Deliberate Practice Research Articles

The fus test: a promising tool for evaluating fundamental motor skills in children and adolescents

Fundamental motor skills (FMS) are essential for enjoyable, confident and skillful participation in physical activity across the lifespan. Due to the alarming low level of FMS proficiency in children and adolescents worldwide, the development of motor competency is an urgent issue for physical education. The promotion and implementation of a systematic process of teaching and learning FMS should be a physical education priority. Accordingly, effective assessment tools for evaluating FMS should be adopted or developed. Because FMS assessment for both children and adolescents need further effective solutions, the primary aim of this study was to develop the new age-related test of FMS (Fundamental Motor Skills in Sport test, in Polish: Test Fundamentalnych Umiejętności Ruchowych w Sporcie, FUS). The secondary aim of this study was to establish validity and inter-rater, intra-rater, test-retest reliabilities and internal consistency of the FUS test. The FUS test involves six sport skill-based tasks: hurdling, jumping rope, forward roll, ball bouncing, throwing and catching a ball, and kicking and stopping a ball. Two hundred sixty-four Polish students in grades 1–3 (7–9 yrs; n = 81), 4–6 (10–12 yrs; n = 89) and 7–8 (13–14 yrs; n = 94), including 139 girls and 125 boys completed the FUS test. The content validity index for all items was notably high. Both inter-rater and intra-rater reliability showed substantial to almost perfect agreement, with observed agreements for FUS skills between 78.5 and 93.1%. Ball bouncing had a moderate correlation with the forward roll and throwing and catching, while other correlations were low or insignificant. ICC values, ranging from 0.95 to 0.97, confirmed excellent test-retest reliability. The results of our study provide evidence that the FUS test is valid, reliable, and feasible to administer in school settings. Therefore, this tool test has the potential to support deliberate practice and improve motor competence by providing a standardized and structured approach to measuring FMS among school-aged children and adolescents.

Competence-based assessment and training for ethical situations in practice: a pilot study

ABSTRACT In this pilot study, deliberate practice and competence-based assessment were incorporated into a first-year graduate course on professional issues and ethics. Students responded to challenging simulations of basic ethical situations in therapy before and after the course. Aspects of deliberate practice were incorporated into the course. Student self-report ratings and independent performance ratings blind to timing found improvements in students’ ability to manage basic ethical situations in practice. Pilot evidence suggests competence-based assessment and training have potential use for training students preparing to engage in their first therapy practicum experiences. Additional controlled studies are needed to examine the benefits of competence-based assessment and training.

“The Rosa Parks of the trans bathroom debate”: Gavin Grimm and the racialization of transgender civil rights

ABSTRACT Gavin Grimm, a white transgender boy from Virginia, successfully sued his school board in Grimm v. Gloucester County School Board and helped secure the right for trans and gender nonconforming students to use public school bathrooms that correspond to their gender identities. His 2021 victory was the culmination of a long legal battle that began in 2014, when the Gloucester County School Board (GCSB) passed a resolution that segregated bathrooms on the basis of “biological gender.” This essay considers the two GCSB meetings at which this resolution was debated as instances of “ordinary democracy,” where local practices of deliberation not only set policy but also sustain community and produce shared opinion. Drawing on Black trans scholarship that proposes the transitivity of Blackness and demonstrates how Blackness is made present in the service of whiteness, I examine how the discussions at the GCSB meetings strategically mobilized civil rights rhetoric and histories of racial segregation to debate Gavin’s entitlement to public space. Blackness, I argue, is invoked and disavowed as a condition of possibility for modern white trans identities and a resource for vernacular articulations of the scope of trans rights.

Deliberate practice of diagnostic clinical reasoning reveals low performance and improvement of diagnostic justification in pre-clerkship students

PurposeDiagnostic errors are a large burden on patient safety and improving clinical reasoning (CR) education could contribute to reducing these errors. To this end, calls have been made to implement CR training as early as the first year of medical school. However, much is still unknown about pre-clerkship students’ reasoning processes. The current study aimed to observe how pre-clerkship students use clinical information during the diagnostic process.MethodsIn a prospective observational study, pre-clerkship medical students completed 10–11 self-directed online simulated CR diagnostic cases. CR skills assessed included: creation of the differential diagnosis (Ddx), diagnostic justification (DxJ), ordering investigations, and identifying the most probable diagnosis. Student performances were compared to expert-created scorecards and students received detailed individualized formative feedback for every case.Results121 of 133 (91%) first- and second-year medical students consented to the research project. Students scored much lower for DxJ compared to scores obtained for creation of the Ddx, ordering tests, and identifying the correct diagnosis, (30–48% lower, p < 0.001). Specifically, students underutilized physical exam data (p < 0.001) and underutilized data that decreased the probability of incorrect diagnoses (p < 0.001). We observed that DxJ scores increased 40% after 10–11 practice cases (p < 0.001).ConclusionsWe implemented deliberate practice with formative feedback for CR starting in the first year of medical school. Students underperformed in DxJ, particularly with analyzing the physical exam data and pertinent negative data. We observed significant improvement in DxJ performance with increased practice.

