The use of deliberate reflection to reduce confirmation bias among orthopedic surgery residents

Introduction: cognitive biases might affect decision-making processes such as clinical reasoning and confirmation bias is among the most important ones. The use of strategies that stimulate deliberate reflection during diagnostic process seems to reduce availability bias, but its effect in reducing needs be evaluated.Aims: examine whether reduces increases accuracy orthopedic residents solving written cases.Methods: experimental study comparing resolution eight cases containing a referral diagnosis. Half had wrong One group used (RG), which stimulates comparison contrast hypotheses systematic manner, control (CG), was asked provide differential diagnoses with no further instruction. included 55 third-year residents, 27 allocated RG 28 CG.Results: on higher scores than CG for correct diagnosis (62.0±20.1 vs. 49.1±21.0 respectively; p = 0.021). For incorrect diagnosis, similar between those (39.8±24.3 44.6±26.7 0.662). We observed an overall 26.3% initial (non-analytic phase) 19.5% final (analytic when Residents from showed reduction given non-analytic phase one provided (25.9±17.7 17.6±18.1, Cohen d: 0.46; 0.003). In CG, not statistically significant.Conclusions: present solved diagnoses, reduced bias. Despite set