Information de reference pour ce titreAccession Number: | 00001888-201511000-00016.
|
Author: | Ericsson, K. Anders PhD
|
Institution: | K.A. Ericsson is Conradi Eminent Scholar and Professor, Department of Psychology, Florida State University, Tallahassee, Florida.
|
Title: | |
Source: | Academic Medicine. 90(11):1471-1486, November 2015.
|
Abstract: | As a part of a special collection in this issue of Academic Medicine, which is focused on mastery learning in medical education, this Perspective describes how the expert-performance approach with deliberate practice is consistent with many characteristics of mastery learning. Importantly, this Perspective also explains how the expert-performance approach provides a very different perspective on the acquisition of skill. Whereas traditional education with mastery learning focuses on having students attain an adequate level of performance that is based on goals set by the existing curricula, the expert-performance approach takes an empirical approach and first identifies the final goal of training-namely, reproducibly superior objective performance (superior patient outcomes) for individuals in particular medical specialties. Analyzing this superior complex performance reveals three types of mental representations that permit expert performers to plan, execute, and monitor their own performance. By reviewing research on medical performance and education, the author describes evidence for these representations and their development within the expert-performance framework. He uses the research to generate suggestions for improved training of medical students and professionals. Two strategies-designing learning environments with libraries of cases and creating opportunities for individualized teacher-guided training-should enable motivated individuals to acquire a full set of refined mental representations. Providing the right resources to support the expert-performance approach will allow such individuals to become self-regulated learners-that is, members of the medical community who have the tools to improve their own and their team members' performances throughout their entire professional careers.
(C) 2015 by the Association of American Medical Colleges
|
References: | 1. Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(10 suppl):S70-S81
2. Ericsson KAEricsson KA, Charness N, Feltovich PJ, Hoffman RR. The influence of experience and deliberate practice on the development of superior expert performance. The Cambridge Handbook of Expertise and Expert Performance. 2006 New York, NY Cambridge University Press:683-703
3. Ericsson KA, Smith JEricsson KA, Smith J. Prospects and limits in the empirical study of expertise: An introduction. Toward a General Theory of Expertise: Prospects and Limits. 1991 Cambridge, UK Cambridge University Press:1-38
4. Ericsson KA, Charness N, Feltovich PJ, Hoffman RR The Cambridge Handbook of Expertise and Expert Performance. 2006 New York, NY Cambridge University Press
5. Hanushek EA, Rivkin SJ. Generalizations about using value-added measures of teacher quality. Am Econ Rev. 2010;100:267-271
6. Saxon D, Barkham M. Patterns of therapist variability: Therapist effects and the contribution of patient severity and risk. J Consult Clin Psychol. 2012;80:535-546
7. Tracey TJ, Wampold BE, Lichtenberg JW, Goodyear RK. Expertise in psychotherapy: An elusive goal? Am Psychol. 2014;69:218-229
8. Jeevan R, Cromwell DA, Browne J, et al. National Mastectomy and Breast Reconstruction Audit 2011. Leeds: The NHS Information Centre. http://www.hscic.gov.uk/catalogu...- ouverture dans une nouvelle fenêtre. Accessed August 5, 2015
9. Waljee JF, Curtin C. Quality assessment in hand surgery. Hand Clin. 2014;30:329-334, vi
10. Lyu H, Wick EC, Housman M, Freischlag JA, Makary MA. Patient satisfaction as a possible indicator of quality surgical care. JAMA Surg. 2013;148:362-367
