Part 2: Solving the challenges of diagnostic mastery
Highlights from Part 1: Recognize Cues for diagnostic mastery
1. All of us are aware of features in our environments that signify greater meaning than what you can see, hear, touch, taste or smell. The low fuel light in your car means time to get gas. A half-open mailbox lid means the mail has arrived.
2. Features that signify a greater meaning are called cues. Knowing the meaning of cues is a key element in going about our daily lives. Cues are also key to making accurate decisions quickly in situations where that is required.
3. 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.
4. 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.
5. 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.
6. What can be done? We can identify mechanisms that contribute to diagnostic excellence.
7. In studies of diagnostic expertise, the dominant characteristic of the most expert diagnosticians is the ability to identify diagnostic cues and recognize patterns.
8. So how do you get better and better at that? Mastery learning practice.
What we know about learning to achieve mastery
In recent years, scientists and researchers have identified adult learning practices that help anyone in any profession move from novice to competent to an expert to master. In health care and in other fields, the science of peak performance enables practitioners to operate at optimum levels in high-stress environments, even in moments when they are not at their personal best.
Here are some highlights – characteristics of mastery learning:
Bite size pieces. First, within each skill set, the requirements are separated into tiny detailed components – very specific actions performed in specific ways. That means in earlier stages of learning something new, you’re not overwhelmed by multiple stimuli, but can focus on one small component at a time.
Immediate feedback. Second, mastery learning requires immediate feedback. You know immediately when you’ve done something correctly and when you’ve made an error, so you can correct the errors and get better and better at doing things right.
Deliberate practice. Third, mastery learning requires deliberate practice (whether to identify specific cues or carry out a specific action). You keep practicing correctly to achieve the intended results until your proficiency is etched in your brain and becomes automatic.
Gradually increasing difficulty and complexity. Within each subset of cues and actions, you gradually increase the difficulty and complexity of the practice tasks so you achieve continuously increasing mastery.
Increasing pattern recognition. On-going deliberate practice of increasing difficulty allows you to get better and better at recognizing patterns. That can increase accuracy and also shortcut the time required for assessment and decision.
Mastery learning for health care practitioners: 4 challenges
It’s useful to identify the kind of learning practices that lead to mastery. Making those mastery learning practices available to health care practitioners will optimize their ability to identify diagnostic cues and recognize patterns. There are challenges, though, in applying mastery learning practices to health care practitioner training.
Hone Virtual Education has been developing solutions to those challenges for a while now. The Recognize virtual reality simulation training modules are a start, as you’ll see later.
Four of the challenges to mastery learning for health practitioners (if you’re a health practitioner you’ve almost certainly experienced them) are…
Multiple Cues. Within each area of initial patient assessment, there are multiple cues related to Airway, Breathing, Circulation, Disabilities, and Exposure (A-B-C-D-E). In classroom, simulation or practicum experiences, or in professional practice, you could go months or years and not encounter some of the possible cues. To become a master of identifying cues and recognizing patterns could take decades.
Multiple sub-actions. Within each skill set involved in assessment and diagnosis, there are many sub-actions. Even during training, you may have few opportunities to practice sub-sets of skills, again and again, to become so proficient you can perform each action expertly and automatically, almost without thinking.
No opportunity to slow it down. During training, whether in classrooms, simulation settings or practicum placements, the entire Observe, Orient, Decide, Act process often unfolds quickly without the opportunity for you to slow it down and look at each cue and its potential meaning or each component of each skill within a larger process. In the real world of practice, of course, “slowing it down” is even less possible than during training.
Limited opportunity for immediate feedback. Though trainers, colleagues, and supervisors to provide feedback to students and practitioners, mastery learning requires immediate feedback about each aspect of your performance. That is simply not possible even during training, and certainly not once you are registered as a certified professional.
How Hone’s “Recognize” simulation training modules help you achieve mastery
The mission of Hone Virtual Education is to “Teach practitioners to perform at peak levels, capable of correctly identifying diagnostic cues, enabling correct clinical decisions.”
Founded by pre-hospital and emergency medical practitioners, Hone is combining the best of mastery learning psychology with augmented reality technology to create simulation training modules you can download to your augmented reality smartphone or tablet.
Recognize is a medically accurate cue recognition training platform that allows you to deliberately practice diagnostic cue recognition and receive immediate, expert feedback – on demand.
Different modules focus on sub-aspects of Airway, Breathing, Circulation, Disabilities, and Exposure. Each module allows you to practice specific observations and skills again and again, as often as you choose, with immediate feedback after each action, until the learning is anchored in your brain. Once your accuracy is assured, the modules increase the speed with which cues are presented, so you learn to make assessments and decisions more quickly.
Recognize’s state of the art modules deliver:
Decrease the mental workload during the initial stages of patient contact, improve your situational awareness, and therefore improve patient safety;
Allow you to build a mental diagnostic cue “pattern recognition database” more quickly than is otherwise possible;
Enable you to develop accurate mental representations of your own performance;
Decrease performance anxiety and workplace stress by improving your confidence.
Find out more
The first Recognize modules will be released early in 2019. In the meantime, you can…