Expertise and Problem Solving in High-Stakes Environments

  • José Hanham
  • Jimmie Leppink


In Chap.   1 of this book, learning is defined as the development and automation of cognitive schemas. These cognitive schemas determine what are information elements that must be processed with more or less effort. As we develop routine in a domain, we can increasingly rely on high-level schemas that allow us to carry out certain tasks with minimal effort and as such enable us to allocate working memory resources to information that still needs to be processed with more effort. Apart from this routine expertise, which is about successfully dealing with problems within one’s domain(s) of expertise, there is increasing interest in what is called adaptive expertise or the ability to adapt to unknown territory. Although both routine and adaptive expertise require expertise in a domain, they differ in response to changes in the environment. It is argued that, given the dynamics and uncertainty, adaptive expertise is likely to be of crucial importance in high-stakes environments. This chapter builds forth on the theoretical foundation of Chap.   1 and substantially informs Chapters   4 (on mental processes in emergency medicine) and   10 (on design guidelines) of this book.


  1. ABC News (2017). Sydney siege: The final minutes of the Lindt Cafe hostage situation. Accessed 13 Feb 2018).
  2. Allworth, E., & Hesketh, B. (1999). Construct-oriented biodata: Capturing change-related and contextually relevant future performance. International Journal of Selection and Assessment, 7, 97–111. CrossRefGoogle Scholar
  3. Barnett, S., & Koslowski, B. (2002). Adaptive expertise: Effects of type of experience and the level of theoretical understanding it generates. Thinking & Reasoning, 8, 237–267. CrossRefGoogle Scholar
  4. Blickle, G., Kramer, J., Schneider, P. B., Meurs, J. A., Ferris, G. R., Mierke, J., et al. (2011). Role of political skill in job performance prediction beyond general mental ability and personality in cross-sectional and predictive studies. Journal of Applied Social Psychology, 41, 488–514. CrossRefGoogle Scholar
  5. Boag, C. (2003). Investigating the cognitive determinants of expert performance in air traffic control. Unpublished doctoral dissertation, University of Queensland, Brisbane.Google Scholar
  6. Bohle Carbonell, K., Stalmeijer, R. E., Könings, K., Segers, M., & Van Merriënboer, J. J. G. (2014). How experts deal with novel situations: A review of adaptive expertise. Educational Research Review, 12, 14–29. CrossRefGoogle Scholar
  7. Charlin, B., Lubarsky, S., Millette, B., Crevier, F., Audetat, M. C., Charbonneau, A., et al. (2012). Clinical reasoning processes: Unravelling complexity through graphical representation. Medical Education, 46, 454–463. CrossRefGoogle Scholar
  8. Chase, W. G., & Simon, H. A. (1973). The mind’s eye in chess. In W. G. Chase (Ed.), Visual information processing. New York: Academic Press.Google Scholar
  9. Chen, G., Thomas, B., & Wallace, J. C. (2005). A multilevel examination of the relationships among training outcomes, mediating regulatory processes, and adaptive performance. The Journal of Applied Psychology, 90, 827–841. CrossRefGoogle Scholar
  10. Chi, M., Glaser, R., & Rees, E. (1982). Expertise in problem solving. In R. Sternberg (Ed.), Advances in the psychology of human intelligence (pp. 7–75). Hillsdale, NJ: Erlbaum.Google Scholar
  11. Comisión De Investigación De Accidentes E Incidentes De Aviación Civil (2011). Report A-032/2008. Retrieved from
  12. Craig, P. A. (2000). Pilot in command. New York: McGraw-Hill.Google Scholar
  13. Crawford, V. M., Schlager, M., Toyama, Y., Riel, M., & Vahey, P. (2005). Characterizing adaptive expertise in science teaching. American Educational Research Association annual conference, Montreal, Canada.Google Scholar
  14. Croskerry, P. (2009). A universal model of diagnostic reasoning. Academic Medicine, 84, 1022. CrossRefGoogle Scholar
  15. Custers, E. J. F. M., Boshuizen, H. P. A., & Schmidt, H. G. (1998). The role of illness scripts in the development of medical diagnostic expertise: Results from an interview study. Cognition and Instruction, 16, 367–398. CrossRefGoogle Scholar
