Thinking about thinking in paediatric critical care

Abstract Diagnostic errors are an important cause of adverse safety incidents in intensive care units. Many of these misdiagnoses can be attributed to cognitive errors; however relatively little importance is given to this topic in medical education. In this article, we describe how cognitive processes affect decision-making and how the human mind can be susceptible to error. We describe a universal model of cognition and decision-making called Dual Process Theory, which provides a framework to understand the key human cognitive processes and the biases that affect it. We provide three clinical cases as examples to describe common cognitive biases that can lead to diagnostic failures. Finally, we review potential debiasing strategies at individual and at organisational level that can help to mitigate the risks of cognitive errors in clinical decision-making.