Inside the Black Box of Deliberate Practice: How do Coaches Coach to Improve Trauma Triage.

Introduction: Deliberate practice, goal-oriented training with feedback from a coach, is a common tool for improving physicians' performance. However, little is known about how coaches foster performance improvement.

Methods: A content analysis of video-recorded training sessions was performed to analyze the coaches' behaviors during a pilot randomized trial of deliberate practice in trauma triage.

Daniel Kahneman (1934-2024).

Pioneer in the psychology of judgment and decision-making.

Clinicians' approach to predicting post-cardiac arrest outcomes for patients enrolled in a United States clinical trial.

Purpose: Perceived poor prognosis can lead to withdrawal of life-sustaining therapies (WLST) in patients who might otherwise recover. We characterized clinicians' approach to post-arrest prognostication in a multicenter clinical trial.

Methods: Semi-structured interviews were conducted with clinicians who treated a comatose post-cardiac arrest patient enrolled in the Influence of Cooling Duration on Efficacy in Cardiac Arrest Patients (ICECAP) trial (NCT04217551).

Using a theory-based, customized video game as an educational tool to improve physicians' trauma triage decisions: study protocol for a randomized cluster trial.

Background: Transfer of severely injured patients to trauma centers, either directly from the field or after evaluation at non-trauma centers, reduces preventable morbidity and mortality. Failure to transfer these patients appropriately (i.e.

Achieving Goals of Care Decisions in Chronic Critical Illness: A Multi-Institutional Qualitative Study.

Background: Physicians, patients, and families alike perceive a need to improve how goals of care (GOC) decisions occur in chronic critical illness (CCI), but little is currently known about this decision-making process.

Research Question: How do intensivists from various health systems facilitate decision-making about GOC for patients with CCI? What are barriers to, and facilitators of, this decision-making process?

Study Design And Methods: We conducted semistructured interviews with a purposeful sample of intensivists from the United States and Canada using a mental models approach adapted from decision science. We analyzed transcripts inductively using qualitative description.

Collection and Analysis of Adherence Information for Software as a Medical Device Clinical Trials: Systematic Review.

Background: The rapid growth of digital health apps has necessitated new regulatory approaches to ensure compliance with safety and effectiveness standards. Nonadherence and heterogeneous user engagement with digital health apps can lead to trial estimates that overestimate or underestimate an app's effectiveness. However, there are no current standards for how researchers should measure adherence or address the risk of bias imposed by nonadherence through efficacy analyses.

Improving Social Bot Detection Through Aid and Training.

Objective: We test the effects of three aids on individuals' ability to detect social bots among Twitter personas: a bot indicator score, a training video, and a warning.

Background: Detecting social bots can prevent online deception. We use a simulated social media task to evaluate three aids.

Cognitive Biases and Shared Decision Making in Acute Brain Injury.

Many patients hospitalized after severe acute brain injury are comatose and require life-sustaining therapies. Some of these patients make favorable recoveries with continued intensive care, while others do not. In addition to providing medical care, clinicians must guide surrogate decision makers through high-stakes, emotionally charged decisions about whether to continue life-sustaining therapies.

When Do Humans Heed AI Agents' Advice? When Should They?

Objective: We manipulate the presence, skill, and display of artificial intelligence (AI) recommendations in a strategy game to measure their effect on users' performance.

Background: Many applications of AI require humans and AI agents to make decisions collaboratively. Success depends on how appropriately humans rely on the AI agent.

Media exposure, risk perceptions, and fear: Americans' behavioral responses to the Ebola public health crisis.

We examined media exposure, psychological fear and worry, perceptions of risk, and health protective behaviors surrounding the 2014 Ebola virus outbreak in a probability-based, representative, national sample of Americans (N = 3447). Structural equation models examined relationships between amount (hours/day) and content (e.g.

Testing a Novel Deliberate Practice Intervention to Improve Diagnostic Reasoning in Trauma Triage: A Pilot Randomized Clinical Trial.

Importance: Diagnostic errors made during triage at nontrauma centers contribute to preventable morbidity and mortality after injury.

Objective: To test the feasibility, acceptability, and preliminary effect of a novel deliberate practice intervention to improve diagnostic reasoning in trauma triage.

Design, Setting, And Participants: This pilot randomized clinical trial was conducted online in a national convenience sample of 72 emergency physicians between January 1 and March 31, 2022, without follow-up.

Communicating health information with visual displays.

Well-designed visual displays have the power to convey health messages in clear, effective ways to non-experts, including journalists, patients and policymakers. Poorly designed visual displays, however, can confuse and alienate recipients, undermining health messages. In this Perspective, we propose a structured framework for effective visual communication of health information, using case examples of three common communication tasks: comparing treatment options, interpreting test results, and evaluating risk scenarios.

