PT  - JOURNAL ARTICLE
AU  - Robert L Trowbridge
AU  - Gurpreet Dhaliwal
AU  - Karen S Cosby
TI  - Educational agenda for diagnostic error reduction
AID  - 10.1136/bmjqs-2012-001622
DP  - 2013 Oct 01
TA  - BMJ Quality & Safety
PG  - ii28--ii32
VI  - 22
IP  - Suppl 2
4099  - http://qualitysafety.bmj.com/content/22/Suppl_2/ii28.short
4100  - http://qualitysafety.bmj.com/content/22/Suppl_2/ii28.full
SO  - BMJ Qual Saf2013 Oct 01; 22
AB  - Diagnostic errors are a major patient safety concern. Although the majority of diagnostic errors are partially attributable to cognitive mistakes, the most effective means of improving clinician cognition in order to achieve gains in diagnostic reliability are unclear. We propose a tripartite educational agenda for improving diagnostic performance among students, residents and practising physicians. This agenda includes strengthening the metacognitive abilities of clinicians, fostering intuitive reasoning and increasing awareness of the role of systems in the diagnostic process. The evidence supporting initiatives in each of these realms is reviewed and a course of future implementation and study is proposed. The barriers to designing and implementing this agenda are substantial and include limited evidence supporting these initiatives and the challenges of changing the practice patterns of practising physicians. Implementation will need to be accompanied by rigorous evaluation.