CRC Press / Routledge · 2024

Thinking About Thinking

A Prescription for Healthcare Improvement

A practical exploration of clinical judgement, bias and better decision-making, for clinicians and the people who teach and lead them.

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Authors
Yang Chen & Myura Nagendran
Published
CRC Press, 2024
Focus
Reasoning, bias, clinical AI
Cover of Thinking About Thinking: A Prescription for Healthcare Improvement by Yang Chen and Myura Nagendran

I have become more and more convinced we need a focus on metacognition in medical training. I hope this book makes you 'stop and think' as much as it did for me.

Professor Sir Andrew Goddard
President of the Royal College of Physicians 2018-2022

A very interesting and novel perspective on how we think about decision making in healthcare.

Martin Bromiley OBE
Founder, Clinical Human Factors Group

This book is a must read for all doctors and healthcare professionals wanting to make better decisions for their patients.

Dr Dominic Crocombe
NIHR Clinical Fellow in Hepatology, UCL

Thinking About Thinking has been a crucial guide in enhancing my decision-making skills as a GP trainee to help navigate the complexities of healthcare.

Dr Carol Chan
Academic GP Trainee, Imperial College London

This is a book for anyone in healthcare who wants to understand how and why they make decisions.

Dr Claire Edwin
GP Registrar

Why now

Clinical judgement matters as healthcare changes.

How do clinicians recognise bias, weigh uncertainty and learn from decisions? The book explores these questions across clinical practice, training and the use of AI. It invites readers to examine both how a decision is made and how it turns out.

Who it is for

Written for the people who practise, teach and lead clinical decision-making.

Clinicians

A language for naming bias, uncertainty and judgement under pressure, with tools to make the everyday decision a better one.

Medical educators

A case for teaching decision-making as an explicit, reflective skill rather than a by-product of passing assessments.

Healthcare leaders

A view of safety, workforce and digital change through the human conditions that actually produce good decisions.

Inside the book

Four movements, from present-day practice to future care.

Part 1 · Context

Why decisions deserve attention

The case for treating the everyday clinical decision as a healthcare improvement problem in its own right.

Part 2 · The wrong kind of training

How clinicians learn to decide

How inherited curricula, assessment culture and apprenticeship by case-count shape clinical reasoning.

Part 3 · How decisions are made now

The anatomy of judgement

The make-up of a decision, the biases that distort it, the split between process and outcome, plus practical fixes.

Part 4 · How decisions will be made

Reasoning with machines

Staff progression, the pairing of human and machine reasoning and what care could look like as AI matures.

Explore every chapter

Authors

Two practising clinicians working at the reasoning layer of healthcare.

Yang Chen

Dr Yang Chen

Cardiologist · Executive MSc Health Economics

Cardiologist and Clinical Research Fellow at University College London. Researches pragmatic clinical trials, decision support and the health economics of cardiovascular care. Principal investigator of the THIRST Alert randomised trial, embedded in the electronic health record at UCLH.

Full biography

Yang Chen is a cardiologist, internal medicine physician and academic with expertise in health informatics and health economics. He read medicine at Gonville and Caius College, Cambridge and Green Templeton College, Oxford, and holds an MSc in health economics, management and cardiovascular outcomes from the LSE, where he focused on the economic evaluation of healthcare technologies. He was Chief Registrar at St Bartholomew's Hospital, one of Europe's largest cardiovascular centres, and co-created a management consulting fellowship for clinicians hosted by Deloitte UK. He was principal investigator of the THIRST Alert randomised trial at UCLH, which tested an electronic-record decision tool for point-of-care trial recruitment.

Myura Nagendran

Dr Myura Nagendran

Intensivist · PhD Clinical AI

Intensive care physician at King's College Hospital and Honorary Clinical Research Fellow at Imperial College London. Researches clinical judgement and how clinicians interact with AI decision support. Co-author of the DECIDE-AI reporting guideline for early-stage clinical evaluation of AI decision support.

Full biography

Myura Nagendran is a board-certified intensivist and clinical AI researcher. He read medicine at Emmanuel College, Cambridge and Green Templeton College, Oxford. His PhD at Imperial College London used eye-tracking and high-fidelity simulation to study how clinicians interact with AI recommendations under cognitive load. He is a co-author of DECIDE-AI, a reporting guideline in Nature Medicine for the early-stage clinical evaluation of AI decision support, and his award-winning BMJ systematic review of deep learning diagnostic accuracy was covered by Fortune and the BBC. He also peer-reviews for journals and funders including the BMJ, Nature Medicine and UKRI.

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Institutional ebook

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Bibliographic details

Thinking About Thinking: A Prescription for Healthcare Improvement

Yang Chen and Myura Nagendran · CRC Press · First edition · Published 2024

Paperback ISBN
9780367340889
Hardback ISBN
9780367340896
Ebook ISBN
9780429323843

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Thinking About Thinking: A Prescription for Healthcare Improvement

Yang Chen & Myura Nagendran · CRC Press / Routledge · Paperback ISBN 9780367340889

Buying for a library or teaching group? Options for libraries and educators