Teaching the use of framing and decontextualization to address context-based bias in psychiatry

Decontextualisation for framing effect reduction

BACKGROUND

The aim of this study is to demonstrate the presence of a framing effect that influences residents' decision-making and to assess decontextualisation as an intervention strategy to reduce the influence of framing on their decision.

METHODS

This is a randomised controlled trial in which researchers sent an evaluation questionnaire to all residents of … University including clinical vignettes, with questions formulated in two different ways on the same subject and a decontextualisation test involving logical reasoning problems. The researchers then sent to all participants different clinical vignettes evaluating the same dimensions as those addressed in the previous part.

RESULTS

The response rate was 86 (28.2%), of which they included 52 (60.4%) in the analysis. The framing effect was present in 37 (71.1%) of responses and then decreased to 35 (67.3%) after the decontextualisation test, especially at the level of the type of framing involving risky decision-making (p = 0.03).

DISCUSSION

Decontextualisation is an effective strategy for reducing bias related to the framing effect among residents, particularly the type of framing involving risky decision-making. In medical teaching, decontextualisation exercises may help improve critical thinking and reduce the framing effect.