  16. Dane, E., & Pratt, M. G. (2007). Exploring intuition and its role in managerial decision making (Vol. 32, pp. 33–54). Academy of Management Review. CrossRefGoogle Scholar
  17. Dane, E., Rockmann, K. W., & Pratt, M. G. (2012). When should I trust my gut? Linking domain expertise to intuitive decision-making effectiveness. Organizational Behavior and Human Decision Processes, 119, 187–194. CrossRefGoogle Scholar
  18. Dismukes, R. K., & Berman, B. (2010). Checklists and monitoring in the cockpit: Why crucial defenses sometimes fail. NASA Technical Memorandum (NASA TM-2010-216396). Moffett Field: NASA Ames Research Center.Google Scholar
  19. Dörfler, V., & Ackermann, F. (2012). Understanding intuition: The case for two forms of intuition. Management Learning, 43, 545–564. CrossRefGoogle Scholar
  20. Durning, S. J., Dong, T., Artino, A. R., Van der Vleuten, C. P. M., Holmboe, E., & Schuwirth, L. (2015). Dual processing theory and experts’ reasoning: Exploring thinking on national multiple-choice questions. Perspectives on Medical Education, 4, 168–175. CrossRefGoogle Scholar
  21. Ehrlinger, J., Readinger, W. O., & Kim, B. (2015). Decision making and cognitive biases. In H. S. Friedman (Ed.), Encyclopedia of mental health (Vol. II, 2rd ed., pp. 5–12). Philadelphia: Elsevier.Google Scholar
  22. Ellström, P. (2001). Integrating learning and work: Problems and prospects. Human Resource Development Quarterly, 12, 421. CrossRefGoogle Scholar
  23. Epstein, S. (1994). Integration of the cognitive and the psychodynamic unconscious. American Psychologist, 49, 709–724.CrossRefGoogle Scholar
  24. Ericsson, K. A., & Charness, N. (1994). Expert performance – Its structure and acquisition. American Psychologist, 49, 725–747. CrossRefGoogle Scholar
  25. Evans, J. S. B. T. (2006). The heuristic-analytic theory of reasoning: Extension and evaluation. Psychonomic Bulletin & Review, 13, 378–395. CrossRefGoogle Scholar
  26. Evans, J. S. B. T. (2010). Thinking twice: Two minds in one brain. Oxford, UK: Oxford University Press.Google Scholar
  27. Evans, J. S. B. T. (2012). In K. J. Holyoak & R. G. Morrison (Eds.)., The Oxford handbook of thinking and reasoning Dual-process theories of reasoning: Facts and fallacies. New York: Oxford University Press.Google Scholar
  28. Evans, J. S. B. T., & Stanovich, K. E. (2013). Dual-process theories of higher cognition: Advancing the debate. Perspectives on Psychological Science, 8, 223–241. CrossRefGoogle Scholar
  29. Feltovich, P. J., & Barrows, H. S. (1984). Issues of generality in medical problem solving. In H. G. Schmidt & M. L. De Volder (Eds.), Tutorials in problem-based learning (pp. 128–142). Assen, The Netherlands: Van Gorcum.Google Scholar
  30. Fisher, F. T., & Peterson, P. L. (2001). A tool to measure adaptive expertise in biomedical engineering students. In Proceedings of the 2001 American Society of Engineering Education Annual Conference, Albuquerque, NM, United States.Google Scholar
  31. Gawande, A. (2009). The checklist manifesto: How to get things right. New York: Metropolitan Books.Google Scholar
  32. Gigerenzer, G. (2008). Why heuristics work. Perspectives on Psychological Science, 3, 20–29. CrossRefGoogle Scholar
  33. Gigerenzer, G., & Gaismaier, W. (2011). Heuristic decision making. Annual Review of Psychology, 62, 451–482. CrossRefGoogle Scholar
  34. Gigerenzer, G., & Goldstein, D. G. (1996). Reasoning the fast and frugal way: Models of bounded rationality. Psychological Review, 103, 650–669. CrossRefGoogle Scholar
  35. Gigerenzer, G., & Todd, P. M. (1999). Fast and frugal heuristics: The adaptive toolbox, Simple heuristics that make us smart (pp. 3–34). New York: Oxford University Press.Google Scholar
  36. Griffin, B., & Hesketh, B. (2003). Adaptable behaviours for successful work and career adjustment. Australian Journal of Psychology, 55, 65–73. CrossRefGoogle Scholar
  37. Halford, G. S., Baker, R., McCredden, J. E., & Bain, J. D. (2005). How many variables can humans process? Psychological Science, 16, 70–76. CrossRefGoogle Scholar
