2002/11/01 by Pat Croskerry · 1 citation
Health Professions · Medicine · Nursing · Psychology · #Clinical Reasoning and Diagnostic Skills #Clinical decision making #Cognition #Cognitive bias #Cognitive load #Cognitive psychology #Computer science #Computer security #Cornerstone #Emergency and Acute Care Studies #Emergency department #Heuristics #Intensive care medicine #Management system #Medicine #Nursing #Operations management #Patient Safety and Medication Errors #Principal (computer security) #Psychiatry #Psychology #Quality (philosophy) #Quality management #Resource (disambiguation)
paper · doi:10.1197/aemj.9.11.1184
openalex publication_date 2002/11/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/05
Clinical decision making is a cornerstone of high‐quality care in emergency medicine. The density of decision making is unusually high in this unique milieu, and a combination of strategies has necessarily evolved to manage the load. In addition to the traditional hypothetico‐deductive method, emergency physicians use several other approaches, principal among which are heuristics. These cognitive short‐cutting strategies are especially adaptive under the time and resource limitations that prevail in many emergency departments (EDs), but occasionally they fail. When they do, we refer to them as cognitive errors. They are costly but highly preventable. It is important that emergency physicians be aware of the nature and extent of these heuristics and biases, or cognitive dispositions to respond (CDRs). Thirty are catalogued in this article, together with descriptions of their properties as well as the impact they have on clinical decision making in the ED. Strategies are delineated in each case, to minimize their occurrence. Detection and recognition of these cognitive phenomena are a first step in achieving cognitive de‐biasing to improve clinical decision making in the ED.