Error orientation in the context of intuitive and competent behaviour: Results of an exploratory study in the domain of emergency medicine

Abstract

This contribution describes an empirical study on the role of emergency physicians’ individual error orientation in the context of intuitive and competent behaviour. It is a special characteristic of the domain of emergency medicine in which physicians have to competently deal with an emergency situation. If they approach an accident, it is usually not possible to oversee the entire situation, nor is it possible to deeply analyse patients’ history. It is instead necessary that physicians cope with an accident intuitively in the sense that they just do the appropriate things without deliberatively reflecting and balancing options. One major advantage of intuitive acting in contrast to the rational consideration of a situation is shaped by the rapidity of intuitive behaviour, which is enabled by the absence of conscious thoughts (Hogarth, Educating Intuition. The University of Chicago Press, Chicago/London, 2001) and an extensive use of implicit knowledge acquired through practical experience (Myers, Intuition. Its powers and perils. Yale University Press, New Haven, 2002; Dreyfus & Dreyfus, Mind over machine. Macmillan, Free Press, New York, 1986). This study explores whether error orientation as individual attitude towards errors influences emergency physicians’ intuitive behaviour and the quality of their casework on simulated emergency situations. The performance of N = 30 physicians with varying working experience was gathered in a simulation experiment using computer controlled patient mannequins. Stimulated recall interviews revealed the number of decisions during the casework. Error orientation was measured by using the error orientation questionnaire (EOQ). The role of error orientation was investigated on the basis of simple and multiple regression analyses. The results show that the extent to which the emergency physicians show intuitive and competent behaviour depends on their work experience. These dependencies are influenced significantly through the moderator variable, which is the emotional handling of errors. Emergency physicians with less anxious orientation towards errors are more likely to make intuitive decisions during the medication of an emergency case and to perform better.