Occult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents

Introduction There is a paucity of simulation literature and curricula addressing cognitive bias and the skills necessary to overcome this common source of clinical error. We designed a scenario for emergency medicine (EM) residents with the intent to trigger an anchoring bias as a nidus for convers...

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Autores principales:	Jonathan Weil, Michael Cassara
Formato:	article
Lenguaje:	EN
Publicado:	Association of American Medical Colleges 2020
Materias:	Medical Simulation Cognitive Bias Sepsis Trauma Physician Clinical Reasoning/Diagnostic Reasoning Medicine (General) R5-920 Education L
Acceso en línea:	https://doaj.org/article/dd456be55be745778a10ca159eb05b3e
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spelling	oai:doaj.org-article:dd456be55be745778a10ca159eb05b3e2021-11-19T15:10:18ZOccult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents10.15766/mep_2374-8265.110232374-8265https://doaj.org/article/dd456be55be745778a10ca159eb05b3e2020-11-01T00:00:00Zhttp://www.mededportal.org/doi/10.15766/mep_2374-8265.11023https://doaj.org/toc/2374-8265Introduction There is a paucity of simulation literature and curricula addressing cognitive bias and the skills necessary to overcome this common source of clinical error. We designed a scenario for emergency medicine (EM) residents with the intent to trigger an anchoring bias as a nidus for conversation about metacognition. Methods We implemented this case for teams of two to three PGYs 1–5, including both EM and EM/internal medicine residents within a longitudinal simulation curriculum. The case was designed to simulate a major trauma wherein evaluation according to standard advanced trauma life support principles failed to identify a traumatic injury to explain the patient's hemodynamic instability. Residents had to reorient their thought process towards other etiologies of shock, ultimately identifying sepsis as the driving force behind the trauma. The scenario ran over 10–15 minutes followed by a 30-minute debrief. Case satisfaction and the success of various learning objectives were assessed via a postsimulation survey. Results Forty-four EM and combined EM/IM residents ranging from PGY 1–5 participated in the simulation over a 5-week period. Nearly 82% of respondents expressed an overall satisfaction with the case. About 76% felt the case succeeded in contributing to their understanding of cognitive biases. Discussion The implementation of misdirection in this simulation was an effective means by which to engage learners in education about cognitive biases.Jonathan WeilMichael CassaraAssociation of American Medical CollegesarticleMedical SimulationCognitive BiasSepsisTraumaPhysicianClinical Reasoning/Diagnostic ReasoningMedicine (General)R5-920EducationLENMedEdPORTAL, Vol 16 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical Simulation Cognitive Bias Sepsis Trauma Physician Clinical Reasoning/Diagnostic Reasoning Medicine (General) R5-920 Education L
spellingShingle	Medical Simulation Cognitive Bias Sepsis Trauma Physician Clinical Reasoning/Diagnostic Reasoning Medicine (General) R5-920 Education L Jonathan Weil Michael Cassara Occult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents
description	Introduction There is a paucity of simulation literature and curricula addressing cognitive bias and the skills necessary to overcome this common source of clinical error. We designed a scenario for emergency medicine (EM) residents with the intent to trigger an anchoring bias as a nidus for conversation about metacognition. Methods We implemented this case for teams of two to three PGYs 1–5, including both EM and EM/internal medicine residents within a longitudinal simulation curriculum. The case was designed to simulate a major trauma wherein evaluation according to standard advanced trauma life support principles failed to identify a traumatic injury to explain the patient's hemodynamic instability. Residents had to reorient their thought process towards other etiologies of shock, ultimately identifying sepsis as the driving force behind the trauma. The scenario ran over 10–15 minutes followed by a 30-minute debrief. Case satisfaction and the success of various learning objectives were assessed via a postsimulation survey. Results Forty-four EM and combined EM/IM residents ranging from PGY 1–5 participated in the simulation over a 5-week period. Nearly 82% of respondents expressed an overall satisfaction with the case. About 76% felt the case succeeded in contributing to their understanding of cognitive biases. Discussion The implementation of misdirection in this simulation was an effective means by which to engage learners in education about cognitive biases.
format	article
author	Jonathan Weil Michael Cassara
author_facet	Jonathan Weil Michael Cassara
author_sort	Jonathan Weil
title	Occult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents
title_short	Occult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents
title_full	Occult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents
title_fullStr	Occult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents
title_full_unstemmed	Occult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents
title_sort	occult sepsis masked by trauma—exploration of cognitive biases through simulation with emergency medicine residents
publisher	Association of American Medical Colleges
publishDate	2020
url	https://doaj.org/article/dd456be55be745778a10ca159eb05b3e
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Occult Sepsis Masked by Trauma—Exploration of Cognitive Biases Through Simulation With Emergency Medicine Residents

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