PPD - Uncertainty In Medical Practice Flashcards Preview

Block 3 - Resp > PPD - Uncertainty In Medical Practice > Flashcards

Flashcards in PPD - Uncertainty In Medical Practice Deck (22):
1

Affective bias

- we tend to prefer to what we hope will happen rather than less appealing alternatives

2

Attribution bias

- patients are prototypes
- gut feeling can be dangerous when emotion is involved

3

Confirmation bias

- selective cognitive cherry picking based on a preconceived idea

4

Momentum bias

- nobody stops to question the diagnosis or clinical situation

5

Commission bias

- tendency to inaction or action

6

Rationalisation

- adopts a distorted or confabulated interpretation of an event
- the interpretation relieves anxiety and confirms a persons self-understanding as a moral individual

7

Euphemistic language

- makes the act seem less harmful

8

Advantageous comparison

- comparing it to something worse
- telling the family will only make them feel worse
- the immoral act trumps the moral act

9

Displacement of responsibility

- somebody else was really to blame
- therefore no need to disclose

10

Diffusion of responsibility

- the responsibility is tranferred to the group
- therefore cant single out who is to blame

11

Attribution of blame

- blaming the vitim of the circumstances for enabling the events to occur
- the patient brought it on themselves

12

Fragmentation

- the individual fragments/splits themselves between the person who made the error and the one who does some good deeds
- divert error to the bad self, but that is not the real person

13

Shared decision making

- both doctor and patient are involved
- information exchange in both directions and by both parties
- mutual deliberation on treatment options
- agreement on treatment
- no a hallmark of good clinical practice, an ethical imperative and a way of enhancing patient engagement and activation
- suggest benefit and increased patient satisfaction if participation preferences are met

14

Clinical skills for shared decision making

- developing a therapeutic relationship with patient
- explain the decision being made
- good communication skills + listening
- askin patient to tell you what they have understood
- support patients and their families to be involved in decision

15

Communicating complex information

- language
- patient understanding
- patient anxiety
- time
- decision aids
- question prompt list
- patient coaching
- consultation audio recording
- option grids
- time to consider decision

16

What does decision support do

- assist consumers to make informed choices about different options in their healthcare
- provides information on options and outcomes
- includes values clarification to weigh up pros and cons
- non-directive

17

Do decision aids work?

- improve knowledge
- lower decisional conflict
- fewer people undecided
- more people accurate risk perception
- less practitioner controlled decision making
- choosing option congruent with values

18

Are question asking interventions effective?

- increased question asking
- increased patient satisfaction
- no increase anxiety
- no increase in consultation length
- enable participants to raise more sensitive issues during consultation

19

Treatment decision questions: ASK

- increased the amount and quality of information given about treatment options and possible outcomes
- improve communication behaviors that encourage patient involvement in decision making
- did not increase consultation time in general practice

20

Summary: Shared decision making

- requires both patient and clinician to consider a healthcare decision together
- is considered best practice and widely endorsed approach to clinical decision making
- is supported on ethical and empirical grounds due to positive effects on decision quality, health outcomes, health service utilization and efficiency of care

21

Communicating uncertainty

- acknowledge uncertainty
- explore prefences and tailor discussion to patient and family in front of you
- consider different ways to explain information so it is understood

22

Decision support tool

- improve the communication of complex information to patients
- increase the quality of patient involvement in care

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