Beyond Knowledge: Addressing Cognitive Bias in Clinical Supervision
Goldin Isserlis MARINA, Tom AXELROD and Amalia WALZER
Clinical reasoning is a core competency in family medicine but is often assumed rather than explicitly taught. Family physicians routinely manage undifferentiated presentations under conditions of uncertainty and time pressure. While trainees receive frequent feedback on clinical decisions, much less attention is given to the reasoning processes behind those decisions. Consequently, cognitive biases affecting both learners and supervisors may go unrecognized. Teaching clinical reasoning requires making clinical thinking explicit and central to everyday supervision in primary care.By the end of this workshop, participants will be able to: Identify common cognitive biases in family medicine practice .Use practical, time-efficient strategies to teach clinical reasoning in real time. Supervise trainees with an explicit focus on reasoning rather than solely on outcomes.This 60-minute interactive workshop uses experiential learning methods suited to busy primary care settings. The session begins with a brief clinical case presented in plenary, followed by participant discussion of immediate diagnostic impressions to highlight intuitive thinking and cognitive bias. Participants then work in small groups, each focusing on a common cognitive bias relevant to family medicine (anchoring, availability, premature closure, or confirmation bias). Groups discuss real-life examples and supervisory questions that can challenge biased reasoning. Key points are shared with the larger group. Facilitators introduce simple, evidence-based tools for teaching clinical reasoning during routine supervision, including reasoning-focused questions, “think-aloud” modeling, and “what if” prompts to test diagnostic flexibility. Participants then engage in brief role-play simulations in triads (supervisor, trainee, observer) using common community-based cases. The workshop concludes with individual reflection and commitment to using one reasoning-focused teaching strategy in practice.Participants will gain increased awareness of cognitive bias and practical tools to teach clinical reasoning during routine supervision.Clinical reasoning is a teachable skill. Focusing supervision on thinking processes rather than answers promotes deeper, more reflective clinical practice.