Antenatal consultation and deliberation: adapting to parental preferences.

Objective: To analyze and compare perspectives on antenatal consultation and decision-making from participants with varying degrees of prematurity experience and clinician-experts.

Study Design: Open-ended interviews structured around topics previously identified by recognized clinician-experts were conducted with participants having different levels of prematurity experience. Analysis used mixed methods (thematic and mental models analysis).

Testing the feasibility, acceptability, and preliminary effect of a novel deliberate practice intervention to reduce diagnostic error in trauma triage: a study protocol for a randomized pilot trial.

Background: Non-compliance with clinical practice guidelines in trauma remains common, in part because physicians make diagnostic errors when triaging injured patients. Deliberate practice, purposeful participation in a training task under the oversight of a coach, effectively changes behavior in procedural domains of medicine but has rarely been used to improve diagnostic skill. We plan a pilot parallel randomized trial to test the feasibility, acceptability, and preliminary effect of a novel deliberate practice intervention to reduce physician diagnostic errors in trauma triage.

Risk heatmaps as visual displays: Opening movie studios after the COVID-19 shutdown.

Upon shutting down operations in early 2020 due to the COVID-19 pandemic, the movie industry assembled teams of experts to help develop guidelines for returning to operation. It resulted in a joint report, The Safe Way Forward, which was created in consultation with union members and provided the basis for negotiations with the studios. A centerpiece of the report was a set of heatmaps displaying SARS-CoV-2 risks for a shoot, as a function of testing rate, community infection prevalence, community transmission rate (R0), and risk measure (either expected number of cases or probability of at least one case).

The value of adherence information during clinical pharmaceutical trials.

Background/aims: The quality of the evidence used to evaluate a drug's safety and efficacy depends, in part, on how well participants adhere to the prescribed drug-taking regime. There are multiple approaches to measure adherence in clinical trials, varying in their cost and accuracy. We demonstrate a method for evaluating the cost-effectiveness of common adherence monitoring methods, considering the costs and data quality for drugs that differ in how forgiving they are of nonadherence.

Duped by Bots: Why Some are Better than Others at Detecting Fake Social Media Personas.

Objective: We examine individuals' ability to detect social bots among Twitter personas, along with participant and persona features associated with that ability.

Background: Social media users need to distinguish bots from human users. We develop and demonstrate a methodology for assessing those abilities, with a simulated social media task.

Assessing How Consumers Interpret and Act on Results From At-Home COVID-19 Self-test Kits: A Randomized Clinical Trial.

Importance: The US Food and Drug Administration (FDA) authorized SARS-CoV-2 rapid at-home self-test kits for individuals with and without symptoms. How appropriately users interpret and act on the results of at-home COVID-19 self-tests is unknown.

Objective: To assess how users of at-home COVID-19 self-test kits interpret and act on results when given instructions authorized by the FDA, instructions based on decision science principles, or no instructions.

Risk perceptions and health behaviors as COVID-19 emerged in the United States: Results from a probability-based nationally representative sample.

Understanding psychosocial correlates of engaging in health-protective behaviors during an infectious disease outbreak can inform targeted intervention strategies. We surveyed a national probability-based sample of 6,514 Americans, with three separate, consecutive representative cohorts between March 18, 2020 and April 18, 2020, as the U.S.

A Procedure for Eliciting Women's Preferences for Breast Cancer Screening Frequency.

Background: We evaluate the construct validity of a proposed procedure for eliciting lay preferences among health care policy options, suited for structured surveys. It is illustrated with breast cancer screening, a domain in which people may have heterogeneous preferences.

Methods: Our procedure applies behavioral decision research principles to eliciting preferences among policy options expressed in quantitative terms.

Physicians' cognitive approach to prognostication after cardiac arrest.

Objective: Elucidate how physicians formulate a neurological prognosis after cardiac arrest and compare differences between experts and general providers.

Methods: We performed semi-structured interviews with experts in post-arrest care and general physicians. We created an initial model and interview guide based on professional society guidelines.

Digital medicines for adherence support: A conceptual framework and qualitative study of adherence among chronically ill patients.

Digital medicine programs (DMPs) are emerging technologies that use sensor-enabled medicine to detect when patients have taken their medication and then provide feedback about adherence. We use qualitative methods to understand how patients change their behavioral patterns while participating in a DMP intervention. An influence diagram outlining the factors hypothesized to affect adherence in DMPs constructed from prior scientific research and expert input was created.

Bereaved Parents: Insights for the Antenatal Consultation.

Objective: The study aimed to explore experiences of extremely preterm infant loss in the delivery room and perspectives about antenatal consultation.

Study Design: Bereaved participants were interviewed, following a semi-structured protocol. Personal narratives were analyzed with a mixed-methods approach.