What is Confirmation Bias in Health and Social Care?

Confirmation bias is a way of thinking that affects how people interpret and recall information. It happens when someone focuses on details that support their existing beliefs or opinions and ignores or undervalues evidence that challenges them. In health and social care, this can influence clinical decisions, diagnosis, treatment plans, and the way support is provided to service users. It is a form of cognitive bias, which means it is based on mental shortcuts our brains use to process information.

In plain terms, confirmation bias can make a person “see what they expect to see”. Once a belief has formed, such as a diagnosis or a view about a person’s behaviour, the mind tends to search for information that fits with that belief and pass over details that do not fit.

How Confirmation Bias Appears in Health and Social Care

In health and social care settings, confirmation bias can affect different relationships:

• Between health professionals and patients, where a doctor may focus on symptoms that match an expected diagnosis.
• Among care workers, where staff might interpret a person’s behaviour according to a past record rather than current circumstances.
• In multidisciplinary teams, where shared assumptions can lead to group thinking and filter out valuable alternative views.

Some common examples include:

• A nurse who believes a patient is exaggerating pain might pay more attention to signs that appear to support that belief rather than evidence of genuine discomfort.
• A GP might suspect a common illness and then highlight test results that support the diagnosis, while downplaying other results that do not fit.
• A social worker might expect a young person in care to struggle socially, and view any withdrawn behaviour as part of that expectation.

Influences that Strengthen Confirmation Bias

Several factors make confirmation bias more likely in health and social care:

• Time pressure: Working under tight schedules can make professionals rely more on familiar patterns of thought.
• Past experience: Prior cases can influence current thinking, sometimes too strongly.
• Emotional involvement: Caring relationships can lead to subjective views.
• Organisational culture: Shared values or methods may steer thinking in one direction.

These influences do not always lead to mistakes, but they can limit the ability to respond accurately to each unique situation.

Risks of Confirmation Bias in Diagnosis and Care

Confirmation bias can create risks in both diagnosis and ongoing care. It can act as a mental filter that blocks consideration of other possibilities. This means:

• Wrong diagnoses can be made.
• Persistent health or social problems can remain unsolved if the real cause is overlooked.
• Care may focus on the wrong aspects of a person’s needs.

For example, consider a patient with fatigue. If the professional is convinced it is stress-related, they may overlook other causes such as anaemia or thyroid problems. In social care, if staff believe a person refuses help out of stubbornness, they may miss signs that the person is anxious or afraid.

Confirmation Bias and Patient Safety

Patient safety depends on accurate assessment and treatment. Confirmation bias can interfere by shaping how evidence is collected and understood. It can lead to:

• Partial gathering of information
• Misinterpretation of test results
• Inattention to early warning signs of deterioration
• Overlooking rare illnesses

In safety-critical settings such as mental health care or emergency medicine, confirmation bias can have far-reaching effects. The same applies to safeguarding situations, where assumptions about a person’s past behaviour may delay recognising abuse or neglect.

Reducing Confirmation Bias in Practice

Professionals can take steps to reduce the influence of confirmation bias:

• Use structured assessment tools to gather full information.
• Ask open-ended questions to allow patients or clients to share without steering their answers.
• Seek second opinions from colleagues.
• List possible explanations before settling on one.
• Review each case afresh rather than relying heavily on previous notes.

These actions encourage a broader view, which can counter the natural tendency to confirm pre-existing beliefs.

Examples of Practical Measures

In daily work, practical measures can help:

• Case reviews: Looking at a case with fresh eyes at regular intervals.
• Reflective practice: Recording and thinking about decision-making steps.
• Peer learning: Sharing cases with peers to gain different perspectives.
• Decision support systems: Using evidence-based guidelines.
• Clinical supervision: Discussing thought processes with a mentor.

By creating opportunities to challenge assumptions, care staff and health professionals are less likely to miss important information.

How Training Affects Bias Awareness

Training in health and social care often includes awareness of cognitive biases. This might involve:

• Explaining how confirmation bias works.
• Practising scenarios with “curveball” information that challenges initial opinions.
• Encouraging professionals to reflect on how emotions and expectations affect their work.

Awareness does not remove the bias completely, but it can make professionals more alert to its effects and more likely to adopt a balanced approach.

Role of Record Keeping

Detailed and accurate records can help to limit confirmation bias. When all relevant information is documented clearly, it becomes harder to filter out points that contradict a preferred view.

Good record keeping includes:

• Recording objective observations rather than personal interpretations.
• Including information from different sources.
• Maintaining chronological notes to show how a situation developed.

In multidisciplinary teams, shared records help ensure that all members have access to the same information, reducing the risk of selective recall.

Working with Service Users

In social care, service users might feel misunderstood if staff act on assumptions formed through confirmation bias. Trust is stronger when professionals keep an open mind and adapt their support based on current evidence rather than fixed ideas.

Tactics that help include:

• Listening actively without interrupting.
• Checking understanding by repeating back what has been said.
• Asking questions that invite new information.

By showing genuine interest in the person’s perspective, staff can guard against bias creeping into daily care tasks.

Impact on Communication

Confirmation bias affects how information is shared between professionals. If a diagnosis or belief has taken hold early on, later communication may focus on reinforcing that view rather than challenging it. This can be seen in:

• Referral letters that highlight certain symptoms over others.
• Briefings that mention only facts supporting existing views.
• Care handovers that omit contradictory observations.

Clear, balanced communication supports better decisions by giving a rounded picture.

Final Thoughts

Confirmation bias in health and social care is a subtle but powerful influence. It can lead professionals to focus on information that supports their expectations and overlook signs that could change their thinking. This affects diagnosis, treatment plans, safeguarding assessments, and everyday interactions with patients or clients.

By recognising its presence and adopting measures to challenge assumptions, professionals can improve accuracy, safety, and trust in care. Structured assessments, open communication, reflective practice, and collaborative working are all ways to reduce the effect of this bias and provide care based on the fullest possible understanding of each individual situation.