DIP Episode 530 - Cognitive Errors and The USMLEs (very HY for Step 1-3)

Welcome to episode 530 of the Divine Intervention Podcast. Into this podcast, I'm going to be considering a topic known as a Cognitive Errors and the US ML Gs. Cognitive Errors and the US ML Gs. This is a super high-yield podcast for step one, step two and step three. And where do many of these cognitive errors come from? A lot of them come from what many people know as a heuristic. It's pretty much like pattern recognition. Many of us use this as medical students or as healthcare professionals. You just use patterns in your mind and you just use that. You know, it's almost like test-taking in a sense. Like, man, I've seen this pattern so many times. So because of that boom, I'm just going to jump to this. That's a common kind of, that's basically like almost like a foundation for many of these errors. You're just like, well, I've seen this pattern before, so you got to be this. That's not always a smart way to think. It's smart to think that way, but sometimes he can have some pitfalls. And one thing I'm going to say about these cognitive errors. So I've said the first thing like where they come from, you know, a lot of them are from heuristics. But the second thing I'm going to mention here is this. The right answer on your exam is going to be based on the way the scenarios describe. The right answer on your exam is going to be based on the way the scenarios describe. The scenario, the same scenario described one way may be one answer.

That identical scenario described a slightly different way, maybe to a completely different kind of error. So just be careful about that. So let's walk through these errors. Number one, what if they give you a question about a physician? And, you know, this physician attended residency during the COVID-19 pandemic. And this physician saw like 400 patients with COVID-19 during the pandemic. And then you were told that this physician examines a patient. And the patient comes in with, you know, upper respiratory symptoms and shortness of breath. And the physician says that the person has COVID-19. And just diagnosis of the person COVID-19. And it is now found out later that the person had the flu. What kind of errors that? What kind of errors that? So I hope you're saying divine. This sounds a lot like availability error. Availability error. Availability error. Sometimes on the exams, they can call it availability bias. So let me explain what kind of bias is this? Basically, you improperly estimate probabilities because something just comes to mind more easily. Right. So let's say something is very common or something is, let's say something is very common to you. Or something has happened more recently or whatever. Then because of that, you're like, oh, future patients that, you know, you're just like, oh, this is what they have. That's an example of availability error. You're pretty more diagnosed in a patient based on what you frequently see.

Because that thing you frequently see in your practice is more memorable, is more frequent. So you pretty much end up ignoring other causes. That may not be more recent, but may actually be quite common. So because this person is so much COVID-19, so so much COVID-19, so so much COVID-19, COVID-19 is almost like all these neural synapses have been established in their brain. Think COVID-19, think COVID-19, think COVID-19. That people that come to them with somewhat similar symptoms, they think just of COVID-19. But there may be other causes of that same symptom like the flu. The flu is actually pretty common. But if you're just thinking just COVID-19, COVID-19, COVID-19, because you've seen so much COVID-19, then you're going to get in a lot of, in quite a bit of trouble. So, you know, for example, maybe let me give another example that people can relate to. So many people know of the Game Stop short squeeze that happened a few years ago. Since like so back in the day, but not really, it was probably like what, like in 2021 or something like that. 2021 or 2022, you can't remember exactly when. But I think it happened in 2021 or 2022. There's a one movie that was made based on this stuff. So after that, you'll notice if you look at Reddit, like Wall Street Bets, everybody started thinking of short squeezes. Anything that happens when a stock has a high short interest, everyone thinks that, wow, this is just be a short squeeze.

