Re-thinking morbidity and mortality

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sumner Abraham ◽  
Andrew Parsons ◽  
Brian Uthlaut ◽  
Peggy Plews-Ogan
Keyword(s):  
Cognitive Biases ◽  
Diagnostic Errors ◽  
Dual Process ◽  
Morbidity And Mortality ◽  
Dual Process Theory ◽  
Habits Of Mind ◽  
Thought Processes ◽  
University Of Virginia ◽  
Self Reflection ◽  
The University

AbstractDespite the breadth of patient safety initiatives, physicians talking about their mistakes to other physicians is a difficult thing to do. This difficulty may be exacerbated by a limited exposure to how to analyze and discuss mistakes and respond in a productive way. At the University of Virginia, we recognized the importance of understanding cognitive biases for residents in both their clinical and personal professional development. We re-designed our resident led morbidity and mortality (M&M) conference using a model that integrates dual-process theory and metacognition to promote informed reflection and analysis of cognitive diagnostic errors. We believe that structuring M&M in this way builds a culture that encourages reflection together to learn our most difficult diagnostic errors and to engage in where our thought processes went wrong. In slowly building this culture, we hope to inoculate residents with the habits of mind that can best protect them from harmful biases in their clinical reasoning while instilling a culture of self-reflection.

scholarly journals The psychology of diagnostic error

2015 ◽  
Vol 8 (3) ◽  
pp. 91-98
Author(s):  
L. Zwaan
Keyword(s):  
Diagnostic Errors ◽  
Diagnostic Error ◽  
Dual Process ◽  
Dual Process Theory ◽  
Process Theory ◽  
Diagnostic Process ◽  
Cognitive Errors ◽  
System 2 ◽  
System 1 ◽  
Analytic Reasoning

Diagnostic errors in medicine occur frequently and the consequences for the patient can be severe. Cognitive errors as well as system related errors contribute to the occurrence of diagnostic error, but it is generally accepted that cognitive errors are the main contributor. The diagnostic reasoning process in medicine, is an understudied area of research. One reason is because of the complexity of the diagnostic process and therefore the difficulty to measure diagnostic errors and the causes of diagnostic error. In this paper, I discuss some of the complexities of the diagnostic process. I describe the dual-process theory, which defines two reasoning modes, 1. a fast, automatic and unconscious reasoning mode called system 1, and a slow and analytic reasoning mode called system 2. Furthermore, the main cognitive causes of diagnostic error are described.

Injector for a 100-500 kV Linac Electron Microscopy Source

1967 ◽  
Vol 25 ◽  
pp. 274-275
Author(s):  
John W. Coleman
Keyword(s):  
Electron Microscopy ◽  
Linear Accelerator ◽  
Beam Current ◽  
Ion Trapping ◽  
University Of Virginia ◽  
Electron Injector ◽  
Illumination System ◽  
Radio Corporation Of America ◽  
The University ◽  
Optical Integration

The injector to be described is a component in the Electron Injector-Linear Accelerator—Condenser Module for illumination used on the variable 100-500kV electron microscope being built at the Radio Corporation of America for the University of Virginia.The injector is an independently powered, autonomous unit, operating at a constant 6kV positive with respect to accelerator potential, thereby making beam current independent of accelerator potential. The injector provides for on-axis ion trapping to prolong filament lifetime, and incorporates a derived Einzel lens for optical integration into the overall illumination system for microscopy. Electrostatic beam deflectors for alignment are an integral part of the apparatus. The entire injector unit is cantilevered off a door for side loading, and is topped with a 4-filament turret released electrically but driven by a self-contained Negator spring motor.

Outcomes: Promoting Reflective Practice Using Performance Indicator Questionnaires

2010 ◽  
Vol 20 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Mary Pat McCarthy
Keyword(s):  
Clinical Education ◽  
Performance Indicator ◽  
Clinical Skills ◽  
Self Assessment ◽  
Clinical Practicum ◽  
Self Reflection ◽  
Healthcare Settings ◽  
Language Pathology ◽  
Traditional Performance ◽  
The University

This article details the process of self-reflection applied to the use of traditional performance indicator questionnaires. The study followed eight speech-language pathology graduate students enrolled in clinical practicum in the university, school, and healthcare settings over a period of two semesters. Results indicated when reflection was focused on students' own clinical skills, modifications to practice were implemented. Results further concluded self-assessment using performance indicators paired with written reflections can be a viable form of instruction in clinical education.

Reflective Knowledge

2018 ◽  
Author(s):  
Chienkuo Mi ◽  
Shane Ryan
Keyword(s):  
Extended Cognition ◽  
Dual Process ◽  
Dual Process Theory ◽  
Process Theory ◽  
Reflective Knowledge ◽  
Epistemological Disjunctivism ◽  
Recent Account

In this paper, we defend the claim that reflective knowledge is necessary for extended knowledge. We begin by examining a recent account of extended knowledge provided by Palermos and Pritchard (2013). We note a weakness with that account and a challenge facing theorists of extended knowledge. The challenge that we identify is to articulate the extended cognition condition necessary for extended knowledge in such a way as to avoid counterexample from the revamped Careless Math Student and Truetemp cases. We consider but reject Pritchard’s (2012b) epistemological disjunctivism as providing a model for doing so. Instead, we set out an account of reflection informed by Confucianism and dual-process theory. We make the case that reflective knowledge offers a way of overcoming the challenge identified. We show why such knowledge is necessary for extended knowledge, while building on Sosa’s (2012) account of meta-competence.

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