Location

University of Windsor

Document Type

Paper

Keywords

gender bias, age bias, racial bias, medical diagnostic reasoning, cognitive forcing, shared-mind approach

Start Date

18-5-2016 9:00 AM

End Date

21-5-2016 5:00 PM

Abstract

Much attention has been paid in the literature to the deleterious effects of errors in diagnostic reasoning due to underlying cognitive biases. This is an important topic since people’s lives and well-being are at stake. Empirical studies cited by Chapman et al. (2013) corroborate the view that gender, racial, or age biases exist in a significant number of clinicians, thereby limiting objective diagnosis. Croskerry (2003, 2013) endorses a so-called metacognitive (or cognitive ‘forcing’) approach to achieve de-biasing in clinicians, a key component of which is critical self-reflection on one’s own diagnostic reasoning (Croskerry, 2003). However, the first empirical study of its kind found cognitive forcing to be relatively ineffective in reducing biases in clinicians (Sherbino et al., 2011). It is the thesis of this paper that a more effective approach to achieve de-biasing in clinicians involves group assessments of colleagues’ diagnostic reasoning, since biases often resist critical self-reflection owing in part to the fact that many of them are unconscious. Objectivity has its roots in ideally diverse group-based critiques of medical decisions where others may be able to expose biases of which the person is unaware, which Epstein (2013) refers to as the ‘shared mind’ approach.

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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May 18th, 9:00 AM May 21st, 5:00 PM

Eliminating Gender-, Racial- and Age-Biases in Medical Diagnostic Reasoning (PAPER)

University of Windsor

Much attention has been paid in the literature to the deleterious effects of errors in diagnostic reasoning due to underlying cognitive biases. This is an important topic since people’s lives and well-being are at stake. Empirical studies cited by Chapman et al. (2013) corroborate the view that gender, racial, or age biases exist in a significant number of clinicians, thereby limiting objective diagnosis. Croskerry (2003, 2013) endorses a so-called metacognitive (or cognitive ‘forcing’) approach to achieve de-biasing in clinicians, a key component of which is critical self-reflection on one’s own diagnostic reasoning (Croskerry, 2003). However, the first empirical study of its kind found cognitive forcing to be relatively ineffective in reducing biases in clinicians (Sherbino et al., 2011). It is the thesis of this paper that a more effective approach to achieve de-biasing in clinicians involves group assessments of colleagues’ diagnostic reasoning, since biases often resist critical self-reflection owing in part to the fact that many of them are unconscious. Objectivity has its roots in ideally diverse group-based critiques of medical decisions where others may be able to expose biases of which the person is unaware, which Epstein (2013) refers to as the ‘shared mind’ approach.