Dropping the baton: Cognitive biases in emergency physicians.

Ng M; Wong E; Sim GG; Heng PJ; Terry G; Yann FY

Dropping the baton: Cognitive biases in emergency physicians.

dc.citation.issue	1
dc.citation.volume	20
dc.contributor.author	Ng M
dc.contributor.author	Wong E
dc.contributor.author	Sim GG
dc.contributor.author	Heng PJ
dc.contributor.author	Terry G
dc.contributor.author	Yann FY
dc.coverage.spatial	United States
dc.date.accessioned	2025-03-13T22:05:05Z
dc.date.available	2025-03-13T22:05:05Z
dc.date.issued	2025-01-02
dc.description.abstract	Introduction Clinical medicine is becoming more complex and increasingly requires a team-based approach to deliver healthcare needs. This dispersion of cognitive reasoning across individuals, teams and systems (termed “distributed cognition”) means that our understanding of cognitive biases and errors must expand beyond traditional “in-the-head” individual mental models and focus on a broader “out-in-the-world” context instead. To our knowledge, no qualitative studies thus far have examined cognitive biases in clinical settings from a team-based sociocultural perspective. Our study therefore seeks to explore how cognitive biases and errors among emergency physicians (EPs) arise due to sociocultural influences and lapses in team cognition. Methodology Our study team comprised four EPs of different seniorities from three different institutions and local and international academics who provided qualitative methodological guidance. We adopted a constructivist paradigm and employed a reflexive thematic analysis approach which acknowledged our researcher reflexivity. We conducted seven focus group discussions with 25 EPs who were purposively sampled for maximum variation. Our research question was: How do sociocultural factors lead to cognitive biases and medical errors among EPs? Results Our themes coalesce around sociocultural pressures related to team psychology. In theme one, the EP is compelled by sociocultural pressures to blindly trust colleagues. In the second, the EP is obliged by cultural norms to be “nice” and neatly summarise cases into illness scripts during handovers. In the last, the EP is under immense pressure to follow conventional wisdom, comply with clinical protocols and not challenge inpatient specialists. Conclusion Cognitive biases and errors in clinical decision-making can arise due to lapses in distributed team cognition. Although this study focuses on emergency medicine, these pitfalls in team-based cognition are relevant across the entire continuum of care and across all specialties of medicine. The hyperacute nature of emergency medicine merely exacerbates and condenses these into a compressed timeframe. Indeed, similar relays are run every day in every discipline of medicine, with the same unified goal of doing the best for our patients while not committing cognitive errors and dropping the baton.
dc.description.confidential	false
dc.format.pagination	e0316361-
dc.identifier.author-url	https://www.ncbi.nlm.nih.gov/pubmed/39746104
dc.identifier.citation	Ng M, Wong E, Sim GG, Heng PJ, Terry G, Yann FY. (2025). Dropping the baton: Cognitive biases in emergency physicians.. PLoS One. 20. 1. (pp. e0316361-).
dc.identifier.doi	10.1371/journal.pone.0316361
dc.identifier.eissn	1932-6203
dc.identifier.elements-type	journal-article
dc.identifier.issn	1932-6203
dc.identifier.number	e0316361
dc.identifier.pii	PONE-D-24-41077
dc.identifier.uri	https://mro.massey.ac.nz/handle/10179/72633
dc.language	eng
dc.publisher	PLOS
dc.publisher.uri	http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0316361
dc.relation.isPartOf	PLoS One
dc.rights	(c) 2025 The Author/s
dc.rights	CC BY 4.0
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/
dc.subject	Humans
dc.subject	Cognition
dc.subject	Physicians
dc.subject	Emergency Medicine
dc.subject	Male
dc.subject	Female
dc.subject	Medical Errors
dc.subject	Bias
dc.subject	Focus Groups
dc.subject	Adult
dc.subject	Patient Care Team
dc.title	Dropping the baton: Cognitive biases in emergency physicians.
dc.type	Journal article
pubs.elements-id	499293
pubs.organisational-group	Other