This is going to be a definitely going to be a short squeeze. No, it's not definitely going to be a short squeeze. Yes, the Game Stop was very recent, it was prevalent in the media. So it's like fixing people's minds heavily. So everything becomes a short squeeze to them. No, that's not the way it is. Because the short squeeze is actually very uncommon, very, very uncommon. So that's an example of availability error. Now, what if they give you a question about a child that presents with hypercalsemia, renal failure, anemia, bone pain, and it's a two year old child, and you're told that, ooh, this child is diagnosed with multiple myeloma. This physician says, oh, this person has multiple myeloma. But they need to find out, oh, this child actually has something completely different, some other disease. Then, what kind of error should you think about here? So you see this person, it's a two year old child, they have the crap symptoms of multiple myeloma. You diagnose them with multiple myeloma. You're like, oh, this child has multiple myeloma. They have hypercalsemia, renal failure, anemia, bone pain, and you're like, oh, it's multiple myeloma. But then it's found out, oh, that this person actually has this other condition. What should you be thinking about here? I hope you're saying, oh, divine, this is a representation error, representation error. So what's the crux of a representation error?

The crux of a representation error is that you see a classic presentation, where you ignore disease prevalence. You literally see a classic presentation of something, where you ignore disease prevalence. Multiple myeloma is found almost exclusively in people that are older, not in two year olds. So you just completely ignore disease prevalence, because you're like, oh, this is slam dunk classic presentation. So I think that's just something you want to be careful about. That's something you want to be careful about on exams. That's something called representation error. You see a classic presentation, where you ignore disease prevalence. You see a classic presentation where you ignore disease prevalence. It's just like, for example, diagnosed in like CLL again in a little kid. Kids really get CLL is very, very rare in kids. But again, you just completely ignore that because, oh, you're like, oh, this is the classic presentation of CLL. Again, that's why it's important to integrate many things in coming to your decisions. Don't just come to decisions because of something. Oh, I see this, this classic thing. So that's it. I'm not going to consider anything beyond that. No, that's not a smart way to think. All right, so that's representation error. Okay, what if they give you a question about a patient that comes into the emergency room? You're told that, you know, this person has a, you know, he's a, has a history of COPD.

And they've had multiple exacerbations and they come into the emergency room. Because for the past two hours, they've been having chest pain, they've been having shortness or breath. And, you know, they're coughing. And you're told in the queue, stem that this person, you're like, oh, this person has a, let's see, the exacerbation. You diagnose the person with a COPD exacerbation. And you notice that, man, this person is not improving. This person is not getting better. And then you're told that the person's clinical status deteriorates. And it is found out, you know, the die, like a few hours after admission. And then they do an autopsy and they find out that this person actually had like a big poem, like a subtle embellish. What kind of error is that? So, and they tell you in the question that, oh, you did not even do a CT, chest angiogram, you know, anything of that nature. Then what, what are you thinking about there? What kind of errors that, what kind of cognitive errors that? Well, that's something called premature closure, premature closure. So what's the deal with premature closure? You pretty much jump to conclusions. You jump to conclusions. You jump to conclusions. So you don't even bother to confirm the diagnosis. So usually in these questions, they'll tell you, you didn't even do much of any kind of diagnostic testing. So you just jump to conclusions. You don't confirm the diagnosis, even with a proper testing.

Like for example, if a person has a COPD exacerbation, at least it maybe makes some sense, give things like an EBG, get things like a chest x-ray, you know, just get a bunch of things and consider all the aspects of the history. But you just pretty much just jump to a conclusion, you're like, oh, it's this, so I'm not, I'm not, you know, this person has a COPD, you've had frequent exacerbation. So this must be another exacerbation. You don't consider the things. You just jump to conclusions without doing a proper diagnostic testing. That's going to be an example of premature closure. Literally an easy way to just encapsulate this in a few words is jumping to conclusions. That's pretty much it. So you're pretty much jump to conclusions. So you don't confirm the diagnosis without appropriate testing. And what are some classic hotspots for this kind of error on the USM at least? It's very common when people have exacerbations of known disorders. So we know they have this disorder and we know they've had frequent exacerbations of it. So whenever they come into the hospital, you're only thinking in terms of that exacerbation. You don't think of all the things that are causing that presentation. Another classic hotspot for this is where a preceding physician has made a diagnosis. So let's say your consult service, let's say you're your, I don't know, surgery consult, like surgery consults.

