Trait-based cue Utilization and initial skill acquisition: implications for models of the progression to expertise

The Role of Cue-Based Strategies in Skilled Diagnosis Among Pathologists

OBJECTIVE

This research was designed to test whether behavioral indicators of pathology-related cue utilization were associated with performance on a diagnostic task.

BACKGROUND

Across many domains, including pathology, successful diagnosis depends on pattern recognition that is supported by associations in memory in the form of cues. Previous studies have focused on the specific information or knowledge on which medical image expertise relies. The target in this study is the more general ability to identify and interpret relevant information.

METHOD

Data were collected from 54 histopathologists in both conference and online settings. The participants completed a pathology edition of the Expert Intensive Skills Evaluation 2.0 (EXPERTise 2.0) to establish behavioral indicators of context-related cue utilization. They also completed a separate diagnostic task designed to examine related diagnostic skills.

RESULTS

Behavioral indicators of higher or lower cue utilization were based on the participants' performance across five tasks. Accounting for the number of cases reported per year, higher cue utilization was associated with greater accuracy on the diagnostic task. A post hoc analysis suggested that higher cue utilization may be associated with a greater capacity to recognize low prevalence cases.

CONCLUSION

This study provides support for the role of cue utilization in the development and maintenance of skilled diagnosis amongst pathologists.

APPLICATION

Pathologist training needs to be structured to ensure that learners have the opportunity to form cue-based strategies and associations in memory, especially for less commonly seen diseases.

Cue utilisation reduces the impact of response bias in histopathology

Histopathologists make diagnostic decisions that are thought to be based on pattern recognition, likely informed by cue-based associations formed in memory, a process known as cue utilisation. Typically, the cases presented to the histopathologist have already been classified as 'abnormal' by clinical examination and/or other diagnostic tests. This results in a high disease prevalence, the potential for 'abnormality priming', and a response bias leading to false positives on normal cases. This study investigated whether higher cue utilisation is associated with a reduction in positive response bias in the diagnostic decisions of histopathologists. Data were collected from eighty-two histopathologists who completed a series of demographic and experience-related questions and the histopathology edition of the Expert Intensive Skills Evaluation 2.0 (EXPERTise 2.0) to establish behavioural indicators of context-related cue utilisation. They also completed a separate, diagnostic task comprising breast histopathology images where the frequency of abnormality was manipulated to create a high disease prevalence context for diagnostic decisions relating to normal tissue. Participants were assigned to higher or lower cue utilisation groups based on their performance on EXPERTise 2.0. When the effects of experience were controlled, higher cue utilisation was specifically associated with a greater accuracy classifying normal images, recording a lower positive response bias. This study suggests that cue utilisation may play a protective role against response biases in histopathology settings.

Differentiating Experience From Cue Utilization in Radiological Assessments

OBJECTIVE

This research was designed to examine the contribution of self-reported experience and cue utilization to diagnostic accuracy in the context of radiology.

BACKGROUND

Within radiology, it is unclear how task-related experience contributes to the acquisition of associations between features with events in memory, or cues, and how they contribute to diagnostic performance.

METHOD

Data were collected from 18 trainees and 41 radiologists. The participants completed a radiology edition of the established cue utilization assessment tool EXPERTise 2.0, which provides a measure of cue utilization based on performance on a number of domain-specific tasks. The participants also completed a separate image interpretation task as an independent measure of diagnostic performance.

RESULTS

Consistent with previous research, a k-means cluster analysis using the data from EXPERTise 2.0 delineated two groups, the pattern of centroids of which reflected higher and lower cue utilization. Controlling for years of experience, participants with higher cue utilization were more accurate on the image interpretation task compared to participants who demonstrated relatively lower cue utilization (p = .01).

CONCLUSION

This study provides support for the role of cue utilization in assessments of radiology images among qualified radiologists. Importantly, it also demonstrates that cue utilization and self-reported years of experience as a radiologist make independent contributions to performance on the radiological diagnostic task.

APPLICATION

Task-related experience, including training, needs to be structured to ensure that learners have the opportunity to acquire feature-event relationships and internalize these associations in the form of cues in memory.

Cue Utilization Differentiates Performance in the Management of Interruptions

OBJECTIVE

To examine the role of cue utilization in the management of interruptions during a high workload, rail control simulation.

BACKGROUND

High-risk, high-consequence environments are characterized by cognitively demanding, time-critical activities, in which operators are required to manage frequent interruptions under conditions of high workload. Interruptions are deleterious to performance as they impose excessive cognitive demand on limited working memory resources, thereby depleting residual resources for the primary task. Cue utilization may enable superior performance in managing interruptions through efficiencies gained by the application of implicit patterns stored in long-term memory.

