Summary day 1

• Medical errors can be categorized in different ways. The participants' choice of Jim Reason's threefold categorization of errors as slips, mistakes, and violations was a good one. They focused more than they have in the past on violations. Other potentially useful error typologies have been provided by Thurstone and by Arkes.
• Ways of improving decision making can be broadly categorized into motivational, cognitive, and technological approaches. Motivational approaches include monetary payment and accountability. The former appears less effective than one might expect and the latter rather more so. Cognitive approaches include providing reasons why a decision might be wrong, training in rules for reasoning, and training in use of alternative representations (eg thinking in terms of frequencies rather than probabilities). Technological approaches include judgmental bootstrapping, decision analysis, and decision support systems. One problem with decision support systems is that, even when they are effective, decision makers are reluctant to use them. Larrick (2004) has discussed these issues thoroughly.

References

Reason J (1992) Human Error Cambridge: Cambridge University Press.

Larrick RP (2004) Debiasing. In DJ Koehler and N Harvey The Blackwell Handbook of Judgment and Decision Making. (pp 317-337) Oxford: Blackwell