Medical decision-making
Mark Williams, LJMU’s Professor of Motor Behaviour, is developing a framework for performance evaluation and error reduction in hospitals.
Professor Williams has devised a simulation-based training programme that identifies potential failings in health care. It is hoped that it can be used to improve future performance among health care professionals. The Expert Performance Approach is an exercise designed to assess the performance of nurses in simulated critical situations.
The research is based on recent evidence that suggests that well qualified care professionals are not performing at a higher level than lesser qualified colleagues. The new approach involves a three step process to critically evaluate health experts in the workplace.
‘Experts’ are defined by the degree of knowledge they seemingly possess, their length of experience within a domain, and peer nomination. However, questions are being raised on whether these facts alone reflect their quality of performance. The Expert Performance Approach evaluates how effective expert decision making is in time-critical emergency care situations.
Divided into three key stages, the process focuses on the capabilities of care providers to perform well in ‘life or death’ situations. The health of actual patients is not at risk, as the approach seeks to assess the behaviour of nurses through simulated scenarios.
In the first step, researchers observe how nurse’s performance reflects their experience, skill, knowledge, practice backgrounds, and past engagement in training activities. They will observe what the care professionals do in the real world and recreate different scenarios that will call on specific knowledge to be engaged.
The second step entails monitoring the higher functioning of health professionals, via verbal reports and also by recording eye movement during task performance under representative conditions. In the third step, the researchers assess how staff gain skills from certain activities and situations. The three step process involves performance and the accumulation of experience, and creates a virtual setting to see how skills are acquired.
The resulting information will be used to develop a simulation-based training programme and to track practice activities and performance in the ‘real-world’ setting.
Prof Mark Williams said: "A number of researchers have successfully adopted this approach, yet few have attempted to apply it to complex, professional and occupational domains such as health care that have typically been examined using more subjective and qualitative methods."