METHOD

Two experiments were conducted. In Experiment 1, 46 university students undertook an assessment of cue utilization and subsequently engaged in a high workload, simulated rail control task while managing multiple interruptive tasks. Experiment 2 replicated and extended Experiment 1, wherein 52 university students completed a measure of cue utilization and engaged in a high workload, simulated rail control task while managing multiple interruptions and breaks.

RESULTS

The analyses revealed that participants who demonstrated a greater capacity for cue utilization also demonstrated a reduced loss of performance following interruptions.

CONCLUSION

The outcomes suggest a relationship between a greater capacity for cue utilization and superior performance in the management of interruptions in high workload conditions.

APPLICATION

Assessments of cue utilization may assist in the selection and training of operators in high-consequence, high-risk environments, to ensure efficient and accurate performance during the management of interruptions.

What can an echocardiographer see in briefly presented stimuli? Perceptual expertise in dynamic search

Background

Experts in medical image perception are able to detect abnormalities rapidly from medical images. This ability is likely due to enhanced pattern recognition on a global scale. However, the bulk of research in this domain has focused on static rather than dynamic images, so it remains unclear what level of information that can be extracted from these displays. This study was designed to examine the visual capabilities of echocardiographers—practitioners who provide information regarding cardiac integrity and functionality. In three experiments, echocardiographers and naïve participants completed an abnormality detection task that comprised movies presented on a range of durations, where half were abnormal. This was followed by an abnormality categorization task.

Results

Across all durations, the results showed that performance was high for detection, but less so for categorization, indicating that categorization was a more challenging task. Not surprisingly, echocardiographers outperformed naïve participants.

Conclusions

Together, this suggests that echocardiographers have a finely tuned capability for cardiac dysfunction, and a great deal of visual information can be extracted during a global assessment, within a brief glance. No relationship was evident between experience and performance which suggests that other factors such as individual differences need to be considered for future studies.

Cue utilisation predicts control room operators' performance in a sustained visual search task

This research was designed to determine whether qualified practitioners' cue utilisation is predictive of their performance during a sustained visual search task in an operational context. Australian Distribution Network Service Provider (DNSP) operators were recruited for two experiments, and were classified with either higher or lower cue utilisation based on an assessment of cue utilisation within the context of power distribution. Operators' performance was assessed using a domain-related sustained visual search task. In both experiments, power distribution operators with higher cue utilisation demonstrated shorter mean response latencies during the sustained visual search task, compared to operators with lower cue utilisation. Further, no differences in accuracy based on cue utilisation were observed during the sustained visual search task. The results are consistent with the proposition that power operators with higher cue utilisation have a greater capacity to sustain visual search during domain-related tasks, compared to operators with lower cue utilisation. Practitioner summary: Power distribution system operators' cue utilisation was used to predict performance during a domain-related sustained visual search task. Power distribution operators with higher cue utilisation demonstrated shorter mean response latencies during the sustained visual search task, but no differences in accuracy, compared to operators with lower cue utilisation. Abbreviations: DNSP: distribution network service provider; EXPERTise 2.0: EXPERT intensive skills evaluation; FAT: feature association task; FDT: feature discrimination task; FIT: feature identification task; fNIRS: functional near infrared spectroscopy; FPT: feature prioritisation task; FRT: feature recognition task; SCADA: supervisory control and data acquisition.

Control Room Operators' Cue Utilization Predicts Cognitive Resource Consumption During Regular Operational Tasks

This study was designed to examine whether qualified practitioners’ cue utilization is predictive of their sustained attention performance during regular operational tasks. Simulated laboratory studies have demonstrated that cue utilization differentiates cognitive load during process control tasks. However, it was previously unclear whether similar results would be demonstrated with qualified practitioners during familiar operational tasks. Australian distribution network service provider (DNSP) operators were classified with either higher or lower cue utilization based on an assessment of cue utilization within the context of electrical power distribution. During two, 20-min periods of operators’ regular workdays, physiological measures of workload were assessed through changes in cerebral oxygenation in the prefrontal cortex compared to baseline, and through eye behavior metrics (fixation rates, saccade amplitude, and fixation dispersion). The results indicated that there were no statistically significant differences in eye behavior metrics, based on levels of cue utilization. However, as hypothesized, during both sessions, operators with higher cue utilization demonstrated smaller increases in cerebral oxygenation in the prefrontal cortex from baseline, compared to operators with lower cue utilization. The results are consistent with the proposition that operators with higher cue utilization experience lower cognitive load during periods of regular activity during their workday, compared to operators with lower cue utilization. Assessments of cue utilization could help identify operators who are better able to sustain attention during regular operational tasks, as well as those who may benefit from cue-based training interventions.

