Improving decision-making and cognitive bias using innovative approaches to simulated scenario and debrief design

The Economist Intelligence Unit has projected a global trend of decreases in the number of hospital beds per 1000 population until 2019, despite growing demand from growing and ageing populations as well as the need for community-care and home-care beds.2 This trend is especially noted in mental health. Since 2013, most UK mental health trusts have regularly experienced a lack of inpatient bed availability, with these problems widely described and addressed in national policy and guidance.3 When patients are in crisis, they are assessed by multidisciplinary mental health teams. Course development focused on the decision-making process, incorporating academic literature which stressed the importance of bias in decision-making.4 The academic theory and educational approaches on cognitive biases were incorporated into the course introduction, scenario design and debrief focus. Debrief The debrief discussion models group decision-making process in practice and follows the decision-making cycle, starting with fact gathering and differentiating those from personal impressions, followed by brainstorming around treatment decisions, then exploring pros and cons to potential decisions (figure 1).