1. Dual Process Theory and Reasoning The Dual Process Theory suggests that ther

1. Dual Process Theory and Reasoning
The Dual Process Theory suggests that there are two distinct cognitive processes involved in decision-making, i.e., Type 1 (intuitive) and Type 2 (deliberative) (Tsalatsanis et al., 2015). Type 1 thinking is fast and spontaneous, while Type 2 is slower, methodical, and analytical. In the context of advanced practice nursing, Type 1 thinking can be useful in familiar or routine situations, while Type 2 thinking can be useful for more complex or ambiguous situations because it allows for a more thorough analysis of clinical data, consideration of differential diagnoses, and evaluation of treatment options.
2. Cognitive dispositions to respond
CDRs, or cognitive dispositions to respond, are people’s inherent tendencies or biases in processing and acting upon information. These cognitive biases affect individuals’ perception, evaluation, and choice-making (Monteiro et al., 2019). In an APN setting, clinical judgment and decision-making can be affected by CDRs. Therefore, APNs need to recognize their own implicit biases and take steps to minimize them in order to deliver quality patient care.
3. Cognitive debiasing
The term “cognitive debiasing” refers to recognizing and correcting cognitive biases that may impact making decisions (Stephens, 2020). It entails actively questioning and analyzing one’s biases, heuristics, and cognitive processes to make more informed decisions. In the APN setting, cognitive debiasing is crucial for reducing diagnostic errors.
4. Applications of Type 1 and Type 2 processes in each case
In case 1, the NP used Type 1 process by relying on common symptoms and examination findings to diagnose the patient with gallbladder disease. Nonetheless, the NP could use Type 2 thinking to conduct a more methodical investigation, reducing the likelihood of making an incorrect diagnosis. This would entail looking beyond gallbladder illness in the differential diagnosis and considering the patient’s risk factors, such as testosterone injections.
In case 2, the NP used Type 1 process to diagnose seasonal influenza based on typical flu symptoms and the fact that it was the flu season. However, the NP should have used Type 2 thinking to reduce the likelihood of diagnostic errors by considering the patient’s atypical features, such as lethargy, aberrant behavior, and lack of a cough. The NP could have considered other diagnoses, such as viral meningitis, that fit the unusual symptoms. This would have involved a more in-depth review, including an assessment of the nervous system, further diagnostic testing, and specialist consultations.
5. Considerations for change to practice
For case 1, the NP should consider improving communication and documentation. The NP should record and update all relevant information in the patient’s medical record, including the administration of testosterone injections. This would be useful for making future treatment decisions. In addition, the NP should consider stepping up their attention to possible differential diagnoses. The NP should maintain a high index of suspicion for alternative conditions, even when the initial diagnosis seems likely.
For case 2, the NP should consider performing comprehensive assessments. In response to atypical symptoms, the NP should consider performing a comprehensive assessment, such as a neurological examination. This aids in identifying indications that may signal a more serious ailment. In addition, the NP should consider implementing clinical guidelines for evaluating and assessing pediatric patients with atypical symptoms. This can help minimize diagnostic errors in the future.
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