The Potential Role of Context-Related Exposure in Explaining Differences in Water Safety Cue Utilization

OBJECTIVE

To examine whether differences in water safety-related cue utilization might be associated with differences in exposure to water-related recreational contexts.

BACKGROUND

A disproportionate number of incidents of drowning were attributable to recent visitors to New South Wales in the 2016-2017 summer swimming season. This was due to their assumed lack of exposure to the water-related recreational settings in which Australians engage and therefore, the absence of cues that are associated with danger.

METHOD

In Study 1, the water safety cue utilization of 101 Australian residents and 328 recent visitors to the country was compared using the Expert Intensive Skills Evaluation (EXPERTise 2.0) program. Accounting for differences between the samples, Australian residents demonstrated significantly superior water safety cue utilization. In Study 2, the water safety cue utilization of a sample of 219 Australian residents was examined, the outcomes of which indicated that those participants who learned to swim before the age of 11 years demonstrated superior water safety cue utilization to participants who learned to swim at a later age.

RESULTS

Overall, the results suggest that there are individual differences in water safety cue utilization that are explained, in part, by differences in country of residence and the age at which participants first learned to swim.

CONCLUSION

Water safety cue utilization is likely to be dependent upon exposure to water-related activities. Identifying individual differences enables the development of more targeted, drowning-prevention strategies.

The role of cue utilisation in reducing the workload in a train control task

Skilled performance has been characterised, in part, by the capacity to accurately identify and respond to patterns as cues in the environment. The outcome is a reduction in cognitive load and a greater residual capacity to undertake concurrent tasks. The present study was designed to examine the relationship between cue utilisation and temporal pattern recognition in the context of a simulated, rail control task. Sixty-one university students undertook an assessment of cue utilisation and engaged in a rail control simulation. The appearance and movement of trains followed a consistent but implicit (undisclosed) pattern. Throughout the second half of the rail task, a secondary task was included. The results indicated that participants with relatively higher cue utilisation were more likely to identify the implicit pattern of rail movements, were more accurate and responded more rapidly under increased workload conditions. The results suggest that a propensity to identify patterns as cues may provide an opportunity to reduce cognitive demands, thereby facilitating performance in a novel task. Implications for selection and system design are discussed. Practitioner Summary: This study was designed to explain differences in the way in which people learn, particularly when tasks involve recurring patterns. Using simulated rail control, the results indicated that participants who display behaviour that is indicative of the utilisation of cues also recognise patterns in the movement of simulated trains. This enables them to manage trains more effectively, even while undertaking other tasks.

Cue Utilization and Cognitive Load in Novel Task Performance

This study was designed to examine whether differences in cue utilization were associated with differences in performance during a novel, simulated rail control task, and whether these differences reflected a reduction in cognitive load. Two experiments were conducted, the first of which involved the completion of a 20-min rail control simulation that required participants to re-route trains that periodically required a diversion. Participants with a greater level of cue utilization recorded a consistently greater response latency, consistent with a strategy that maintained accuracy, but reduced the demands on cognitive resources. In the second experiment, participants completed the rail task, during which a concurrent, secondary task was introduced. The results revealed an interaction, whereby participants with lesser levels of cue utilization recorded an increase in response latency that exceeded the response latency recorded for participants with greater levels of cue utilization. The relative consistency of response latencies for participants with greater levels of cue utilization, across all blocks, despite the imposition of a secondary task, suggested that those participants with greater levels of cue utilization had adopted a strategy that was effectively minimizing the impact of additional sources of cognitive load on their performance.

Cognitive foundations of organizational learning: re-introducing the distinction between declarative and non-declarative knowledge

Contemporary research into socio-cognitive foundations of organizational learning tends to disregard the distinction between declarative and non-declarative knowledge. By reviewing the literature from organizational learning research and cognitive psychology we explain that this distinction is crucial. We describe the foundations of organizational learning by referring to models that consider the interplay between individual and collective knowledge-related processes in organizations. We highlight the existence of a research gap resulting from the finding that these approaches have widely neglected the existence of different types of knowledge. We then elaborate on characteristics of declarative and non-declarative knowledge in general, consider organizations as structures of distributed cognition, and discuss the relationship between organizational knowledge and practice. Subsequently, we examine the role of declarative and non-declarative knowledge in the context of organizational learning. Here, we analyze (1) the cognitive and social mechanisms underlying the development of declarative and non-declarative knowledge within structures of distributed cognition; and (2) the relationship between alterations in declarative and non-declarative types of knowledge on the one hand and changes in organizational practice on the other. Concluding, we discuss implications of our analysis for organizational learning research. We explain how our integrative perspective may offer starting points for a refined understanding of the sub-processes involved in organizational learning and unlearning and may support a better understanding of practical problems related to organizational learning and change.