News Release

Doctors can do better if they learn from their mistakes

Peer-Reviewed Publication

PLOS

Doctors Can Do Better if They Learn from their Mistakes

image: Physicians who suffered from confirmation bias -- the low performers -- tended to activate areas of their frontal and parietal lobes (related to cognitive control and attention, respectively) more after the successful trials than after the unsuccessful trials. These physicians paid more attention to the successful trials that confirmed their existing beliefs. In contrast, the high performers -- the physicians who learned effectively from experience -- displayed the exact opposite pattern, activating their frontal and parietal lobes much more after the unsuccessful trials, indicating that they were better able to learn from their failures. view more 

Credit: Downar J, Bhatt M, Montague PR (2011) Neural Correlates of Effective Learning in Experienced Medical Decision-Makers. PLoS ONE 6(11): e27768.doi:10.1371/journal.pone.0027768

We rely on our doctors to make appropriate decisions for our treatment, but this process can be subject to a variety of potentially conflicting influences. To identify what makes a good decision-maker, a team of researchers, led by Read Montague, PhD, director of the Human Neuroimaging Laboratory at Virginia Tech Carilion Research Institute, tested 35 experienced physicians for their ability to make appropriate treatment choices, and found that the doctors who performed best were those who learned from both their successes and failures, rather than focusing just on the successful outcomes. The results are reported in the Nov. 23 issue of the online journal PLoS ONE.

The doctors were tested in a series of virtual patient encounters, and the results were measured both in terms of their ability to choose the right treatment for the "patients" and by fMRI, a neuroimaging technique that detects the regions of the brain that are engaged in a particular activity. The fMRI imaging reveals characteristic patterns for the high performers and low performers, providing the evidence that better performance was correlated with increased attention to failed treatments.

"These findings underscore the dangers of disregarding past failures when making high-stakes decisions," said Read Montague, PhD. "'Success-chasing' not only can lead doctors to make flawed decisions in diagnosing and treating patients, but it can also distort the thinking of other high-stakes decision-makers, such as military and political strategists, stock market investors, and venture capitalists."

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Citation: Downar J, Bhatt M, Montague PR (2011) Neural Correlates of Effective Learning in Experienced Medical Decision-Makers. PLoS ONE 6(11): e27768.doi:10.1371/journal.pone.0027768

Financial Disclosure: This research was funded by the following grants: National Institutes of Health grant # 1 RC4 AG039067, National Institutes of Health grant # R01 DA11723-02, National Institutes of Health grant # 2R01 MH085496-05A2 The Kane Foundation Fellowship. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.

Competing Interest Statement: The authors have declared that no competing interests exist.

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