Running head: METACOGNITION AND THE EFFECTS ON

Karen Theus
Metacognition and the effects on the Health Care Technology
CHOP 300
Ferris State University

METACOGNITION AND THE EFFECTS ON HEALTH CARE TECHNOLOGY

Introduction
The article reviewed that will be summarized below is Metacognition in human decisionmaking: confidence and error monitoring by Yeung and Summerfield. In order to understand this
article in its entirety one must understand the true definition of metacognition. According to
Veeman et al., (2008) Metacognition was originally referred to as the knowledge about and
regulation of ones cognitive activities in learning processes (p. 3). Metacognition can be looked
at as how it effects decisions whether it may be right or wrong and the amount of time it takes
one to realize the mistake and correct it. It has even been put thinking about thinking.
Article Summary
In summarizing the article by Yeung and Summerfield I first had to understand
Metacognition and how it affects the decision process. The article proposes metacognition
abilities help people avoid making the same mistake twice and avoid over committing time or
resources to decisions that are based on unrealistic evidence (Yeung & Summerfield, 2008).
There is also what the article defines as metacognition confidence basically (how confident do
you think you are in making the right decision). Think about this, you initially made a decision
you thought was correct, but then you changed your mind. What made you think to change your
mind, or why do feel you are more correct than the first decision you made?
What metacognition confidence in this article proves to find is why do we sometimes
change our minds after a motor response has been made? Yeung and Summerfield propose or
hope to find if people are aware they have made an error under conditions of uncertainty or
conflict. They even go a step further and suggest visual information and noise in the environment
can change the dynamics of neural processing.

METACOGNITION AND THE EFFECTS ON HEALTH CARE TECHNOLOGY

Yeung and Summerfields study introduce what is called a drift-diffusion model (DDM)
with a Decision Variable (DV). Simply put the external environment can be manipulated;
overtime integrate the information, making decisions only when information is of sufficient
quality. DV is what is causing one to mentally change the mind, and DDM the process of
determining of the two choices one being correct with a stimulus involved.
Yeung and Summerfield where able to correlate decisions of uncertainty with the amount
quality and quantity of evidence stimulating ones environment. Humans are more likely to base
decisions off of the quality and quantity of evidence. It was also found that humans are more
likely to change their minds when new evidence is introduced. By knowing what, when, and why
we change our minds or decisions it can predict everyday behavior. It also suggest decision
making promise to similarly profound implications for our understanding of the way people
evaluate their decisions in the service of adapting and optimizing those decisions in the of an
uncertain, complex and ever-changing environment (Yeung & Summerfield, 2008).
Metacognition and its relation to Health Information Systems
Metacognition and decision making can be related to Health Information Systems in a
few different ways. Metacognition is a way thinking, how humans process information, how new
information is learned, and applied to different situations according to Veeman et al., (2008). In
order to build software and teach others to use the system it must be programmed on the
predicted response of human behavior. Computers and technology is built and developed by
man. Understanding how humans think, learn, and process information drives the direction of
technology.
Metacognition in health information systems can predict human behaviors and how they
respond to information or technology. The term information technology (IT) includes

METACOGNITION AND THE EFFECTS ON HEALTH CARE TECHNOLOGY

not only the use of computers but also communications networks and computer literacy
knowledge of how to use computer technology (Burke &Weill p. 1, 2013). Knowing how one
learns and applies knowledge can predict how soft ware can be used and developed. Computers
can be programmed to mimic human response even thinking and processing information faster
than human beings.
Developers have been able to take the way the brain thinks and insert it into technology
and computers. Man has been able to take cognitive thinking patterns versus the way the humans
learn information and develop software to do the work for us. This soft ware has even created
online tutorials, interactive technology, online classes, and programs to sort data and organize it.
The creation of health care technology is just an example of how human information has been
collected from experts and complied into systems, so one does not have to even make
metacognitive decisions; the work is all being done for you. In other words computer systems
have become so sophisticated in making metacognitive decision making it can predict human
behavior and outcomes.
Metacognition and its importance to the future of health informatics
The future of health care informatics is the way of the future. The advancement of technology
and how these systems operate is phenomenal. As stated above computer systems have the
ability to process highly intelligent information, predict outcomes, and human behavior, or
mimic so to speak. In the future or nearly there sophisticated equipment/robotics has been
developed to assist or perform accurate surgeries.
Computer Assisted Medical Diagnosis
What is futuristic is the computers ability to diagnose medical conditions in humans that
has been misdiagnosed or under-diagnosed. Computer systems in the future will be able to take

METACOGNITION AND THE EFFECTS ON HEALTH CARE TECHNOLOGY

signs and symptoms and give a more definite medical diagnosis. Some may argue providers are
already diagnosing patients. In the interim if medical providers are wrong delayed treatment can
result in worsening conditions or death. Croskerry (2003) argues that new formulas and models
for cognitive decision - making should be implemented because errors in medicine can be
predicted. He goes on to say in the moment staff will need to make decisions for them selves
with limited resources.
Assisting Medical Providers
Advanced medical equipment with advanced metacognitive decision capabilities can also
assist medical providers. The issue with medical providers can good or bad whether they are
seasoned with knowledge or freshly starting out. According Feyzi-Behnagh (2014) Clinician
overconfidence or under confidence when evaluating performance on diagnostic tasks can result
in sub-optimal patient care (para 1). Undereducated medical professionals can result in
inaccurate diagnosis or treatment. Medical providers will be able to use sophisticated technology
to treat patients, prescribe treatment specific in certain conditions, and assist in continued
learning, or guided assistance in decision making processes. For this reason alone Teleconference
is beneficial to the medical field. Technology has created away for health professional to
exchange information, diagnose, or converse about medical conditions if needed (Burke & Weill,
2013).
Pathology and Radiology
According to Feyzi- -Behnagh (2014) computer assisted technology is and will be able to aide in
the correct diagnosis of pathologic conditions. Typically radiology and pathology rely on visual
interpretation and can be assisted or replaced by state of the art equipment. An analysis of more
than three hundred pathology malpractice claims filed by patients affected by misdiagnosis

