Concept Of Deliberate Practice Research Articles

Equitable approach to introductory calculus-based physics courses focused on problem solving

Introductory calculus-based mechanics (“Physics 1”) is an important gateway course for students desiring to pursue a science, technology, engineering, and mathematics (STEM) career. A major challenge with this course is the large spread in the students’ incoming physics preparation. This level of preparation is strongly predictive of a students’ performance because of the overlap between Physics 1 and high school physics courses. Because the level of students’ incoming preparation is largely determined by the quality of their high school physics courses, Physics 1 can amplify K–12 educational inequities and be a barrier for marginalized students wishing to pursue a STEM career. Here, we present a novel introductory course design to address this equity challenge. The design and implementation are based on the concept of deliberate practice as applied to learning real-world problem solving. Students explicitly practice research-identified decision-based skills required for problem solving in the context of solving real-world problems. The problems used in the course and their solutions have little resemblance to what students encounter in high school physics, thereby reducing the dependence of course performance on the high school physics preparation. Versions of this course were taught at a highly selective private and a lightly selective public university. The students who took the course learned the physics content knowledge they needed for future courses, particularly in engineering, and their problem-solving skills improved substantially. Furthermore, their course performance had much less correlation with their incoming physics preparation than was the case for the outcomes from the traditional Physics 1 courses at both institutions: in one case the correlation dropped from r=0.62 to 0.14, and on the other case the correlation dropped from r=0.56 to 0.26. These findings suggest this course design can be a more equitable version of the traditional Physics 1 course, and hence particularly beneficial for marginalized students.Received 8 August 2022Accepted 23 September 2022DOI:https://doi.org/10.1103/PhysRevPhysEducRes.18.020124Published by the American Physical Society under the terms of the Creative Commons Attribution 4.0 International license. Further distribution of this work must maintain attribution to the author(s) and the published article’s title, journal citation, and DOI.Published by the American Physical SocietyPhysics Subject Headings (PhySH)Research AreasDiversity & inclusionInstructional strategiesStudent preparationPhysics Education Research

Effectiveness of Individual Feedback and Coaching on Shared Decision-making Consultations in Oncology Care: Protocol for a Randomized Clinical Trial.

BackgroundShared decision-making (SDM) is particularly important in oncology as many treatments involve serious side effects, and treatment decisions involve a trade-off between benefits and risks. However, the implementation of SDM in oncology care is challenging, and clinicians state that it is difficult to apply SDM in their actual workplace. Training clinicians is known to be an effective means of improving SDM but is considered time consuming.ObjectiveThis study aims to address the effectiveness of an individual SDM training program using the concept of deliberate practice.MethodsThis multicenter, single-blinded randomized clinical trial will be performed at 12 Dutch hospitals. Clinicians involved in decisions with oncology patients will be invited to participate in the study and allocated to the control or intervention group. All clinicians will record 3 decision-making processes with 3 different oncology patients. Clinicians in the intervention group will receive the following SDM intervention: completing e-learning, reflecting on feedback reports, performing a self-assessment and defining 1 to 3 personal learning questions, and participating in face-to-face coaching. Clinicians in the control group will not receive the SDM intervention until the end of the study. The primary outcome will be the extent to which clinicians involve their patients in the decision-making process, as scored using the Observing Patient Involvement–5 instrument. As secondary outcomes, patients will rate their perceived involvement in decision-making, and the duration of the consultations will be registered. All participating clinicians and their patients will receive information about the study and complete an informed consent form beforehand.ResultsThis trial was retrospectively registered on August 03, 2021. Approval for the study was obtained from the ethical review board (medical research ethics committee Delft and Leiden, the Netherlands [N20.170]). Recruitment and data collection procedures are ongoing and are expected to be completed by July 2022; we plan to complete data analyses by December 2022. As of February 2022, a total of 12 hospitals have been recruited to participate in the study, and 30 clinicians have started the SDM training program.ConclusionsThis theory-based and blended approach will increase our knowledge of effective and feasible training methods for clinicians in the field of SDM. The intervention will be tailored to the context of individual clinicians and will target the knowledge, attitude, and skills of clinicians. The patients will also be involved in the design and implementation of the study.Trial RegistrationNetherlands Trial Registry NL9647; https://www.trialregister.nl/trial/9647International Registered Report Identifier (IRRID)DERR1-10.2196/35543

A Personal Account: Attaining Muscle Memory and Higher Mental Functioning

Many articles have been written about elite performers that attain muscle memory and experience flow and zoneness. This article details how the author personally attained higher level performance and explains the feelings experienced during the process. A one-person study was designed to experience muscle memory and explore the mental aspects of putting. Twenty thousand attempts (strokes) were used. The design included four parts; a) Establish Baseline, b) Master Mechanics, c) Experience Muscle Memory, and d) Explore Mental Aspects. The conversion rate for the first 1,000 attempts during baseline was 58.3 percent and for the last 1,000 attempts was 90.4 percent. The concept of deliberate practice was used throughout the study showing performance increases. When experiencing muscle memory it was found to be boring and far from fun. When the mental aspects were explored the concepts of flow and pre-live generated enthusiasm and joy.

