If your answer changed before you submitted it , then you were able to successfully perform a forcing function to get to system 2 analytic thinking. Much like procedural time outs reduce operative errors, so too can “diagnostic time-outs.” Here’s a more relevant example:

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On first glance, you’d be forgiven for thinking STEMI or acute ischemia. But take a moment to look again the way you were trained to interpret ECGs – the way you train others to do. Is the left ventricular aneurysm more obvious now?
 
The trick with diagnostic time-outs is not to frame them in a way that biases the team toward the current diagnosis or management plan. What data goes for—and against—the diagnosis? What can—and can’t—be explained? This week, take time outs for a test drive and demonstrate for learners how questioning one’s own assumptions and decision making can positively impact patient care.

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Resources:

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Croskerry P, Singhal G, Mamede S. (2013). Cognitive debiasing 1: origins of bias and theory of debiasing. BMJ Quality & Safety, 22 Suppl 2: ii58-ii64.

Croskerry P, Singhal G, Mamede S. (2013). Cognitive debiasing 2: impediments to and strategies for change. BMJ Quality & Safety,0:1-8.

Daniel M, Khandelwal S, Santen S, Malone M, Croskerry, P. (2017). Cognitive Debiasing Strategies for the Emergency Department. Academic Emergency Medicine,1:41-42.

Graber ML, Kissam S, Payne VL, et al. (2012). Cognitive Interventions to Reduce Diagnostic Error: A Narrative Review. BMJ Quality & Safety, 21:535-57.

Kahneman, Daniel. Thinking, Fast and Slow. (2011). New York: Farrar, Straus and Giroux.

Norman GR, Eva KW. (2010). Diagnostic error and clinical reasoning. Medical Education, 44(1), 94-100.

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