incorporates physiological sensor(s) for automatic manipulation of a physiological variable through actuation of therapy that is conventionally made by a clinician. These emerging devices enable automatic therapy delivery and may have the potential to revolutionize the standard of care by ensuring adequate and timely therapy delivery with improved performance in high workload and high-stress environments. For emergency response and military applications, automatic PCLC devices may play an important role in reducing cognitive overload, minimizing human error, and enhancing medical care during surge scenarios (ie, events that exceed the capability of the normal medical infrastructure). CDRH held an open public workshop on October 13 and 14, 2015 with the aim of fostering an open discussion on design, implementation, and evaluation considerations associated with PCLC devices used in critical care environments. CDRH is currently developing regulatory recommendations and guidelines that will facilitate innovation for PCLC devices. This article highlights the contents of the white paper that was central to the workshop and focuses on the ensuing discussions regarding the engineering, clinical, and human factors considerations. (Anesth Analg 2018;126:1916–25)

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Reducing Cognitive Skill Decay and Diagnostic Error: Theory-Based Practices for Continuing Education in Health Care

Cited by 28 publications

References 67 publications

Cognitive and System Factors Contributing to Diagnostic Errors in Radiology

Cognitive and System Factors Contributing to Diagnostic Errors in Radiology

Approaches to health-care provider education and professional development in perinatal depression: a systematic review

Regulatory Considerations for Physiological Closed-Loop Controlled Medical Devices Used for Automated Critical Care: Food and Drug Administration Workshop Discussion Topics

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