Cognitive biases and collapse of prioritization accuracy under incongruent clinical data: a mixed-methods study of nursing diagnostic reasoning
Nursing prioritization errors are systematic cognitive failures rather than random mistakes or simple knowledge deficits. The core vulnerability appears to be metacognitive: an impaired ability to detect and resolve conflict between an activated mental model and new, incongruent information. Interventions to reduce diagnostic and prioritization errors should explicitly train cognitive and metacognitive skills for managing incongruence and flexibly updating clinical representations.
Authors
- Maria Massaro (ORCID: https://orcid.org/0000-0002-8007-0839)
- Sara Gandini (ORCID: https://orcid.org/0000-0002-1348-4548)
- K. Mazzocco
- Laura Zoppini (ORCID: https://orcid.org/0009-0008-9526-1321)
- Anna Sponton
- S. Boselli
- Claudia Cafiero
- Luisa Saiani
- Silvana Lacapra
- Alessandra Milani
- Eliana Misurelli
Institutions
- University of Rome Tor Vergata (IT)
- University of Verona (IT)
- Humanitas University (IT)
- University of Milan (IT)
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- European Institute of Oncology (IT)
Publication Details
- Journal
- Diagnosis
- Published
- 2026-03-13
- DOI
- https://doi.org/10.1515/dx-2025-0178
- Primary Topic
- Clinical Reasoning and Diagnostic Skills
- Type
- article
- Field-Weighted Citation Impact
- 0.00