Type 1 thinking can be described as:

1. Reflexive*
2. Deductive
3. Analytical
4. Rule-based

• Type 1 thinking, also known as fast thinking, is described as intuitive, heuristic, unconscious, and reflexive.
• Type 2 thinking, also known as slow thinking, is described as analytical, deductive, deliberate, and rule-based.

Metacognition describes an individual’s ability to:

1. Step back from his or her own thinking, observe it, and recognize opportunities for using thinking strategies*
2. Seek out a more thorough clinical history from the electronic medical record or directly from the ordering provider
3. Reference sources of information beyond one’s personal experience, including relevant peer-reviewed publications
4. Be mindful of known combinations of injuries

• The term metacognition refers to an individual’s ability to step back from his or her own thinking, observe it, and recognize opportunities for using thinking strategies.
• Seeking out a more thorough clinical history from the electronic medical record or directly from the ordering provider is an approach to mitigate framing bias.
• Referencing sources of information beyond one’s personal experience, including relevant peer-reviewed publications, is an approach to mitigate availability bias.
• Being mindful of known combinations of injuries is a strategy to mitigate satisfaction of search.

Which of the following is an example of metacognition?

1. Using heuristics to make decisions when there is uncertainty
2. Employing pattern recognition to make a diagnosis
3. Tendency to be influenced by how a problem is presented
4. Recognizing instances when data are not fitting together*

• One key feature of metacognition is the ability to recognize incongruity, ambiguity, atypical presentations, and instances when data are not fitting together.
• Using heuristics to make decisions when there is uncertainty is a normal process for radiologists and other physicians. Being aware of the fact that you are using heuristics is an example of metacognition.
• Employing pattern recognition to make a diagnosis is a normal process for radiologists and other physicians. Being aware of the fact that pattern recognition can sometimes lead to diagnostic errors is an example of metacognition.
• The tendency to be influenced by how a problem is presented describes framing bias.

Which of the following is a feature of metacognition?

1. Execution of an automatized motor skill
2. Capacity for self-critique*
3. Employing pattern recognition
4. Overconfidence in judgment

• Capacity for self-critique is one feature of metacognition. Additional features include Awareness of requirements of the learning process, recognition of limitations in memory, ability to appreciate perspective, and ability to select strategies
• Execution of an automated motor skill does not involve metacognition.
• Employing pattern recognition to make a diagnosis is a normal process for radiologists and other physicians. Being aware of the fact that pattern recognition can sometimes lead to diagnostic errors is an example of metacognition.
• Overconfidence in judgment can lead to diagnostic errors, but is not a feature of metacognition. Being aware of a tendency to be overconfident in judgment is an example of metacognition.

Which of the following is the first step in developing a cognitive forcing strategy?

1. Gaining knowledge of particular cognitive errors
2. Identification of scenarios in which cognitive errors are likely to occur
3. Understanding the features of various cognitive forcing strategies
4. Initial training in the theory of metacognition*

• Initial training in the theory of metacognition is the first step in developing a cognitive forcing strategy.
• Gaining knowledge of particular cognitive errors, identification of scenarios in which cognitive errors are likely to occur, and understanding the features of various