A WEB-BASED “DIAGNOSTICIAN 101” LEARNING MODULE: TEACHING COGNITIVE STRATEGIES TO REDUCE DIAGNOSTIC ERRORS

Monday, October 25, 2010
Vide Lobby (Sheraton Centre Toronto Hotel)
Satid Thammasitboon1, Stephanie Grayson1 and Geeta Singhal2, (1)West Virginia University, Morgantown, WV, (2)Baylor College of Medicine, Houston, TX

Statement of problem: Diagnostic errors have gained considerable attention in the past recent years. The Agency for Health Care Research and Quality has identified diagnostic errors as an area of special emphasis. Recently, there has been increased recognition of its prevalence and a better understanding about how these errors may occur, and how we could minimize them. Most clinicians, however, are unaware of the significance of diagnostic errors, and receive little instruction about techniques to avoid such errors. We suggest that despite advancements in diagnostic technology, clinicians frequently misdiagnose patients. Approximately two-thirds of the causes are related to a cognitive component involving failure of data gathering or synthesis.

Description of the intervention or program: We developed a Web-based learning module to teach clinicians how to use cognitive strategies to reduce diagnostic errors. The module utilizes adult learning principles to enhance knowledge and to promote desired changes in behavior. The learning module includes: 1) A series of case-based, interactive lectures about the framework of cognitive errors and biases, clinical expertise, dual processing model and clinical reasoning; 2) A cognitive exercise analyzing diagnostic errors using a cognitive autopsy format, and identifying cognitive strategies that can be used to minimize them; and 3) A tool box for instruction and clinical application of various cognitive strategies. Users may work at their own pace by choosing from various parts of the module independently. An instruction manual is provided for clinical instructors that allows for teaching the entire module as a curriculum for an elective course. A learner’s self-assessment and a course evaluation are available for the users.

Findings to date: Learners have used the learning module as an educational resource to prepare monthly mortality and morbidity conferences. A cognitive autopsy exercise during an elective course has resulted in multiple case reports.

Lessons learned: The effectiveness of the learning module is being evaluated systematically.