Expertise in medicine: using the expert performance approach to improve simulation training http://researchonline.ljmu.ac.uk/3561/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LJMU Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.The version presented here may differ from the published version or from the version of the record. Please see the repository URL above for details on accessing the published version and note that access may require a subscription.
Context:We critically review how medical education can benefit from systematic use of the 2 expert performance approach as a framework for measuring and enhancing clinical practice. 3We discuss how the expert performance approach can be used to better understand the 4 mechanisms underpinning superior performance among healthcare providers and how the 5 framework can be applied to created simulated learning environments that present increased 6 opportunities to engage in deliberate practice. Expert Performance approach: The expert 7 performance approach is a systematic, evidence-based framework for measuring and 8 analysing superior performance. It has been applied in a variety of domains, but has so far 9 been neglected in medicine and healthcare. In this paper, we outline the framework and 10 demonstrate how it can be effectively applied to medical education. Deliberate Practice: 11Deliberate practice is defined as structured and reflective activity, which is designed to 12 develop a critical aspect of performance. Deliberate practice provides an opportunity for error 13 detection and correction, repetition, access to feedback and requires maximal effort, complete 14 concentration and full attention. The paper provides guidance on how to structure simulated 15 learning environments to encourage the accumulation of deliberate practice.
Conclusions: 16We highlight the role of simulation-based training in conjunction with deliberate practice 17 activities such as reflection, rehearsal, trial-and-error learning, and feedback in improving the 18 quality of patient care. We argue that the development of expertise in healthcare is directly 19 related to the systematic identification and improvement of quantifiable performance metrics. 20In order to optimize the training of expert healthcare providers, advances in simulation 21 technology need to be coupled with effective instructional systems design, with the latter 22 being strongly guided by empirical research from the learning and cognitive sciences.