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Newly-Acquired Complex Performance Competence and Medical Errors

Chapter
Part of the Health Informatics book series (HI)

Abstract

Increasingly, the acquisition of competence is defined using learning progressions [1]. For conceptual bodies of knowledge, such progressions are reasonably straightforward. They state stages of understanding and capability that people pass through on the path to expertise. Generally, once each stage is fully mastered, performance at that stage is relatively less demanding of cognitive processing resources, leaving some capacity free to notice cues for routine required actions. In mission critical areas, including many areas of medicine, competence includes not only knowing how to deal with situations but also being reliable, while exercising that expertise, in carrying out critical routines (e.g., hand washing) even when overloaded when complex problems that must be solved. This chapter considers the circumstances during the course of progressing to expertise under which there is a danger of routine but critical actions being omitted and then discusses possible ways to minimize the likelihood of critical omissions.

Keywords

Cognitive Load Medical Error Health Care Worker Symptom Cluster Critical Action 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Smith CL, Wiser M, Anderson CW, Krajcik J. Implications of research on children’s learning for standards and assessment: a proposed learning progression for matter and the atomic molecular theory. Meas Interdiscipl Res Perspect. 2006;4:1–98.CrossRefGoogle Scholar
  2. 2.
    Stevens SY, Shin N, Krajcik JS. Towards a model for the development of an empirically tested learning progression. In: Learning progressions in science conference, Iowa City, 2009.Google Scholar
  3. 3.
    Lesgold A, Rubinson H, Feltovich P, Glaser R, Klopfer D, Wang Y. Expertise in a complex skill: diagnosing X-ray pictures. In: Chi M, Glaser R, Farr M, editors. The nature of expertise. Hillsdale: Erlbaum; 1988. p. 311–42.Google Scholar
  4. 4.
    Lesgold AM. Acquiring expertise. In: Anderson JR, Kosslyn SM, editors. Tutorials in learning and memory: essays in honor of Gordon Bower. San Francisco: Freeman; 1984. p. 31–60.Google Scholar
  5. 5.
    Cashon CH, Cohen LB. Beyond U-shaped development in infants’ processing of faces: an information-processing account. J Cogn Dev. 2004;5:59–80.CrossRefGoogle Scholar
  6. 6.
    Siegler RS. U-shaped interest in U-shaped development – and what it means. J Cogn Dev. 2004;5:1–10.CrossRefGoogle Scholar
  7. 7.
    Cohen LB, Chaput HH, Cashon CH. A constructivist model of infant cognition. Cogn Dev. 2002;17:1323–43.CrossRefGoogle Scholar
  8. 8.
    Boshuizen HP, Schmidt HG. On the role of biomedical knowledge in clinical reasoning by experts, intermediates and novices. Cogn Sci. 1992;16:153–84.CrossRefGoogle Scholar
  9. 9.
    Schmidt HG, Rikers RM. How expertise develops in medicine: knowledge encapsulation and illness script formation. Med Educ. 2007;41:1133–9.PubMedGoogle Scholar
  10. 10.
    Patel VL, Glaser R, Arocha JF. Cognition and expertise: acquisition of medical competence. Clin Invest Med. 2000;23:256–60.PubMedGoogle Scholar
  11. 11.
    Patel VL, Groen GJ, Arocha JF. Medical expertise as a function of task difficulty. Mem Cogn. 1990;18:394–406.CrossRefGoogle Scholar
  12. 12.
    Hales B, Terblanche M, Fowler R, Sibbald W. Development of medical checklists for improved quality of patient care. Int J Qual Health Care. 2008;20:22–30.PubMedCrossRefGoogle Scholar
  13. 13.
    Helmreich RL, Merritt AC, Wilhelm JA. The evolution of crew resource management training in commercial aviation. Int J Aviat Psychol. 1999;9:19–32.PubMedCrossRefGoogle Scholar
  14. 14.
    Flin R, O’Connor P, Mearns K. Crew resource management: improving team work in high reliability industries. Team Perform Manag. 2002;8(3/4):68–78.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.School of EducationUniversity of PittsburghPittsburghUSA

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