And let's say there are two other physicians that have already seen this patient since they were admitted. And those two other physicians said, oh, it's condition A. And you pretty much don't even do any independent thinking of your own or consideration. You're just like, oh, yeah, the other clinician said it's condition A. So it must be condition A. You don't think you're doing a valid case. That's going to be an, you make an error because of that. That's an example of premature closure. All right. So what if they give you a question about a person that comes to the emergency room and they have shortness or breath. And they have a medical history of CHF and they've had multiple exacerbations for that CHF. And then you're told in the Houston that the person's BMP is fine. The person has minimal peripheral edema. There are no crackles on the scutation of the lungs. An EKG showing you sinus tachycardia. But you're still saying, this person has, this person has a, I told in the question that, oh, the physician diagnosis the patient with the CHF exacerbation. And then it is found later that while this person had a PE and the diet or whatever, what kind of bias is that? What kind of error is that? What is going to be an anchoring bias? Anchoring bias? So anchoring error? Anchoring error? Anchoring bias? So what is the crux of this? Basically, you stick to the first thing that comes to mind.

Even if the question's thing is giving you other evidence that is beginning to accumulate that man. This person, these other pieces of evidence do not agree with. Also, just that he should maybe consider something else. Right? So like, for example, you know in this case, I just related that, wow, this person, they have a history of CHF. They've had multiple exacerbations. Okay. Well, and then you're like, oh, this is CHF exacerbation. Even if you're beginning to see all the things that don't fit, the person's brain-nutrinated peptide is completely fine. This person has minimal peripheral edema. This person doesn't have crackles on the scutation of the lungs. EKG is shown sinus-tactic cardio. You know, and let's say they won't tell you that, wow, this person recently had like a long plane ride or whatever. But because you think, oh, this is slum long CHF exacerbation. That's the first thing that comes to mind. You think, oh, this is CHF exacerbation and CHF exacerbation alone. You don't consider all the things. You don't consider all the things. I mean, sometimes in those Q-stems, they will tell you that, oh, they'll give you other pieces of history. I'll tell you that, man. This person's CHF exacerbation is kind of a weird diagnosis. Yes, I know they have this history. I know this is the first thing that comes to mind, but there's also mounting pieces of evidence that tells me that, this may not be a CHF exacerbation. This may be more like a PE.

That's going to be an example of anchoring bias. An example of anchoring air. I mean, I would not be so, so again, let me just make sure this is clear to you. What is anchoring bias? What's anchoring air? You stick to the first thing that comes to mind. Even if all the evidence is beginning to accumulate, other things are beginning to accumulate that, man, doesn't agree with what was the first thing that came to your mind. Or suggest that maybe you should consider something else. That's a classic error in judgment that many people make. I will not be surprised if this kind of bias or error is common in police departments. The thing's one is a suspect from the get go. Even if they begin to accumulate evidence, the man, this is not really fit. They still stick with that person. That's an example of anchoring air. That's an example of anchoring bias. Now, what if they give you a question about a patient that presents to the emergency room with... Let me try to see if I can make a good example for that. Okay, so they give you a question about a patient that comes in to the emergency room. They're speaking to you as the emergency physician. And they tell you that, oh, I have condition X. I think I have condition X. I think I'm having some anxiety. I think I'm having some anxiety. Let me try a different example. I think this is one of those things where we have to use vague descriptors.

Let's see if a patient comes in and they say they have some symptoms and they tell the physician as you're interviewing them. I think I have condition X. I think I have condition X. And then that physician only orders tests to evaluate for condition X. Only others tests to evaluate for condition X. To confirm condition X. And those are considered other things. What kind of bias is this? What kind of error is this? This is a confirmation bias. This is confirmation error. Confirmation bias, confirmation error. So what are some classic ways? Basically, what is confirmation bias or confirmation error? Essentially, you consider one thing and you only order tests for that thing. You keep trying to do everything you can to confirm that thing. Everything you can to confirm that thing. You don't consider other possibilities. So classic examples of this on an exam will be a patient thinking that, oh, they have a certain problem. They tell you that, oh, I'm thinking I have this issue. And then as the clinician, you pretty much order only tests to confirm what the patient has just said. Or let's say, oh, you thought of X condition as a physician. So the patient didn't say anything to you. They told you the symptoms and you're like, oh, I think it's this. And then you only order tests to confirm that thing you were thinking. That can cause a lot of problems, folks. Why? Because you need to rule out other things. And I wouldn't be surprised. It's not a no surprise.

