Injury Risk Estimation Expertise: Interdisciplinary Differences in Performance on the ACL Injury Risk Estimation Quiz

Background: Simple observational assessment of movement is a potentially low-cost method for anterior cruciate ligament (ACL) injury screening and prevention. Although many individuals utilize some form of observational assessment of movement, there are currently no substantial data on group skill differences in observational screening of ACL injury risk. Purpose/Hypothesis: The purpose of this study was to compare various groups’ abilities to visually assess ACL injury risk as well as the associated strategies and ACL knowledge levels. The hypothesis was that sports medicine professionals would perform better than coaches and exercise science academics/students and that these subgroups would all perform better than parents and other general population members. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 428 individuals, including physicians, physical therapists, athletic trainers, strength and conditioning coaches, exercise science researchers/students, athletes, parents, and members of the general public participated in the study. Participants completed the ACL Injury Risk Estimation Quiz (ACL-IQ) and answered questions related to assessment strategy and ACL knowledge. Results: Strength and conditioning coaches, athletic trainers, physical therapists, and exercise science students exhibited consistently superior ACL injury risk estimation ability (þ2 SD) as compared with sport coaches, parents of athletes, and members of the general public. The performance of a substantial number of individuals in the exercise sciences/sports medicines (approximately 40%) was similar to or exceeded clinical instrument-based biomechanical assessment methods (eg, ACL nomogram). Parents, sport coaches, and the general public had lower ACL-IQ, likely due to their lower ACL knowledge and to rating the importance of knee/thigh motion lower and weight and jump height higher. Conclusion: Substantial cross-professional/group differences in visual ACL injury risk estimation exist. The relatively profound differences in injury risk estimation accuracy and their potential implications for risk screening suggest the need for additional training and outreach

Using Visual Aids to Improve Communication of Risks about Health: A Review

Recent research has shown that patients frequently experience difficulties understanding health-relevant numerical concepts. A prominent example is denominator neglect, or the tendency to pay too much attention to numerators in ratios (e.g., number of treated patients who died) with insufficient attention to denominators (e.g., overall number of treated patients). Denominator neglect can lead to inaccurate assessments of treatment risk reduction and thus can have important consequences for decisions about health. Here, we reviewed a series of studies investigating (1) different factors that can influence patients' susceptibility to denominator neglect in medical decision making—including numerical or language-related abilities; (2) the extent to which denominator neglect can be attenuated by using visual aids; and (3) a factor that moderates the effectiveness of such aids (i.e., graph literacy). The review spans probabilistic national U.S. and German samples, as well as immigrant (i.e., Polish people living in the United Kingdom) and undergraduate samples in Spain. Theoretical and prescriptive implications are discussed

Adaptive diversity and misbelief

Although it makes some progress, McKay & Dennett’s (M&D’s) proposal is limited because (1) the argument for adaptive misbelief is not new, (2) arguments overextend the evidence provided, and (3) the alleged sufficient conditions are not as prohibitive as suggested. We offer alternative perspectives and evidence, including individual differences research, indicating that adaptive misbeliefs are likely much more widespread than implied

Visual estimation of ACL injury risk: Efficient assessment method, group differences, and expertise mechanisms

Simple observational assessment of movement quality (e.g., drop vertical jump biomechanics) is an efficient and low cost method for anterior cruciate ligament (ACL) injury screening and prevention. A recently developed test (see www.ACL-IQ.org) has revealed substantial cross-professional/group differences in visual ACL injury risk estimation skill. Specifically, parents, sport coaches, and to some degree sports medicine physicians, would likely benefit from training or the use of decision support tools. In addition, expertise mechanisms (perceptual-cognitive characteristics of skilled performers) were investigated in order to design training systems to improve risk estimation performance

Predicting biases in very highly educated samples: Numeracy and metacognition

We investigated the relations between numeracy and superior judgment and decision making in two large community outreach studies in Holland (n=5408). In these very highly educated samples (e.g., 30–50% held graduate degrees), the Berlin Numeracy Test was a robust predictor of financial, medical, and metacognitive task performance (i.e., lotteries, intertemporal choice, denominator neglect, and confidence judgments), independent of education, gender, age, and another numeracy assessment. Metacognitive processes partially mediated the link between numeracy and superior performance. More numerate participants performed better because they deliberated more during decision making and more accurately evaluated their judgments (e.g., less overconfidence). Results suggest that well-designed numeracy tests tend to be robust predictors of superior judgment and decision making because they simultaneously assess (1) mathematical competency and (2) metacognitive and self-regulated learning skills

The dynamics of development: Challenges for Bayesian rationality

Commentary on Oaksford & Chater, Precis of Bayesian Rationality Oaksford & Chater draw a rather static picture of human reasoning by focusing on typical patterns of responses from adults. We propose a more dynamic perspective, which considers that reasoning systematically varies within individuals over the lifespan (Howe & Rabinowitz 1996; Markovits & Barrouillet 2002) and between individuals with different levels of knowledge and expertise (Ericsson et al. 2006). The original articles, the full set of commentaries, and the authors\u27 response are attached (below) as an Additional file