making good decisions rcem 2015 manchester wednesday

What do we mean by judgement

ACP Journal Club March/April 2005 | Volume 142 • Number 2

93% of Americans69% of Swedes

Svenson 1981 Acta Psychologica

Illusory superiority cognitive bias

Are you a better than average driver?

we are a risky speciality with the potential for subsequent harmPatients are at an early stage of disease

ClocksPatients

Discharge

Biological onset of disease

Early features

Late features

Physiological manifestation

Critical Illness

Time

Disease manifestation

Time

Disease manifestation

Probabilityof error

Time

Disease manifestation

Probabilityof error

Time

EM Visit

Disease manifestation

Probabilityof error

Time

On the post take ward round

Radiopaedia

headache and collapse

Headache

Feedback in Emergency Medicine

clinicalfeedback

performance

adaptation

feedback

assessment

m&m

• 2. Ask the right questions

What were you thinking….

Why did that seem to be the right idea at the time…..

How did you/we decide that…

What else were you thinking about….

Summary

population medicine vs individuals

Gestalt plus PERC rule will fail to spot two PEs for every

thousand patients investigated.

http://www.ncbi.nlm.nih.gov/pubmed/17967963

Making Good DecisionsSimon Carley