title: Right diagnosis, wrong care: patient management reasoning errors in emergency care computer-based case simulations.
abstract: The pervasiveness of reasoning errors in emergency care (EC) is commonly acknowledged in clinical research. Much of this work has focused on diagnostic errors; yet, in EC, providing a specific diagnosis is generally secondary to managing the patient. To gain insights into non-diagnostic, treatment-related errors, we presented EC residents with computer-based case simulations and recorded their actions and verbalized thoughts. Nearly all participants diagnosed both study cases correctly yet made a variety of patient management errors, some with serious consequences. More substantial errors could be classified as stemming from incorrect patient status and treatment inferences. These EC reasoning errors are discussed within the framework of underlying cognitive processes.
authors.affiliation: Center for Cognitive Informatics and Decision Making, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Guido F
authors.initials: GF
authors.lastname: Schauer
authors.forename: David J
authors.initials: DJ
authors.lastname: Robinson
authors.forename: Vimla L
authors.initials: VL
authors.lastname: Patel
mesh_terms: D000328:Adult; D003198:Computer Simulation; D003657:Decision Making; D004632:Emergency Medical Services; D004635:Emergency Medicine / Q000193:education; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D005791:Patient Care