Background:
Cognitive bias is a significant contributor to medical errors. Curriculums have been developed for internal medicine, emergency medicine and family medicine residents and had shown a positive impact on residents’ knowledge and skills in recognition and mitigation of cognitive biases. To date, there is no published curriculum intended for neurology residents.
Design/Methods:
We developed a four-session curriculum modeled after the one developed by Emily Ruedinger, MD and Andrew Olson, MD. The curriculum consists of interactive presentations, group discussions, and narrative writing. It addresses core concepts of recognizing cognitive bias, implementing strategies to counteract biases, and openly discussing personal errors. This will be delivered over the span of 10 months. We distributed surveys to assess residents’ experiences and attitudes toward cognitive bias before the curriculum. After the conclusion of the curriculum, we will distribute surveys to assess the impact of the curriculum on residents’ behavior.
Results:
Of 12 neurology residents, seven residents participated in the pre-curriculum survey. All the participants believe they have a significant role in reducing diagnostic errors. Three (43%) participants reported they had not seen discussion of cognitive error modeled by their supervising attendings, four (57%) had not seen discussion modeled by their peers, and four (57%) reported they were encouraged to discuss cognitive errors. Three (43%) participants report they are aware of the strategies to reduce cognitive error.
Conclusions:
Before the curriculum, nearly half of the neurology residents were unfamiliar with the concept of cognitive bias or strategies to reduce it. There may be a lack of modeling by both residents and attendings in reducing cognitive bias. The survey indicates a need for cognitive bias education for neurology residents. We expect to conclude the curriculum in February and will collect a post-curriculum survey to assess its impact on residents’ behavior.