ArticleBMJ quality & safety2013
Cognitive debiasing 2: impediments to and strategies for change.
Article in BMJ quality & safety, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 2 of them syntheses that pooled it.
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Who cites it
104 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effect on diagnostic accuracy of cognitive reasoning tools for the workplace setting: systematic review and meta-analysis.BMJ quality & safety · 2022Pooled it
- Real time self-rating of decision certainty by clinicians: a systematic review.Clinical medicine (London, England) · 2019Pooled it
- The effect of a provisional diagnosis on intern diagnostic reasoning: a mixed methods study.Diagnosis (Berlin, Germany) · 2025Trial
- Influence of comorbid depression and diagnostic workup on diagnosis of physical illness: a randomized experiment.Diagnosis (Berlin, Germany) · 2023Trial
- Trial
- Using Virtual Patients to Explore the Clinical Reasoning Skills of Medical Students: Mixed Methods Study.Journal of medical Internet research · 2021Trial
- Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial.BMC medical education · 2020Trial
- Impact of caller's degree-of-worry on triage response in out-of-hours telephone consultations: a randomized controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2019Trial
- A cognitive forcing tool to mitigate cognitive bias - a randomised control trial.BMC medical education · 2019Trial
- Respectful Debiasing in Democratic Deliberation.Bioethics · 2026Article
- Data-Informed Intuition in Hepatology: Integrating Evidence, Context, and Clinical Reasoning.Gut and liver · 2026Review
- Article
- Cognitive Biases in Early Trauma Transfusions: Lessons From Three Rare Cases of Acute Hemolytic Reaction.Clinical case reports · 2026Article
- Intrinsic Influences on Medical Emergency Team Call Stand-Down Decision-Making: An Observational Study.Journal of advanced nursing · 2026Observational
- Community pharmacists' practices and clinical reasoning towards hospital discharge prescription: a study using simulations and retrospective think-aloud methodology.International journal of clinical pharmacy · 2026Article
- Cognitive reshaping and resurgence of humanness: restructuring the medical education continuum in the era of generative AI.Frontiers in medicine · 2026Review
- Enhancing Cognitive Reflection in Medical Trainees and Physicians: An EBM-CBL-PBL Integrated Teaching Model.Advances in medical education and practice · 2026Article
- Distinguishing anchoring from confirmation bias in diagnostic vignette studies: methodological implications for clinical decision-making.Frontiers in public health · 2026Article
- Teaching common cognitive biases and associated errors in veterinary neurologic diagnosis using clinical vignettes: a narrative review.Frontiers in veterinary science · 2026Review
- Physicians' metacognition in medical decision-making.Neuroscience of consciousness · 2026Article
44 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In a companion paper, we proposed that cognitive debiasing is a skill essential in developing sound clinical reasoning to mitigate the incidence of diagnostic failure. We reviewed the origins of cognitive biases and some proposed mechanisms for how debiasing processes might work. In this paper, we first outline a general schema of how cognitive change occurs and the constraints that may apply. We review a variety of individual factors, many of them biases themselves, which may be impediments to change. We then examine the major strategies that have been developed in the social sciences and in medicine to achieve cognitive and affective debiasing, including the important concept of forcing functions. The abundance and rich variety of approaches that exist in the literature and in individual clinical domains illustrate the difficulties inherent in achieving cognitive change, and also the need for such interventions. Ongoing cognitive debiasing is arguably the most important feature of the critical thinker and the well-calibrated mind. We outline three groups of suggested interventions going forward: educational strategies, workplace strategies and forcing functions. We stress the importance of ambient and contextual influences on the quality of individual decision making and the need to address factors known to impair calibration of the decision maker. We also emphasise the importance of introducing these concepts and corollary development of training in critical thinking in the undergraduate level in medical education.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.