11. Lyu H, Cooper M, Freischlag JA, Makary MA. Patient satisfaction as a possible indicator of quality surgical care-reply. JAMA Surg. 2013;148:986-987
12. Yadlapati R, Gawron A, Keswani RN. Patient satisfaction does not correlate with established colonoscopy quality metrics. Am J Gastroenterol. 2014;109:1089-1091
13. Vickers AJ, Bianco FJ, Serio AM, et al. The surgical learning curve for prostate cancer control after radical prostatectomy. J Natl Cancer Inst. 2007;99:1171-1177
14. Vickers AJ, Bianco FJ, Gonen M, et al. Effects of pathologic stage on the learning curve for radical prostatectomy: Evidence that recurrence in organ-confined cancer is largely related to inadequate surgical technique. Eur Urol. 2008;53:960-966
15. Elo AE The Rating of Chess Players: Past and Present. 19862nd ed. New York, NY Arco
16. de Groot AD Thought and Choice in Chess. 19782nd English ed. The Hague, The Netherlands Mouton Publishers
17. van der Maas HL, Wagenmakers EJ. A psychometric analysis of chess expertise. Am J Psychol. 2005;118:29-60
18. Page G, Bordage G, Allen T. Developing key-feature problems and examinations to assess clinical decision-making skills. Acad Med. 1995;70:194-201
19. Guid M, Bratko I. Using heuristic-search based engines for estimating human skill at chess. ICGA J. 2011;34:71-81
20. Ericsson KA, Krampe RT, Tesch-Romer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev. 1993;100:363-406
21. Ericsson KA, Lehmann AC. Expert and exceptional performance: Evidence of maximal adaptation to task constraints. Annu Rev Psychol. 1996;47:273-305
22. Bloom BSBloom BS. Generalizations about talent development. Developing Talent in Young People. 1985 New York, NY Ballantine Books:507-549
23. McPherson G, Renwick J. Longitudinal study of self-regulation in children's musical practice. Music Educ Res. 2001;3:169-186
24. Ericsson KAEricsson KA, Charness N, Feltovich PJ, Hoffman RR. Protocol analysis and expert thought: Concurrent verbalizations of thinking during experts' performance on representative task. The Cambridge Handbook of Expertise and Expert Performance. 2006 New York, NY Cambridge University Press:223-242
25. Ericsson KA. Deliberate practice and the modifiability of body and mind: Toward a science of the structure and acquisition of expert and elite performance. Int J Sport Psychol. 2007;38:4-34
26. Ericsson KA. Deliberate practice and the modifiability of body and mind: A reply to the commentaries. Int J Sport Psych. 2007;38:109-123
27. Ericsson KA, Roring RW, Nandagopal K. Giftedness and evidence for reproducibly superior performance: An account based on the expert-performance framework. High Abil Stud. 2007;18:3-56
28. Ericsson KA, Roring RW, Nandagopal K. Misunderstandings, agreements, and disagreements: Toward a cumulative science of reproducibly superior aspects of giftedness. High Abil Stud. 2007;18:97-115
29. Krampe RT, Ericsson KA. Maintaining excellence: Deliberate practice and elite performance in young and older pianists. J Exp Psychol Gen. 1996;125:331-359
30. Winfred A Jr, Winston B Jr, Stanush PL, McNelly TL. Factors that influence skill decay and retention: A quantitative review and analysis. Hum Perf. 1998;11:57-101
31. Moxley JH, Ericsson KA, Scheiner A, Tuffiash M. The effects of periods of disuse on performance in a skilled activity. Appl Cogn Psychol. 2014;29:73-80
32. Mujika I, Padilla S. Detraining: Loss of training-induced physiological and performance adaptations. Part II: Long term insufficient training stimulus. Sports Med. 2000;30:145-154
33. Tanaka H, Seals DR. Endurance exercise performance in masters athletes: Age-associated changes and underlying physiological mechanisms. J Physiol. 2008;586:55-63
34. Krampe RT, Charness NEricsson KA, Charness N, Feltovich PJ, Hoffman RR. Aging and expertise. The Cambridge Handbook of Expertise and Expert Performance. 2006 New York, NY Cambridge University Press:723-742
