Information processing and intuitive decision making theory

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Lecture 2

• Information processing and intuitive decision
  making theory
• Carl Thompson

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Decision making theory

• Descriptive approaches how people actually make
  decisions
• Normative approaches how people ought to make
  decisions
• NB. Most approaches have elements of both

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Information processing

• Assumptions
• Human reasoning as the interface between short
  (stimuli) and long-term (semantic/factual
  knowledge experiential (episodic knowledge)
  memory
• Human reasoning is rational
• Rationality is bounded

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Information processing the process

• Elstein et al. 1978
• Cue acquisition
• H generation
• Cue interpretation
• H evaluation

• Carnevali et al 1984
• Exposure to pre-encounter data
• Entry to the data search field and shaping data
  gathering
• Coalescing cues into chunks
• Activating possible H
• H directed search of the data field
• Testing H
• Dx

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he could not take the sleeping tablets as he
could not swallow. the DN said that they might
have to put up a syringe driver for the night if
he was not settling and could not take anything
orally.

.. he had a couple of dressings on his bottom
and the dressings were intact. The DN decided to
leave them and not to move him around too much as
he had not slept much that night..

she told her that it
would not be long until he died his breathing
would get shallower, occasionally it would seem
as though he would not breathe again..it showed
that he was nearer to dying
the DN said that the Marie Curie
nurses could work for up to 27 hours and she
thought that it would be better if they came at
night
..she would return in the afternoon to
reassess him
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Information cues
Signs and symptoms
Optimal judgement
Test results
Nurses Judgements
Patient preferences
Etc.
Brunswiks lens model
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Social judgement approaches to modelling cue use
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Importance Utility(s.e.) Factor öòø
SYSTOLIC systolic BP 4.59 ó ó
3.4298(9.3211) ó- normal õò
-2.9035(9.3211) -ó equivocal
ó -.5263(8.9352) ó abnormal
ó öòòòòòòòòòø PULSE
pulse ó26.80 ó 18.5965(9.3211) ó----
normal õòòòòòòòòò -18.404(9.3211) ----ó
equivocal ó -.1930(8.9352) ó
abnormal ó öòòòòø
RESPS resps 13.13ó ó -5.0702(9.3211)
-ó normal õòòòò -6.5274(8.9598)
-ó equivocal ó 11.5976(8.9598)
ó-- abnormal ó öòòòòø
O2 oxygen sats 14.73ó ó
-12.070(9.3211) ---ó normal õòòòò
8.2632(9.3211) ó-- equivocal
ó 3.8070(8.9352) ó- abnormal
ó öòòòòòòòø URINE urine
output ó21.64 ó 11.6393(8.9598) ó---
normal õòòòòòòò 6.5965(9.3211) ó-
equivocal ó -18.236(8.9598) ----ó
abnormal ó öòòòòòòø
GCS glasgow coma score ó19.11 ó
-7.5702(9.3211) --ó normal õòòòòòò
-9.4035(9.3211) --ó equivocal
ó 16.9737(8.9352) ó---- abnormal
ó 53.5702(6.5013) CONSTANT Pearson's
R .838 Significance
.0000 Kendall's tau .570
Significance .0003
Summary of judgement policy for one clinician
faced with the Dx of shock in critical
care. Utilities Importance Internal consistency
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Problems with info processing

• Role of H
• Over emphasising positive findings
• Excessive data collection

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Intuition and expertise

• Understanding without a rationale (Benner
  Tanner 1987 p2)
• A perception of possibilities, meanings and
  relationships by way of insight (Gerrity 1987
  p63)
• Knowledge of a fact or truth, as a whole
  immediate possession of knowledge and knowledge
  independent of the linear reasoning process (Rew
  and Barron 1987 p60)
• Immediate knowing of something without the
  conscious use of reason (Schrader and Fischer
  1987 p45)
• A process whereby the nurse knows something
  about a patient that cannot be verbalised, that
  is verbalised with difficulty or for which the
  source of knowledge cannot be determined (Young
  1987 p52)

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Intuition

• Type of knowledge vs mode of thought
• Lack of visibility
• Dubious morality?
• Reflective paradox and ?black box
• Accurate sometimes (hindsight?)
• Lack of power

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Novice - expert

• Dreyfus and Benner
• Novice
• Advanced beginners
• Competent
• Proficient
• Expert

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performance

• Whole situation
• Orientation
• Decision
• Situation components
• Perception
• action

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Level of organisation Lower Higher
Sub process Perception Action Orientation Decision
Stage Perceives the elements of the situation Acts on those elements Recognises whole situations Makes decisions and plans to attain goals in the situation
Novice Analytical Analytical Rely on others Rely on others
Advanced beginner Intuitive Analytical Rely on others Rely on others
Competent Intuitive Intuitive Analytical Analytical
Proficient Intuitive Intuitive Intuitive Analytical
Expert Intuitive Intuitive Intuitive Intuitive
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the rules

• Realise that expertise is acquired step-by-step
• Avoid trying to think like an expert
  (intuitively)
• Practice intensively using the rules and logic
  that are available
• NB the proponents discipline (sociology/naturali
  stic research) does not demand empirical testing
  so caution advised

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Points of contact and divergence

• Communicability
• Simplification
• Context specificity
• applicability