ANSWER
Reaction to the Post by Laritza R.
Laritza, you did a good job of highlighting the differences between Type 1 and Type 2 processes in clinical decision-making in your explanation of the Dual Process Theory. You raised an excellent point regarding the function of Type 1 thinking in effectively managing situations that are familiar to you while also recognizing that it is prone to mistakes in situations that are unfamiliar. Furthermore, your use of Type 2 thinking to solve challenging clinical issues is in line with its function of reducing diagnostic errors.
Your description of Cognitive Dispositions to Respond (CDRs) and how they affect therapeutic practice is also quite helpful. APNs aiming for the best possible patient outcomes must acknowledge reflective techniques as a way to reduce CDR-related failures. Your argument can have been strengthened even further by adding instances or mentioning particular biases like confirmation bias or anchoring bias.
You provide a useful and pertinent explanation of cognitive debiasing techniques like awareness-building and introspection. These tactics are especially crucial in situations such as the first one, when the delayed diagnosis of a pulmonary embolism may have been avoided by identifying risk factors (such as testosterone medication). One crucial element that encourages ongoing decision-making improvement is the emphasis on getting feedback.
You provided a clear explanation of how you used Type 1 and Type 2 procedures to the two situations. Your emphasis on switching to Type 2 thinking when circumstances deteriorate or diverge from the anticipated clinical trajectory really caught my attention. For instance, Case 2 shows a methodical and comprehensive approach by identifying viral meningitis using Type 2 reasoning after flu-like symptoms persisted.
Last but not least, your suggestions for practice changes—such as keeping current medical records and teaching parents about red flag symptoms—are practical and patient-centered. Reducing diagnostic mistakes and improving care outcomes need these actions.
Building on your observations, I would recommend highlighting the function of group decision-making as an additional tactic to reduce bias and raise diagnostic precision. Diverse viewpoints are frequently brought about by collaboration, which can assist APNs in avoiding cognitive traps and reaching more precise diagnoses.
Well done on your thoughtful and well-organized response!
If you need assistance further honing this, please let me know!
QUESTION
Laritza R
Dual Process Theory and Reasoning Process Description and Its Application to Decision Making
The Dual Process Theory is highly known for describing the two forms of cognitive process commonly used in making decisions. Significantly, the Dual Processing Theories hold the perception that the cognition of human beings is governed primarily by the type 1 and type 2 processes (Tsalatsanis et al., 2015). The type 1 process applies to decision-making by enabling coming up with comprehensive and quick decisions especially in well-known situations though vulnerable errors particularly in unfamiliar situations (Monteiro et al., 2019). The type 2 process is helpful in decision-making decisions by coming up with suitable solutions to the most complicated situations (Monteiro et al., 2019).
Cognitive Dispositions to Respond
Cognitive dispositions to respond (CDRs) is a considerable subset regarded to be linked to failures of perception, cognitive biases, and failed heuristics. Traditionally, these failures have been perceived as the morbidity and mortality contributory factors in the process of thinking within the clinical practice incorporated with legal and medical impacts (Vinaykumar et al., 2023). CDRs are applicable in the APN setting by ensuring that a reflective practice is created resulting in optimal patient outcomes (Vinaykumar et al., 2023).
Cognitive Debiasing
Cognitive debiasing refers to the varied strategies initiated for cognitive bias mitigation, especially in decision-making in different situations. One of the strategies involves awareness creation which helps ensure that significant biases and how they impact thinking are understood accordingly (Vinaykumar et al., 2023). The other strategy constitutes regular reflection about decisions and looking for feedback for bias identification and correction.
Type 1 and Type 2 Application in Cases
In case 1, the type 1 process is applicable through the gall bladder diseases’ common presentations used accordingly in the initial assessment. Significantly, the type 2 process can be applied in this case in a situation where the symptoms manifested by the patient worsen. This allows for a nurse practitioner to adopt and implement systematic evaluation which incorporates ordering significant diagnostic tests for a comprehensive investigation of the condition.
In case 2, the type 1 process can be applied in the seasonal influenza initial diagnosis. This should be grounded on the same cases of high prevalence together with symptoms of common flu. Predominantly, the type 2 process is applied in this case through the nurse practitioner getting involved highly in systematic evaluation in instances where the condition of the child fails to improve. Through this evaluation, viral meningitis and dehydration can be made creating an environment for suitable intervention plans to be initiated, promoting desirable optimal health outcomes.
Considerations for Change
In case 1, NP should consider the maintenance of updated and comprehensive medical records capable of impacting risk factors. In addition, the NP can ensure that practices for reassessment are implemented accordingly for desirable health outcomes to be achieved. Predominantly, in case 2, the NP is expected to create awareness and educate parents on the possible risk factors and warnings necessitating quick response to medical treatment. Through this, they will be informed on the need for follow-up care impacting health outcomes optimally.
References
Djulbegovic, B., Hozo, I., Beckstead, J., Tsalatsanis, A., & Pauker, S. G. (2012). Dual processing model of medical decision-making. BMC Medical Informatics and Decision Making, 12(1). https://doi.org/10.1186/1472-6947-12-94
Monteiro, S., Sherbino, J., Sibbald, M., & Norman, G. (2019). Critical thinking, biases and dual processing: The enduring myth of generalisable skills. Medical Education, 54(1), 66–73. https://doi.org/10.1111/medu.13872
Tsalatsanis, A., Hozo, I., Kumar, A., & Djulbegovic, B. (2015). Dual Processing model for Medical Decision-Making: an extension to diagnostic testing. PloS One, 10(8), e0134800. https://doi.org/10.1371/journal.pone.0134800
Vinaykumar, N., Gugapriya, T. S., & Kalaiselvi, S. (2023). Exploring Knowledge of Cognitive Disposition to Respond in Clinical Decision-Making among Early Clinical Learners. Mædica, 18(2). https://doi.org/10.26574/maedica.2023.18.2.317