PS200 Unit 8 Decision-Making Heuristics Analysis Example

Chest Pain at Thirty-Four: A PS200 Unit 8 Problem-Solving and Decision-Making Analysis of One Call

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Purdue University Global

PS200: Introduction to Cognitive Psychology

Unit 8 Problem-Solving and Decision-Making Analysis

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[Date]

The call, the caller and the call-taker are composite; the studies cited are real.

The Call

At 2:40 a.m., a woman called about her 34-year-old husband, who had chest pain and said his heart was racing. He had been drinking energy drinks to stay awake for a work deadline. The call-taker's first impression, formed within seconds, was a young man having a panic reaction to caffeine. The center's medical protocol, followed question by question, led instead to the highest priority because the man was pale, sweating and had become short of breath. Paramedics later found a dangerous heart rhythm that needed treatment at the hospital.

The First Judgment: Representativeness

Tversky and Kahneman (1974) described the representativeness heuristic: people judge how likely something is by how closely it resembles a typical case. A heart attack's typical patient is older; a 34-year-old with a racing heart after caffeine resembles a typical anxiety case more closely. The call-taker's first impression followed that resemblance and set aside the base rate, the fact that serious cardiac events do occur in young adults, especially with stimulant use.

The young caller did not look like a cardiac case, and resemblance briefly outweighed the symptoms.

Reinforcement: Availability

Under the availability heuristic, an outcome seems common when instances of it are quick to recall (Tversky & Kahneman, 1974). Two nights earlier the same call-taker had handled three chest pain calls from young adults, all of which turned out to be panic attacks. Those cases were vivid and recent, and they made a panic explanation feel more likely than it was.

Anchoring on the First Detail

The caller's first words were about the energy drinks. That detail became an anchor, and later information was interpreted relative to it. Pallor and sweating fit a caffeine reaction too, if one starts from caffeine. Starting from the symptoms instead would have pointed elsewhere.

The Safeguard: A Structured Protocol

The protocol asked the same questions regardless of the call-taker's impression: is the patient breathing normally, is the patient alert, is the patient changing color. It did not ask what the call-taker thought was happening. Because the answers, not the impression, determined priority, the heuristics shaped the call-taker's thinking but not the response.

When Intuition Can Be Trusted

This does not mean experienced judgment is worthless. Klein (1998) studied firefighters and other experts and found that they often recognize a situation and act effectively without comparing options, drawing on patterns learned over years. Kahneman and Klein (2009) agreed that such intuition can be reliable, but only where the environment provides valid cues and the expert has had extensive practice with feedback. A call-taker rarely learns how a call ended, so feedback is thin, and intuitions about medical causes are less trustworthy than intuitions about, for example, a caller's emotional state.

What the Analysis Suggests

Protocols should keep their questions fixed, even when the call-taker's impression differs. Centers can strengthen feedback by sharing outcomes of selected calls with call-takers, which over time could make intuition more reliable. And training can name these heuristics explicitly, so call-takers notice when a first impression is doing too much work.

References

Kahneman, D., & Klein, G. (2009). Conditions for intuitive expertise: A failure to disagree. American Psychologist, 64(6), 515-526. https://doi.org/10.1037/a0016755

Klein, G. (1998). Sources of power: How people make decisions. MIT Press.

Tversky, A., & Kahneman, D. (1974). Judgment under uncertainty: Heuristics and biases. Science, 185(4157), 1124-1131. https://doi.org/10.1126/science.185.4157.1124