I'm almost certain this is probably a common kind of error in emergency medicine because there's a lot of pressure to move through patients quickly. So you pretty much latch on to any shortcut you have. Well, I think it's this. I'm just going to confirm this and move along. No, that can cause problems. That's an example of confirmation bias. That's an example of confirmation bias. So like say, for example, you think that, oh, let me give another example that some people really to a real life as well. Oh, you think that the stock is going to rise. I think the stock is definitely going to rise. And then you're looking up news articles reading whatever and you're only considering like you're only reading articles that are bullish on that stock. You don't consider anything else. You just read articles that are bullish on that stock. Everything like that. You're just trying to like basically like equal chamber your thoughts. You read ready threads that say, oh, I'm bullish on the stock. That's an example of confirmation bias. You can see, I think intuitively why some of these biases and errors can cause people to kind of lose their shirt in the stock market. But let's go ahead and continue here. So what if they give you a question about a patient that has a history of illness, anxiety disorder? And the telling the questions, then that they've come into the hospital many times.

Come to the physician, see they have X, they have this problem, they have that problem, they have this problem, they have that problem. And then they didn't tell you that, oh, they present again today, complaining of this condition. And let's say they have very weak symptoms. And then you're, you're told in the queue, that all this physician chalks it up to illness anxiety disorder, just, just pretty much chalks it up to illness anxiety disorder. And they don't do any kind of evaluation or anything like that. And then the person is, you know, maybe they are clinical starters deteriorates. Many times with these errors and biases, clinical starters is going to deteriorate. And then they test the person, you know, the person started deteriorated. And then persons found to have some actually real medical condition down the line that has caused them harm or whatever. Then what is that? What is that? That's going to be an example of attribution error, attribution error, attribution error, attribution error. This is basically a negative stereotype. So this person with this history of illness anxiety disorder, you know, always thinking, because remembering illness anxiety disorder, the person always thinks they have one medical problem or the other when they don't. So because this person always thinks that they have one medical condition or the other, any new complaints they come up with, you just chalk it up to, oh, it's in your head again.

I promise you it's okay, you don't have anything. And then because of that, you miss like a real organic medical problem, the half. That's an example of attribution error. That's an example of attribution error. Okay, now what if they give you a question about a patient that has CHF and they tell you that this patient you've seen them for years in your practice and you've recommended that you eat a low-salt diet and the exercise. I am told that you know, this physician is really frustrated with the patient because this person has pretty much never followed any of their recommendations. The person still, and they will give you these questions since we pretty long and lengthy. They tell you in the question that, you know, this person, pretty much does not follow the physician's recommendations. Still eats salty fries and salty crackers and takes a lot of soda and does not exercise. And this person comes into the clinic and they're complaining of chest pain. And you know, you don't evaluate them for PE just because of your feelings. You're just like, you know, of course, percent of CHF, you didn't take my recommendations. Of course, you have CHF. And you don't evaluate them but then they have found little to have a PE or whatever, you know, obviously, they go start as deteriorate and whatnot. What kind of error is this? This is going to be an example of affective error. Effective error. Effective error. Basically, personal, your personal feelings affect the care that you give.

