Part 1: Recognize cues for diagnostic mastery
Features with deeper meaning
The low fuel light in your car.
The half-open lid of your mailbox.
The sound of your front door opening.
These are all features of our environment that have meaning for us. They all signify something deeper than what you see or hear. We need to get gas, the mail arrived, our significant other is home.
Features that signify deeper meaning – called cues – are all around us. Knowing the meaning of cues is a key element of going about our daily lives. Cues are also key to making accurate decisions quickly in situations when making accurate decisions is important.
In chess, your opponent’s piece positions are cues that allow you to calculate your next move. In tennis, your opponent’s position on the court is a cue that changes where you serve the ball. In the fire service, a warning alarm is a cue that could indicate low levels of air in your cylinder. In health care, a patient with chest pain is exhibiting a cue that may indicate a heart attack.
Recognizing and attaching accurate meaning to cues in situations and environments is the critical first step to accomplish what’s needed in those circumstances.
In health care, especially pre-hospital and emergency health care, recognizing and attaching meaning – accurately and quickly – to diagnostic cues presented by patients and their environments can make a life-or-death difference.
Hone Virtual Education will soon be releasing a resource called Recognize that helps you achieve even greater mastery in making quick and accurate decisions based on cues presented by patients in multiple types of environments. More about that later, but first, here’s a quick summary of the logic that’s driving the development of this simulation training you can download to your augmented reality enabled smartphone or tablet.
The essential diagnostic skills: Identify cues and recognize patterns
In health care, accurate diagnosis is the basis of everything that comes later. However, diagnostic errors are one of the biggest problems of modern health care. The third leading cause of death in North America is medical error, and the most frequent type of medical error is an error of diagnosis.
Nobody wants medical diagnosis error and nobody intends it – probably especially not you! But still, medical diagnosis errors happen.
So what can be done? For one thing, we can identify the mechanisms that contribute to diagnostic excellence.
In studies that examined diagnostic expertise, one dominant characteristic distinguished the most expert diagnosticians from others: the ability to identify diagnostic cues and recognize patterns. For example, Loveday et al reported that, “It is evident that 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.”
Health care practitioners – especially those on the front lines who work with patients in pre-hospital or emergency care – need to master the ability to identify diagnostic cues and recognize patterns, quickly and accurately.
So how do you get better and better at that?
Perfect practice that makes your practice perfect: mastery learning
An old adage is, “Practice makes perfect.” It turns out that is not necessarily true. In fact, the wrong kind of practice can actually make someone better at doing things wrong! A sobering research finding is that within the practice of medicine, additional professional experience does not seem to improve performance.
Much research is now available to tell us the exact characteristics of learning practices that lead to mastery. You’ll learn more about those characteristics in Part 2 next week. You’ll also learn some of the challenges of applying mastery learning practices to health practitioner training. Best of all, you’ll learn how Hone Virtual Education’s Recognize training modules are able to apply mastery learning practices to increase your mastery of identifying diagnostic cues and recognizing patterns.
Find out more
The first Recognize modules will be released early in 2019. Until then, you can…
Anders K. Ericcson (2015): “Acquisition and Maintenance of Medical Expertise: A Perspective from the Expert-Performance Approach with Deliberate Practice.” Academic Medicine: Journal of the Association of American Medical Colleges. 90.10.1097/ACM.0000000000000939