Christensen, C., Larson, J. R., Jr., Abbott, A., Ardolino, A.,
Franz, T. M., & Pfeiffer, C. (2000). Decision Making of Clinical
Teams: Communication Patterns and Diagnostic Error. Medical Decision
Making, 20, 45-50.
Abstract. This study examined the discussions of mixed-status
clinical teams while constructing differential diagnoses. Twenty-four
ad hoc teams, each consisting of a resident, an intern, and a third-year
medical student, were given two hypothetical patient cases to discuss and
diagnose. Prior to discussion, team members individually viewed different
versions of a videotaped interview with a 'patient' (trained actor).
Each videotape contained some information that was present in all three versions
(shared information) and some that was present in only that one version (unique
information). In addition, half of the time, the cases were constructed
so that the unique information that appeared in only one tape was crucial
for a correct diagnosis (a "hidden profile" condition). After viewing
the videotapes, team members met to discuss the case and develop a differential
diagnosis. These discussions were videotaped. Overall, shared
information was mentioned significantly more often than unique information.
Furthermore, teams offered incorrect diagnoses significantly more often for
hidden-profile cases than for control cases. The teams' overreliance
on previously shared information (inability to appropriately utilize unique
information) was detrimental when a correct diagnosis demanded the inclusion
of such information. Clinical discussions that require the consideration
of uniquely held information may thus be susceptible to error.