376TF Development of a Critical Thinking Curriculum for Emergency Medicine Residents

Abstract

Diagnostic errors account for a large portion of medical errors, leading to significant patient morbidity and mortality. There has been a focus in the past 2 decades on increased awareness and education of critical thinking and the cognitive biases that can lead to diagnostic errors. This has trickled into medical school education, but significant education and training of residents, in how thinking and cognitive errors affect practice, is lacking. The goal of this curriculum is to impart the knowledge and skills to emergency medicine residents to understand basic cognitive theory and cognitive errors, and use that knowledge to prevent diagnostic mistakes. By the end of this course residents will be able to 1) explain the dual process theory of cognitive decisionmaking 2) describe biases that can lead to diagnostic errors 3) apply the biases to clinical scenarios and 4) use tools, such as metacognition, to help prevent their own diagnostic errors. Participants will take a pretest prior to the start of the curriculum. They will receive reading material on critical thinking and diagnostic errors to review. This information will be reinforced with a didactic lecture followed by a small group session. During the small group session, faculty with understanding of critical thinking will lead discussions based on case studies to better understand the various cognitive biases. Participants will have opportunity to provide feedback of both the lecture and small group session. Residents will receive continuous exposure to these concepts during monthly morbidity and mortality (M&M) conference. A work sheet will be given to every participant during M&M conference where they will be asked to describe the cognitive errors that may have led to the results in the cases presented. After 1 year, residents will take a post-test to determine retention and understanding. Critical thinking is an important aspect to optimal and safe care of patients, but it is often excluded from resident education. This curriculum will help emergency medicine residents make better clinical decisions by understanding why and how they make those decisions.