Medical Decision-Making

Medical Decision-Making

In the clinical setting, the decision-making process employed by “expert” physicians is one that aims to be as reflective, unbiased and as purposefully thoughtful as is humanly possible. This decision-making process is informed by the specific circumstances of each individual patient, is calibrated by relevant findings of evidence, and is mindful of the pitfalls of cognitive biases and conflicts of interest. The College of Physicians and Surgeons is committed to providing students opportunities to develop the knowledge, skills and attitudes of effective medical decision-making. Over the four years of medical school students participate in educational activities focused on one or more learning objectives of the Medical Decision-Making curriculum. These educational activities are organized as a thematic thread that is woven into the curriculum. 
 
There are four major themes of the medical decision-making thread: Clinical Reasoning and Decision Analysis are the processes utilized in nearly every patient encounter to make a diagnosis and choose an appropriate therapy; and Conflicts of Interest and Cognitive Biases are the unconscious influences that routinely threaten to undermine optimal decision-making. The Table below lists the thread themes, objectives and location in the curriculum: Fundamentals (FND), Major Clinical Year (MCY), or Differentiation and Integration (D&I).
 
Theme Topic Location in Curriculum Phase
Clinical Reasoning Introduction Foundations of Clinical Medicine FND
Clinical Reasoning Slow and fast thinking Mechanisms & Practice MCY
Decision Analysis Decision Trees Mechanisms & Practice MCY
Decision Analysis Sensitivity Analysis Back to the Classroom D&I
Cognitive Biases Recognition of biases Mechanisms & Practice MCY
Cognitive Biases Managing biases Back to the Classroom D&I
Conflicts of Interest Overview Foundations of Clinical Medicine FND
Conflicts of Interest Managing conflicts Mechanisms & Practice MCY