Twelve tips for teaching avoidance of diagnostic errors

TLDR

Diagnostic error remains common and causes significant clinical consequences despite advances in technology and a global emphasis on patient safety. This paper aims to teach medical trainees the cognitive roots of diagnostic error and how to avoid them through a 12‑tip educational series. The authors describe meta‑cognitive techniques, the importance of the clinical exam, and simple strategies such as diagnostic time‑outs and worst‑case scenario medicine to reduce error.

Abstract

Despite an increasing emphasis on patient safety on the part of healthcare systems worldwide, diagnostic error remains common. Errors frequently result in significant clinical consequences and persist despite remarkable advances in diagnostic technology. Most medical students and physician trainees receive little instruction regarding both the root causes of diagnostic errors and how to avoid such errors.This installment of the '12 tips' series discusses how to familiarize the learner with the cognitive underpinnings of diagnostic error. It also describes how to teach several approaches to the diagnostic process that may lessen the likelihood of error.Specific educational practices are discussed in detail. Emphasis is placed on describing meta-cognitive techniques, promoting the value of the clinical examination, and employing simple diagnostic strategies, including 'diagnostic time-outs' and the practice of 'worst-case scenario' medicine.Clinical educators may help learners avoid diagnostic errors by employing several of the educational techniques described herein.