Tuesday, March 1, 2016

Natural Decision Making under duress: a Conversation with Gary Klein

Natural Decision Making under duress: a Conversation with Gary Klein

My understanding of decision making under pressure, from reading the works of Gary Klein (GK) and Sayra Cristancho, is that one gathers sensory input that they hopefully utilize to trigger a memory (from experience in the field or in training) of something familiar that creates a story as Paul Van Riper says. I tend to visualize it as a mental map whereby I use familiar landmarks similar to driving or walking somewhere. We use landmarks that are either familiar to us by past experience or through research to get from one place to the other. All this is subconscious and done fairly instantaneous if we are successful. It is highly subjected to heuristics / bias so how can we improve this? What makes one person excellent and another poor at this process of problem detection? I decided to go straight to the source for that.
1.    Is Photographic memory a necessity? That is if we don’t recall in pictures, how can one create that story and then simulate in our head if our interpretation is correct and if our action will be successful?
GK: “I would hope not. Most people do not have a photographic memory but most can do this well. Photographic memory does not have a lot to do with this… It is a snapshot of what is there. I have not seen this before… If this relied on photographic memory you would have to shift thru all the photographs in your memory. What appears to happen seems to be that people develop buckets of prototypes. If the situation does not fit the buckets then they need detect familiarity or non-familiarity. You need natural experience- prototypes. If it does not fit, some try to force it into a bucket, but if you have been burned before, then you become alert to those features and assess further.”
2.    Is IQ a factor? If I have a high IQ, is this faster? Is this a product of Fluid intelligence or Crystalized intelligence?
GK: “IQ does have an influence if you look at the whole range of IQ variability but in medicine there is a lower range for IQ. That is you have selected out for a higher IQ in that population.” “For that matter, what is the IQ range of Surgeons, SEALS… do we have any study to tell us”. “It’s like playing poker (five card draw), you have to have Jacks or better. In 5 card draw, you cannot open w/o jacks or better, but you may not win. You may not even bet.”
3.    If we practice using clues to solve problems in daily life do we get better, i.e. When I used to use a map to get from one place to another was I better off at problem resolution than now when I use Siri all the time- am I getting dumber?
GK: “we may not be getting dumber, but we are not using navigation skills. I used to use a GPS system to get to and from a place that was 30min out. It took me a while to realize that I had no idea how to get there. Before I used a map and had a clear notion and I had an ability to change course if there was a problem in the route I had chosen. Now I had no idea what to do if something was blocking my way. As we use this technology we are losing these skills. Soldiers using GPS have map skill erosion. I don’t remember phone numbers now.”
Does this deteriorate our problem solving ability- sign detection? GK “we are getting lazy, not losing the ability to recognize signs but we are becoming passive. I wrote a chapter about this in POWER OF INTUITION, on smart machines making us stupid.” How do we get people up to speed faster?
GK “I hear the same complaint in police, nursing, medical school… people come out and on paper they are qualified but they lack the judgment skills needed and it will take a few years to bridge that gap”. “probably not spending the same hours per week. ”
ME: We had books, not phones and we had to carry our knowledge in our heads or on cards, not on the phone.
GK “We had photocopy machines and could not take out the article from the library so in the 60s we had to remember everything.”
4.    Since he understands this process how does he train to avoid missing the gorilla in front of him.
GK: “I am not training myself like a firefighter or military leader or physician trains their self as a first responder. I am now trying to identify the practices people engage in. Scenario exercises to train these responders. Our company is designing scenario based decision training”. We teach the Shadowbox method.”

Kenneth A. Lipshy, MD, FACS

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