METACOGNITION AND THE EFFECTS ON HEALTH CARE TECHNOLOGY

indicates that approximately 63% of claims involved failure to diagnose cancer (skin, breast, and
ovarian), resulting in delay in diagnosis or in inappropriate treatment (Feyzi- -Behnagh, para 2,
2014).
Self-Regulated Learning
According to Feyzi- -Behnagh (2014) Self-Regulated Learning (SRL) are SRL theories
attempt to model the ways cognitive, metacognitive, motivational, and emotional processes
influence the learning processes (para, 5). SRL has taken off in recent years and developed into
online learning and classes. Some students prefer not to choose online learning because they are
aware of their learning techniques and how they learn best. Feyzi- -Behnagh proposes learning
occurs in four phases: task definition; goal-setting and planning; studying tactics; and
adaptations to metacognition (2014). One must not only be able to learn information but also
recall and apply information to correct situation. Strle (2012) included Metacognition research
concerns the processes by which people self-reflect on their own cognitive and memory
processes (monitoring) and how they put their metaknowledge to use in regulating their
information processing and behavior (control) (p. 286). Judgment is affected by metacognitive
knowledge, and continued monitoring possesses control over ones environment.
Recommendations:
Croskey 2003 claims medical providers have been using outdated decision models with
lack of real word application, he states:
What is needed, instead, is a systematic analysis of what Reason has called flesh and
blood decision-making. This is the real decision making that occurs at the front line,
when resources are in short supply, when time constraints apply, and when shortcuts are
being sought.

METACOGNITION AND THE EFFECTS ON HEALTH CARE TECHNOLOGY

My recommendation is to continue to explore metacognitive decision-making and how it

influences behavior. As our environment continues to change and the mind set of oncoming
generations it is imperative to study how the brain works cognitively or determines decisions.
Just like human beings soft ware will be need to be updated and reprogrammed based on human
capabilities and behavior change. In order for health informatics to remain relevant and
significant metacognitive decision-making has to be understood to predict human behavior. We
must also have reliable staff to assist in training and implementing new technologies or new
decision models.
Conclusion
In conclusion technology is advancing daily faster than a human mind can adapt. All
though, as humans we must continue to recognize our learning capabilities, apply information,
and decipher between right and wrong actions. The metacognitive decisions we make are
controlled by environment or learned behavior so to speak, and can be manipulated by variables.
With computers being able to think for us we must also need to take responsibility for our own
learning abilities.
As these systems continue to evolve we will need to continue to evolve our thinking
processes and adapt to changes. The metacognitive decisions making processes all encompasses
initial action versus a change in thought and why we think our second decision is better than the
first. Is it the time we take to process the information that can change our mind? Is it some type
of variable that influences the environment, or is it a neural action that triggers one to respond
differently based on past events or intuition? I like to think it is combination of all thee above
and realizing what effects or influence your behavior can assist humans in better learning
techniques, applying information, and adapting to change.

METACOGNITION AND THE EFFECTS ON HEALTH CARE TECHNOLOGY

Determining the behavior of humans can predict many outcomes significant to the world
of health informatics. Technology has the ability to replace where people once worked or
maintained employment. The advance in health informatics is beneficial to staff by reducing
errors, precision, and consistency in its approaches.

METACOGNITION AND THE EFFECTS ON HEALTH CARE TECHNOLOGY

References
Burke, L. & Weill, B (2009). Information Technology for the Health Professions (4th Ed). Upper
Saddle River, NJ: Pearson/Prentice Hall
Croskerry, P. (2003). The importance of cognitive errors in diagnosis and strategies to minimize
them. Academic Medicine: 78(8), 775780
Feyzi-Behnagh, R., Azevedo, R., Legowski, E., Reitmeyer, K., Tseytlin, E., & Crowley, R. S.
(2014). Metacognitive scaffolds improve self judgement of accuracy in a medical
intelligent tutoring system.. Instructional Science, 42(2), 159181. doi:10.1007/s11251013-9275-4
Strle, T.. (2012. Metacognition and decison making: Between first and third person
perspective.Interdisciplinary Description of Complex Systems 10(3), 284-297. DOI:
10.7906/indecs.10.3.6
Veenman, M. V. J., Van Hout-Wolters, B. H. A. M., & Afflerbach, P. (2006).Metacognition and
learning: conceptual and methodological considerations. Metacognition Learning. (2006)
1: 314. Springer Science + Business Media, Inc.DOI 10.1007/s11409-006-6893-0
Yeung, N., & Summerfield, C. (2012). Metacognition in human decision-making: confidence and
error monitoring. Philosophical Transactions of the Royal Society B: Biological
Sciences, 367(1594), 13101321. doi:10.1098/rstb.2011.0416