Step-Specific Simulation: The Utility of 3D Printing for the Fabrication of a Low-Cost, Learning Needs-Based Rhinoplasty Simulator

Rhinoplasty is a complex procedure that requires meticulous planning and precise execution. Plastic surgeons involved in teaching residents must balance a trainee's hands-on experience while ensuring appropriate execution of difficult maneuvers. Surgical simulation, a field of growing importance with the shift towards competency-based education, may aid in trainee skill development. Through the concept of deliberate practice, the authors looked to explore the utility and economics of 3-dimensional (3D) printing technology to develop a step-specific rhinoplasty simulator. The main objective of this study was to address rhinoplasty skills previously identified as "learning areas of weakness" and develop a low-cost, step-specific simulator to help rhinoplasty teaching. A patient's facial bones, upper and lower lateral cartilages, and septum were segmented from a computed tomography scan and rendered in 3D format. This was 3D printed utilizing Ultimaker Polylactic filament with a polyvinyl acetate dissolvable support for bone, a mixture of Rigur 450 and Tango plus polyjet material for cartilage, and Smooth-On Dragon Skin for skin. A modular simulator was developed with 3 separate, interchangeable components with a perfect fit design. The simulator allowed for deliberate practice of the 5 rhinoplasty learning areas of weakness, with a maximal recurring cost of $75 CAD. Through the employment of 3D printing, a low-cost, maneuver-specific rhinoplasty simulator reinforcing deliberate practice was developed. This concept of simulation-based deliberate practice may be of increasing interest when considering the implementation of competency-based curricular standards in plastic surgery education.

Deliberate Practice as an Effective Remediation Strategy for Underperforming Medical Students Focused on Clinical Skills: a Prospective Longitudinal Study.

BackgroundIt is critical to develop remedial education for underperforming medical students, but little is known about how to create an effective remediation program. Deliberate practice (DP) is a structured and reflective activity that is designed to optimize performance. Here we applied the concept of DP to create remedial education to improve the clinical practices of medical students. We also analyzed the effectiveness of the remediation program.MethodsBased on the expert performance approach of DP, we designed a 4-week remedial program for clinical performance that included feedback and reflection. There were 74 student participants in this program from 2014 to 2017. Their clinical performance was re-evaluated after completion, and changes in their clinical performance scores were analyzed.ResultsStudents who completed the remediation program showed significant improvements in clinical performance scores (P < 0.001). Most students found the program to be instructive and helpful for improving their clinical performance. They reported that role play with peers was the most helpful for improving their skills.ConclusionThe DP-based remediation program improved the clinical performance of failing medical students. This remediation program should continue to be offered to underperforming students to ensure that medical school graduates are competent.

Exploring the Role and Application of the Deliberate Practice Concept in Radiation Therapy

The concept of deliberate practice (DP) has been extensively applied to the development of skill and expert performance in many domains of professional practice. Although it has been widely reviewed in other health professions, there is a lack of evidence on its application in radiation therapy practice. This article aims to explore the concept of DP and how it can be applied to radiation therapy practice. The authors define DP, why it is essential, and how it can be implemented in radiation therapy. Evidence from the DP literature in the health professions was used to clarify the guiding principles for successful DP implementation within both the clinical and educational contexts. While the authors encourage radiation therapy practitioners to engage in DP approaches, every profession utilizing DP will develop strategies unique to the individual discipline. Hence, rather than imitating other professions, it is essential that radiation therapists engage evidence-based approaches that will generate empirical evidence to model radiation therapy-specific DP approaches.

Deliberate Practice and Skill Acquisition in Nursing Practice.

The purpose of this article is to describe an educational process designed to accelerate skill acquisition for new nurse graduates through deliberate practice and situated learning experiences. The concept of deliberate practice provides the framework for authentic learning experiences based on real-life situations that incorporate targeted outcomes for success while pushing their limits beyond what was previously achieved. Through deliberate practice, new graduate nurses are given the opportunity to gain valuable practical experiences that otherwise would have taken years to accomplish in a clinical practice. The structure and intensity of the experience grounded in realistic or authentic circumstances as supported by deliberate practice enhances learning to promote professional development. J Contin Educ Nurs. 2018;49(6):269-273.

