Article review: Macrocognition in novices and experts in the ED

Expert physicians: These are the ones who effortlessly handle a busy Emergency Department while juggling patient load, learners and consultants.  

• How do they make decisions?  
• How do they get there?

This article studied macro-cognition differences between novices and experts in the Emergency Department.

What was the study method?
Qualitative study using semistructured interviews with novices (first year residents) and experts (more than 5 years in practice). Questions probe specifically for critical decision making cues.

What were the results?
Between the 5 novices and 6 experts, their differences are summarized:

How would I apply this in teaching? 
Specifically for junior trainees, I might: 

• Set time frame for procedures
• Explain hospital policies
• Discuss potentially difficult interactions beforehand
• Ensure learners feel safe to ask questions

Reference
Schubert CC, Denmark TK, Crandall B, Grome A, Pappas J. Characterizing Novice-Expert Differences in Macrocognition: An Exploratory Study of Cognitive Work in the Emergency Department. Ann Emerg Med. 2012 Oct 2. Pubmed .