Think fast and slow in the cognitive process for decision making in medicine

Abstract

Being a doctor requires making quick and accurate decisions, whether it is diagnosis or therapy, and has implications for patient safety. Several theories have been proposed to explain how clinicians make their reasoning, pointing out differences between skilled and inexperienced clinicians. Our brain has two systems of thought: fast and slow. Fast is associated with intuitive and automatic decisions, requires little energy or attention, allows decisions to be made with little information. Slow cognitive processing involves deeper, more analytical cognitive processing, requires effort, and can be strenuous. Recent research indicates that quick thinking is used in most medical decisions. This form of intuitive thinking is part of the process is very effective, but it is also vulnerable to cognitive errors. The dual theory of reasoning, reflecting the great importance of intuition in most decisions, allows us to better understand how we doctors think in our daily practice. Medical schools should use new didactic spaces in which problem-based learning is greatly facilitated, in subjects such as integrated workshops, medical practice, or integrative sessions, with similar methodology, that provide our students with opportunities to obtain knowledge and critical thinking skills to solve medical problems in a holistic way, in any context, with both systems of thought. More years in the classroom, continuing medical education, certification by advice do not solve the problem, there are those who invoke to eliminate cognitive errors in medical practice, that it must be redesigned and reinvented.