Decision Making- Some end of year field notes and thoughts

22 Nov

Health- How do experts produce outstanding care?

When we research people who work in health and are renowned for providing excellent care, the value of experience becomes apparent. Experts have developed rules of thumb which allow them to size up scenarios quickly, picking up cues and patterns; formulating a global picture of what is unfolding and how the scenario is likely to play out.

This cognitive process allows experts to operate beyond formal procedures and processes, anticipating potential problems and producing flexible plans, all with the goal of providing excellent care. For example, a highly experienced nurse may look first at the physical signs of a patient before looking at the patients chart, applying years of experience to recognise subtle signs and cues which may have been missed or recently developed. Simply following procedures and processes may miss cues which could be very meaningful to the patients care.

Information is crucial in health environments, but it loses its potential when it is not accompanied by analysis and sense making. Analysis and sense making are what separates health experts from novices, and so, when more information is introduced into an environment it runs the risk of being subjected to poor analysis.

Our recommendation- To enhance information’s value first illicit the current knowledge of experts and ensure it supports their experience based analysis and sense making skills. If not then information can run the risk of drowning out the tacit skills which deliver outstanding care outcomes

Decision challenges when using big data and new technology

We find that when a new technology is introduced into a workplace aimed at improving decision making the technology runs into an immediate problem-world visualisation. World visualisation means that the introduction of a new technology fundamentally changes the role which it is meant to support. This creates a contradiction- the technology is designed to improve decision making in a job, but the technology fundamentally changes the job it’s meant to support. You’ve created a new job with a new set of cognitive challenges, some of which may remain hidden for some time.

And more significant questions- has the technology supported the decision making processes or created a new set of skill requirements? Does the technology support the existing skills of the best members of staff? Do the cues and patterns which the best staff notice become more apparent or do they get drowned out by the noise? The authors Hoffman et al (2003) point out that when pilots were introduced to new sophisticated auto pilot systems, designed to make flying easier, a whole new set of cognitive tasks were created. How were they to integrate the new technology into their current methods of flying? How should they attend to the data? What should they pay more attention to, when and where?

I read recently that no one needed to be instructed how to use Google, however this misses the point, Google fundamentally changed the way a lot of people searched for information. It created a new set of reasoning strategies. As researchers who use Google constantly we always have to ask- how valid is this source? Where did it come from? What patterns are hidden in this text which could produce my next search terms? Not everyone thinks likes this, and one of our tasks is to instruct our trainee researchers on the cognitive skills required to place the masses of information Google produces in context, without it we just have easy cherry picked answers.

For organisations like intelligence agencies this is a fundamental challenge; there is no shortage of data but the sense making and analysis, the ability to join the dots creatively and effectively, is what prevents the terrorists’ attacks. Data without knowledge of the cognitive skills needed to analyse it is worthless.

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