I have recently been playing QuizUp. It is an online quiz
which you can play real time against other people from all parts of the world.
There are innumerable topics and categories with thousands of people playing
it.
I chose a topic that was familiar and another one which was
not familiar. What I learned was something many of us may already know. But are we
applying what we already know? Are we harming people by not recognising and
applying what we know in a proper manner?
When I start playing QuizUp even for very familiar topics
such as medicine or healthcare I had to read the questions slowly because the
style and format of the question is different for each question. Some are
direct, some are linked with directly topic related pictures, some are related with
general pictures from news and social media that relate to the topic, some have
humour, others have pun and so on. Then comes the answers there are very
technical answers from some questions, lay answers for some, humorous answers
for others and so on. So even when I understood the question perfectly well and
knew AN answer which was right, THE answer that was right for QuizUp took time
to learn. Of course there is the issue of learning the answers that I did not
know before.
Now, once these were learned, the issue became one of speed,
because even if I knew all the answers if I did not answer them fast enough I
would lose. At this point, I began winning a number of matches/plays/games. But
also loosing a number of them because the speed itself caused errors due to
many reasons including the jumbling of answers and the pressure involved in a
fast recall and response to a touch screen.
At this stage, there is enough knowledge, memory, recall and
speed which then moves on to pattern recognition. Most often there was no need
to read the questions or the answers the responses came automatically, fast and
correctly. It was on auto-pilot and very successful.
My scores were soaring, the whole thing was getting a bit
monotonous, repetitive and pointless. This is when QuizUp decided to update the
questions so there were a number of new questions thrown in. Obviously I had to
go through the sequence described above for these new questions. That is when I
discovered that I not only had trouble with the new questions in terms of
knowledge, speed etc. Because the new questions had been interspersed with the
older/original ones I was struggling with the older ones as well.
I was struggling to answer questions that I used to answer
automatically and correctly within a second. I was getting them either slow or
wrong. I was UK
top ten for a particular month in the topic and was getting stuff wrong. Interestingly, because I was
already way up top ten it really did not matter, I did not drop too many ranks
if at all. Mind you, I am talking about marginal differences here. The nature
of the game and my overall rank meant I was still winning but not as
efficiently as before.
The worrying thing was that the minute I stopped pattern matching my scores fell.
The worrying thing was that the minute I stopped pattern matching my scores fell.
The last point I wish to draw your attention to is this. I
was concerned about the efficiency of my wins and started reviewing my
questions by reading the question and answer in detail after playing each game.
I was surprised that I was neither fully aware of the wordings of the question
nor the logic of the answers; I knew what the question was and what the answer
was that is knowledge but while answering them repeatedly my knowledge formed
the basis of pattern matching but as the pattern matching became dominant
potential and/or real drops in awareness of knowledge and on some occasions of knowledge
itself happened.
Pondering on the above gave rise to some worrying thoughts
and certain concepts which may be negatively affecting some of us.
Many of you with some knowledge about education and learning
methods will recognise the model where we are
Unconsciously incompetent
Consciously incompetent
Consciously competent
Unconsciously competent
These are called the four stages of learning or four stages
of competence and linked with the concepts around the Johari window.
Is there a risk with Unconscious Competence?
You would have noticed from my above description that like
any learning or skill my QuizUp journey moved from Unconsciously Incompetent to
Unconsciously Comptent. Educationalists and trainers want us to be
unconsciously competent, it is supposed to be the highest in the hierarchy of
learning and competence.
Here is the worry or the risk.
Many senior experienced older doctors are unconsciously
competent, i.e. where we actually want them to be. When we want them to
incorporate something new into their routines we are pushing them back to
conscious competence. We are aware for that for the new skill there is a
learning curve, we accept that. I am not sure if whether while the new skill is
being incorporated their performance with their established skills fall, even
temporarily; and if it were to fall whether we even notice it as it is likely
to be subsumed in the averages of their overall numbers/performance which had a
good baseline to start with.
But, here is the more worrying aspect. Due to some
unfortunate reason if any of the senior established busy doctors were referred
for an assessment of their knowledge and competence (say to an agency such as
NCAS) these doctors are tested for their conscious competence when their daily
practice is in the domain of unconscious competence. Add the pressure and
stress of going through the formal assessments that decide the fate of their
careers, these doctors often unsurprisingly come out as lacking in knowledge
and skills, i.e. incompetent.
I have no empirical research or data to show this. I can
only hypothesise based on my observation of my play of QuizUp that I really
enjoy and am good at to some extent. Also, this phenomenon of slipping back
into conscious competence may be limited only to me and not the rest of the
world (though I doubt it) and so this whole concept may be relevant only to me.
However, my concerns are two fold. First, in teaching new
skills to the old dogs we may be negatively impacting on their overall
competence at least temporarily (while their new skill competence gradually
improves – learning curve) and while this may be happening we may not be able
to recognise it. Secondly, once these doctors are in difficulty, we may be
testing the skills of race car driving with a normal driving test template and
failing them in both.
Whether this is purely theoretical or not, it is worth
putting some research into this. It may be beneficial to both patients and
doctors.
M. HEMADRI
Follow me on twitter @HemadriTweets