Your personal feelings affect the care that you give. For example, in this scenario, I describe here, you're pretty angry with this patient. And that's reasonable. This person has just not followed any recommendations. But the things you still have to be objective in your care. You still have to be objective in your care. You're learning your personal feelings kind of getting away. Because this person has not followed your recommendations, you feel so angry, so frustrated with them, that you don't evaluate them deeply for what may be causing the occurring completes. That's an example of an affective error. Or say, for example, a person is your very close friend or your spouse or whatever. And you're trying something that has very limited clinical benefit. Many studies have shown that thing to not be beneficial. What you're trying those things, you're trying everything just because they're your close friend. That's an example of affective error because you're literally doing everything for them. But it just because again, feelings have gotten in the way. Feelings have pretty much gotten in the way. That's essentially what is getting you in trouble. Your feelings have gotten in the way. Now, one thing I'm going to say here real quick is I just also want to define something called a near miss common mistake that people make. A near miss, an error happened, what harm did not occur. That's kind of like the easy way to choke that up. You made a mistake, but error did not happen.

I mean harm did not occur as a result of it. That's a near miss. That's a near miss. And then another thing I want to define here is an active error. An active error is something where you're the physician, you're the health care professional, you're taking care of the patient at the bedside and you make a mistake in care for that patient. That's an example of a latent, I mean, sorry, of an active error. That's an example of an active error. A latent error is kind of close, but a latent error is almost like a mistake waiting to happen. Like the way the health care system is set up, it just makes people more susceptible to make it mistakes, more susceptible to errors. So no errors happen, but point the setup here is like, oh, this is a mistake waiting to happen. That's going to be an example of a latent error. It's going to be an example of a latent error. So I know that this topic people will be like, wow, the one distance sound really close. Again, I'm just going to encourage you, just going to encourage you know the memory hook for each of these things, know the memory hook for each of these things, because to be honest with you, like for example, people could easily mix up attribution error to affective error, you know, attribution error, you saw the example I gave, ooh illness anxiety disorder.

So you just chalk up, you're like, oh, it's in their head, it's in their head, you know, they come with these new symptoms and you're like, it's still their illness anxiety disorder. That's going to be more attribution error, just because you have this negative steward type in your mind. Effective error is more, your personal feelings are affecting your care of the patient. So you just have to make sure that you are able to compare and contrast some of these things. Like another example, maybe like availability error versus premature closure, premature closure, you're just jumping to conclusions, you're just jumping to conclusions. But the thing is in premature closure, they will give you that element that you don't even confirm the diagnosis without proper testing. Then that tells you that, ooh, that's premature closure. But in availability error, something that you've seen, they will give you that element of, ooh, you've seen that thing so much or that thing happened very recently. So it's like super rooted in your mind, and because of that, you consider a and you pretty much, you're like, oh, this must be what the person has. This must be what the person has. In that case, think more about availability error. In that case, think more about availability error. So I think maybe one thing that will be useful here is going over like divine. What are the absolute cells will see? They'll tell me that it's this error.

Okay, so let's walk through them because pretty much today we talked about a bunch of errors. Number one, we talked about availability error. What's the thing you should fix in your mind and what's the, or you've seen the question that I'll tell you that weight. This is availability error. Basically, you make a mistake because something more easily comes to your mind. You make a mistake. Why? Because something more easily comes to your mind. Something more easily comes to your mind. That's availability error. So something more easily comes to your mind because you frequently see that particular thing. That's availability error. There was an example I read online from the AFP. So I'm giving credit where credit is due. From the AFP where a person was diagnosed with in. Tertraigo, even if the person actually had. Lime disease, the person had lime disease, but because the person was obese and had. I think a rush around the under arm. So whatever. Again, I'm not remembering this exactly. The person was like, Oh, this is in Tertraigo. But then down the line. The person was actually diagnosed with. Lime disease. And maybe this clinician or the person that I wrote the example, you know, Oh, wow. I've seen so many cases of intertragal. So many cases of intertragal. So many cases of intertragal. Or man, maybe last week I saw a case just like this that looked like an intertragal. So because it's more availability in your mind, it's just easily comes to mind. You make that mistake.