  38. Hatano, G., & Inagaki, K. (1986). Two courses of expertise. In H. Stevenson, H. Azuma, & K. Hakuta (Eds.), Child development and education in Japan (pp. 262–272). New York: Freeman.Google Scholar
  39. Hatano, G., & Oura, Y. (2003). Commentary: Reconceptualizing school learning using insight from expertise research. Educational Researcher, 32, 26–29. CrossRefGoogle Scholar
  40. Haynes, A. B., Weiser, T. G., Berry, W. R., Lipsitz, S. R., Breizat, A. H., Dellinger, E. P., et al. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. The New England Journal of Medicine, 360, 491–499. CrossRefGoogle Scholar
  41. Holyoak, K. J. (1991). In K. A. Ericsson & J. Smith (Eds.)., Toward a general theory of expertise: Prospects and limits Symbolic connectionism: Toward third-generation theories of expertise (pp. 301–335). Cambridge, UK: Cambridge University Press.Google Scholar
  42. Joung, W., Hesketh, B., & Neal, A. (2006). Using “war stories” to train for adaptive performance: Is it better to learn from error or success? Applied Psychology, 55, 282–302. CrossRefGoogle Scholar
  43. Kahneman, D., & Klein, G. (2009). Conditions for intuitive expertise: A failure to disagree. American Psychologist, 64, 515–526. CrossRefGoogle Scholar
  44. Kahneman, D., Slovic, P., & Tversky, A. (1982). Judgment under uncertainty: Heuristics and biases. Boston: Cambridge University Press.CrossRefGoogle Scholar
  45. Kalyuga, S. (2013). Enhancing transfer by learning generalized domain knowledge structures. European Journal of Psychology of Education, 28, 1477–1493. CrossRefGoogle Scholar
  46. Kalyuga, S., & Hanham, J. (2011). Instructing in generalized knowledge structures to develop flexible problem solving skills. Computers in Human Behavior, 27, 63–68. CrossRefGoogle Scholar
  47. Klein, G. (2009). Streetlights and shadows: Searching for the keys to adaptive decision making. Cambridge, MA: MIT Press.Google Scholar
  48. Leppink, J. (2017). Evaluating the strength of evidence in research and education: The theory of anchored narratives. Journal of Taibah University Medical Sciences, 12, 284–290. CrossRefGoogle Scholar
  49. Leppink, J., & Pérez-Fuster, P. (2016). What is science without replication? Perspectives on Medical Education, 5, 320–322. CrossRefGoogle Scholar
  50. Leppink, J., Van Gog, T., Paas, F., & Sweller, J. (2015). Chapter 18: Cognitive load theory: Researching and planning teaching to maximise learning. In J. Cleland & S. J. Durning (Eds.), Researching medical education (pp. 207–218). Chichester, UK: Wiley & Blackwell.CrossRefGoogle Scholar
  51. Martin, T., Petrosino, A. J., Rivale, S. D., & Diller, K. R. (2006). The development of adaptive expertise in biotransport. New Directions for Teaching and Learning, 2006, 35–47. CrossRefGoogle Scholar
  52. Martin, T., Rivale, S. D., & Diller, K. R. (2007). Comparison of student learning in challenge-based and traditional instruction in biomedical engineering. Annals of Biomedical Engineering, 35, 1312–1323. CrossRefGoogle Scholar
  53. Mosier, K. L. (2010). The human in flight. From kinesthetic sense to cognitive sensibility. In E. Salas & D. Maurino (Eds.), Human factors in aviation (3rd ed.). San Diego, CA: Elsevier.Google Scholar
  54. Moulton, C., Regehr, G., Mylopoulos, M., & MacRae, H. (2007). Slowing down when you should: A new model of expert judgment. Academic Medicine, 82, S109–S116. CrossRefGoogle Scholar
  55. Moxley, J. H., Ericsson, K. A., Charness, N., & Krampe, R. T. (2012). The role of intuition and deliberative thinking in experts’ superior tactical decision-making. Cognition, 124, 72–78. CrossRefGoogle Scholar
  56. Murata, A., Nakamura, T., & Karwowski, W. (2015). Influence of cognitive biases in distorting decision making and leading critical unfavorable incidents. Safety, 1, 44–58. CrossRefGoogle Scholar
  57. Mylopoulos, M., & Scardamalia, M. (2008). Doctors’ perspectives on their innovations in daily practice: Implications for knowledge building in health care. Medical Education, 42, 975–981. CrossRefGoogle Scholar
