Developing Expertise in Clinical Radiology: The Feedback Challenge
Sohil H Patel, Jason N Itri
J Am Coll Radiol . 2021 Sep;18(9):1348-1350. doi: 10.1016/j.jacr.2021.05.005. Epub 2021 Jun 3.
In 2009, psychologists Daniel Kahneman and Gary Klein published a now widely cited article describing conditions for developing expert intuition [ 1 ]. The article represented an “adversarial collaboration” because the authors hold contrasting perspectives on the topic of professional judgment and decision making. Kahneman is a Nobel prize winner who (along with his former colleague Amos Tversky) is famous for having developed the “heuristics and bias” research program [ 2 ]. Their seminal research studies uncovered many of the heuristics (ie, mental shortcuts) that humans use for judgment and decision making and the conditions under which bias and systemic error predictably ensue. Given the focus on error-prone aspects of human cognition, heuristics and bias researchers generally maintain a skeptical stance toward claims of expertise among professionals. In contrast, Klein represents the naturalistic decision-making school, whose major focus is understanding how experts successfully carry out judgment and decision making in real-world situations. Klein’s research on experts across a variety of task domains (eg, intensive care unit nurses, fireground commanders, design engineers, naval commanders) formed the basis of the recognition-primed decision model, which maps how much of expert decision making is carried out in high-stakes, real-world scenarios [ 3 ]. In contrast to heuristics and bias researchers, naturalistic decision-making researchers generally take a more admiring stance toward expert skill.
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