all doctors are jackasses
DESCRIPTION
Slideshow for the talk I gave at SMACC 2013 titled 'All Doctors Are Jackasses' - see http://lifeinthefastlane.com/2013/03/all-doctors-are-jackasses/ TRANSCRIPT
![Page 1: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/1.jpg)
![Page 2: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/2.jpg)
![Page 3: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/3.jpg)
![Page 4: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/4.jpg)
![Page 5: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/5.jpg)
![Page 6: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/6.jpg)
Photo by Publicenergy
A Talk by Chris Nickson
All
Doctors
Are
Jackasses
![Page 7: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/7.jpg)
WHAT DO I
MEAN ?
![Page 8: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/8.jpg)
Photo by Zanthia
BLINDSPOT
BIAS
![Page 9: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/9.jpg)
Photo by Zanthia
![Page 10: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/10.jpg)
Photo by Zanthia
What? Me..
A Jackass?
![Page 11: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/11.jpg)
The
dual process
model
![Page 12: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/12.jpg)
From: Croskerry P. Healthc Q. 2009 PMID: 19667765.
![Page 13: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/13.jpg)
PATIENT
PRESENTATION
Pattern
PROCESSOR
SYSTEM
ONE
SYSTEM
TWO
recognised NOT recognised
![Page 14: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/14.jpg)
SYSTEM
ONE
Photo from Star Trek
Reason? Probability?
WTF?!
![Page 15: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/15.jpg)
SYSTEM
TWO
Photo from Star Trek
Captain Kirk is in charge?
That’s illogical!
![Page 16: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/16.jpg)
Photo by Loupe Clean
How they interact
![Page 17: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/17.jpg)
Photo by Loupe Clean
COGNITVE MISER
![Page 18: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/18.jpg)
Photo by Loupe Clean
RELEGATION
![Page 19: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/19.jpg)
Photo by Loupe Clean
OVER RIDE
![Page 20: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/20.jpg)
Photos from Star Trek
Loin pain + haematuria =
RENAL COLIC
Don’t forget AAA!
![Page 21: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/21.jpg)
Photos from Star Trek
That’s not a good idea
Jim..
Set phasers
on STUN!
![Page 22: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/22.jpg)
Photo by Charles Fred
Off to work we go..
![Page 23: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/23.jpg)
Photo by Defence Images
ENTER THE
COGNITIVE
MINEFIELD
Is the Well’s Score 0 or +3?
![Page 24: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/24.jpg)
Not too tight… OUCH!
MEET THE
PATIENT
Photo courtesy of Cliff Reid
![Page 25: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/25.jpg)
Photo courtesy of Cliff Reid
I’m starving!
![Page 26: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/26.jpg)
Photo from Dr Strangelove
Could it be acute
coronary syndrome?
Perhaps if the D-dimer is negative…
![Page 27: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/27.jpg)
I said “NO CHEESE”!
Photo courtesy of Cliff Reid
![Page 28: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/28.jpg)
Photo courtesy of Cliff Reid
I’m NOT laughing… My chest HURTS!
![Page 29: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/29.jpg)
hNp://lifeinthefastlane.com/ecg-‐library/anterior-‐stemi/
![Page 30: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/30.jpg)
CABG then OFF WE GO
TO THE ICU
Photo from Wikipedia
![Page 31: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/31.jpg)
hNp://lifeinthefastlane.com/2010/04/to-‐err-‐is-‐human-‐002/
![Page 32: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/32.jpg)
![Page 33: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/33.jpg)
![Page 34: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/34.jpg)
Photo by Klearchos Kapoutsis
What were they
thinking?
![Page 35: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/35.jpg)
![Page 36: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/36.jpg)
Over-attachment
to a particular diagnosis
Photo by visualpanic
1
![Page 37: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/37.jpg)
Anchoring
confirmation bias
premature closure
Photo by visualpanic
![Page 38: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/38.jpg)
Failure to consider
alternative diagnoses
Photo by Darwin Bell
2
![Page 39: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/39.jpg)
SEARCH SATISFICING
SUTTON’s slip
Photo by Darwin Bell
![Page 40: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/40.jpg)
Inheriting someone else’s
thinking
Photo by just.Luc
3
![Page 41: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/41.jpg)
DIAGNOSTIC MOMENTUM
FRAMING EFFECT
Photo by just.Luc
![Page 42: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/42.jpg)
prevalence perception
or estimation
Photo by Darwin Bell
4
![Page 43: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/43.jpg)
AVAILABILITY BIAS
BASE RATE NEGLECT
Photo by Darwin Bell
![Page 44: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/44.jpg)
patient characteristics
or presentation context
5
![Page 45: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/45.jpg)
NEGATIVE STEREOTYPING
TRIAGE CUEING
![Page 46: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/46.jpg)
physician affect, personality or
decision style
Photo by Tal Bright
6
![Page 47: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/47.jpg)
UNDERCONFIDENCE
VISCERAL BIAS
Photo by Tal Bright
![Page 48: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/48.jpg)
Photo from Apollo 13
UNUSUAL
DEMANDS
Only a JACKASS
would do that job!
![Page 49: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/49.jpg)
Image by Nasa Goddard Photo and Video
A PERFECT
STORM
![Page 50: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/50.jpg)
Photo by The Flying Gerbil
Being a Jackass ain’t so bad… At least I’m not a
doctor!
![Page 51: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/51.jpg)
Can we think
better ?
![Page 52: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/52.jpg)
![Page 53: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/53.jpg)
HOW we CAN
think better
![Page 54: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/54.jpg)
Metacognition
Image from: hNp://www.usask.ca/educa]on/coursework/802papers/Adkins/SEC1.HTM
![Page 55: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/55.jpg)
USE
cognitive
checkpoints
![Page 56: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/56.jpg)
REDUCE
Cognitive
load
![Page 57: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/57.jpg)
Turn experience
into expertise
![Page 58: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/58.jpg)
think
critically
![Page 59: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/59.jpg)
OPTIMISE work conditions
![Page 60: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/60.jpg)
look after
yourself
Photo by Kugel
![Page 61: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/61.jpg)
FINALLY…
What you
need to do now
![Page 62: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/62.jpg)
Think
Learn
Talk
Do
![Page 63: All Doctors Are Jackasses](https://reader034.vdocuments.site/reader034/viewer/2022051400/54bf90684a795964728b465f/html5/thumbnails/63.jpg)
Photo by asibiri
The End!