ABSTRACT
This chapter utilizes naturalistic decision-making (NDM) as a framework to review and integrate existing research on emergency medical services (EMS) worker decision-making. It presents a brief review of the NDM literature, and focuses on the performance mechanisms that underlie expert performance and development. NDM is concerned with how experts make decisions and how attributes of the environment shape the decisions that are made. The chapter reviews the current literature related to EMS decision-making to provide recommendations for work system design. It discusses implications for training and learning interventions to accelerate the development of expert EMS decision makers. The chapter describes five core performance mechanisms of expert decision-making as identified in the NDM literature: situation assessment and problem representation, pattern recognition, sensemaking, mental simulation, and automaticity. It provides a worked-out example of how NDM-based design principles viewed in the context of an NDM-based design framework can be used to inform the design of safe work systems.
