Heuristics as a Barrier or a Bridge

Something that struck me during the first day was how it seems that our thinking as humans predisposes us towards medical errors. We are fallible beings with a limited capacity for understanding complexity practicing in a field with infinite complexities. We have to use heuristics, or mental shortcuts, because if we didn’t we would be inundated with so much information that we would become incapacitated. When this thinking goes wrong, we fall victim to confirmation bias and our patients can suffer. While this can be combatted through more mindful practice, overcoming thinking patterns that have persisted through millennia of evolution is no small feat. I ended the first day feeling discouraged that better safety outcomes would only come through a constant battle against our inherent thinking patterns.


During the second day, a different heuristic came to mind. The availability heuristic is the idea that we judge the probability of an event happening as more likely if an example readily comes to mind. For example, you might be more worried about your flight going down if you watched a news segment about a plane crash the day before. The actual statistics haven’t changed, but you perceive it as being more likely to occur. Watching as faculty members spoke about medical errors that they had experienced, clearly emotional even many years later, made me wonder if the availability heuristic could actually be beneficial. When a loved one is affected by a medical error or when we commit an error ourselves, that experience never leaves us. If it stays at the forefront of our minds, hopefully without affecting our ability to practice going forward, the experience can serve as a constant reminder of the ever-present risk of an error. In other words, the availability heuristic may actually help us to provide safer care. Rather than being a barrier to safety,  our thinking patterns can actually be a bridge to better outcomes.