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Learning from Medical Errors

December 4, 2011

For our Dutch readers: an interesting lecture of Sidney Dekker on ‘Learning from medical error’.

Prof. Sidney Dekker is Professor of Human Factors and System Safety at Lund University, Sweden and Director of Research at the Leonardo Da Vinci Center for Complexity and Systems Thinking.

Medical error has been the subject of much public debate in recent times, and the past decades have seen a steep increase in the frequency and size of claims against doctors and other medical personnel, as well as a heightened concern among lawmakers, insurers and regulators. The problem with a judgment of “error” (or, worse, “negligence”) is the constructed and negotiated nature of both concepts, which are subject to what are known as the outcome bias and hindsight bias. The hindsight bias is one of the most well-researched biases in psychology and relates to the overestimation of probability of an adverse event, as well as the oversimplified causality of that event, perceived by a retrospective outsider. The outcome bias is a largely preconscious cognitive effect produced by the observer’s knowledge of the outcome, which distorts the assessment of decisions leading up to that outcome. In this talk, Prof. Dekker will run through some of the relevant legal, medical, psychological and sociological literature on the operation of these pervasive and universal biases in judgments of medical “error” and “negligence” and seek ways to address the problem.

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