35. Spaner SJ, Warnock GL. A brief history of endoscopy, laparoscopy, and laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 1997;7:369-373
36. Moore MJ, Bennett CL. The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club. Am J Surg. 1995;170:55-59
37. Davis DAEricsson KA. How to help professionals maintain and improve their knowledge and skills: Triangulating best practices in medicine. The Development of Professional Expertise: Toward Measurement of Expert Performance and Design of Optimal Learning Environments. 2009 New York, NY Cambridge University Press:180-202
38. Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: The relationship between clinical experience and quality of health care. Ann Intern Med. 2005;142:260-273
39. Ericsson KA, Whyte J 4th, Ward P. Expert performance in nursing: Reviewing research on expertise in nursing within the framework of the expert-performance approach. ANS Adv Nurs Sci. 2007;30:E58-E71
40. Spengler PM, White MJ, AEgisdottir S, et al. The meta-analysis of clinical judgment project: Effects of experience on judgment accuracy. Couns Psychol. 2009;20:350-399
41. Crommelinck M, Anseel F. Understanding and encouraging feedback-seeking behaviour: A literature review. Med Educ. 2013;47:232-241
42. Gauthier S, Cavalcanti R, Goguen J, Sibbald M. Deliberate practice as a framework for evaluating feedback in residency training. Med Teach. 2015;37:551-557
43. Hays RT, Jacobs JW, Prince C, Salas E. Flight simulator training effectiveness: A meta analysis. Mil Psychol. 1992;4:63-74
44. Noble C. The relationship between fidelity and learning in aviation training and assessment. J Air Transp. 2002;7:33-54
45. Roessingh JJM. Transfer of manual flying skills from PC-based simulation to actual flight-Comparison of in-flight measured data and instructor ratings. Int J Aviat Psychol. 2005;15:67-90
46. Rantanen EM, Talleur DA. Incremental transfer and cost effectiveness of ground-based flight trainers in university aviation programs. Proceedings of the Human Factors and Ergonomics Society 49th Annual Meeting. 2005 Thousand Oaks, Calif Sage:764-767
47. Lintern G, Roscoe SN, Koonce JM, Segal LD. Transfer of landing skills in beginning flight training. Hum Factors. 1990;32:319-327
48. Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Med Teach. 2005;27:10-28
49. McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. Effect of practice on standardised learning outcomes in simulation-based medical education. Med Educ. 2006;40:792-797
50. Van Sickle KR, Ritter EM, McClusky DA 3rd, et al. Attempted establishment of proficiency levels for laparoscopic performance on a national scale using simulation: The results from the 2004 SAGES Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) learning center study. Surg Endosc. 2007;21:5-10
51. Tsuda S, Scott D, Doyle J, Jones DB. Surgical skills training and simulation. Curr Probl Surg. 2009;46:271-370
52. McGaghie WC, Issenberg SB, Barsuk JH, Wayne DB. A critical review of simulation-based mastery learning with translational outcomes. Med Educ. 2014;48:375-385
53. Block JHBlock JH. Introduction to mastery learning: Theory and practice. Mastery Learning: Theory and Practice. 1971 New York, NY Holt, Rinehart, and Winston:2-12
54. Carroll JB. A model of school learning. Teach Coll Rec. 1963;64:723-733
55. Issenberg SB, McGaghie WCMcGaghie WC. Looking to the future. International Best Practices for Evaluation in the Health Professions. 2013 New York, NY Radcliffe Publishing:341-359
56. Anderson JR. Acquisition of cognitive skill. Psychol Rev. 1982;89:369-406
57. Fitts PM, Posner MI Human Performance. 1967 Belmont, Calif Brooks/Cole
58. Dreyfus SE, Dreyfus HL. A five stage model of the mental activities involved in direct skill acquisition. 1980 Berkeley, Calif University of California http://www.dtic.mil/dtic/tr/full...- ouverture dans une nouvelle fenêtre. Accessed August 5, 2015
