Experiencing Rudeness Amplifies Medical Diagnoses Anchoring Bias

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rude nurse

Have you ever been interrupted in a meeting by a coworker and found yourself replaying the scenario in your thoughts long after you’ve left work for the day? Or have you ever been cut off in traffic by another car and been left fuming for miles?

Minor nasty occurrences like these happen all the time, but you might be shocked by the size of the impact they have on our decision-making and functioning. In fact, recent research co-authored by management professor Trevor Foulk at the University of Maryland’s Robert H. Smith School of Business reveals that in certain scenarios, inadvertent rudeness like this can be fatal.

Foulk and colleagues Binyamin Cooper of Carnegie Mellon University, Christopher R. Giordano and Amir Erez of the University of Florida, Heather Reed of Envision Physician Services, and Kent B. Berg of Thomas Jefferson University Hospital investigated how rudeness increases the anchoring bias effect.

Medical Diagnoses Anchoring

Anchoring bias is the propensity to fixate on one piece of information when making a decision (even if that information is irrelevant).

If someone asks, for example, “Do you think the Mississippi River is shorter or longer than 500 miles?” the 500-mile proposal can become an anchor that influences how long you think the Mississippi River is. When this happens, it’s difficult to deviate from the initial proposal, according to Foulk.

Anchoring bias can occur in a variety of situations, but it is especially common in medical diagnoses and negotiations.

“If you go into the doctor and say ‘I think I’m having a heart attack,’ that can become an anchor and the doctor may get fixated on that diagnosis, even if you’re just having indigestion. If doctors don’t move off anchors enough, they’ll start treating the wrong thing,”

Foulk explains.

Workplace Rudeness

Because anchoring can occur in a variety of contexts, Foulk and his colleagues wanted to learn more about it and what factors exacerbate or mitigate it.

They had been researching workplace rudeness for years and knew from past research that when people are unpleasant, it consumes a lot of their psychological resources and narrows their mentality. They assumed it had anything to do with the anchoring effect.

The researchers put their notion to the test by running a medical simulation with anesthesiology residents. The residents had to diagnose and treat the patient, and the participants were given a (incorrect) suggestion regarding the patient’s health shortly before the simulation began.

This suggestion served as the anchor, but the simulator provided feedback throughout the exercise that the ailment was not the suggested diagnosis but rather something else.

In some iterations, before the simulation began, the researchers had one doctor enter the room and berate another doctor in front of the residents.

Rudeness Narrows Perspective

What they discovered is that when participants experienced rudeness prior to the simulation start, they continued to treat the wrong thing, even in the presence of consistent information that it was actually something else.

“They kept treating the anchor, even though they had plenty of reason to understand that the anchor diagnosis was not what the patient was suffering from,”

said Foulk.

This effect was observed in a range of other tasks, including negotiations and general knowledge tests. The findings were constant across studies: being impolite increases the likelihood that a person will become fixed to the first suggestion they hear.

“Across the four studies, we find that both witnessed and directly-experienced rudeness seemed to have a similar effect,”

said Foulk. Essentially, they were detecting a narrowing effect. Rudeness narrows your perspective, and a restricted perspective increases the likelihood of anchoring.

In general, the anchoring tendency is usually not a big deal, according to Foulk.

“But when you’re in these important, critical decision-making domains — like medical diagnoses or big negotiations — interpersonal interactions really matter a lot. Minor things can stay on top of us in a way that we don’t realize,”

he said.

Information Elaboration and Perspective-taking

The researchers looked for techniques to combat this behaviour in order to gain more knowledge about it. Because rudeness narrows your perspective and makes you more likely to anchor, the researchers looked into two tasks that have been shown to broaden your perspective: perspective-taking and information elaboration.

Perspective-taking allows you to broaden your perspective by viewing the world through the eyes of another person, whereas information elaboration allows you to see the situation from a broader perspective by thinking about it more broadly. The researchers discovered that both activities could counteract the effect of rudeness on anchoring throughout their trials.

While these treatments can help make rudeness less likely to anchor people, according to Foulk, they should only be used as a last option. What, then, is the best solution to the rudeness problem?

Reconsidering Rudeness Tolerance

We must reconsider how we treat people in important domains where people make critical decisions.

“We never really did allow aggressive behavior at work. But we’re fine with rudeness, and now we’re learning more and more that small insults are equally impactful on people’s performance,”

he says.

And it needs to stop, he says.

“We tend to underestimate the performance implications of interpersonal treatment. We hear ‘If you can’t stand the heat, get out of the kitchen.’ It’s almost like being able to tolerate people’s treatment of you is like a badge of honor,”

said Foulk.

However, the reality is that this poor treatment is having a significant negative impact on performance in fields that we care about, such as medicine. It is significant.

This is the fourth paper in a series of Foulk’s research showing that rudeness has a negative impact on medical performance, where the consequences can be much larger – and far more dire – than the insults, he claims.

In simulations, his team has discovered that rudeness increases mortality. People could die because someone disrespected the surgeon before the operation began.

Reference:
  1. Binyamin Cooper, Christopher R. Giordano, Amir Erez, Trevor A. Foulk, Heather Reed, Kent B. Berg. Trapped by a first hypothesis: How rudeness leads to anchoring. Journal of Applied Psychology, 2021; DOI: 10.1037/apl0000914

Last Updated on September 23, 2023