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Cognitive and Decision-Making Skills in Catheter-Based Cardiovascular Interventions

  • Peter Lanzer
Chapter

Abstract

For the past nearly four decades, performance of catheter-based cardiovascular interventions has been considered largely inaccessible to formal scrutiny. It has been assumed that interventional knowledge and skills are based on empiricism and can be transferred only tacitly. In addition, over the past decades, the importance of clinical trials based evidence and charms of instrumentation technology have been strongly overemphasized with these factors contributing to the demise of the importance of cognitive skills and decline of technical abilities of the operators, both required for the procedural interventional expertise. In this chapter, the key importance of cognitive skills for interventional expertise has been emphasized. Development of training curricula and clinical practice based on deliberate practice and acquisition of relevant cognitive skills is needed to raise the level of professional standards and to improve the quality of interventional services in the best interest of all stakeholders, of which our patients are the most important.

Keywords

Cognitive Skill Fractional Flow Reserve Deliberate Practice Algorithmic Level Hindsight Bias 
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.
    Dotter CT, Judkins MP (1964) Transluminal treatment of arteriosclerotic obstruction. Circulation 30:654–670PubMedCrossRefGoogle Scholar
  2. 2.
    Arendt H (1971) The life of the mind. Harcourt, Brace, Jovanovich, San Diego/New York/LondonGoogle Scholar
  3. 3.
    Gilson E (1936) The spirit of medieval philosophy. University of Notre Dame Press, Notre DamGoogle Scholar
  4. 4.
    Kant I (2000) Critique of the power of judgment. Cambridge University Press, CambridgeGoogle Scholar
  5. 5.
    Gazzaniga MS (ed) (2005) The cognitive neurosciences III. MIT Press, BostonGoogle Scholar
  6. 6.
    Glimcher PW, Caterer CF, Fehr E, Holdback RA (2009) Neuroeconomics; decision making and the brain. Elsevier, Amsterdam/Boston/HeidelbergGoogle Scholar
  7. 7.
    Stanovich KE (1999) Who is rational? Studies of individual differences in reasoning. Erlbaum, MahwehGoogle Scholar
  8. 8.
    Stanovich KE (2004) The robot’s rebellion: finding meaning in the age of Darwin. University of Chicago Press, ChicagoGoogle Scholar
  9. 9.
    Stanovich KE, West RF (2002) Individual differences in reasoning: implications for the rationality debate. In: Gilovich T, Griffin D, Kahneman D (eds) Heuristics and biases. Cambridge University Press, Cambridge, pp 421–440CrossRefGoogle Scholar
  10. 10.
    Kahneman D (2011) Thinking, fast and slow. Pinquin Books, London, p 105Google Scholar
  11. 11.
    Leslie AM (1987) Pretense and representation: the origins of “theory of mind”. Psychol Rev 94:412–426CrossRefGoogle Scholar
  12. 12.
    Perner I (1991) Understanding the representational mind. MIT Press, CambridgeGoogle Scholar
  13. 13.
    Stanovich KE (2008) Distinguishing the reflective, algorithmic, and autonomous minds: is it time for a tri-process theory? In: Evans J, Frankisch K (eds) In two minds: dual process and beyond. Oxford University Press, OxfordGoogle Scholar
  14. 14.
    Wang Y, Wang Y, Patel S, Patel D (2006) A layered reference model of the brain (LRMB). IEEE Trans Syst Man Cybern 36:124–133Google Scholar
  15. 15.
    Ebbinghaus H (1885) Über das Gedächtnis. Untersuchungen zur experimentellen Psychologie. Duncker & Humblot, LeipzigGoogle Scholar
  16. 16.
    Bloom BS (ed) (1956) Taxonomy of educational objectives, the classification of educational goals handbook I: cognitive domain. McKay, New YorkGoogle Scholar
  17. 17.
    Ericsson KA (ed) (2009) Development of professional expertise. Cambridge University Press, CambridgeGoogle Scholar
  18. 18.
    Ericsson KA, Charness N, Feltovich PJ, Hoffman RR (eds) (2006) The Cambridge handbook of expertise and expert performance. Cambridge University Press, CambridgeGoogle Scholar
  19. 19.
