Capturing expertise in the development of practice: methodology and approaches

Abstract

This study employed two distinct methodologies: 18 months of participant observation whilst working as a nurse and invited observations of episodes of skilled behaviour followed by knowledge interviews using heuristic devices as mediating artefacts. Access to the ward and invitations to observe (with patient consent) were granted in return for free labour between episodes and whenever the ward was exceptionally busy. The ethnographic data was analysed using Strauss’s paradigm analysis; the resultant accounts of ward activities, culture and performance were checked by participants. Two forms of mediating artefact were used to facilitate knowledge elicitation interviews and the co‐construction with practitioners of representations of their expertise. The first was a small knowledge map linking scientific knowledge to nursing interventions and processes, sketched immediately after observation; this followed the format developed by Eraut. The second was a sequence of digital photographs taken during the episode itself, subject to immediate censorship by the patient. Post‐interview accounts of the episode, supplemented by revised maps and relevant photographs, were checked by the practitioner on the following day. The 52 accounts were then analysed according to type of task, degree of fluency, use of deliberation, nurse’s levels of experience, situational recognition and degree of guidance provided by anticipated outcomes. The dual methodology provides a unique perspective on factors affecting access to learning opportunities and the relationship between individuals learning and transactions within the context of everyday practice. Subsequent publications will further discuss the progressive development of nursing expertise, illustrating the following: the role of disposition towards learning of capable practitioners; whether learning was facilitated or constrained by the system of work allocation on the ward; learning and individual dispositions towards the constraints of context, and the role of historical camps, loyalties and allegiances in promoting domain traditions in nursing work.

The role of expertise in dynamic risk assessment: A reflection of the problem-solving strategies used by experienced fireground commanders

“…Just as proposed in these theories we found that the amount of templates chunked into an expert's memory is a function of the amount of incidents they have attended in the past, their years of experience and their level of exposure to difficult tasks -through which they are then able to build up a reservoir of recognized pattern (see Table 1). Previous studies have shown that the more patterns people are able to acquire over their years of practice, the more they are able to match a new situation to one of the patterns stored in their reservoir of knowledge (Shanteau, 1992;Zsambok, 1997;Eraut, 2000;Fessey, 2002;Rosen, Shuffler, and Salas, 2010). This explains why fire fighters, in real life, could see the colour of a smoke and intuitively know that toxic chemicals and other combustible materials are involved.…”

“…The excerpts in table 3 demonstrate how participants reported this experience-based prototypical decision making strategy: As shown in Table 3 all the expert participants agreed that dealing with a current problem often requires making use of previous knowledge and experiences, mainly by matching cues from the environment to the numerous patterns that have been pre-stored in the memory. Prior research has evidenced how experienced commanders develop domain knowledge from the consistent and repeated experiences they have linked together unconsciously to form a pattern (Crandall and Gretchell-Leiter, 1993;Fessey, 2002;Hogarth, 2003;Klein, 2003;Perry and Wiggins, 2008). A pattern therefore represents a set of "action scripts" that is chunked together and often triggered by one or more internal or external cues.…”

“…A number of studies have suggested that experts often make decisions about what is risky/not in dynamic and time-pressured conditions mainly through experiential knowledge (Shanteau, 1992;Wong, 2000;Fessey, 2002;Adams, 2003;Grimwood, 2003;Perry and Wiggins, 2008;Rosen, Shuffler and Salas, 2010;Okoli et al, 2013). For instance, the fact that a particular procedure is labelled high risk in the fire manual does not necessarily always imply that incident commanders must take a defensive (or risk averse) position when such situations are encountered in real life; some level of risks must still be accepted and managed based on experience.…”

Eliciting experts’ knowledge in emergency response organizations

“…There is substantial evidence to demonstrate that experiences gained in real-life (on-the-job) practice settings have the potential of making more important contributions that cannot be afforded by experiences in other settings (c/f Klein, 2003). Learning should therefore be seen as an ongoing activity for less-experienced personnel as well as a crucial part of their daily thinking and acting 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 (Fessey, 2002). This way, novices are made to learn the most current, tailored and up-to-date skills based on the constantly changing environment typical of most high risk organizations.…”

“…This is because experts can unintentionally misrepresent the conceptual knowledge upon which their competence is based: a paradox where professionals are able to refer to scientific data, theoretical manuals and standard operational procedures (SOPs) in clear explicit terms, yet using the same factual knowledge tacitly (Eraut, 2004;Fessey, 2002;Spender, 2008;Feldon, 2007). On this note, it therefore seems that experts' performance is qualified by another type of knowledge i.e.…”