Performance Under Pressure

How well do you perform when the pressure is high? This is one of my favorite emergency medicine topics. Emergency personnel pride themselves on thriving under pressure. Doctors like to think of themselves as perfect, maybe even god-like. Combine the two, and you can imagine the ego of the average emergency physician. But underneath all that bravado, we are all human. We all experience stress, and we all respond to stress in distinctly human ways.

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Cognitive theory in medicine: Some problems

The final installment of the cognitive theory series explores a few of the problems of attempting to apply current cognitive theory to medical practice

Finally, part 4 of this 4 part series will explore some of the problems with the current description of cognitive theory in medicine.

Cognitive biases are an increasingly popular topic of discussion in the medical community. They are fascinating to read about. It is fun to consider our fallibility when we are so often expected to be perfect. Most descriptions of the topic focus on the content of the first three posts: dual process theory, biases, and possible solutions. However, there are several problems with dual process theory and its application to medicine that must be acknowledged.

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Cognitive errors in medicine: Mitigation of cognitive errors

A brief review of some of the techniques described to avoid cognitive errors in medicine

This is Part 3 of a 4 part series.

  1. Part 1: A brief overview of cognitive theory
  2. Part 2: Common cognitive errors
  3. Part 4: Problems with cognitive theory

Part 2 of this series consisted of a long list of common cognitive errors we are all prone to committing. It can be discouraging to think that, despite all our training and all our effort, our brains are out to get us; that error may be inevitable. However, there may be some ways to mitigate our biases.

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Cognitive errors in medicine: The common errors

A brief review of the many common cognitive errors we all make in the practice of medicine

This is Part 2 of a 4 part series.

This post will review the common cognitive errors described in medicine. You will notice that this list is not clean. Human cognition is a complex process. Many of the biases overlap. Some are more general descriptions that encompass other more specific examples. Often, two different biases will represent opposite ends of a cognitive spectrum, both ends of which can result in errors. This list represents the cognitive biases that are most often described in the context of medical errors, but there are many other cognitive biases that affect our daily lives. For example, I particularly like the IKEA effect: our tendency to disproportionately value objects we had a hand in putting together, regardless of end result.

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Cognitive theory in medicine: A brief overview

A brief summary of the role of cognitive theory and errors medicine

This is Part 1 of a 4 part series. The future holds:

Emergency medicine, despite our love of action and procedures, is primarily a cognitive profession. We see patients with vague, undifferentiated symptoms and have to rapidly and accurately arrive at a diagnosis and management plan. Unfortunately, despite our best efforts, we occasionally err. Cognitive biases, rather than knowledge deficits, are thought to be the primary cause of our errors.

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