Theoretical, Conceptual, and Operational Aspects in Simulation Training With Rapid Cycle Deliberate Practice: An Integrative Review.

An integrative review following Whittemore and Knafl's 5-stage approach (problem identification, literature search, data evaluation, data analysis, and presentation) was conducted to synthesize the evidence on the theoretical, conceptual, and operational aspects of simulation training with rapid cycle deliberate practice (RCDP). After the literature search, 2 reviewers independently read and critically evaluated primary studies using the eligibility criteria. A third more experienced reviewer solved disagreements between the reviewers.This review included 31 articles. Eight themes were identified and grouped into 2 pre-established categories: theoretical/conceptual and operational aspects. The first category had the following 3 themes: definition of RCDP, concepts related to the principles of RCDP, and theories underpinning RCDP. The second category had the following 5 themes: total training time, number of participants in the training, training system, first scenario without intervention, and progressive difficulty. This review showed that knowledge about RCDP is still under construction. As a new simulation strategy, there are some theoretical, conceptual, and operational differences in the studies applying RCDP interventions as simulation training.

Self-efficacy assessment hinders improvement on a deliberate cricket bowling practice task.

Previous research indicates that external focused attention is linked to superior performance on motor tasks. This study examined how attention directed toward one's self-efficacy affected performance in a cricket bowling task. In the pre-test phase, participants attempted to bowl in a designated "good length" zone across 12 trials. Following this, participants were randomly assigned to either an experimental group, where they rated their own general and task-specific self-efficacy, or a control group, where they rated someone else's ability. They each then bowled 12 more trials. Their performance was measured based on the number of trials that were bowled within the standard "good length" zone. Paired t-tests showed that while the performance of the control group improved significantly from pre-test to post-test, t = 2.613, p = 0.008; the experimental group did not show a significant improvement, t = 1.156, p = 0.131. Results indicate that asking people to rate their self-efficacy level may reduce their improvement on a deliberate practice task. Implications for sport performance and researchers are discussed.

The PATH to PPE Mastery - Programme for Assessment and Training in HCID (High Consequence Infectious Diseases) PPE (Personal Protective Equipment), Mastery

High Consequence Infectious Diseases (HCIDs), have the potential to cause pandemics and require particular focus for preparedness due to their high mortality rates. The application of Personal Protective Equipment (PPE) for HCIDs is complex and carries significant risk of Health Care Worker (HCW) contamination if done incorrectly. Previous reviews have reported a lack of information on the nature of training provided and the ideal timing of repeat training to best retain skills. Simulation Based Mastery Learning (SBML) is a methodology for skill acquisition which encompasses deliberate practice and repeated assessment until the learner achieves a pre-set Mastery standard. SBML has been demonstrated to improve competence, skill retention and patient outcomes in other clinical procedures. SBML has not been previously studied or utilised in HCID PPE training. We aimed to increase the likelihood of safe clinical practice by evidencing that Lothian modified SBML for PPE effectively prepares our priority learners. A quasi-experimental within group post-test design was used. Learners undertook a modified SBML programme which included two-hour asynchronous and two-hour synchronous components. 11 learners (10 infectious diseases registrars and 1 infectious diseases consultant) were enrolled in the programme with 8 completing all stages, all of whom achieved the Mastery passing standard. The resources were highly rated by learners with the exemplar videos of skills highlighted as particularly useful. Self-assessed preparedness for each skill increased following pre-learning and synchronous sessions. Modified SBML can be used as an effective methodology for the training and assessment of HCWs in the donning and doffing of HCID PPE.