  58. Mylopoulos, M., & Woods, N. N. (2009). Having our cake eating it too: Seeking the best of both worlds in expertise research. Medical Education, 43, 406–413. CrossRefGoogle Scholar
  59. Nance, J. J. (2008). Why hospitals should fly: The ultimate flight plan to patient safety and quality care. Bozeman, MT: Second River Healthcare Press.Google Scholar
  60. Nickerson, R. S. (1998). Confirmation bias: A ubiquitous phenomenon in many guises. Review of General Psychology, 2, 175–220.CrossRefGoogle Scholar
  61. Phillips, J. K., Klein, G., & Sieck, W. R. (2004). Expertise in judgment and decision making: A case for training intuitive decision skills. In D. J. Koehler & N. Harvey (Eds.), Handbook of judgment and decision making. Malden, MA: Blackwell.Google Scholar
  62. Rotgans, J. I. (2015). It is time to progress beyond the system1 versus system 2 dichotomy. Perspectives on Medical Education, 4, 163–164. CrossRefGoogle Scholar
  63. Salas, E., Rosen, M. A., & Diaz Granados, D. (2010). Expertise-based intuition and decision making in organizations. Journal of Management, 36, 941–973. CrossRefGoogle Scholar
  64. Schwartz, D. L., Bransford, J. D., & Sears, D. (2005). Efficiency and innovation in transfer). In J. P. Mestre (Ed.), Transfer of learning from a modern multidisciplinary perspective (pp. 1–51). Greenwich, CT: Information Age Publishing.Google Scholar
  65. Shiffrin, R. M., & Schneider, W. (1977). Controlled and automatic human information processing. II. Perceptual learning, automatic attending and a general theory. Psychological Review, 84, 127–190.CrossRefGoogle Scholar
  66. Sibbald, M., & De Bruin, A. B. H. (2012). Feasibility of self-reflection as a tool to balance clinical reasoning strategies. Advances in Health Sciences Education, 17, 419–429. CrossRefGoogle Scholar
  67. Sibbald, M., De Bruin, A. B. H., & Van Merriënboer, J. J. G. (2013). Do checklists improve experts’ diagnostic decisions? Medical Education, 47, 301–308. CrossRefGoogle Scholar
  68. Sibbald, M., De Bruin, A. B. H., & Van Merriënboer, J. J. G. (2014). Twelve tips on engaging learners in checking health care decisions. Medical Teacher, 36, 111–115. CrossRefGoogle Scholar
  69. Stanovich, K. E. (1999). What is rational? Studies of individual differences in reasoning. Mahwah, NJ: Erlbaum.CrossRefGoogle Scholar
  70. Stanovich, K. E., & Toplak, M. E. (2012). Defining features versus incidental correlates of Type 1 and Type 2 processing. Mind & Society, 11, 3–13. CrossRefGoogle Scholar
  71. Strasser, J., & Gruber, H. (2015). Learning processes in the professional development of mental health counselors: Knowledge restructuring and illness script formation. Advances in Health Sciences Education, 20, 515–530. CrossRefGoogle Scholar
  72. Tracey, J. G., Wampold, B. E., Lichtenberg, J. W., & Goodyear, R. K. (2014). Expertise in psychotherapy: An elusive goal? American Psychologist, 69, 218–229.CrossRefGoogle Scholar
  73. Tversky, A., & Kahneman, D. (1974). Judgment under uncertainty: Heuristics and biases. Science, 185, 1124–1130. CrossRefGoogle Scholar
  74. Van den Heuvel, C., Alison, L., & Crego, J. (2012). How uncertainty and accountability can derail strategic ‘save life’ decisions in counter-terrorism simulations: A descriptive model of choice deferral and omission bias. Journal of Behavioral Decision Making, 25, 165–187. CrossRefGoogle Scholar
  75. Van Merriënboer, J. J. G., & Sweller, J. (2010). Cognitive load theory in health professions education: Design principles and strategies. Medical Education, 44, 85–93. CrossRefGoogle Scholar
  76. Varpio, L., Schryer, C. F., & Lingard, L. (2009). Routine and adaptive expert strategies for resolving ICT mediated communication problems in the team setting. Medical Education, 43, 680–687. CrossRefGoogle Scholar
  77. Wagenaar, W. A., Van Koppen, P. J., & Crombag, H. F. M. (1994). Anchored narratives: The psychology of criminal evidence. New York: Palgrave Macmillan.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • José Hanham
    • 1
  • Jimmie Leppink
    • 2
  1. 1.Western Sydney UniversityPenrithAustralia
  2. 2.Maastricht UniversityMaastrichtThe Netherlands

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