Recently I had the privilage to write a blog post in OSLER, a fantastic academic and humanistic forum created by Johns Hopkins colleagues aiming to rescue Medicine from being purely technical into a more intellectual and clinically relevant field. It helps to reengage us as physicians end enhance our best qualities as humans.
One of the sections in CLOSLER is about Clinical Reasoning. This is very dear to our heart as clinician-educators; and to me personally, because as a Quality and Patient Safety Officer for a large academic institution, my responsibility it to promote a culture of safety and zero harm. I engage in a high reliability organization aiming to acknowledge that this is a complex system environment and we want to eliminate the chance of clinical and diagnostic errors.
In clinical reasoning we always step back - do not assume things; if a diagosis was made in the ED or the ICU before the patient arriving to our service, we must have a healthy skepticism; avoid anchoring, availability, recall, commission or omission, etc. We need to have awarenes of our cognitive process and bias. Understand whether we are appraising these bias and aim to mitigate them. You can read a further commentary based on a clinical case in my CLOSLER post.
As I always conclude my blog posts - physicians aim for the patients' best outcomes. First principle is do not harm.