The role of deliberate practice in development of essential sonography skills

AbstractThe role of deliberate practice (DP) theory in the development of expert performance has been widely studied. This paper reviews the concept of DP and the various factors that could impact the development or refining of essential sonography skills for students and practitioners. In this article, the authors review the concept of DP for its potential benefits and limitations in Medical Sonography education and its potential impact on the future calibre of practitioners. The paper encourages both novice and experienced practitioners to rethink how DP could enhance the notion of grasping a skill. Evidence from various areas of practice including the health professions has been used to argue that sonographers can successfully incorporate DP. This review opens up the opportunity for further conversations on how various skills could be isolated and improved using DP theory, with the primary aim of improving the quality of patient care in sonography practice.

The future of regional anesthesia education: lessons learned from the surgical specialty.

Application of ultrasound in regional anesthesia has now become the standard of care and its use has shown to reduce complications. Nevertheless, gaining expertise in ultrasound-guided regional anesthesia requires the acquisition of new cognitive and technical skills. In addition, due to a reduction in resident working hours and enforcement of labour laws and directives across various states and countries, trainees perform and witness fewer procedures. Together, these issues create challenges in the teaching and learning of ultrasound-guided regional anesthesia in the time-based model of learning. The challenges of teaching ultrasound-guided regional anesthesia are similar to those experienced by our surgical counterparts with the advent of minimally invasive surgery. In order to overcome these challenges, our surgical colleagues used theories of surgical skills training, simulation, and the concept of deliberate practice and feedback to shift the paradigm of learning from experience-based to competency-based learning. In this narrative review, we describe the theory behind the evolution of surgical skills training. We also outline how we can apply these learning theories and simulation models to a competency-based curriculum for training in ultrasound-guided regional anesthesia.

Geritalk: Using Deliberate Skills Practice in Communication Skills Training (302)

1.Compare and contrast the traditional method of medical education with the concept of deliberate practice, as applied to communication skills.2.Describe Geritalk, a model communication skills training program for palliative medicine and geriatrics fellows.3.Explore ways to translate deliberate practice to participants’ specific learners and teaching environment. The care of the seriously ill is frequently complicated by communication challenges. Delivering bad news, coping with clinical uncertainty, supporting a patient through periods of functional or cognitive decline, and establishing appropriate goals of care are a few of the challenges that palliative medicine clinicians confront daily. Despite the frequency of these difficult conversations and the fact that the ACGME has identified communication as a core clinical skill, fellows in palliative medicine receive little focused communication training. Most fellowship programs do not have a formal curriculum for teaching communication skills. Geritalk is a 2-day communication skills workshop for palliative medicine and geriatrics fellows that specifically addresses their common communication challenges, including giving bad news and discussing transitions to palliative care. Particular focus is placed on the intricacies of discussing these topics with surrogate decision makers and establishing specific goals of care for patients with profound functional and cognitive impairment. Developed by Drs. Neill and Kelley, the program relies heavily on skills practice sessions with simulated patients, complemented by brief didactic sessions and reflective discussions. The session will make the case for formal communication workshops as a method for teaching communication skills. Complex in many ways, communication is not something that can simply be learned by the “see one, do one, teach one” strategy. It requires many hours of practice. Geritalk fosters, in fellows, an importance on deliberate practice-practice which includes setting personal goals, observed communication encounters, reflection on one's own work, and feedback by a skilled coach. Participants will have an opportunity to see how the model of deliberate practice is applied to communication skills teaching in palliative care through a demonstration of a Geritalk skills practice session and then reflect on how they might apply this method of teaching in their home environment.

A deliberate practice account of typing proficiency in everyday typists.

The concept of deliberate practice was introduced to explain exceptional performance in domains such as music and chess. We apply deliberate practice theory to intermediate-level performance in typing, an activity that many people pursue on a regular basis. Sixty university students with several years typing experience participated in laboratory sessions that involved the assessment of abilities, a semistructured interview on typing experience as well as various typing tasks. In line with traditional theories of skill acquisition, experience (amount of typing since introduction to the keyboard) was related to typing performance. A perceptual speed test (digit-symbol substitution) and a measure of motor abilities (tapping) were not significantly related to performance. In line with deliberate practice theory, the highest level of performance was reported among participants who had attended a typing class in the past and who reported to adopt the goal of typing quickly during everyday typing. Findings suggest that even after several years of experience engagement in an everyday activity can serve as an opportunity for further skill improvement if individuals are willing to push themselves.