    Ericsson KA, Krampe RTh, Tesch-Römer C (1993) The role of deliberate practice in the acquisition of expert performance. Psychol Rev 100:363–406CrossRefGoogle Scholar
  20. 20.
    Holyoak KJ, Cheng PW (2011) Causal learning and inference as a rational process: the new synthesis. Annu Rev Psychol 62:135–163PubMedCrossRefGoogle Scholar
  21. 21.
    Sullivan ME, Brown CV, Peyre SE, Salim A, Martin M, Towfigh S, Grunwald T (2007) The use of cognitive task analysis to improve the learning of percutaneous tracheostomy placement. Am J Surg 193:96–99PubMedCrossRefGoogle Scholar
  22. 22.
    Campbell JC (2010) Employing cognitive task analysis supported instruction to increase medical student and surgical resident performance and self-efficacy. Dissertation presented to the Faculty of the USC Rossier School of Education, University of Southern California (unpublished)Google Scholar
  23. 23.
    Tirapille LA (2010) The effect of cognitive task analysis based instruction on surgical skills expertise and performance. Dissertation presented to the Faculty of the USC Rossier School of Education, University of Southern California, in partial fulfillment of the requirements for the Degree of Doctor of Education (unpublished)Google Scholar
  24. 24.
    Maupin FG (2010) Comparing cognitive task analysis to behavior task analysis in training first year interns to place central venous catheters. Dissertation proposal presented to the Faculty of the USC Rossier School of Education, University of Southern California (unpublished)Google Scholar
  25. 25.
    Aristotle (1962) Categories and De Interpretatione (trans: Ackrill JH). Clarendonce Press, OxfordGoogle Scholar
  26. 26.
    Taylor R (1957) The problem of future contingencies. Philos Rev 66:1–28CrossRefGoogle Scholar
  27. 27.
    Taylor R (1962) Fatalism. Philos Rev 71:56–66CrossRefGoogle Scholar
  28. 28.
    Devin K. The unfinished game: Pascal, Fermat, and the seventeeth century letter that made the world modern. New York: Basic Books, 2008Google Scholar
  29. 29.
    Arnauld A, Nicole P (1996) Logic or the art of thinking. Cambridge University Press, Melbourne, pp 274–275Google Scholar
  30. 30.
    Bernoulli D (1954) Exposition of a new theory on the measurement of risk. Econometrica 22:23–36 (translation from Specimen theoriae novae de mensura sortis. Commentarii Academiae Scientiarum Imperialis Petropolitanae, Tomus V, 1738:175–192Google Scholar
  31. 31.
    Bayes T (1763) An essay toward solving a problem in the doctrine of chances. Philos Trans Essay LII:370–418CrossRefGoogle Scholar
  32. 32.
    von Neumann J (1928) Zur Theorie der Gesellschaftsspiele. Math Ann 100:295–320CrossRefGoogle Scholar
  33. 33.
    von Neumann J, Morgenstern O (1944) Theory of games and economic behavior. Princeton University Press, PrincetonGoogle Scholar
  34. 34.
    Shannon CE, Weawer W (1963) The mathematical theory of communication. Chicago University Press, Urbana/Chicago; copyright 1949Google Scholar
  35. 35.
    Turing AM (1936) On computable numbers, with an application to the Entscheidungsproblem. Proceedings of London Mathematical Society, series 2, 42:230–265Google Scholar
  36. 36.
    Zadeh L (1965) Fuzzy sets. Inf Control 8:338–353CrossRefGoogle Scholar
  37. 37.
    Lorenz EN (1963) Deterministic non-periodic flow. J Atmos Sci 20:130–141CrossRefGoogle Scholar
  38. 38.
    Alexander C (1964) Notes on the synthesis of form. Harvard University Press, CambridgeGoogle Scholar
  39. 39.
    Goethe JW von (2012) Faust, Teil 1. http://www.­gutenberg.org/cache/epub/2229/pg2229.html. Accessed 19 Jan 2012
  40. 40.
