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Professionals ’ adaptive expertise and adaptive performance in educational and workplace settings: an overview of reviews
AbstractProfessionals will increasingly be confronted with new insights and changes. This raises questions as to what kind of expertise professionals need, and how development of this expertise can be influenced within the contexts of both education and work. The terms adaptive expertise and adaptive performance are well-known concepts in the domains of education and Human Resource Development respectively. The literature, however, lacks a conceptual overview. Our research seeks to provide an overview on how adaptive expertise and adaptive performance are conceptualized. In addition we looked for what individual, task and ...
Source: Advances in Health Sciences Education - December 12, 2022 Category: Universities & Medical Training Source Type: research

Stress and conflict from tacit culture forges professional identity in newly graduated independent physicians
We describe a novel theory of how tacit group culture shaped new attending physicians ’ professional identity in a new community of practice. Internal stress and external conflict occurred due to high expectations and tacit culture elements. New attendings’ doubt, adjust, or avoid responses, shaped by support they received, in turn crafted their professional identity. Education l eaders should prepare graduating trainees to navigate aspects of transition to independent practice successfully. (Source: Advances in Health Sciences Education)
Source: Advances in Health Sciences Education - December 7, 2022 Category: Universities & Medical Training Source Type: research

Teacher, Gatekeeper, or Team Member: supervisor positioning in programmatic assessment
AbstractCompetency-based assessment is undergoing an evolution with the popularisation of programmatic assessment. Fundamental to programmatic assessment are the attributes and buy-in of the people participating in the system. Our previous research revealed unspoken, yet influential, cultural and relationship dynamics that interact with programmatic assessment to influence success. Pulling at this thread, we conducted secondary analysis of focus groups and interviews (n  = 44 supervisors) using the critical lens of Positioning Theory to explore how workplace supervisors experienced and perceived their positioning withi...
Source: Advances in Health Sciences Education - December 5, 2022 Category: Universities & Medical Training Source Type: research

How workplace learning is put into practice: contrasting the medical and nursing contexts from the perspective of teaching and learning regimes
This study aimed to explore practices of workplace learning in the two adjacent healthcare professions; medicine and nursing. We adopted an ethnographic qualitative design. Field observations and follow-up interviews were performed in three clinical departments and the data set comprised 12 full days of observations and 16 formal follow-up interviews. Thematic analysis was performed deductively according to the theoretical framework. Four teaching and learning regimes were found in the data. In the medical context, workplace learning was either practiced as reproduction of current practice or through stimulation of profess...
Source: Advances in Health Sciences Education - December 2, 2022 Category: Universities & Medical Training Source Type: research

The imperative for (and opportunities of) research on adaptive expertise in health professions education
AbstractIn this editorial, threeAdvances in Health Sciences Education editors argue for the importance and impact of adaptive expertise on the future of health professions education and work. They present a sample of the broad range of theory-informed research currently contributing to understanding and applying adaptive expertise in health professions education. They reflect on the unique opportunities that interdisciplinarity offers this endeavour. Finally they offer potential ways forward for continued efforts to advance collective understanding of education, expert development and health professions practice. (Source: ...
Source: Advances in Health Sciences Education - December 2, 2022 Category: Universities & Medical Training Source Type: research

Scholarly practice in healthcare professions: findings from a scoping review
AbstractScholarly practitioners are broadly defined as healthcare professionals that address critical practice problems using theory, scientific evidence, and practice-based knowledge. Though scholarly practice is included in most competency frameworks, it is unclear what scholarly practiceis, how itdevelops and how it isoperationalized in clinical practice. The aim of this review was to determine what is known about scholarly practice in healthcare professionals. We conducted a scoping review and searched MEDLINE, EMBASE, CINAHL from inception to May 2020. We included papers that explored, described, or defined scholarly ...
Source: Advances in Health Sciences Education - December 1, 2022 Category: Universities & Medical Training Source Type: research

To a fault
AbstractAre first impressions misleading? This commentary explores that question by drawing on the more general cognitive psychology literature aimed at understanding when, why, and how any non-analytic reasoning process can help or hurt decision-making. (Source: Advances in Health Sciences Education)
Source: Advances in Health Sciences Education - November 30, 2022 Category: Universities & Medical Training Source Type: research

