Check out the timestamps below to help you navigate through the many topics we discussed.
On This Episode:
Cognitive biases are systematic errors in thinking that can influence clinical judgment and potentially lead to adverse outcomes for patients. By understanding these biases, anesthesia providers can improve their decision-making process and enhance patient safety. Today we’ll take a deep dive into the world of cognitive biases and how they affect decision-making in anesthesia practice.
We’ll begin with an overview of heuristics—mental shortcuts used in quick decision-making—and how these shortcuts can pair with cognitive biases to cloud clinical judgment. Then we’ll recognize several key biases, such as confirmation bias, overconfidence bias, anchoring bias, and availability bias, offering real-world examples of how they can manifest during anesthesia care.
We’ll also discuss strategies to mitigate the impact of cognitive biases on clinical care, including the use of checklists, team communication, and decision-support tools. Today’s show will emphasize the need for anesthesia providers to engage in reflective practice, use cognitive aids in emergencies, and stay open to multiple viewpoints for more balanced decision-making.
Here’s some of what we discuss in this episode:
- Heuristics or decision-making shortcuts can lead to cognitive biases.
- How the different biases impact the performance of CRNAs.
- The framing effect and the gambler's fallacy influence decision-making.
- Effective team communication reduces the likelihood of confirmation bias or anchoring bias.
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"Avoiding confirmation bias requires that we acknowledge our potential biases."
- Garry & Terry
References
Kahneman, D. (2011) Thinking, Fast and Slow. Farrar, Straus and Giroux. United States. ISBN 978-0374275631.
Yan L., Karmchandani, K., Gaisser, R.R., and Carr, Z.J. (2024) Identifying, Understanding, and Minimizing Unconscious Biases in Perioperative Crisis Management: A Narrative Review. Anesthesia and Analgesia, (139) 1. 68-77.
Dunning, David (1 January 2011). "Chapter Five – The Dunning–Kruger Effect: On Being Ignorant of One's Own Ignorance". Advances in Experimental Social Psychology. Vol. 44. Academic Press. pp. 247–296. doi:10.1016/B978-0-12-385522-0.00005-6.
Thilen, S.R. et. al. (2023). 2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade: A Report by the American Society of Anesthesiologists Task Force on Neuromuscular Blockade. Anesthesiology (138) 1. 13-41.
Stanford Emergency Manuals: https://emergencymanual.stanford.edu.
Tewfik, G., Vivoli, S., and Harbell, M.W. (2023) Recognizing and Combating Cognitive Bias in Anesthesiology: Implications for Patient Safety. APSF Newsletter. 38 (1).