Why Do Politicians Not Act Upon Citizens’ Deliberations? Evidence From Iceland

Politicians are expressing increasing support for deliberative practices around the world. However, knowledge about their actions beyond expressing support is scarce. To address this gap in the literature, this article aims to explain why politicians do not pick up the results arising from deliberative practices and integrate them into their policies. Our analysis focuses on the 2019 deliberation in Iceland as the most likely case in which we would expect such a process to occur. We use original data from 25 semi-structured interviews conducted in 2021 with Icelandic MPs elected at the national level, which also cover all the party leaders of the eight parliamentary parties in the 2017–2021 term in office. The reflexive thematic analysis finds that, irrespective of their ideological affiliation, politicians are critical of deliberative practices both in procedural and substantive terms. They display a strong belief that political representation achieved through elections must be the rule of the democratic game. As such, deliberation is considered redundant since citizens already have many ways to participate in representative democracy.

Application of mobile-based web app to enhance simple suturing skills of nurse practitioners

BackgroundSuturing is a crucial clinical skill for nurse practitioners (NPs), but the effectiveness of traditional training methods (e.g., physical suture kits combined with video content) is low. ObjectiveThis study compared the effectiveness and usability of a mobile-based web app (MoWa) developed for NPs to learn simple suturing skills with those of traditional instructional video–based training. MethodsThe MoWa system utilizes mobile devices to simulate hands-on suturing and provides learning guidance and feedback to support self-learning with a physical suturing kit. Fifty-four suturing novices (NPs) were recruited as participants, divided into an experimental group (EG: 28 participants) and a control group (CG: 26 participants), and instructed to self-learn for 3 weeks. Learning effectiveness and system usability were evaluated through a pretest and posttest. ResultsThe EG exhibited significant improvements in learning outcomes, self-confidence, self-efficacy, and learning anxiety and expressed satisfaction with the MoWa system. Furthermore, the EG also considerably enhanced learning outcomes, self-efficacy, and learning anxiety compared to the CG, with no significant difference in self-confidence. ConclusionThe MoWa system combined with deliberate practice is an effective strategy for supporting suturing skills training.

Comparing Virtual Simulations to Paper Case Studies in Combination With Manikin-Based Medication Administration Simulations: A Quasi-Experimental Study.

Medication errors are among the most common preventable adverse events in health care. A quasi-experimental approach with a pre/posttest design was used to explore the effectiveness of an enhanced medication administration simulation bundle that included the use of manikin-based simulation-based experiences (SBEs) in combination with either virtual SBEs (V-SBEs) for deliberate practice (DP) or traditional paper case studies for DP on safe medication administration in undergraduate nursing students. Nursing students (n = 101) participated in multiple medication administration-focused SBEs including DP via V-SBEs or DP via traditional paper case studies. Student performance in the medication administration SBEs improved after the third experience. There was no statistically significant difference between the V-SBE groups compared with the traditional paper case study groups across the 3 medication administration-focused SBEs. Findings from this study highlight the importance of DP with medication administration for undergraduate nursing students.

The paradigm shift with the uses of AI-enhanced virtual patients in the medical education for clinical reasoning

&lt;p&gt;臨床診斷是提升醫療品質及確保病人安全的一個關鍵，學員需要經驗眾多病人情境的量與種類，又需被觀察與指導，傳統醫學教育教育與臨床實習不容易達到這些目的，COVID-19疫情造成空間隔離等多重問題，帶來了更大的學習困境。虛擬智慧型參與式擬真訓練，提供了虛擬病人、虛擬醫院及系統中的專家，可以讓學員隨時隨地演練臨床決策能力，在疫情中疫情後提供了臨床思辨教育的轉機。教學上的應用，可以將臨床思辨架構導入診療照護任務中的各步驟，例如: 病史詢問、進行檢查／檢驗探索、身體檢查、診斷分析及病歷寫作的教學訓練，藉此基礎而精進醫療人員之臨床診療能力。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Clinical diagnosis is a key determinant of health-care quality and patient safety. To attain proficiency, learners must hone their clinical reasoning through deliberate practice while being exposed to a large number and diverse range of patients. However, these goals are difficult to attain in traditional medical education and clinical internships. The emergence of the COVID-19 pandemic has further exacerbated these challenges. Thus, this study formulated an NLP-enhanced virtual simulation platform that allows students to practice with virtual patients, virtual hospital environments, and expert guidance behind the scenes. This platform allows hands-on practice in clinical decision-making anywhere anytime, thus presenting a novel avenue for educational enhancement during the pandemic as well as in the post-pandemic era. The virtual simulation training system can be used in the teaching of various clinical tasks, including history taking, physical examination, laboratory investigations, image studies, differential diagnosis, and medical documentation.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Minimum standard assessment of informed consent for internal medicine transition to residency program: A cohort study.