59. Dreyfus HL, Dreyfus SE, Athanasiou T Mind Over Machine: The Power of Human Intuition and Expertise in the Era of the Computer. 1986 New York, NY Free Press
60. Craig C, Klein MI, Griswold J, Gaitonde K, McGill T, Halldorsson A. Using cognitive task analysis to identify critical decisions in the laparoscopic environment. Hum Factors. 2012;54:1025-1039
61. Pauley K, Flin R, Azuara-Blanco A. Intra-operative decision making by ophthalmic surgeons. Br J Ophthalmol. 2013;97:1303-1307
62. Cristancho SM, Vanstone M, Lingard L, LeBel ME, Ott M. When surgeons face intraoperative challenges: A naturalistic model of surgical decision making. Am J Surg. 2013;205:156-162
63. Beilock SL Choke: What the Secrets of the Brain Reveal About Getting It Right When You Have To. 2010 New York, NY Free Press
64. Abernethy B, Gill DP, Parks SL, Packer ST. Expertise and the perception of kinematic and situational probability information. Perception. 2001;30:233-252
65. Ward P, Ericsson KA, Williams AM. Complex perceptual-cognitive cognitive expertise in a simulated task environment. J Cogn Eng Decis Mak. 2013;7:231-254
66. Endsley MREricsson KA, Charness N, Feltovich PJ, Hoffman RR. Expertise and situation awareness. The Cambridge Handbook of Expertise and Expert Performance. 2006 New York, NY Cambridge University Press:633-652
67. O'Brien KS, O'Hare D. Situational awareness ability and cognitive skills training in a complex real-world task. Ergonomics. 2007;50:1064-1091
68. Endsley MR, Sulistyawati K, Wickens CD, Chui YP. Prediction in situation awareness: Confidence bias and underlying cognitive abilities. Int J Aviat Psychol. 2011;21:153-174
69. Wiegmann DA, ElBardissi AW, Dearani JA, Daly RC, Sundt TM 3rd. Disruptions in surgical flow and their relationship to surgical errors: An exploratory investigation. Surgery. 2007;142:658-665
70. Way LW, Stewart L, Gantert W, et al. Causes and prevention of laparoscopic bile duct injuries: Analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg. 2003;237:460-469
71. Moulton CA, Regehr G, Lingard L, Merritt C, MacRae H. Slowing down to stay out of trouble in the operating room: Remaining attentive in automaticity. Acad Med. 2010;85:1571-1577
72. Bann S, Khan M, Datta V, Darzi A. Surgical skill is predicted by the ability to detect errors. Am J Surg. 2005;189:412-415
73. Ali S Validation of a Novel Methodology for Evaluating Surgical Tissue Plane Identification [unpublished dissertation]. 2014 London, Ontario, Canada University of Western Ontario
74. Mentis HM, Chellali A, Schwaitzberg S. Learning to see the body: Supporting instructional practices in laparoscopic surgical procedures. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (CHI 2014). 2014 New York, NY Association for Computing Machinery:2113-2122
75. Stone S, Bernstein M. Prospective error recording in surgery: An analysis of 1108 elective neurosurgical cases. Neurosurgery. 2007;60:1075-1080
76. Oremakinde AA, Bernstein M. A reduction in errors is associated with prospectively recording them. J Neurosurg. 2014;121:297-304
77. El Ahmadieh TY, Harrop J, Batjer HH, Resnick DK, Bendok BR. Blinded peer assessment of surgical skill is feasible and can predict complication rates: A step toward measuring surgical quality. Neurosurgery. 2014;74:N12-N14
78. Zevin B, Bonrath EM, Aggarwal R, Dedy NJ, Ahmed N, Grantcharov TPATLAS Group. . Development, feasibility, validity, and reliability of a scale for objective assessment of operative performance in laparoscopic gastric bypass surgery. J Am Coll Surg. 2013;216:955-965.e8
79. Birkmeyer JD, Finks JF, O'Reilly A, et al.Michigan Bariatric Surgery Collaborative. Surgical skill and complication rates after bariatric surgery. N Engl J Med. 2013;369:1434-1442
80. Ericsson KA. Necessity is the mother of invention: Video recording firsthand perspectives of critical medical procedures to make simulated training more effective. Acad Med. 2014;89:17-20
