Experts and Decision Making: First Steps Towards a Unifying Theory of Decision Making in Novices, Intermediates and Experts

Expertise research shows quite ambiguous results on the abilities of experts in judgment and decision making (JDM) classic models cannot account for. This problem becomes even more accentuated if different levels of expertise are considered. We argue that parallel constraint satisfaction models (PCS) might be a useful base to understand the processes underlying expert JDM and the hitherto existing, differentiated results from expertise research. It is outlined how expertise might influence model parameters and mental representations according to PCS. It is discussed how this differential impact of expertise on model parameters relates to empirical results showing quite different courses in the development of expertise; allowing, for example, to predict under which conditions intermediates might outperform experts. Methodological requirements for testing the proposed unifying theory under complex real-world conditions are discussed.Judgment and Decision Making, Expertise, Intermediate Effects, Parallel Constraint Satisfaction, Mental Representation

Psychologists’ Diagnostic Processes during a Diagnostic Interview

In mental health care, psychologists assess clients’ complaints, analyze underlying problems, and identify causes for these problems, to make treatment decisions. We present a study on psychologists’ diagnostic processes, in which a mixed-method approach was employed. We aimed to identify a common structure in the diagnostic processes of different psychologists. We engaged an actor to simulate a client. Participants were asked to perform a diagnostic interview with this “client”. This interview was videotaped. Afterwards participants first wrote a report and then were asked to review their considerations during the interview. We found that psychologists were comprehensive in their diagnostic interviews. They addressed the client’s complaints, possible classifications, explanations, and treatments. They agreed about the classifications, more than about causal factors and treatment options. The content of the considerations differed between the interviews and the reports written afterwards. We conclude that psychologists continuously shifted between diagnostic activities and revised their decisions in line with the dynamics of the interview situatio

Diagnostic reasoning in medical students using a simulated environment

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Teacher Thinking & Professional Action

Over the past twenty years the International Study Association on Teachers and Teaching (ISATT) has become world-renowned as an organisation dedicated to the discussion of current thinking in educational policy and practice. As such, the ideas aired at ISATT conferences are of the greatest significance to today's educational practitioners. This book satisfies the demand for a lasting record of ISATT's illuminating discussions on the theme. It is based on a selection of papers presented at their third bi-annual conference and has been updated by each contributor to include their current thoughts and opinions. Containing nineteen articles, each an in-depth examination of the topic, it is divided into four sections: conceptual frames for teacher thought and action methods and approaches to the study of teacher though and action teacher judgment and evaluation of students teacher thinking and teacher education. Broad in theme, international in scope and detailed this book is essential and enlightening reading for anyone with a serious interest in the ongoing development of educational thought

Modelling of expert nurses' pressure sore risk assessment skills as an expert system for in-service training

In the nursing literature to date there have been no reported applications of `cognitive simulation' nor of intelligent Computer Assisted Learning. In Chapter 1 of this thesis a critical review of existing nurse education by computer is used to establish a framework within which to explore the possibility of simulation of thinking processes of nurses on computer. One conclusion from this review which is offered concerns the importance of firstly undertaking reliable study of nursing cognition. The crucial issue is that an understanding must be gained of how expert nurses mentally represent their patients in order that a valid model might be constructed on computer. The construction of a valid computer based cognitive model proves to be an undertaking which occupies the remainder of this thesis. The approach has been to gradually raise the specificity of analysis of the knowledge base of expert and proficient nurses while seeking concurrently to evaluate validity of the findings. Reported in Chapter 2, therefore, are the several experimental stages of a knowledge acquisition project which begins the process of constructing this knowledge base. Discussed firstly is the choice of the skill domain to be studied - pressure sore risk assessment. Subsequently, the method of eliciting from nurses top-level and micro-level descriptors of patients is set out. This account of knowledge acquisition ends with scrutiny of the performance of nurse subjects who performed a comprehensive simulated patient assessment task in order that two groups might be established - one Expert and one Proficient with respect to the nursing task. In Chapter 3, an extensive analysis of the data provided by the simulated assessment experiment is undertaken. This analysis, as the most central phase of the project, proceeds by degrees. Hence, the aim is to `explain' progressively more of the measured cognitive behaviour of the Expert nurses while incorporating the most powerful explanations into a developing cognitive model. More specifically, explanations are sought of the role of `higher' cognition, of whether attribute importance is a feature of cognition, of the point at which a decision can be made, and of the process of deciding between competing patient judgements. Interesting findings included several reliable differences which were found to exist between the cognition of subjects deemed to be proficient and those taken as expert. In the final part of this thesis, Chapter 4, a more formal evaluation of the computer based cognitive model which was constructed and predictions made by it was undertaken. The first phase involved analysis in terms of process and product of decision making of the cognitive model in comparison to two alternative models; one derived from Discriminant Function Analysis and the other from Automated Rule Induction. The cognitive model was found to most closely approximate to the process of decision making of the human subjects and also to perform most accurately with a test set of unseen patients. The second phase reports some experimental support for the prediction made by the model that nurses represent their patients around action-related `care concepts' rather than in terms of diagnostic categories based on superficial features. The thesis concludes by offering some general conclusions and recommendations for further research

