MDT Training: Cognitive Errors and Communicating Uncertainty

Workshop 1

Title: Improving on What We Cannot See: The Invisible Thought Processes that Drive How We Think

Objectives:

1. Explore how personal experiences influence perception.
2. Understand how errors occur in decision making.
3. Learn how errors can compound.
4. Develop skills to counteract those problems.

Description:

Cognitive errors are common in complex thought processes, even among highly trained professionals. The evaluation, diagnosis and investigation of child abuse is inherently complex. This session will cover common errors in thinking, discuss how these errors can build on one another both within a decision maker and between decision makers and will explore how these errors can be avoided and/or mitigated. Participants will learn how to think about their own beliefs and biases, how to challenge assumptions in cases and how to avoid situations that can lead to errors in thinking. This talk is relevant to medical providers, investigators, and lawyers as everyone is known to make these cognitive slip-ups.

Workshop 2

Title: Possible is Seldom Definite and Only Sometimes Probable: Communicating Uncertainty

Objectives:

1. Identify key factors that create uncertainty in a medical diagnosis.
2. Develop an approach to improve communication around issues of uncertainty.
3. Identify some tools that can be used to support the words we use to communicate probability.

Description:

Communicating clearly can be challenging, communicating uncertainty can be downright confusing. This session will discuss uncertainty in diagnosis from a patient, provider, and community partner perspective. It is well known that medical communication often fails to effectively communicate what it is the provider is trying to say. This can be frightening and frustrating for both patients and medical providers. When the medical issue is child abuse, clear communication is critical.  Many medical diagnoses have inherent uncertainty associated with them.  How that uncertainty is communicated is important to ensure that a patient hears what the provider is trying to say.  If the possible diagnosis is child abuse, there is another audience that needs to understand what is being said: the community partners who will be working with the child and family.  With all these different “consumers” of information, miscommunication can happen even if someone is careful.  How do we handle uncertainty in making a diagnosis?  How do we communicate uncertainty in our written and oral communications?  Do people really understand what we are trying to say?  Do we really understand what we are trying to say? We will explore some of the literature about uncertainty and communication and develop some strategies to approach cases that aren’t black or white to try to be more clear about what we really can say.