81. Buckley CE, Kavanagh DO, Traynor O, Neary PC. Is the skillset obtained in surgical simulation transferable to the operating theatre? Am J Surg. 2014;207:146-157
82. Crochet P, Aggarwal R, Dubb SS, et al. Deliberate practice on a virtual reality laparoscopic simulator enhances the quality of surgical technical skills. Ann Surg. 2011;253:1216-1222
83. Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, et al. Pediatric resident resuscitation skills improve after "rapid cycle deliberate practice" training. Resuscitation. 2014;85:945-951
84. Thijssen AS, Schijven MP. Contemporary virtual reality laparoscopy simulators: Quicksand or solid grounds for assessing surgical trainees? Am J Surg. 2010;199:529-541
85. Lipner RS, Messenger JC, Kangilaski R, et al. A technical and cognitive skills evaluation of performance in interventional cardiology procedures using medical simulation. Simul Healthc. 2010;5:65-74
86. Rader SB, Abildgaard U, Jorgensen E, Bech B, Lonn L, Ringsted CV. Association between endovascular performance in a simulated setting and in the catheterization laboratory. Simul Healthc. 2014;9:241-248
87. Ericsson KA, Simon HA Protocol Analysis: Verbal Reports as Data. 1993Rev ed Cambridge, Mass Bradford Books
88. Palter VN, Grantcharov TP. Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: A randomized controlled trial. Ann Surg. 2014;259:443-448
89. Hockenberry JM, Lien HM, Chou SY. The impacts of task repetition and temporal breaks in production on human capital and productivity. J Hum Capital. 2008;2:303-335
90. Hockenberry JM, Lien HM, Chou SY. Surgeon and hospital volume as quality indicators for CABG in Taiwan: Examining hazard to mortality and accounting for unobserved heterogeneity. Health Serv Res. 2010;45(5 pt 1):1168-1187
91. Huesch MD, Sakakibara M. Forgetting the learning curve for a moment: How much performance is unrelated to own experience? Health Econ. 2009;18:855-862
92. Miglioretti DL, Gard CC, Carney PA, et al. When radiologists perform best: The learning curve in screening mammogram interpretation. Radiology. 2009;253:632-640
93. Nodine CF, Kundel HL, Mello-Thoms C, et al. How experience and training influence mammography expertise. Acad Radiol. 1999;6:575-585
94. Taylor PM. A review of research into the development of radiologic expertise: Implications for computer-based training. Acad Radiol. 2007;14:1252-1263
95. Lesgold A, Rubinson H, Feltovitch P, Glaser R, Klopher D, Wang YChi MTH, Glaser R, Farr MJ. Expertise in a complex skill: Diagnosing X-ray pictures. The Nature of Expertise. 1988 Hillsdale, NJ Lawrence Erlbaum Associates:311-342 http://csjarchive.cogsci.rpi.edu...- ouverture dans une nouvelle fenêtre. Accessed August 5, 2015
96. Azevedo R, Faremo S, Lajoie SPMcNamara DS, Trafton JG. Expert-novice differences in mammogram interpretation. Proceedings of the 29th Annual Cognitive Science Society. 2007 Nashville, Tenn Cognitive Science Society:65-70 http://csjarchive.cogsci.rpi.edu...- ouverture dans une nouvelle fenêtre. Accessed August 5, 2015
97. Mello-Thoms C, Trieu PD, Rawashdeh MA, Tapia K, Lee WB, Brennan PCFujita H, Hara T, Muramatsu C. Understanding the role of correct lesion assessment in radiologists' reporting of breast cancer. Breast Imaging: 12th International Workshop, IWDM 2014, Gifu City, Japan, June 29-July 2, 2014. Proceedings. 2014 Cham, Switzerland Springer:341-347
98. Buist DS, Anderson ML, Smith RA, et al. Effect of radiologists' diagnostic work-up volume on interpretive performance. Radiology. 2014;273:351-364
99. Ericsson KA. Deliberate practice and acquisition of expert performance: A general overview. Acad Emerg Med. 2008;15:988-994
100. Boutis K, Pecaric M, Seeto B, Pusic MV. Using signal detection theory to model changes in serial learning of radiological image interpretation. How much practice is enough? Using learning curves to assess the deliberate practice of radiograph interpretation. Adv Health Sci Educ Theory Pract. 2010;15:647-658