Learning law:Expertise differences and the effect of instructional support

Nievelstein, F. (2009). Learning law. Expertise differences and the effect of instructional support. Doctoral thesis. September, 18, 2009, Heerlen, Nederland: Open Universiteit.One of the main aims of law education in both the Civil (European-Continental) law and Common (Anglo-Saxon) law systems is to teach students to reason about cases. As reviewed in Chapter 1, students experience serious difficulties in learning to reason about cases, which seem to arise from the complexity of the domain, the way in which knowledge is acquired in complex domains, as well as the instructional approach widely used in law schools. This approach often consists of ‘learning by doing’, which means that students have to reason about lots of cases throughout their study by using information sources that professionals also use. The studies presented in Chapters 2 to 4 were designed to gain more insight in the kind of difficulties and the underlying causes that students with differing levels of expertise have when they learn to reason about cases in law school, as well as to investigate the requirements for effective instructional approaches that provide more support and might help to diminish or overcome the experienced difficulties

Clinical Reasoning and Causal Attribution in Medical Diagnosis

Forming a medical diagnosis is a complicated reasoning process undertaken by physicians. Although there has been much research focusing on clinical reasoning approaches, there is limited empirical evidence in relation to causal attribution in medical diagnosis. The research on which this thesis is based explored and examined the social process of medical diagnosis and provides an explanation of the clinical reasoning and causal attribution used by physicians. The research was undertaken in an Emergency Department within an acute hospital, the data were collected using mixed method approach including one to one semi-structured interviews with individual physicians; observation of their medical assessments of patients and secondary data analysis of the subsequent recorded medical notes. The study involved 202 patients and 26 physicians. The analysis of the physicians’ semi-structured interviews, shows how physicians describe the diagnostic step process and how they blend their clinical reasoning skills and professional judgment with evidence-based medicine. Physicians apply prior learning of taught biomedical and pathophysiological knowledge to question patients using pattern recognition of common signs and symptoms of disease. These findings are portrayed through taped narratives of the physician/patient interaction during the medical diagnostic process, which shows how physicians control the medical encounter. The analysis/interpretation of documentary evidence (recorded medical notes) provides an insight into the way in which physicians used the information gathered during the diagnostic step process. By using SPSS it was possible to cluster the cases (individual patients) into groups. This stage-ordered classification procedure demonstrated commonality amongst individual cases whilst highlighting the uniqueness of any cases. A pattern emerged of two groups of cases: Group 1 - comprised of patients with the presenting complaints of chest pain, shortness of breath, collapse, abdominal pain, per rectal bleed, nausea, vascular and neurological problems and Group 2 - comprised of patients presenting with trauma, mechanical falls, miscarriage/gynaecological problems, allergies/rashes and dental problems. Findings show that the clinical reasoning approaches used varied according to the complexity of the patient’s presenting complaint. The recorded medical notes for the patients in Group 1, were comprehensive and demonstrated a combined approach of hypothetic-deductive and probabilistic reasoning which enabled the physicians to deal with the degree of uncertainty that is inherent in medicine. The recorded process in the medical notes was shortened for the majority of patients in Group 2, and here the clinical reasoning approach used was found to deterministic. It is acknowledged, that this is not always the case. By using crisp set QCA it was possible to explore causal conditions consistent with Group 1. Further analysis led to examination of the link of causal conditions presented in the medical notes with the individual impression/working diagnosis made by physicians.Plymouth Universit