Enhancing healthcare practitioner cue recognition: Part 1

The nightmare risk of medical error

By Bonnie Hutchinson

Whether you’re a student, recently-certified or an experienced health practitioner, whether your focus is paramedicine, medicine or nursing, you know one of the biggest challenges of your profession is to make accurate assessments and decisions in high-stress environments.

Factors that challenge accuracy and speed are many. Tolerance for error is zero.

This may be the exact high stakes combination that attracted you to your profession in the first place. (Only people with a high tolerance for intensity take on these professions!)

Now that you’re in it, you have a greater understanding of the depth of your profession’s core challenges. Not for the faint of heart! But of course, you’re up for the challenge or you wouldn’t be reading this.

The worst nightmare of any practitioner is a medical error that causes harm. And yet, with the best of intentions, mistakes still happen. A Johns Hopkins study found that every year in North America, medical errors claim more than 250,000 lives – the third leading cause of death, after heart disease and cancer. Other studies put the number even higher.

Hone Virtual Education aims to change that. And you can be part of it (see below).

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Improving assessment and diagnosis in a high-stress environment: pattern recognition

The risk of medical error begins within the first few minutes of patient contact: assessment and diagnosis in a high-stress environment. The most common type of medical error is an error of diagnosis.

We know about factors that contribute to error (chaotic environments, high mental workload, distraction, fear, time constraints, etc.) – but what do we know about factors that contribute to expert diagnostic performance?

One key factor dominates pattern recognition – the mental integration of cues in the patient and the environment, synthesis of a larger picture, and comparison of that picture to knowledge stored in long-term memory. Cue recognition is an integral component of pattern recognition.

In 2013, Loveday et al reported on two studies that examined diagnostic expertise. They said, “…experts who have been identified on the basis of their diagnostic performance are more likely to use pattern recognition in comparison to their non-expert peers” and “…experienced diagnosticians could be divided into competent and expert practitioners based on their capacity for pattern recognition or cue utilization.”

In short, practitioners who demonstrate diagnostic mastery identify cues and their meaning, recognize the patterns and connect that to larger knowledge.

So how do you achieve mastery at cue recognition and pattern recognition? Practice. But not just any kind of practice. Deliberate practice.

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Scientific articles:

  1. The Johns Hopkins study, led by Dr. Martin Makary of the Johns Hopkins School of Medicine, was released in 2016. A follow-up about whether anything had changed was reported by Ray Sipherd, special to CNBC.com  Published 9:31 AM ET Thu, 22 Feb 2018 and updated 9:39 AM ET Wed, 28 Feb 2018.

  2. Loveday, T., Wiggins M., Fest M., Scheel Dl, Twigg D. (2013), “Pattern Recognition as an Indicator of Diagnostic Expertise” in Latorre Carmona P., Sanchez J., Fred A. (eds) in Pattern Recognition – Application and Methods, Advances in Intelligent Systems and Computing, Vol 204. Springer, Berlin, Heidelberg.

About the Author:

  1. About the Author: Bonnie Hutchinson is a freelance writer and lifelong learner with degrees in Education and Whole Systems Design and extensive training and experience in adult learning and teaching. She’s the best-selling author of Transitions: Pathways to the Life and World Your Soul Desires.