That's availability error. Representation error is where you see a classic presentation in a non-classic population. That's the hook. A classic presentation in a non-classic population. So you ignore disease prevalence. You're like, wow, this classic presentation will mean the age does not fit. That's a presentation error, you exempts. Premature closure is the third one we talked about. You jump to conclusions. You literally just jump to conclusions. So you don't even bother to confirm that. And they put that element of wow. You just jump to a conclusion and you don't even consider. You don't even confirm the diagnosis with appropriate testing. You're like, Oh, I think this is slam dunk XYZ. You don't even do any kind of diagnostic testing to rule it out. That is reasonable diagnostic testing should have done. That's going to be an example of premature closure. Encoring error, anchoring bias is you stick with the first thing that comes to mind. Even if there is other evidence that is like, hmm, doesn't agree with this thing or you should really consider something else here. That's an example of anchoring bias or anchoring error. So again, because you may be like divine anchoring error availability error is the same thing. You know, availability error first thing that comes to mind anchoring error first thing that comes to mind. Now, they may look similar, but they're different availability error as I said is something comes to mind because it's more recent in your memory.

Or you've seen that thing very recently. That thing is very common to you. So because that thing is so around you, you just estimate that, Oh, this is what is happening. This is what is happening. This is what is happening. Encoring error. Yeah, something is going to come to your mind first. You're going to make that diagnosis first, but then you will get elements in the queue stem that tell you that, hmm, there's all this mounting evidence that does not agree with this first thing that came to your mind. There is all this mounting evidence that suggests that you should probably consider something else. But you're still sticking with that first thing that came to your mind. Despite all that evidence to the contrary, think of anchoring error. So you see there is a slight difference from availability error. And then confirmation bias was the fifth one we talked about. Basically, you think of X and then you start selecting diagnostic tests to confirm only X. You don't think of any other thing. So if they give you that element of, wow, I thought of X first. And then they give you that element of you're just only considering diagnostic tests. Basically equal chamber tests to agree with X that you considered X you consider X you considered. You're only picking tests is almost like you're just like I thought of one disease. And I'm going to confirm that one disease. I'm going to do everything for that one disease and nothing else.

You're just so faithful to that one disease you thought about. That's going to be an example of confirmation bias. You're basically doing things. That's what's called confirmation. You're trying to confirm that first thing you thought about. That's all you do. You don't think of any other possibilities. That's going to be an example of confirmation bias. And then attribution error was the sixth one we talked about. Attribution error we talked about that is basically what a negative stereotype. A negative stereotype. A negative stereotype. So many times with these kinds of questions, they will not bring in personal feelings. Basically, it will be a person that has always presented with this. Always presented with this. Always presented with this. So you're like, the coming with new complaints and you're like, it must be this. It must be this. It must be this. It must be this. It must be this one thing you've always presented with. Or it's in your head. You just chalk it up to this. That's an example of attribution error. That's a negative stereotype. Negative stereotype. It's a stereotype. So you stereotype the person for having this thing. You stereotype the person because of previous presentations. So many times the person would have presented with the same thing over and over again. And just like, oh, of course, this new thing they have must be this. That's a stereotype. That's stereotype. That's attribution error.

I'm trying to be painstaking here because this thing is very important. I want you to really get this. I'm pretty much like teaching the errors one last time. And then effective error. What's the clue there? Personal feelings. Personal feelings. Personal feelings. Personal feelings. Personal feelings. You may see, well, divine. This is so close to attribution error. What attribution error is a stereotype. Is a stereotype. Is a stereotype. Is a stereotype. Because the person has presented in this same way so many times. You build a stereotype in your mind. Everything you present with you like it must be this problem. Effective error. Personal feelings. Come in. You're going to see like feelings of anger, feelings of frustration. Or whatever. Those things will be expressed in the question. Then you let that modulate your care. You let that modulate the way you care for the patient. That'll be an example of a effective error. And then we talked about a near miss. We said a near miss was you made a mistake. What harm did not happen? We talked about the active error. Active error literally in the process of caring for a patient. You make a mistake literally at the bedside. That's an active error. And then we talked about a latent error. A latent error is no mistake has happened. But with a system is set up. Boy, you're prone to making. It's just like an error prone process that has been set up. It's like mistake within to happen. That's a latent error.

