Novel Education Tool to Detect and Prevent Errors in Diagnostic Cytopathology

Summary: Introduction: Cytopathology is a well-regulated practice and has developed robust quality assurance systems. While adept at reducing systematic errors, it does not offer personalized tools to mitigate individual errors. This study aimed to develop a structured educational model to enhance the understanding of heuristics in diagnostic processes and equip individuals with a tool to prevent errors under time constraints. Materials and Methods: All revised cytopathologic diagnoses made by a single experienced cytopathologist at our institution were retrospectively examined from 2017-2023. Six reports with diagnostic discrepancies were selected for further qualitative analysis. Errors were categorized into the misuse of the five common heuristics used in diagnostic practice: Anchoring, Representativeness, Availability, Familiarity, and Affect. A novel educational tool comprising an active checklist to identify the pathologist's pitfall was applied to each misdiagnosis. A trainee was educated about each heuristic and the tool, six months prior to its application allowing for time to understand the concept. Results: Using the tool, misused heuristics were identified for each case and discussed to assess the teachability of each scenario (Table 1). The trainee was able to independently articulate error preventative strategies for each case to faculty. We now intend to expand our case cohort and apply the tool prospectively. Conclusions: Healthcare advances combined with complex systems and new technology heighten the risk of diagnostic errors by trainees and inexperienced practitioners who are trying to manage high caseloads with time constraints. Traditional learning from past errors is insufficient to thrive in this complex environment. We introduce an innovative educational tool that not only identifies common heuristic pitfalls but also allows individuals to develop a structured process to preventing errors. We believe that the application of our tool early in training will further enhance individual performance, skill, and professional satisfaction in our rapidly changing environment.