Interns must be proficient in obtaining informed consent (IC), which is the Association of American Medical College's 11th of 13 Entrustable Professional Activities (EPAs). Medical students have limited opportunity to practice IC during clerkships, resulting in inconsistent proficiency. We aimed to create a tool to assess whether our transition to residency (TTR) workshop enables fourth-year medical students to meet a minimum standard of obtaining IC. Sixty fourth-year medical students were enrolled in the internal medicine virtual TTR course during AY2021. The curriculum prioritizes deliberate practice activities. Pre- and postworkshop assignments involved students typing verbatim what they would say during IC encounters. We modified an IC abstraction tool created by Spatz et al. to assess a minimum standard for students'IC assignments. Our final 7-item tool consisted of the following domains: "What," "Why," "How," "Benefits," "Quantitative Risks," "Qualitative Risks," and "Alternatives,"weighing 1 point each. A minimum standard was obtained with a score of 6 or more points by appropriately discussing at least one domain involving risk and all other domains. Students scored highly on the prework domains pertaining to "What," "Why," and "How" of the procedure with no significant difference on postwork. Significant improvement was achieved on postwork domains covering "Benefits" (p = 0.039) and "Alternatives" (p = 0.031). For domains involving "Qualitative" and "Quantitative Risks," there were no statistically significant improvements from pre- to postwork scores. Fifteen and 22students met the minimum standard for IC on pre- and postwork, respectively. Our students demonstrated a good a priori understanding of the "What," "Why," and "How" domains. After the workshop, they more reliably discussed "Benefits" and "Alternatives." Our abstraction tool helped assess the strengths and weaknesses in our students'IC skillset and helped recognize areas of our curriculum that will benefit from improvements to bring students to meet the minimum standard.

Time for Students to Take the Stage: Improving Career Readiness via a Deliberate‐Practice Case Pedagogy

AbstractWhat skills do supply chain students need to be career ready? The answer: Critical thinking, communication, collaboration, and professionalism. Regrettably, recruiters lament today’s graduates too often lack these core skills. Worse, declining student learning and diminished engagement, especially post‐pandemic, are undermining the value of a supply chain education. To help close the supply chain skills gap and re‐engage students, we describe a deliberate‐practice case pedagogy. We begin by reviewing the pros and cons of various case pedagogies to highlight how they might fit in a professor’s case‐teaching portfolio. We then discuss deliberate practice and show how professors can embed it into a student‐led case pedagogy. We conclude by sharing post‐graduation student feedback that shows this approach not only closes career‐readiness gaps but also helps students build the confidence needed to achieve early career success.

Pre-service teachers’ perceptions on eliciting learners’ knowledge in a mixed-reality simulation environment

Background: Concerns have been raised about the inconsistency and quality of pre-service teacher preparation, especially in reading literacy. Mixed-reality simulations can potentially revolutionise initial teacher education by offering realistic, risk-free practice opportunities to master reading practices.Objectives: This study explores pre-service teachers’ perceptions of: (1) interacting with avatars, (2) teaching core reading skills, particularly eliciting background information on informational text, and (3) using an action review cycle within a mixed-reality simulation environment.Method: A qualitative exploratory case study design was used in this study in order to document pre-service teachers’ perceptions of engaging within a mixed-reality simulation environment. A purposive sampling strategy was used to select participants for this study. Data were analysed using thematic analysis.Results: Findings reveal that pre-service teachers valued interacting with the avatars and appreciated the unique focus on eliciting learners’ background knowledge, a core reading practice. They typically teach full lessons with limited genuine engagement during microteaching opportunities, making this an interesting experience. They highlighted the mixed-reality simulation’s features, such as pausing, redoing, and receiving immediate feedback. The simulator allowed them to concentrate on skill mastery rather than staging lessons for grades.Conclusion: This study concludes that pre-service teachers’ skill development benefits from deliberate practice opportunities designed to enhance complex skills. Mixed-reality simulations could reshape how student teachers are prepared for reading instruction.Contributions: This research contributes to the understanding of pre-service teachers’ perspectives on teaching core reading practices in a mixed-reality simulation environment.

Design and Evaluation of Using Head-Mounted Virtual Reality for Learning Clinical Procedures: Mixed Methods Study.

