Fluid Intelligence Versus Crystallized Intelligence
The Atlantic this month had articles dealing with fluid intelligence and the notion that adaptive, problem-solving intelligence is different from task-specific skills, or crystallized intelligence. Jerry Useem looked at the U. S. Navy’s experience with “minimally manned” staffing ships. Born of an experiment twenty years ago, the Navy abandoned its traditional staffing, where ships’ crews were built with complements of sailors trained in detail about specific skills such as engineering, armaments, and so forth, and, instead, staffed a new class of ships with sailors who were expected to have one basic skill and perform several supplemental tasks. Similar notions have caught on in business. As the author notes:
“The phenomenon is spread by automation, which usurps routine tasks, leaving employees to handle the nonroutine and unanticipated—and the continued advance of which throws the skills employers value into flux. It would be supremely ironic if the advance of the knowledge economy had the effect of devaluing knowledge. But that’s what I heard, recurrently, while reporting this story…Minimal manning—and the evolution of the economy more generally—requires a different kind of worker, with not only different acquired skills, but different inherent abilities. It has implications for the nature and utility of a college education, for the paths of careers, for inequality and unemployment—even for the generational divide…How deep these implications go depends, ultimately, on how closely employers embrace concepts behind minimal manning.”
As the Navy set about implementing the program, they did tests to assess individual sailor’s ability to adjust to changing circumstances and found one predictor of failure was a strong tendency to “conscientiousness,” which is normally thought of as a highly desirable trait. People who did best on various tests were open to new experience, and demonstrated what might be called distractibility, which is normally not thought of as positive in a candidate.
“High in fluid intelligence, low in experience, not terribly conscientious, open to potential distraction—this is not the classic profile of a winning job candidate. But what if it is the profile of the winning job candidate of the future? If that’s the case, some important implications would arise.”
The second article looks at the impact of aging on intellectual capability and starts with the observations that most Nobel Prize-winning breakthroughs in the physical sciences are produced by scientists under thirty years of age. While the age of peak performance varies by specialty, the author notes that intellectual decline is inevitable if you live long enough, and it may happen sooner than you think.
“In sum, if your profession requires mental processing speed or significant analytic capabilities—the kind of profession most college graduates occupy—noticeable decline is probably going to set in earlier than you imagine.”
He goes on to look more closely at the notions of fluid and crystallized intelligence first developed by Raymond Cattell.
“Cattell defined fluid intelligence as the ability to reason, analyze, and solve novel problems—what we commonly think of as raw intellectual horsepower…It is highest in early adulthood and diminishes starting in one’s 30’s and 40’s…Crystallized intelligence, in contrast, is the ability to use knowledge gained in the past. Think of it as possessing a vast library and understanding how to use it. It is the essence of wisdom. Because crystallized intelligence relies on an accumulating stock of knowledge, it tends to increase through one’s 40’s, and does not diminish until very late in life…Patterns like this match what I have seen as the head of a think tank full of scholars of all ages. There are many exceptions, but the most profound insights tend to come from those in their early 30’s and 40’s. The best synthesizers and explainers of complicated ideas—that is the best teachers—tend to be in their mid-60’s or older, some of them well into their 80’s.”
The third article examined data showing most subject matter experts are bad at forecasting the future. They were highly specialized “hedgehogs.” They knew one big idea and were resistant to others. The “foxes” were those could integrate “many little things” and were open to contradictory ideas. In a follow up study, a group of non-experts were matched against panels of experts. The “amateurs” who seemed the “foxiest” were curious about lots of things, crossed disciplines, and “viewed teammates as sources for learning, rather than peers to be convinced.” They also consistently outperformed the experts.
What are the implications of these observations for physicians and for medical practice? Once I was making attending rounds as a visiting professor when the real attending had to take a phone call. I asked the assembled trainees what one skill would be improved 10 years hence. Some answered that they would be defter in procedural skills. I suggested the real answer is they would get better at talking to people—this was the one skill that could really improve over an entire practice. For that to happen, though, physicians need to come to value this skill as much as patients value it. The manual skills and application of the latest technology will always be the province of younger people. A good program will have a mix of both younger and older physicians and a process for incorporating both fluid intelligence and crystallized intelligence in the solving of patient and organizational problems. But for this to happen, peer input needs to be seen by all as a source of wisdom, not opposition. How is your program doing with this?
24 June 2019
 Useem J. At Work Expertise Is Falling Out of Favor. The Atlantic, July 2019. Accessed 21 June 2019 at https://www.theatlantic.com/magazine/archive/2019/07/future-of-work-expertise-navy/590647/
 Brooks AC. Your Professional Decline Is Coming (Much) Sooner Than You Think. The Atlantic. July 2019. Accessed 21 June 2019 at https://www.theatlantic.com/magazine/archive/2019/07/work-peak-professional-decline/590650/
Messaging is replacing dialogue in clinical practice to the detriment of all.
Emotional Intelligence for Physicians
How do physicians rate in the domains of emotional intelligence?
Is empathy the value we have tossed out as part of "improving" health care?
Physician Decision Making
Physician decision-making is both complex and deals with uncertainty dooming current simple approaches to changing physician behavior.
How do physicians deal with complex, uncertain health care situations? Scenario planning is better than quoting statistics.
Variation in Health Care
Is variation in health care good, bad, or inevitable? The answer may determine future medical practice.