20240913 - experts

11-Clinical-Actuarial-Judgment.Rmd

@@ -96,12 +96,29 @@ This stands in contrast to the [Diagnostic and Statistical Manual of Mental Diso
 Humans are typically given no feedback on their judgments.\index{clinical judgment}
 To improve accuracy of judgments, it is important for feedback to be clear, consistent, and timely.\index{clinical judgment}
 It is especially unlikely for feedback in clinical psychology to be timely because we will have to wait a long time to see the outcomes of [predictions](#prediction).\index{clinical judgment}
+The feedback that clinicians receive regarding their clients' long-term outcomes tends to be sparse, delayed or nonexistent, and too ambiguous to support learning from experience [@Kahneman2011].\index{clinical judgment}
+Moreover, it is important to distinguish short-term anticipation in a therapy session (e.g., what the client will say next) from long-terms predictions [predictions](#prediction).\index{clinical judgment}
+Although clinicians may have strong intuitions dealing with short-term anticipation in therapy sessions, their long-term [predictions](#prediction) are not accurate [@Kahneman2011].\index{clinical judgment}
 
 Clinicians are susceptible to representative schema [biases](#bias) [@Dawes1986].\index{clinical judgment}\index{bias}
 Clinicians are exposed to a skewed sample of humanity, and they make judgments based on a prototype from their ([biased](#bias)) experiences.\index{clinical judgment}\index{bias}
 This is known as the representativeness heuristic.\index{clinical judgment}\index{bias}
 Different clinicians may have different prototypes, leading to lower [inter-rater reliability](#interrater-reliability).\index{clinical judgment}\index{bias}\index{reliability!inter-rater}
 
+Intuition is a form of recognition-based judgment (i.e., recognizing cues that provide access to information in memory).\index{clinical judgment}
+Development of strong intuition depends on the quality and speed of feedback, in addition to having adequate opportunities to practice [i.e., sufficient opportunities to learn the cues; @Kahneman2011].\index{clinical judgment}
+The quality and speed of the feedback tend to benefit anesthesiologists who often quickly learn the results of their actions.\index{clinical judgment}
+By contrast, radiologists tend not to receive quality feedback about the accuracy of their diagnoses, including their [false-positive](#falsePositive) and [false-negative](#falseNegative) decisions [@Kahneman2011].\index{clinical judgment}
+
+In general, many so-called experts are "pseudo-experts" who do not know the boundaries of their competence—that is, they do not know what they do not know; they have the illusion of validity of their predictions and are overconfident about their predictions [@Kahneman2011].\index{clinical judgment}
+Yet, many people arrogantly proclaim to have predictive powers, including in low-validity environments such as clinical psychology.\index{clinical judgment}
+True experts know their limits in terms of knowledge and ability to predict.\index{clinical judgment}
+
+Intuitions tend to be skilled when a) the environment is regular and predictable, and b) there is opportunity to learn the regularities, cues, and contingencies through extensive practice [@Kahneman2011].\index{clinical judgment}
+Example domains that meet these conditions supporting intuition include activities such as chess, bridge, and poker, and occupations such as medical providers, athletes, and firefighters.
+By contrast, clinical psychology and other domains such as stock-picking and other long-terms forecasts are low-validity environments that are irregular and unpredictable.\index{clinical judgment}
+In environments that do not have stable regularities, intuition cannot be trusted [@Kahneman2011].\index{clinical judgment}
+
 ## Humans Versus Computers {#humansVsComputers}
 
 ### Advantages of Computers {#advantagesOfComputers}