The capacity of health care professionals to perform clinical procedures safely and competently is crucial as it will directly impact patients' outcomes. Given the ability of head-mounted virtual reality to simulate the authentic clinical environment, this platform should be suitable for nurses to refine their clinical skills for knowledge and skills acquisition. However, research on head-mounted virtual reality in learning clinical procedures is limited. The objectives of this study were (1) to describe the design of a head-mounted virtual reality system and evaluate it for education on clinical procedures for nursing students and (2) to explore the experience of nursing students using head-mounted virtual reality for learning clinical procedures and the usability of the system. This usability study used a mixed method approach. The stages included developing 3D models of the necessary instruments and materials used in intravenous therapy and subcutaneous injection procedures performed by nurses, followed by developing the procedures using the Unreal Engine (Epic Games). Questionnaires on the perception of continuance intention and the System Usability Scale were used along with open-ended questions. Twenty-nine nursing students took part in this questionnaire study after experiencing the immersive virtual reality (IVR) intervention. Participants reported largely favorable game perception and learning experience. Mean perception scores ranged from 3.21 to 4.38 of a maximum score of 5, while the mean system usability score was 53.53 of 100. The majority found that the IVR experience was engaging, and they were immersed in the game. The challenges encountered included unfamiliarity with the new learning format; technological constraints, such as using hand controllers; and physical discomfort. The conception of IVR for learning clinical procedures through deliberate practice to enhance nurses' knowledge and skills is promising. However, refinement of the prototypes is required to improve user experience and learning. Future research can explore other ways to use IVR for better education and health care purposes.

Use of Simulation-Based Mastery Learning Curriculum to Improve Difficult Conversation Skills Among Anesthesiologists: A Pilot Study.

Breaking bad news (BBN) is an important clinical task for physicians. Unfortunately, there is no standard method to teach and assess these skills of anesthesiologists. Although anesthesiology has become a relatively safe medical specialty, complications still occur that require disclosure to patients and their families. Disclosure of bad news can be a significant source of stress for clinicians, especially for those who have low confidence in their BBN skills. Anesthesiologists' skills in BBN can be improved with simulation-based mastery learning (SBML), an intense form of competency-based learning. An SBML curriculum was developed using the SPIKES (Situation, Perception, Invitation, Knowledge, Emotion, Summarize) framework for BBN and the NURSE (Naming, Understanding, Respecting, Supporting, Exploring) statements for expressing empathy. A pretest-posttest study was conducted from March 2020 to June 2022 to evaluate anesthesiologists' performance in BBN. Participants completed a 2-hour curriculum consisting of a pretest, didactic session, deliberate practice with feedback, and a posttest. Anesthesiologists were assessed using a 16-item skills checklist. Six anesthesiology attendings and 14 anesthesiology fellows were enrolled in the study. Three of 20 participants met the minimum passing score (MPS) at the time of their pretest. All study participants met the MPS on their first posttest (P < .001). The median participant confidence in BBN significantly increased (3 to 4, P < .001). Overall course satisfaction in the curriculum was high, with a median score of 5. Our study demonstrates that a BBN SBML curriculum for anesthesiologists significantly improved communication skills and confidence in a simulated environment. Because only 3 participants met the MPS before training, our results suggest that anesthesiologists could benefit from further education to gain effective communication skills and that SBML training may be effective to achieve this result.

M1 transcranial direct current stimulation augments laparoscopic surgical skill acquisition

The acquisition of basic surgical skills is a key component of medical education and trainees in laparoscopic surgery typically begin developing their skills using simulation box trainers. However, despite the advantages of simulation surgical training, access can be difficult for many trainees. One technique that has shown promise to enhance the deliberate practice of motor skills is transcranial electric stimulation (tES). The purpose of this study was to assess the impact of transcranial direct current stimulation (tDCS) on training induced improvements and retention of traditional time and kinematic based laparoscopic surgical skill metrics. Forty-nine medical students were randomly allocated to a neurostimulation or sham group and completed 5 training sessions of a bead transfer and threading laparoscopic task. Participants in both the sham and stimulation groups significantly improved their time and kinematic performance on both tasks following training. Although we did find that participants who received M1 tDCS saw greater performance benefits in response to training on a bead transfer task compared to those receiving sham stimulation no effect of neurostimulation was found for the threading task. This finding raises new questions regarding the effect that motor task complexity has on the efficacy of neurostimulation to augment training induced improvement and contributes to a growing body of research investigating the effects of neurostimulation on the sensory-motor performance of laparoscopic surgical skill.

