Educating for adaptive expertise: case examples along the medical education continuum

Pusic, Martin; Hall, Elissa; Billings, Heather; Branzetti, Jeremy; Hopson, Laura R.; Regan, Linda; Gisondi, Michael A.; Cutrer, William B.

doi:10.1007/s10459-022-10165-z

Cited by 9 publications

(7 citation statements)

References 37 publications

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“…These strategies can be used in individual teaching sessions; however, helping learners adjust to an adaptive expertise framing requires educators who have this “shared language” and a faculty who has a goal of adaptive expertise [ 39 ]. These approaches can be challenging and more effortful for students in the moment, so it is important to help students tolerate the short-term uncertainty of not being told the correct answer immediately [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Contrasting cases are collections of specific examples that can help learners understand the structure of a phenomenon [ 32 ]. Contrasting cases can be employed to help learners compare and contrast their exemplars or illness scripts with unique patient presentations and progressions [ 39 ]. Inventing with contrasting cases has also been described as “meaningful variation” in the literature.…”

Section: Three Instructional Design Strategies To Support the Develop...mentioning

confidence: 99%

“…Another effective way to employ this strategy is by asking “what if” questions [ 3 ]. Although many educators use this strategy in clinical settings, some institutions (for example, Johns Hopkins) also employ meaningful variation in a structured manner when remediating struggling learners to help them build the cognitive schemas that underpin conceptual understanding and sound clinical reasoning [ 39 ]. Pusic describes that meaningful variation was helpful for residence with superficial foundation knowledge, because it is impossible to see the “breadth of all clinical presentations” during training.…”

Section: Three Instructional Design Strategies To Support the Develop...mentioning

confidence: 99%

“…Pusic describes that meaningful variation was helpful for residence with superficial foundation knowledge, because it is impossible to see the “breadth of all clinical presentations” during training. By using meaningful variation, faculty can support residents as they synthesize commonalities and differences in patient presentations through using divergent presentations and etiologies of common cases [ 39 ]. Example: Propose a series of problems for a student (for example, several patients presenting with shortness of breath, coughing, and wheezing) and ask the students to think of possible explanations for the phenomena.…”

Section: Three Instructional Design Strategies To Support the Develop...mentioning

confidence: 99%

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Adaptive Expertise in Undergraduate Pharmacy Education

Steenhof

2023

Pharmacy

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Pharmacy educators are grappling with concerns around curriculum overload and core pharmacist competencies in a rapidly changing and increasingly complex healthcare landscape. Adaptive expertise provides a conceptual framework to guide educators as they design instructional activities that can support students on their journey towards becoming pharmacists who can perform procedural tasks efficiently, as well as creatively handle new and difficult-to-anticipate problems that arise regularly in pharmacy practice. This article explores undergraduate pharmacy education through a cognitive psychology lens and foregrounds three instructional design strategies which support the development of adaptive expertise: (1) cognitive integration, (2) productive failure, and (3) inventing with contrasting cases. These three evidence-based strategies cultivate long-term learning and provide a practical mechanism to combat curriculum overload and backwards-facing assessments. Pharmacy education can encourage the development of procedural and conceptual knowledge and position pharmacy students to excel as they move into more complicated and ambiguous roles in our healthcare system.

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Section: Discussionmentioning

confidence: 99%

Section: Three Instructional Design Strategies To Support the Develop...mentioning

confidence: 99%

Section: Three Instructional Design Strategies To Support the Develop...mentioning

confidence: 99%

Section: Three Instructional Design Strategies To Support the Develop...mentioning

confidence: 99%

See 2 more Smart Citations

Adaptive Expertise in Undergraduate Pharmacy Education

Steenhof

2023

Pharmacy

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“…Ultimately, the goal of research in health professions education is to meaningfully impact education and work in health professions education. Pusic et al, (2022) have demonstrated how the theoretical framework of adaptive expertise, and in particular the research conducted with a specific HPE lens, can be implemented across the continuum of health profes-sions education. They provided case studies from the United States across different contexts and levels of development and drew out common themes.…”

Section: This Special Issuementioning

confidence: 99%

The imperative for (and opportunities of) research on adaptive expertise in health professions education

Mylopoulos

Dolmans

Woods

2022

Adv in Health Sci Educ

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In this editorial, three Advances 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.A few years ago, during a lively discussion about adaptive expertise, one exasperated colleague finally declared, "I just don't think we need to invent another term for expertise in the health professions". This comment reflects broader methodological debates in the field (e.g. Albert et al., 2019) and concerns that medical education is continuously (and unnecessarily) inventing new constructs and theories rather than harnessing existing theoretical frameworks. However, in this case, we didn't "invent another term" as the construct of adaptive expertise was not developed in the context of health professions education research (HPER). Rather, this robust theoretical framework evolved through decades of research in the learning sciences (

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The case for metacognitive reflection: a theory integrative review with implications for medical education

Merkebu,

Veen,

Hosseini

et al. 2024

Adv in Health Sci Educ

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The concepts of metacognitive reflection, reflection, and metacognition are distinct but have undergone shifts in meaning as they migrated into medical education. Conceptual clarity is essential to the construction of the knowledge base of medical education and its educational interventions. We conducted a theoretical integrative review across diverse bodies of literature with the goal of understanding what metacognitive reflection is. We searched PubMed, Embase, CINAHL, PsychInfo, and Web of Science databases, including all peer-reviewed research articles and theoretical papers as well as book chapters that addressed the topic, with no limitations for date, language, or location. A total of 733 articles were identified and 87 were chosen after careful review and application of exclusion criteria. The work of conceptually and empirically delineating metacognitive reflection has begun. Contributions have been made to root metacognitive reflection in the concept of metacognition and moving beyond it to engage in cycles of reflection. Other work has underscored its affective component, transformational nature, and contextual factors. Despite this merging of threads to develop a richer conceptualization, a theory of how metacognitive reflection works is elusive. Debates address whether metacognition drives reflection or vice versa. It has also been suggested that learners evolve along on a continuum from thinking, to task-related reflection, to self-reflection, and finally to metacognitive reflection. Based on prior theory and research, as well as the findings of this review, we propose the following conceptualization: Metacognitive reflection involves heightened internal observation, awareness, monitoring, and regulation of our own knowledge, experiences, and emotions by questioning and examining cognition and emotional processes to continually refine and enhance our perspectives and decisions while thoughtfully accounting for context. We argue that metacognitive reflection brings a shift in perspective and can support valuable reconceptualization for lifelong learning.

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Educating for adaptive expertise: case examples along the medical education continuum

Cited by 9 publications

References 37 publications

Adaptive Expertise in Undergraduate Pharmacy Education

Adaptive Expertise in Undergraduate Pharmacy Education

The imperative for (and opportunities of) research on adaptive expertise in health professions education

The case for metacognitive reflection: a theory integrative review with implications for medical education

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