    Wang Y, Ruhe G (2007) The cognitive process of decision making. Int J Cognit Inf Nat Intell 1(2):73–85CrossRefGoogle Scholar
  41. 41.
    Peterson M (2009) An introduction to decision theory. Cambridge University Press, CambridgeGoogle Scholar
  42. 42.
    Kahneman D, Slovic P, Tversky A (eds) (1982) Judgment under uncertainty: heuristics and biases. Cambridge University Press, CambridgeGoogle Scholar
  43. 43.
    Smith JQ (2010) Bayesian decision analysis; principles and practice. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  44. 44.
    Meehl PE (1996) Clinical versus statistical prediction: a theoretical analysis and a review of the evidence. Jason Aronson, MinnesottaGoogle Scholar
  45. 45.
    Klein G (1999) Sources of power: how people make decisions. MIT Press, CambridgeGoogle Scholar
  46. 46.
    Kahneman D, Klein G (2009) Conditions for intuitive expertise: a failure to disagree. Am Psychol 64:515–526PubMedCrossRefGoogle Scholar
  47. 47.
    Arkes HR (2001) Overconfidence injudgmental forecasting. In: Armstrong JS (ed) Principles of forecasting: a handbook for researchers and practitioners. Kluwer Academic, Boston, pp 495–516Google Scholar
  48. 48.
    Bishop MA, Trout JD (2004) Epistemology and the psychology of human judgment. Oxford University Press, New YorkGoogle Scholar
  49. 49.
    List of cognitive biases. http://en.wikipedia.org/wiki/List_of_cognitive_biases. Accessed 4 Nov 2011
  50. 50.
    Gigerenzer G, Gaissmaier W (2011) Heuristic decision making. Annu Rev Psychol 62:451–482PubMedCrossRefGoogle Scholar
  51. 51.
    Reason J (1990) Human error. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  52. 52.
    Kahneman D, Tversky A (1979) Prospect theory: an analysis of decision under risk. Econometrica 47:263–291CrossRefGoogle Scholar
  53. 53.
    Bernstein PL (1998) Against gods; remarkable story of risk. Wiley, PhiladelphiaGoogle Scholar
  54. 54.
    National Defence and the Canadian Forces. www.forces.gc.ca. Accessed 5 Sept 2011
  55. 55.
    Ferguson N. (2008) The ascent of money. Penguin Books, London, pp 192–196Google Scholar
  56. 56.
    Center for Chemical Process Safety (2009) Guidelines for developing quantitative safety risk criteria. Wiley, HobokenGoogle Scholar
  57. 57.
    Safety management system for aviation. http://www.safeopsys.com/docs/SOS_SMS_Article.pdf. Accessed 5 Sept 2011
  58. 58.
    Semmelweis I (1983) The etiology, concept, and prophylaxis of childbed fever. University of Wisconsin, Wisconsin; translated from Semmelweis IP. Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers. Original published 1860. Reprinted from: Györy von T (ed) (2007) Semmelweis’ gesammelte Werke. In copyright: Verlag Dr. Müller, SaarbrückenGoogle Scholar
  59. 59.
    Kohn LT, Corrigan JM, Donaldson MS (eds) (Committee of Quality of Health Care in America, Institute of Medicine) To err is human: building a safer health system. (http://books.nap.edu/html/to_err_is_human/exec_summ.html)
  60. 60.
    Landrigan CP, Parry GJ, Bones CB, Hackbarth AD, Goldmann DA, Sharek PJ (2010) Temporal trends in rates of patient harm resulting from medical care. N Engl J Med 363:2124–2134PubMedCrossRefGoogle Scholar
  61. 61.
    Sherman H, Loeb J (for Joint Commission on Accreditation of Healthcare Organizations, WHO Consultants) (2005) The WHO World Health Organization Alliance for patient safety. World Health Organization. http://www.who.int/patientsafety/taxonomy/IPSET_Sept05_FINAL.pdf (accessed March 18, 2012).
  62. 62.
    Prechelt L, Lanzer P (2006) The decision-making process in percutaneous coronary interventions. In: Lanzer P (ed) Mastering endovascular techniques: a guide to excellence. Lippincott Williams & Wilkins, Philadelphia, pp 103–113Google Scholar
  63. 63.
