| Cognitive Forcing Strategy |
Practical Application |
| Change the base case assumption |
Do not assume that a return or referred patient is fully worked up. Rather, assume undiagnosed secondary problems are present that require thoughtful evaluation. |
| Use a checklist |
Assess regional skin in the field of surgery as a routine part of each patient visit to help minimize missing diagnoses. |
| Engage in self-assessment |
Review prior objective evidence- photographs, biopsy reports, lab tests- for signs of medical error that may have been overlooked due to heuristics. Keep a log of these diagnostic errors to periodically review and prevent future cognitive bias. |
| Avoid fatigue and reduce cognitive strain |
Consider small glucose snacks to refill one’s mental reserve, get adequate sleep, limit interruptions, allocate ample time for cognitively demanding cases. |
| Alter the practice environment |
Build extra time into your schedule to allow for feedback, checklists, and reflective self-evaluation. Consider using scribes and information technology to allow more focused energy on patient care. |
