How does metacognition improve decision-making in healthcare practitioners?

Abstract

Background: Metacognition is the process of awareness of the way in which we think. Healthcare practitioners are intrinsically required to make complex and demanding decisions daily—and just as with non-healthcare-related industries, they are susceptible to human error. Human factors (HF) can have catastrophic implications and the use of metacognition is a well-regarded tool to aid decision-making. Objective: This systematic review aimed to determine how metacognition and human factors influence decision-making in healthcare practitioners. Methods: the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine (AMED) Database, Dentistry & Oral Sciences Source, MEDLINE, SPORTDiscus, APA PsycArticles Psychology & Behavioral Sciences Collection and APA PsychInfo were searched for eligible qualitative studies. The search was carried out in December 2021. Results: Six studies met the inclusion criteria for the current review. Twenty main themes and twenty-eight subthemes were categorised into twenty-one descriptive themes. These were synthesised into fourteen analytical themes, four of which were determined to be recurrent and one of which held significant implications for clinical practice: (1) Cognitive bias identification; (2) Systematic approach; (3) Holistic approach and creative thinking; (4) Identifying uncertainty; and (5) Drawbacks. Conclusions: This review found that metacognition improves decision-making in healthcare practitioners through cognitive bias identification, facilitation of systematic approaches, holistic approaches, and creative thinking. However, consideration should be made to its limitations. Further research is required to fully understand the findings in relation to specific practice areas and their clinical implications.