How to Avoid Cognitive Errors in Rheumatology

Practice Makes Perfect

Much like any other skill in medicine, learning to recognize and minimize cognitive errors takes practice. Invariably, the first step entails acknowledging one’s vulnerability to cognitive biases. Next steps involve being aware of 1) the situations in which cognitive errors are most likely to occur and 2) the types of biases to which you, as an individual, are most prone. Then we must develop and practice debiasing strategies, which should be shared with trainees as we role model mitigating our own biases.

In Sum

By admitting our susceptibility to bias, practicing cognitive forcing techniques, being introspective when we are especially predisposed to making cognitive errors and teaching our trainees to engage us daily in conversations about biases, we can learn to identify biases in real time, providing the opportunity to compensate for those biases and avoid a mis­diagnosis. Mastering cognitive errors provides us the opportunity to become the master diagnosticians we all strive to be.  

Megan Milne, MD, is currently is a second-year rheumatology fellow at Duke University, Durham, N.C. She completed her medical education at the University of Pittsburgh School of Medicine and her internal medicine residency training at University of Texas Southwestern Medical Center, Dallas.

Rebecca E. Sadun, MD, PhD, is an adult and pediatric rheumatologist at Duke University School of Medicine, Durham, N.C., with an interest in how cognitive biases impact diagnostic reasoning in rheumatology.

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