Professionals’ adaptive expertise and adaptive performance in educational and workplace settings: an overview of reviews

Pelgrim, Els; Hissink, Elske; Bus, Lotte; Schaaf, Marieke F. van der; Nieuwenhuis, Loek; Tartwijk, Jan van; Kuijer-Siebelink, Wietske

doi:10.1007/s10459-022-10190-y

Cited by 8 publications

(4 citation statements)

References 22 publications

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“…Rather, the practitioner engages in adaptive practices by shifting focus when facing uncertainty. This observation further supports the argument that uncertainty does not indicate incompetence (Ott et al, 2018 ) and echoes findings from a recent meta review, that adaptive practices are engaged when physicians are faced with a change in their environment (Pelgrim et al, 2022 ). In this study, we added nuance to this picture, in that such changes could result in unproductive uncertainty.…”

Section: Discussionsupporting

confidence: 86%

Exploring adaptive expertise in residency: the (missed) opportunity of uncertainty

Gamborg

Mylopoulos

Mehlsen

et al. 2023

Adv in Health Sci Educ

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Preparing novice physicians for an unknown clinical future in healthcare is challenging. This is especially true for emergency departments (EDs) where the framework of adaptive expertise has gained traction. When medical graduates start residency in the ED, they must be supported in becoming adaptive experts. However, little is known about how residents can be supported in developing this adaptive expertise. This was a cognitive ethnographic study conducted at two Danish EDs. The data comprised 80 h of observations of 27 residents treating 32 geriatric patients. The purpose of this cognitive ethnographic study was to describe contextual factors that mediate how residents engage in adaptive practices when treating geriatric patients in the ED. Results showed that all residents fluidly engaged in both adaptive and routine practices, but they were challenged when engaging in adaptive practices in the face of uncertainty. Uncertainty was often observed when residents’ workflows were disrupted. Furthermore, results highlighted how residents construed professional identity and how this affected their ability to shift between routine and adaptive practices. Residents reported that they thought that they were expected to perform on par with their more experienced physician colleagues. This negatively impacted their ability to tolerate uncertainty and hindered the performance of adaptive practices. Thus, aligning clinical uncertainty with the premises of clinical work, is imperative for residents to develop adaptive expertise.

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Section: Discussionsupporting

confidence: 86%

Exploring adaptive expertise in residency: the (missed) opportunity of uncertainty

Gamborg

Mylopoulos

Mehlsen

et al. 2023

Adv in Health Sci Educ

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“…Adaptation to contextual demands typically belongs to Layer 2 competence. Assessment of the ability to adapt to new medical environments has not extensively been studied, but promising examples [91][92][93] and theoretical insights 94,95 are emerging. The binary entrustment decision (yes or no) is a holistic decision that combines the evaluation of competence, the gauging of risks and the granting of autonomy, and can only be made by an examiners who know the learner and who have the authority for patient care in the context of interest.…”

Section: Layermentioning

confidence: 99%

Medical competence as a multilayered construct

ten Cate,

Khursigara‐Slattery,

Cruess

et al. 2023

Medical Education

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BackgroundThe conceptualisation of medical competence is central to its use in competency‐based medical education. Calls for ‘fixed standards’ with ‘flexible pathways’, recommended in recent reports, require competence to be well defined. Making competence explicit and measurable has, however, been difficult, in part due to a tension between the need for standardisation and the acknowledgment that medical professionals must also be valued as unique individuals. To address these conflicting demands, a multilayered conceptualisation of competence is proposed, with implications for the definition of standards and approaches to assessment.The modelThree layers are elaborated. This first is a core layer of canonical knowledge and skill, ‘that, which every professional should possess’, independent of the context of practice. The second layer is context‐dependent knowledge, skill, and attitude, visible through practice in health care. The third layer of personalised competence includes personal skills, interests, habits and convictions, integrated with one's personality. This layer, discussed with reference to Vygotsky's concept of Perezhivanie, cognitive load theory, self‐determination theory and Maslow's ‘self‐actualisation’, may be regarded as the art of medicine.We propose that fully matured professional competence requires all three layers, but that the assessment of each layer is different.ImplicationsThe assessment of canonical knowledge and skills (Layer 1) can be approached with classical psychometric conditions, that is, similar tests, circumstances and criteria for all. Context‐dependent medical competence (Layer 2) must be assessed differently, because conditions of assessment across candidates cannot be standardised. Here, multiple sources of information must be merged and intersubjective expert agreement should ground decisions about progression and level of clinical autonomy of trainees. Competence as the art of medicine (Layer 3) cannot be standardised and should not be assessed with the purpose of permission to practice. The pursuit of personal excellence in this level, however, can be recognised and rewarded.