    Lanzer P, Prechelt L (2011) Expanding the base for teaching of percutaneous coronary interventions: the explicit approach. Catheter Cardiovasc Intervent 77:372–380CrossRefGoogle Scholar
  64. 64.
    Lanzer P, Prechelt L (2008) Spelling out risk reduction strategies for intracoronary stenting. EuroIntervention 3:622–626PubMedCrossRefGoogle Scholar
  65. 65.
    ACCF/AHA Task Force on Practice Guidelines. Manual for ACCF/AHA Guideline Writing Committees: methodologies and policies from the ACCF/AHA Task Force on Practice Guidelines. Available at http://assets.cardiosource.com/Methodology_Manual_for_ACC_AHA_Writing_Committees.pdf and http://circ.ahajournals.org/manual/. American College of Cardiology and American Heart Association. Accessed 1 Oct 2010
  66. 66.
    Gawande A (2011) The checklist manifesto: how to get things right. McMillan, PhiladelphiaGoogle Scholar
  67. 67.
    Morrow DA, Antman EM, Charelsworth A, Cairns R, Murphy SA, de Lemos JA, Giugliano RP, McCabe CH, Braunwald E (2000) TIMI risk score for ST-elevation myocardial infarction: a convenient, bedside, clinical score for risk assessment at presentation. Circulation 102:2031–2037PubMedCrossRefGoogle Scholar
  68. 68.
    Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G, Mautner B, Corbalan R, Radley DE (2000) The TIMI score for unstable angina/non-ST-elevation MI: a method for prognostication and therapeutic decision making. JAMA 284:835–842PubMedCrossRefGoogle Scholar
  69. 69.
    Ranasighe I, Alprandi-Costa B, Chow V, Elliott JM, Waites J, Counsell JT, Lopez-Sendon J, Avezum A, Goodman SG, Granger CB, Brieger D (2011) Risk stratification in the setting of Non-ST elevation acute coronary syndromes 1999–2007. Am J Cardiol 108:617–624CrossRefGoogle Scholar
  70. 70.
    Ryan TJ, Dp F, Gunnar RM et al (1988) Guidelines for percutaneous transluminal coronary angioplasty: a report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures. J Am Coll Cardiol 12:529–545CrossRefGoogle Scholar
  71. 71.
    Sianos G, Morel M-A, Kappetein AP, Morice M-C, Colombo A, Dawkins K, van den Brand M, van Dyck N, Russell ME, Mohr FW, Serruys PW (2005) The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention 1:219–227PubMedGoogle Scholar
  72. 72.
    Lanzer P (2006) Coronary interventions. In: Lanzer P (ed) Mastering endovascular techniques: guide to excellence. Lippincott, Williams & Wilkins, Philadelphia, pp 208–225Google Scholar
  73. 73.
    KDOQI clinical practice guidelines for ghronic kidney disease: evaluation, classification, and stratification. http://www.kidney.org/professionals/kdoqi/guidelines_ckd/toc.htm (accessed March 18, 2012).
  74. 74.
    Manual on contrast media v7. American College of Radiology. http://www.acr.org/SecondaryMainMenuCategories/quality_safety/contrast_manual.aspx (accessed March 18, 2012).
  75. 75.
    Jones DM, Song X, Rockwood K (2004) Operationalizing a frailty index from a standardized comprehensive geriatric assessment. J Am Geriatr Soc 52:1929–1933PubMedCrossRefGoogle Scholar
  76. 76.
    Lanzer P (2003) Vascular multimorbidity in patients with a documented coronary artery disease. Z Kardiol 92:650–659PubMedCrossRefGoogle Scholar
  77. 77.
    Lanzer P, Weser R, Prettin C (2007) Intentional single-stage revascularization of two different vascular beds in patients with vascular multimorbidity: a feasibility study. Clin Res Cardiol 96:497–501PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of Internal Medicine, Division of Cardiovascular DiseaseGesundheitszentrum Bitterfeld/Wolfen gGmbHBitterfeld-WolfenGermany

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