<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0301-696X</journal-id>
<journal-title><![CDATA[Revista de sanidad militar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. sanid. mil.]]></abbrev-journal-title>
<issn>0301-696X</issn>
<publisher>
<publisher-name><![CDATA[Secretaría de la Defensa Nacional, Dirección General de Sanidad]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0301-696X2024000300004</article-id>
<article-id pub-id-type="doi">10.56443/4jmsfj87</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Pensar rápido y lento en el proceso cognitivo para la toma de decisiones en medicina]]></article-title>
<article-title xml:lang="en"><![CDATA[Think fast and slow in the cognitive process for decision-making in medicine]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Alday]]></surname>
<given-names><![CDATA[Jorge Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villegas-Delgado]]></surname>
<given-names><![CDATA[Caridad Guadalupe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Delgado-Villegas]]></surname>
<given-names><![CDATA[Carlos Héctor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Durango Santander Escuela de Medicina Campus Hermosillo]]></institution>
<addr-line><![CDATA[ Sonora]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad del Valle de México Campus Hermosillo ]]></institution>
<addr-line><![CDATA[ Sonora]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2024</year>
</pub-date>
<volume>78</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0301-696X2024000300004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0301-696X2024000300004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0301-696X2024000300004&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Ser médico demanda tomar decisiones rápidas y precisas, que atañen ya sea al diagnóstico o la terapéutica, y tiene implicaciones en la seguridad de los pacientes. Varias teorías se han propuesto para explicar cómo los clínicos hacen su razonamiento, señalando diferencias entre los clínicos expertos y los inexpertos. Nuestro cerebro tiene dos sistemas de pensamiento: el rápido y el lento. El rápido está asociado con decisiones intuitivas y automáticas, requiere poca energía o atención, permite tomar decisiones con poca información. El lento implica un procesamiento cognitivo más profundo y analítico, necesita de esfuerzo y puede ser extenuante. Investigaciones recientes señalan que, en la mayoría de las decisiones médicas, se utiliza el pensamiento rápido. Esta forma de pensamiento intuitivo es parte del proceso es muy efectivo, pero también es vulnerable a errores cognitivos. La teoría dual del razonamiento, refleja la gran importancia de la intuición en la mayoría de las decisiones, nos permite comprender mejor como pensamos los médicos en nuestra práctica diaria. Las escuelas de medicina deben utilizar nuevos espacios didácticos en los que se facilite ampliamente el aprendizaje basado en problemas, en materias como talleres integrados, práctica médica, o sesiones integradoras con metodología similar, que faciliten a nuestros estudiantes, oportunidades para obtener conocimientos, y habilidades del pensamiento crítico para resolver problemas médicos de una manera holística, en cualquier contexto, con ambos sistemas de pensamiento. Más años en las aulas, educación médica continua o certificaciones por consejos no resuelven el problema. Hay quienes invocan para eliminar los errores cognitivos en la práctica médica, que esta debe ser rediseñada y reinventada.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Being a doctor requires making quick and accurate decisions, whether it is diagnosis or therapy, and has implications for patient safety. Several theories have been proposed to explain how clinicians make their reasoning, pointing out differences between skilled and inexperienced clinicians. Our brain has two systems of thought: fast and slow. Fast is associated with intuitive and automatic decisions, requires little energy or attention, allows decisions to be made with little information. Slow cognitive processing involves deeper, more analytical cognitive processing, requires effort, and can be strenuous. Recent research indicates that quick thinking is used in most medical decisions. This form of intuitive thinking is part of the process is very effective, but it is also vulnerable to cognitive errors. The dual theory of reasoning, reflecting the great importance of intuition in most decisions, allows us to better understand how we doctors think in our daily practice. Medical schools should use new didactic spaces in which problem-based learning is greatly facilitated, in subjects such as integrated workshops, medical practice, or integrative sessions, with similar methodology, that provide our students with opportunities to obtain knowledge and critical thinking skills to solve medical problems in a holistic way, in any context, with both systems of thought. More years in the classroom, continuing medical education, certifications by advice do not solve the problem, there are those who invoke to eliminate cognitive errors in medical practice, that it must be redesigned and reinvented.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Cognitive process]]></kwd>
<kwd lng="en"><![CDATA[fast and slow thinking]]></kwd>
<kwd lng="en"><![CDATA[medical decisions]]></kwd>
<kwd lng="es"><![CDATA[Proceso cognitivo]]></kwd>
<kwd lng="es"><![CDATA[Pensamiento rápido y lento]]></kwd>
<kwd lng="es"><![CDATA[decisiones médicas]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tsang]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Blissett]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Gauthier]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Muhammed]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[What Do Clinicians Mean by &#8220;Good Clinical Judgment&#8221;: A Qualitative Study]]></article-title>
<source><![CDATA[International Medical Education]]></source>
