Learning from success and failure among skilled workers: The case of coronary angioplasty

This study examines learning from success and failure in the context of coronary stenting in Florida from 1995-2000 (the first years in which the stent procedure was performed). The conceptual model is that individuals conduct a search process in which they attempt to determine their own ability level. Greater accumulated successes will lead the individual to attempt more difficult tasks, while greater failures will lead the individual to attempt less difficult tasks. Further, the size of the adjustment is expected to be affected by historical and social aspirations: individuals performing below their previous quality levels are expected to be more risk-averse in the cases they choose, and individuals performing below their peers' quality levels will be even more risk-averse. The results suggest that physicians change the average difficulty of their caseloads depending on their cumulative successes and failures, and that the size of the adjustment depends on whether they are above or below social aspirations.