are we willing to change our impression of first impressions?
TRANSCRIPT
COMMENTARY
Are we willing to change our impression of firstimpressions?
Kevin McLaughlin
Received: 22 November 2013 / Accepted: 5 December 2013� Springer Science+Business Media Dordrecht 2014
As humans we are all obligate raters of each other. We rate even when we find ourselves
unable to define precisely the construct that we are being asked to rate, and often do so with
surprising confidence (Dunning et al. 1990). From more than 60 years of research on
impression formation we know that when we first encounter baristas, hairdressers, financial
advisors, or medical trainees in a social setting we immediately begin to form an
impression of them, their personality traits, motivations and abilities (Asch 1946; Asch and
Zukier 1984; Reeder et al. 2004). Theories on how we form social impressions have
evolved since Asch initially proposed that we simply create a Gestalt impression from all
of the available data (Asch 1946; Asch and Zukier 1984) to more recent theories sug-
gesting that we consider two separate categories of data: stereotypes and individuating
information (Brewer 1988; Fiske and Neuberg 1990). Stereotypes shape a priori expec-
tations of an individual’s behaviour based upon their age, gender, ethnicity, and occupa-
tion, while individuating information refers to observed behaviours. As to how these data
are integrated, Brewer proposes a dual process model whereby we default to stereotypes
unless we have personal knowledge of this individual or their observed behaviour is
inconsistent with the stereotype (Brewer 1988). In their continuum model Fiske and
Neuberg propose a variation on dual processing such that we form and initial impression
from stereotypes and then—depending upon our motivation—we may attend to individ-
uating information and recategorize the individual based upon these data (Fiske and
Neuberg 1990).
Dual processing is not unique to impression formation, and while the terminology may
differ between domains, there are many examples of this in sociology, psychology, and
medicine (Croskerry 2009; Kahneman 2011; Reyna 2004, 2008; Sloman 1996; Smith and
DeCoster 2000). This ubiquity is partly explained by the existence of two types of memory,
This comment refers to the article available at doi:10.1007/s10459-013-9453-9.
K. McLaughlin (&)Office of Undergraduate Medical Education, Health Sciences Centre, University of Calgary, 3330Hospital Drive NW, Calgary, AB T2N 4N1, Canadae-mail: [email protected]
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Adv in Health Sci EducDOI 10.1007/s10459-013-9490-4
implicit and explicit (Sherry and Schacter, 1987; Smith and DeCoster 2000). In implicit
memory we store a large sample of our prior experiences, which allows us to form average
expectations of any given situation (i.e., stereotypes). These expectations can be accessed
rapidly and subconsciously (System 1 processing) and, as they predict the most probable
outcome, implicit expectations have a high likelihood of being correct. In explicit memory
we store symbolic representations of knowledge, typically in the form of rules, which we
can then apply consciously (System 2 processing) when analyzing case-specific data (i.e.,
individuating information). There are cognitive advantages to having two systems of
information processing rather than one. For example, we can make decisions based upon
System 1 processing alone if data or time limitations do not allow for effective System 2
processing. Alternatively, if additional data and time are available, we can use System 2
processing to validate or revise our System 1-based decision. With experience, the
application of explicit rules may shape implicit expectations. For example, if we have
learned an explicit rule that female residents are better at communicating than male res-
idents, with repeated application this rule may develop into an implicit expectation (Roese
1994).
In the current issue of Advances, Wood offers a narrative review of the literature on first
impressions and ponders how System 1 processing by raters might impact trainees’
evaluations as we transition to a competency-based framework of training (Holmboe et al.
2010; Wood 2013). The review is balanced in drawing from a wide variety of literature,
including that on heuristics and biases, in which System 1 processing is typically con-
sidered to be error-prone (Kahneman 2011), and naturalistic decision-making, where the
ability to make good decision quickly based upon limited data is considered the hallmark
of expertise (Klein 2009). In his review, Wood does not declare any preconceptions
regarding the accuracy of System 1-based ratings. Instead, he describes equipoise
regarding the merits of Systems 1 and 2 when rating competencies of trainees, and pro-
poses a research agenda to study the role of the two processing systems in evaluation. As
we enter a new era of evaluation in medical education, this review and the resulting
research questions are particularly well-timed. In reality, with our long tradition in medical
education of humans rating humans in a social setting—for example in the objective
structured clinical examination and in-training evaluation report—we have, perhaps
unknowingly, been incorporating System 1 processing into competency rating all along.
Ironically, Wood’s proposed research agenda challenges us to take a System 2 approach
to System 1 processing! For some in medical education this concept might represent a
challenge as the typical first impression of information processing is that System 1 leads to
bad decisions (Croskerry 2013; Graber et al. 2005). However, there is a large body of
literature on decision making to suggest that System 1 processing does not inevitably lead
to poor decisions (Gigerenzer and Gaissmaier 2011)—and even those in the heuristics and
biases camp recognize the virtues of System 1 processing (Kahneman and Klein 2009). So
perhaps it is time for us to reconsider our first impression.
References
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Asch, S. E., & Zukier, H. (1984). Thinking about persons. Journal of Personality and Social Psychology, 46,1230–1240.
K. McLaughlin
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Are we willing to change our impression of first impressions?
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