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“…Innovativeness is needed when a teacher's theoretical knowledge about child development needs to be put into practice in rapidly changing situations and novel situations with children, as it reflects teacher's ethics of equality and cognitive flexibility to meet children's need sensitively (Kua et al, 2021). These characteristics of individual ECE teacher, ECE teacher's work and children's learning environment are related to characteristics of adaptive expertise (Pelgrim et al, 2022). Inquisitiveness as a component of teachers' expertise takes different behavioral forms of intellectual curiosity and desire to learn and understand (Hogan and Hogan, 2007;Proyer, 2017).…”

Section: Oliw Facets Description Of Teacher's Actionsmentioning

confidence: 99%

“…In addition to spontaneity, ECE teacher needs to be inquisitive, which includes following characteristics: intellectual curiosity and desire to learn and understand (Proyer, 2017), ethics of equality and theoretical knowledge about child development (Kua et al, 2021). Furthermore, it includes ECE teachers to be innovative, curious, creative, and flexible in interactions with children and ECE team staff (Proyer, 2017;Pelgrim et al, 2022). We consider inquisitiveness as a part of an ECE teacher's adaptive expertise taking different behavioral forms of intellectual curiosity and desire to learn and understand (Proyer, 2017) challenging situations and making quick and strategically important decisions to refine, change and implement different strategies to meet children's needs (Toom and Husu, 2016;Männikkö and Husu, 2019;Kua et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Pre-service early childhood teachers’ perceptions of their playfulness and inquisitiveness

Hurme,

Siklander,

Kangas

et al. 2023

Front. Educ.

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Recognizing one’s own playfulness is important for early childhood education (ECE) teachers, who are responsible for organizing and implementing child-initiated pedagogy in ECE centers. Playfulness research has focused on children’s play and playfulness in workplaces, but playfulness as a part of ECE teachers’ pedagogical and adaptive expertise is rarely studied. Using multiple playfulness and innovativeness instruments, first- and third-year pre-service ECE teachers’ (n = 208) self-reported playfulness and inquisitiveness was examined. Correlation coefficients and Student t-tests were performed to examine the connections between playfulness, the facets of playfulness, and inquisitiveness, also between the first- and third-year pre-service ECE teachers. The results of the study show that playfulness, the facets of playfulness and inquisitiveness are connected. The results also show that although there were no statistically significant differences among the first- and third-year pre-service ECE teachers’ playfulness and inquisitiveness, they had different orientations towards playfulness. Additional research is needed to explore how in-service teachers and pre-service teachers can learn playfulness and inquisitiveness as a part of their pedagogical expertise. The results are implementable for designing, developing and evaluating ECE teacher education.

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Professionals’ adaptive expertise and adaptive performance in educational and workplace settings: an overview of reviews

Cited by 8 publications

References 22 publications

Exploring adaptive expertise in residency: the (missed) opportunity of uncertainty

Exploring adaptive expertise in residency: the (missed) opportunity of uncertainty

Medical competence as a multilayered construct

Pre-service early childhood teachers’ perceptions of their playfulness and inquisitiveness

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