So please, I will encourage you to listen to this podcast a few times. It's just one of those things you can almost tell yourself that I'm very likely going to get a question on this. On my exams. If you know the stuff, you know it well. They are going to be in pretty good shape. And again, if you love the way I teach, I would encourage you to consider the classes that I offer. I have a series of classes that are starting out willing next week Thursday. I have a test taking strategies class. Twenty-half hours long for step one to three. I have a biostatistics class. Four hours long for step one to three. That's next week Friday. And then I have a social sciences and ethics and quality improvement healthcare systems class. Also for step one to step three coming up next week Saturday. It's a five hour class. And then the week after that, studying on the 22nd, I believe. I have a 20 hour class that is for step two and step three. Iran's from pretty much from Iran's on Monday. Tuesday Thursday and Friday of that week. And then for step two and step three, obviously also for complex level two and three. Have a last minute review. That's three hours long. Taking place on Saturday. So I believe that's the 27th of this month. I've made podcast where I address this topic. These are these are classes. There's actually also step one classes of 25 hour class taking place in the very first five days of of me. So if you're interested in any of these classes, just shoot me an email.

The all over zoom will give some more information. There's many people that have attended these classes and they've done extremely well. Like I literally kid you not. I get stories of people where just before they start the class like they won like my 20 hour class. This is a fairly common thing I've heard. Actually, there's one I heard. I'm probably like within the last few days. I'm just trying to be here. So I don't reveal a person at the end of the day. But this person literally before they started the class, they were in the two 30s. And the exam was literally like very, very close to when the class was holding. And just within that one week period, the person bumped up and ended up getting the 260s. So that's a very common testimony with my classes where people will be bump up in points like a lot within that short time frame. So this class is a very good. I really do put a lot of effort into helping you understand. Like I really truly genuinely care about teaching. Teaching is something I love doing. It's a passion of mine. I've done it for many years and I love doing it. So if you're thinking of any of these classes, I will encourage you. I will say that they will be well worth your, your while. They will be well worth your, your while. Okay, so I think I'm going to stop here. I can have this podcast on Apple Google and Spotify. I have a You Tube channel. You can check out. I do offer one on one tutoring and also help with earless applications and whatnot.

So if you need any of these things, just shoot me an email through the website. And I have another website called divinineintervention, life lessons.com. Divinineinterventionlifelessens.com. Basically every week from a biblical perspective, I'll upload two podcasts that try to address a life lesson again from a biblical perspective. I believe we have like 260 or more podcasts. Usually about 10 minutes long. Usually I upload them on Fridays and Sundays. There's actually an Apple podcast associated with that. So thank you for joining me today. Again, I hope you find this podcast very beneficial. God bless you and have a wonderful week. Bye for now.

Diagnosing a condition because it is highly frequent or recently seen in your practice, making it easily recalled.

Seeing a classic textbook presentation of a disease but ignoring the patient's age or demographics (i.e., ignoring disease prevalence).

Availability relates to how easily something comes to mind due to frequency/recency; Anchoring involves sticking to the first piece of information received, even when conflicting evidence mounts.

Jumping to a diagnosis or conclusion without performing adequate diagnostic testing or considering all aspects of the history.

Allowing personal feelings (like frustration or anger) toward a patient to negatively influence the objective care provided.

Actively seeking out and ordering tests/evaluations that disagree with your initial hypothesis, rather than only confirming it.

Diagnosing a condition based on a classic presentation despite the patient's age or population making the disease rare (ignoring prevalence).

High frequency, recent exposure, or high memorability of a specific diagnosis.

Anchoring Bias/Error.

Attribution Error (Negative Stereotyping).

The failure to confirm a diagnosis because the clinician jumps to conclusions without appropriate diagnostic testing.

Affective Error.

Diagnosing a condition based on a classic presentation despite the patient's age or population making the disease rare (ignoring prevalence).

High frequency, recent exposure, or high memorability of a specific diagnosis.

Anchoring Bias/Error.

Attribution Error (Negative Stereotyping).

The failure to confirm a diagnosis because the clinician jumps to conclusions without appropriate diagnostic testing.

Affective Error.