Browsing by Subject "heuristinen ajattelu"

Aims. Clinical errors cause a significant number of deaths both in the field of medicine and clinical psychology, hence being a major threat to patient safety. One explanation behind clinical errors is heuristic thinking which affects decision-making automatically and aims for a result that is sufficient enough. Heuristic thinking can also lead to cognitive biases which affect decision-making by distorting interpretations of observations. The clinical errors caused by physicians have been studied far more than those caused by psychologists and psychotherapists. However, research has shown that a clinical error, such as a diagnostic mistake or unsuitable therapy method, affects the treatment of every fifth psychiatric patient. Thus, the main aim of this literature review was to investigate which heuristics and biases affect therapists’ decision-making and through which mechanisms they affect. In addition, the review examined which characteristics related to the therapist, patient and situation predispose to the adverse effects and how these effects could be minimized. Methods. The literature for this review was retrieved from the databases of Helsinki University Library and Google Scholar with the search statement (heuristic* OR bias*) AND (clinical reasoning OR clinical decision* OR clinical judgement). The search was limited to articles published between 2015-2022, but some previously published articles found in the references and the older original editions of the most influential papers were also used. Results and conclusion. This review showed that spending an insufficient amount of time with the case evidence, being too inflexible, therapist’s emotional reactions and false beliefs of their competence are strongly related to the adverse effects of cognitive biases and heuristics. This review also identified that the characteristics of patients, like their ability to cooperate, and the complexity of situations also affect the quality of clinical decisions. In addition, this review showed that it is possible to minimize the adverse effects by participating in training that focuses on these effects, using a patient-therapist feedback system, and keeping the mechanisms through which biases and heuristics affect consciously in mind when making decisions. These strategies should be implemented as quickly as possible to ensure safety and health equality.