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Introduction: Cognitive biases leading to diagnostic errors are associate with adverse outcomes and compromise
patient safety and contribute to morbidity and mortality. Exploration and identification of cognitive biases have
been a difficult task for the clinicians and medical educators. The literature is deficient in the identification of
cognitive biases in surgical trainees. The objective of the study was to identify various cognitive biases that may
negatively impact clinical reasoning skills and lead to diagnostic errors in trainees of general surgery.
Materials and Methods: A quantitative study was conducted involving 48 trainees of general surgery to explore
the various cognitive biases. The questionnaire was devised and consisted of ten items devised to explore five
biases. .Descriptive statistical analysis was done on SPSS 20 and the respondents with score >25 were categorized
as predisposed to error scores of 20-25 were taken as a borderline and overall score of <25 was insignificant for
the presence of cognitive bias.
Results: Premature closure was the most frequent cognitive bias found significant in 34 (70%) of trainees followed
by anchoring bias in 14 (58, 3%) trainees. The relative frequencies of different biases are shown in Table 2. The
mean score of the questionnaire was 22.7 (range 10 to 38) SD 7.2. Ten out of forty-eight (21%) trainees with a mean
score of >25 showed a clear inclination toward cognitive errors whereas 11 (22%) with a score in the range of 21 to
25 were categorized as having an equivocal tendency towards committing an error, Whereas 27 (56%) with a score
of less than 20 were less prone to cognitive errors.
Conclusion: The two most common errors seen in the study were anchoring bias and premature closure and both
are related to information gathering. A larger study is required to explore the association of cognitive bias with
different specialties and experience of clinicians.
Muhammad Waqas Raza, Maria Zubair, Mailk Irfan Ahmed, Rehan Ahmed Khan. (2020) Cognitive disposition to respond in postgraduate trainees of general surgery at Rawalpindi Medical University, The Journal of Rawalpindi Medical College, Volume 24, Issue 3.
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