ANNOTATING TRANSLATION AS A MEANINGFUL METACOGNITION-ORIENTED PRACTICE IN THE TRANSLATION CLASSROOM

Translating is a cognitively complex activity aimed at tackling an ill-defined problem: selecting only one viable rendition in the target language from a series of multiple viable choices for a given text in a source language (PYM, 2003). Developing the ability to perform such an activity with a reasonable speed and justified confidence (PYM, 2003) may profit from learning how to perform a parallel activity, i.e., annotating, as a fruitful avenue toward metacognition (ALVES, 2005; SHREVE, 2006) and the articulation thereof. We argue in this article that annotating (or commenting) can be an effective practice in the translation of any genre and play a relevant role from the beginning of translator’s training. Building both on a review of expertise (ERICSSON, 2001) and translation pedagogy (GONÇALVES, 2020; ESQUEDA, 2020) and on our own teaching experience, we suggest that annotating translation can: a) be performed as part of deliberate practice (in the broad sense) during the translation process, b) honestly inform students and trainers about the difficulties faced during the process, c) invite useful feedback, and d) potentially leverage students’ metacognition.

Integrating simulation into surgical training: a qualitative case study of a national programme

BackgroundApplying simulation-based education (SBE) into surgical curricula is challenging and exacerbated by the absence of guidance on implementation processes. Empirical studies evaluating implementation of SBE interventions focus primarily on outcomes. However, understanding the processes involved in organising, planning, and delivering SBE adds knowledge on how best to develop, implement, and sustain surgical SBE. This study used a reform of early years surgical training to explore the implementation of a new SBE programme in Scotland. It aimed to understand the processes that are involved in the relative success (or failure) when implementing surgical SBE interventions.MethodsThis qualitative case study, underpinned by social constructionism, used publicly available documents and the relevant surgical SBE literature to inform the research focus and contextualise data obtained from semi-structured interviews with core surgical trainees (n = 46), consultant surgeons (n = 25), and key leaders with roles in surgical training governance in Scotland (n = 7). Initial data coding and analysis were inductive. Secondary data analysis was then undertaken using Normalisation Process Theory (NPT). NPTs’ four constructs (coherence, cognitive participation, collective action, reflexive monitoring) provided an explanatory framework for scrutinising how interventions are implemented, embedded, and integrated into practice, i.e. the “normalisation” process.ResultsDistributed leadership (individual SBE initiatives assigned to faculty but overall programme overseen by a single leader) and the quality improvement practise of iterative refinement were identified as key novel processes promoting successful normalisation of the new SBE programme. Other processes widely described in the literature were also identified: stakeholder collaboration, personal contacts/relational processes, effective communication, faculty development, effective leadership, and tight programme management. The study also identified that learners valued SBE activities in group- or team-based social environments over isolated deliberate practice.ConclusionsSBE is most effective when designed as a comprehensive programme aligned to the curriculum. Programmes incorporating both group-based and isolated SBE activities promote deliberate practice. Distributed leadership amongst faculty attracts wide engagement integral to SBE programme implementation, while iterative programme refinement through regular evaluation and action on feedback encourages integration into practice. The knowledge contributed by critically analysing SBE programme implementation processes can support development of much needed guidance in this area.

What Can Therapists Learn from Coding Therapy Sessions? Interviewing Clinicians to Explore the Case of Innovative Moments Training

This qualitative study explored eight therapists’ perceptions about how training and research into the Innovative Moment Coding System (IMCS) has influenced their clinical practice. Participants, that worked both as researchers and therapists, were interviewed using a semi-structured script written for the current study. The interviews explored whether or not coding psychotherapy sessions (participants’ research experience with innovative moments; IMs) had impacted their clinical practice. A descriptive–interpretative qualitative approach was used to analyze the video recordings of the interviews. Four themes identified the effects of coding therapy sessions with IMs in therapists’ clinical practice: (1) increasing attention to clients’ change instances, (2) noticing clients’ development, (3) implementing strategies inspired by the IM model, and (4) identifying hindering situations. Results suggested that coding therapy sessions appears to bring benefits to practice, regardless of the participant’s theoretical orientation. We discuss how coding sessions may bring subtle but valuable additions to therapists’ everyday practice offering better attunement to clients’ micro-processes of change. In particular, IMCS categorization of such processes could present a useful form of feedback for therapist’s interventions or deliberate practice, further developing therapists’ sensitivity to the interplay between change and problem narratives (called double listening).