101. Pusic M, Pecaric M, Boutis K. How much practice is enough? Using learning curves to assess the deliberate practice of radiograph interpretation. Acad Med. 2011;86:731-736
102. Geller BM, Bogart A, Carney PA, et al. Educational interventions to improve screening mammography interpretation: A randomized controlled trial. AJR Am J Roentgenol. 2014;202:W586-W596
103. Wouda JC, van de Wiel HB. Education in patient-physician communication: How to improve effectiveness? Patient Educ Couns. 2013;90:46-53
104. Horne R. Compliance, adherence, and concordance: Implications for asthma treatment. Chest. 2006;130(1 suppl):65S-72S
105. Haughney J, Price D, Kaplan A, et al. Achieving asthma control in practice: Understanding the reasons for poor control. Respir Med. 2008;102:1681-1693
106. Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363:733-742
107. Higginson IJ, Evans CJ. What is the evidence that palliative care teams improve outcomes for cancer patients and their families? Cancer J. 2010;16:423-435
108. Curtis JR, Back AL, Ford DW, et al. Effect of communication skills training for residents and nurse practitioners on quality of communication with patients with serious illness: A randomized trial. JAMA. 2013;310:2271-2281
109. O'Leary KJ, Darling TA, Rauworth J, Williams MV. Impact of hospitalist communication-skills training on patient-satisfaction scores. J Hosp Med. 2013;8:315-320
110. Chi J, Verghese A. Improving communication with patients: Learning by doing. JAMA. 2013;310:2257-2258
111. Ericsson KA. An expert-performance perspective of research on medical expertise: The study of clinical performance. Med Educ. 2007;41:1124-1130
112. Ericsson KAFry H, Kneebone R. The surgeon's expertise. Surgical Education: Theorising an Emerging Domain. 2011 Berlin, Germany Springer:107-121
113. Wouda JC, van de Wiel HB. The effects of self-assessment and supervisor feedback on residents' patient-education competency using videoed outpatient consultations. Patient Educ Couns. 2014;97:59-66
114. Bishawi M, Pryor AD. Should technical aptitude evaluation become part of resident selection for surgical residency? Surg Endosc. 2014;28:2761-2762
115. Wanzel KR, Hamstra SJ, Anastakis DJ, Matsumoto ED, Cusimano MD. Effect of visual-spatial ability on learning of spatially-complex surgical skills. Lancet. 2002;359:230-231
116. Wanzel KR, Hamstra SJ, Caminiti MF, Anastakis DJ, Grober ED, Reznick RK. Visual-spatial ability correlates with efficiency of hand motion and successful surgical performance. Surgery. 2003;134:750-757
117. Buckley CE, Kavanagh DO, Nugent E, Ryan D, Traynor OJ, Neary PC. The impact of aptitude on the learning curve for laparoscopic suturing. Am J Surg. 2014;207:263-270
118. Nomura T, Miyashita M, Shrestha S, et al. Can interview prior to laparoscopic simulator training predict a trainee's skills? J Surg Educ. 2008;65:335-339
119. Keehner M, Lippa Y, Montello DR, Tendick F, Hegarty M. Learning a spatial skill for surgery: How the contributions of abilities change with practice. Appl Cogn Psychol. 2006;20:487-503
120. Hogle NJ, Widmann WD, Ude AO, Hardy MA, Fowler DL. Does training novices to criteria and does rapid acquisition of skills on laparoscopic simulators have predictive validity or are we just playing video games? J Surg Educ. 2008;65:431-435
121. Hogle NJ, Chang L, Strong VE, et al. Validation of laparoscopic surgical skills training outside the operating room: A long road. Surg Endosc. 2009;23:1476-1482
122. Ericsson KA. Why expert performance is special and cannot be extrapolated from studies of performance in the general population: A response to criticisms. Intelligence. 2014;45:81-103
|
Language: | English.
|
Document Type: | Perspectives.
|
Journal Subset: | Clinical Medicine. Health Professions.
|
ISSN: | 1040-2446
|
NLM Journal Code: | acm, 8904605
|
DOI Number: | https://dx.doi.org/10.1097/ACM.0...- ouverture dans une nouvelle fenêtre
|
Annotation(s) | |
|
|