The readings help me reflect on how I make decisions in make clinical practice. I would like to believe that all my decision are based on EBP and the lowest cost and greatest benefit. But I wonder how often I am guilty of the three common heuristics and biases in clinical decision-making that Thompson (2003) discusses: a) overconfidence, b) hindsight, and c) base rate neglect. While nursing experience is valuable it is important for those making clinical decisions to realize that there is a potential for heuristics and biases. This potential needs to be weighted against the value of nursing experience. Nursing experience can provide confidence but this need to be tempered by "adjusting your own personal confidence estimates downwards" (Thompson, 2003, p 233). The bias of hindsight can be combated by attempting to ignore hindsight and focusing on alternative possibilities (Thompson, 2003). Finally, effects of base rate neglect bias can be mediated by learning about base rates and using them in decision-making process (Thompson, 2003). It seems that clinical decision support systems would be one methods of helping to reduce biases. "Decision support system aid in and strengthen the selection of viable options using the information of an organization or a field to facilitate decision making and overall efficiency" (Hebda & Czar, 2009, p 158).
Hebda, T., & Czar, P. (2009). Handbook of Informatics for Nurses and Healthcare Professionals (4th Edition ed.). Upper Saddle River, New Jersey: Pearson.
Thompson, C. (2003). Clinical experience as evidence in evidence-based practice. Journal of Advanced Nursing, 43(3), 230-7.
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