The Impact of Availability Heuristic and Confirmation Bias on Team Dynamics Through a Game Theoretical Lens

Abstract

Critical-care teams operate in high-stakes environments where cognitive shortcuts can lead to misdiagnoses and treatment delays. This thesis employs a game-theoretical framework to examine how the availability heuristic and confirmation bias influence decision-making in paediatric intensive care units. Drawing on the Volunteers’ Dilemma, Battle of the Sexes, and Principal–Agent models, semi-structured interviews were conducted with six physicians, nurses, and trainees across three hospitals, of which two were in the Netherlands and one in Belgium. Using a hybrid deductive–inductive Gioia methodology, transcripts were coded to identify first-order concepts, second-order themes, and aggregate dimensions. Results indicate that past cases and initial diagnoses act as anchors in coordination (Battle of the Sexes), while established hierarchies in the Volunteers’ Dilemma and transparent communication in Principal–Agent scenarios effectively mitigate heuristic-driven distortions. By integrating cognitive insights into normative game theory, this research clarifies where structured protocols reduce bias and offers practical recommendations, such as real-time outcome registries and formalised discussion protocols, to enhance critical-care decision-making.