Self-reflection on the quality of decisions in health care

Regehr, Glenn

doi:10.1111/j.1365-2929.2004.01979.x

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…The use of clinical guidelines and algorithms, computer‐assisted decision aids and evidence‐based medicine assist in the decision‐making process, particularly with the interpretation of data. Finally, feedback on the outcomes of decisions and also on the decision‐making process itself is required to promote self‐assessment 20 . Clinical audits and feedback, in particular, provide trainees with external objective data against which they can judge their reasoning.…”

Section: The Context Of General Practice: Dealing With Uncertaintymentioning

confidence: 99%

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Promoting clinical reasoning in general practice trainees: role of the clinical teacher

Atkinson¹,

Ajjawi²,

Cooling³

2011

The Clinical Teacher

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The journey to expertise in clinical reasoning is unique to each clinician, with different skills developing at different rates, depending on content, context and past experience. Doctors enter into general practice training with the building blocks of biomedical and clinical knowledge and a desire to learn how to be a general practitioner. Clinical teachers are integral in the process of helping trainees learn how to 'think like a general practitioner'.

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Section: The Context Of General Practice: Dealing With Uncertaintymentioning

confidence: 99%

“…Finally, feedback on the outcomes of decisions and also on the decision-making process itself is required to promote self-assessment. 20 Clinical audits and feedback, in particular, provide trainees with external objective data against which they can judge their reasoning.…”

Section: Metacognition Self-assessment and Self-awarenessmentioning

confidence: 99%

Promoting clinical reasoning in general practice trainees: role of the clinical teacher

Atkinson¹,

Ajjawi²,

Cooling³

2011

The Clinical Teacher

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“…Feedback from reliable others (here GP supervisors, medical educators and pharmacists) has been suggested as necessary to inform the ability to judge actions and decisions [28-30]. This refers to feedback not just on the outcomes of decisions, which occur ad hoc when pharmacists call or patients return to see the GP, but also on the decision making process itself [31]. Academic detailing and prescribing audits with specific feedback have been found to improve prescribing and would assist GP registrars as a source of external and objective feedback [32-34].…”

Section: Discussionmentioning

confidence: 99%

What are the perceived learning needs of Australian general practice registrars for quality prescribing?

et al. 2010

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BackgroundLittle is known about the perceived learning needs of Australian general practice (GP) registrars in relation to the quality use of medicines (QUM) or the difficulties experienced when learning to prescribe. This study aimed to address this gap.MethodsGP registrars' perceived learning needs were investigated through an online national survey, interviews and focus groups. Medical educators' perceptions were canvassed in semi-structured interviews in order to gain a broader perspective of the registrars' needs. Qualitative data analysis was informed by a systematic framework method involving a number of stages. Survey data were analysed descriptively.ResultsThe two most commonly attended QUM educational activities took place in the workplace and through regional training providers. Outside of these structured educational activities, registrars learned to prescribe mainly through social and situated means. Difficulties encountered by GP registrars included the transition from hospital prescribing to prescribing in the GP context, judging how well they were prescribing and identifying appropriate and efficient sources of information at the point of care.ConclusionsGP registrars learn to prescribe primarily and opportunistically in the workplace. Despite many resources being expended on the provision of guidelines, decision-support systems and training, GP registrars expressed difficulties related to QUM. Ways of easing the transition into GP and of managing the information 'overload' related to medicines (and prescribing) in an evidence-guided, efficient and timely manner are needed. GP registrars should be provided with explicit feedback about the process and outcomes of prescribing decisions, including the use of audits, in order to improve their ability to judge their own prescribing.

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“…Certainly there are a number of studies (Mamede et al 2010;Schmidt et al 2014) showing that if you create cases where people will be vulnerable to a particular cognitive bias, clinicians will commit more errors than when it is absent. But that begs the issue of the extent to which such cognitive biases actually result in errors with ''real'' cases (Eva and Norman 2005;Regehr 2004). Here the evidence is more tenuous.…”

mentioning

confidence: 98%

The Bias in researching cognitive bias

Norman

2014

Adv in Health Sci Educ

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Self-reflection on the quality of decisions in health care

Cited by 5 publications

References 9 publications

Promoting clinical reasoning in general practice trainees: role of the clinical teacher

Promoting clinical reasoning in general practice trainees: role of the clinical teacher

What are the perceived learning needs of Australian general practice registrars for quality prescribing?

The Bias in researching cognitive bias

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