An exploration of “real time” assessments as a means to better understand preceptors’ judgments of student performance
AbstractClinical supervisors are known to assess trainee performance idiosyncratically, causing concern about the validity of their ratings. The literature on this issue relies heavily on retrospective collection of decisions, resulting in the risk of inaccurate information regarding what actually drives raters ’ perceptions. Capturing in-the-moment information about supervisors’ impressions could yield better insight into how to intervene. The purpose of this study, therefore, was to gather “real-time” judgments to explore what drives preceptors’ judgments of student performance. We performed a prospective study...
Source: Advances in Health Sciences Education - November 28, 2022 Category: Universities & Medical Training Source Type: research

Balancing closure and discovery: adaptive expertise in the workplace
This study sought to investigate how clinical supervision might support the development of adaptive expertise. The present study used a focused ethnography in two emergency departments. We observed 75 supervising situations with the 27 residents resulting in 116 pages of field notes. The majority of supervision was provided by senior physicians, but also included other healthcare professionals. We found that supervision could serve two purposes: closure and discovery. Supervision aimed at discovery included practices that reflected instructional approaches said to promote adaptive expertise, such as productive struggle. Su...
Source: Advances in Health Sciences Education - November 23, 2022 Category: Universities & Medical Training Source Type: research

Re-examining the integration of routine and adaptive expertise: there is no such thing as routine from a motor control perspective
We present a focused review of literature to argue that repetitive practice is much less repetitive than often perceived. Our main thesis is that all skilled movement reflects components of adaptive expertise. Through an overview of perspectives from the field of motor control and learning, we emphasize the interplay between the inherent noisiness of the human motor architecture and the stability of motor skill performances. Ultimately, we challenge the very idea of routine. Our goal is threefold: to reconcile common misconceptions about the rote nature of routine precision skill performance, to offer educators principles ...
Source: Advances in Health Sciences Education - November 22, 2022 Category: Universities & Medical Training Source Type: research

Educating for adaptive expertise: case examples along the medical education continuum
AbstractAdaptive expertise represents the combination of both efficient problem-solving for clinical encounters with known solutions, as well as the ability to learn and innovate when faced with a novel challenge. Fostering adaptive expertise requires careful approaches to instructional design to emphasize deeper, more effortful learning. These teaching strategies are time-intensive, effortful, and challenging to implement in health professions education curricula. The authors are educators whose missions encompass the medical education continuum, from undergraduate through to organizational learning. Each has grappled wit...
Source: Advances in Health Sciences Education - November 21, 2022 Category: Universities & Medical Training Source Type: research

From burden to benefit: a multi-site study of the impact of allied health work-based learning placements on patient care quality
This study explored whether the quality of patient care was enhanced when services were re-designed using a collaborative partnership approach to more purposefully integrate students into delivery of care. Using an embedded multiple case study design, data were collected through focus groups and interviews, patient experience surveys, and secondary administrative data sources. Cases were across physiotherapy and occupational therapy in six different hospital settings. Perception of care provided by students was viewed positively by all stakeholders, including patients. Perceived health outcomes of faster improvement of hea...
Source: Advances in Health Sciences Education - November 19, 2022 Category: Universities & Medical Training Source Type: research

Redressing injustices: how women students enact agency in undergraduate medical education
This study presents descriptions of epistemic injustice in the experiences of women medical students and provides accounts about how these students worked to redress these injustices. Epistemic injustice is both the immediate discrediting of an individual ’s knowledge based on their social identity and the act of persistently ignoring possibilities for other ways of knowing. Using critical narrative interviews and personal reflections over an eight-month period, 22 women students during their first year of medical school described instances when th eir knowledge and experience was discredited and ignored, then the ways t...
Source: Advances in Health Sciences Education - November 17, 2022 Category: Universities & Medical Training Source Type: research

An ethnographic investigation of medical students ’ cultural competence development in clinical placements
This study provides a rare view of students’ development of cultural competence in clinical placements, which may inform the pedagogic development of cultural competence and diversity education in medicine and healthcare. (Source: Advances in Health Sciences Education)
Source: Advances in Health Sciences Education - November 12, 2022 Category: Universities & Medical Training Source Type: research

Beyond the tensions within transfer theories: implications for adaptive expertise in the health professions
We present three instructional principles that may better support transfer and adaptive expertise in trainees: i) identifying and incorporating meaningful variability in practice, ii) integrating conceptual knowledge during practice iii) using assessments of trainees ’ transfer. Taken together, we offer an integrative perspective to how educational systems and experiences can be designed to develop and encourage adaptive expertise and transfer. (Source: Advances in Health Sciences Education)
Source: Advances in Health Sciences Education - November 11, 2022 Category: Universities & Medical Training Source Type: research