<year>2023</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-10</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Linn]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Khaw]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Kildea]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Tonkin]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical reasoning - a guide to improving teaching and practice]]></article-title>
<source><![CDATA[Australian Family Physician]]></source>
<year>2012</year>
<volume>41</volume>
<numero>1-2</numero>
<issue>1-2</issue>
<page-range>18-20</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kahneman]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<source><![CDATA[Thinking, Fast and Slow de Daniel Kahneman (2011-10-25). Pensar Rápido, Pensar Despacio]]></source>
<year>2013</year>
<publisher-name><![CDATA[New York]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Richards]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[Hayes]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Schwartzstein]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Teaching Clinical Reasoning and Critical Thinking: From Cognitive Theory to Practical Application]]></article-title>
<source><![CDATA[Chest]]></source>
<year>2020</year>
<volume>158</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>1617-28</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nendaz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Perrier]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnostic errors and flaws in clinical reasoning: mechanisms and prevention in practice]]></article-title>
<source><![CDATA[Swiss Medical Weekly]]></source>
<year>2012</year>
<volume>142</volume>
<page-range>w13706</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shin]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reasoning processes in clinical reasoning: from the perspective of cognitive psychology]]></article-title>
<source><![CDATA[Korean Journal of Medical Education]]></source>
<year>2019</year>
<volume>31</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>299-308</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Norman]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[Monteiro]]></surname>
<given-names><![CDATA[SD]]></given-names>
</name>
<name>
<surname><![CDATA[Sherbino]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ilgen]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Schmidt]]></surname>
<given-names><![CDATA[HG]]></given-names>
</name>
<name>
<surname><![CDATA[Mamede]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Causes of Errors in Clinical Reasoning: Cognitive Biases, Knowledge Deficits, and Dual Process Thinking]]></article-title>
<source><![CDATA[Academic Medicine: Journal of the Association of American Medical Colleges]]></source>
<year>2017</year>
<volume>92</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>23-30</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Croskerry]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Abbass]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[AW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Emotional influences in patient safety]]></article-title>
<source><![CDATA[Journal of Patient Safety]]></source>
<year>2010</year>
<volume>6</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>199-205</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McGrath]]></surname>
<given-names><![CDATA[B. M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How doctors think]]></article-title>
<source><![CDATA[Canadian Family Physician]]></source>
<year>2009</year>
<volume>55</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1113</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Melo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Scarpin]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Amaro]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Passos]]></surname>
<given-names><![CDATA[RBD]]></given-names>
</name>
<name>
<surname><![CDATA[Sato]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Friston]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How doctors generate diagnostic hypotheses: a study of radiological diagnosis with functional magnetic resonance imaging]]></article-title>
<source><![CDATA[PloS One]]></source>
<year>2011</year>
<volume>6</volume>
<numero>12</numero>
<issue>12</issue>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[van den Berg]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[de Bruin]]></surname>
<given-names><![CDATA[ABH]]></given-names>
</name>
<name>
<surname><![CDATA[Marsman]]></surname>
<given-names><![CDATA[JBC]]></given-names>
</name>
<name>
<surname><![CDATA[Lorist]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Schmidt]]></surname>
<given-names><![CDATA[HG]]></given-names>
</name>
<name>
<surname><![CDATA[Aleman]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thinking fast or slow? Functional magnetic resonance imaging reveals stronger connectivity when experienced neurologists diagnose ambiguous cases]]></article-title>
<source><![CDATA[Brain Communications]]></source>
<year>2020</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>fcaa023</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pelaccia]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Tardif]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Triby]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Charlin]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory]]></article-title>
<source><![CDATA[Medical Education Online]]></source>
<year>2011</year>
<volume>16</volume>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Michel]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thinking fast and slow in medicine]]></article-title>
<source><![CDATA[Proceedings (Baylor University. Medical Center)]]></source>
<year>2019</year>
<volume>33</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>123-5</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
