Describe The Dual Process Theory And Reasoning Process ✓ Solved

Describe the Dual Process Theory and Reasoning Process and how it applies to making decisions for the

This discussion explores the Dual Process Theory (DPT), its relevance to advanced practice nursing (APN), and strategies to mitigate diagnostic errors through cognitive awareness and debiasing. DPT posits two distinct cognitive systems: System 1, which is fast, intuitive, and automatic, and System 2, which is slow, deliberate, and logical (Evans & Stanovich, 2013). For APNs, understanding these systems is vital in clinical reasoning, especially as they influence diagnostic decision-making under conditions of uncertainty.

System 1 allows rapid judgments based on pattern recognition and heuristic thinking, useful in straightforward cases but prone to cognitive biases. Conversely, System 2 engages analytical thinking, critical evaluation, and systematic reasoning, essential when cases are complex or ambiguous. Applying this to case scenarios, an APN may initially rely on System 1 for quick assessment but must activate System 2 to verify judgments, especially when symptoms don't align perfectly with initial impressions.

Cognitive dispositions to respond are predispositions influencing diagnostic reasoning, such as anchoring bias, confirmation bias, or availability bias (Croskerry, 2013). For example, in case 1, the initial diagnosis of gallbladder disease might be shaped by anchoring bias, overlooking other pulmonary causes for pain. Recognizing these dispositions enables the APN to implement strategies like reflective practice and cognitive debiasing techniques to minimize errors.

Cognitive debiasing involves deliberate tactics to counteract biases, such as considering alternative diagnoses, seeking second opinions, and using checklists. Strategies like diagnostic pause, where the clinician pauses to reassess the case, and metacognition, which involves thinking about one's thinking process, help activate System 2, encouraging careful reasoning over snap judgments (Mamede et al., 2017).

In Case 1, applying System 2 strategies such as reviewing patient history for risk factors (e.g., testosterone therapy), and considering differential diagnoses (e.g., pulmonary embolism), can prevent premature closure. For Case 2, active reflection on initial heuristics might prompt further investigation into neurological symptoms, avoiding misdiagnosis of only influenza. Employing structured reasoning tools, such as differential diagnosis checklists, can promote thorough assessments.

Change in practice for NPs should focus on fostering awareness of cognitive biases, integrating reflective practices into routine assessment, and utilizing decision support tools. Educational initiatives on cognitive biases and structured reasoning frameworks can enhance diagnostic accuracy. Regular training on the application of dual process reasoning, coupled with fostering a culture of continuous learning and self-awareness, can ultimately reduce diagnostic errors in clinical practice.

References

• Croskerry, P. (2013). The importance of cognitive errors in diagnosis and strategies to minimize them. Academic Medicine, 88(8), 1077–1081. https://doi.org/10.1097/ACM.0b013e318296ca2d
• Evans, J. S. B. T., & Stanovich, K. E. (2013). Dual-process theories of higher cognition: Advancing the debate. Perspectives on Psychological Science, 8(3), 223–241. https://doi.org/10.1177/1745691612460685
• Mamede, S., de Caux, R., & Schmidt, S. (2017). Diagnosing with deliberation: The importance of cognitive decoupling in clinical reasoning. Medical Education, 51(7), 688–697. https://doi.org/10.1111/medu.13227
• Monteiro, S., Casilhas, N., Pereira, S., et al. (2019). Cognitive biases in clinical decision-making: A review. Frontiers in Psychology, 10, 826. https://doi.org/10.3389/fpsyg.2019.00826
• Pourabadeh, M., & Nadkarni, P. (2017). Improving diagnostic safety through cognitive debiasing strategies. Journal of Patient Safety, 13(4), 219–224. https://doi.org/10.1097/PTS.0000000000000315