# The Cognitive Error Styles of Midwifery Students in Clinical Decision-Making: A Directed Qualitative Content Analysis Study

## TL;DR

This study identifies common thinking errors among midwifery students that affect their clinical decision-making and could impact patient outcomes.

## Contribution

The study identifies 11 specific cognitive error styles among midwifery students using directed qualitative content analysis.

## Key findings

- Midwifery students exhibit cognitive errors such as emotional reasoning, procrastination, and anchoring.
- Understanding these errors can improve education and clinical performance in midwifery.
- Cognitive biases among students may contribute to medical errors and financial costs in healthcare.

## Abstract

Cognitive error styles refer to faulty patterns of thinking that can negatively influence individuals’ decision-making and behavior. Among midwifery students, identifying and understanding these errors is particularly important, as their decisions directly impact maternal and neonatal outcomes. Thus, the present study aimed to explain the cognitive error styles of midwifery students in clinical decision-making.

This qualitative study was carried out using a directed qualitative content analysis approach. Initially, empirical literature and studies from databases such as ERIC, PubMed, Web of Science, ScienceDirect, and Scopus were reviewed to identify relevant components of cognitive error styles among midwifery students. Next, unstructured and semi-structured interviews were conducted with 12 midwifery students (bachelor’s and master’s levels) enrolled at Shahrekord University of Medical Sciences, Iran, from August 2023 to May 2024.

Among 32 main categories extracted from the literature review, 11 functional components of cognitive error styles were confirmed by the midwifery students, including emotional reasoning, procrastination, lack of confidence, anchoring, recency bias, catastrophizing, stereotyping, negative filtering, labeling, fortune telling, and all-or-nothing thinking.

Given the significant impact of cognitive error styles on clinical decision-making by midwives and midwifery students, it is essential to identify the causes of medical errors associated with these cognitive biases to minimize mistakes and their related financial consequences. A deeper understanding of these errors can ameliorate the education and clinical performance of midwifery students, ultimately enhancing healthcare delivery.