자연주의적 탐구조사(Naturalistic Inquiry)

The theory of affordances

Theory in Practice: Increasing Professional Effectiveness

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Cognition In The Wild

This is the first handbook where the world’s foremost “experts on expertise” review our scientific knowledge on expertise and expert performance and how experts may differ from non-experts in terms of their development, training, reasoning, knowledge, social support, and innate talent. Methods are described for the study of experts’ knowledge and their performance of representative tasks from their domain of expertise. The development of expertise is also studied by retrospective interviews and the daily lives of experts are studied with diaries. In 15 major domains of expertise, the leading researchers summarize our knowledge of the structure and acquisition of expert skill and knowledge and discuss future prospects. General issues that cut across most domains are reviewed in chapters on various aspects of expertise, such as general and practical intelligence, differences in brain activity, self-regulated learning, deliberate practice, aging, knowledge management, and creativity.

The Cambridge Handbook of Expertise and Expert Performance

The flipped classroom is a relatively new approach to undergraduate teaching in science. This approach repurposes class time to focus on application and discussion; the acquisition of basic concepts and principles is done on the students' own time before class. While current flipped classroom research has focused on student preferences and comparative learning outcomes, there remains a lack of understanding regarding its impact on students' approaches to learning. Focusing on a new flipped classroom-based course for basic medical sciences students, the purpose of the present study was to evaluate students' adjustments to the flipped classroom, their time on task compared with traditional lectures, and their deep and active learning strategies. Students in this course worked through interactive online learning modules before in-class sessions. Class time focused on knowledge application of online learning module content through active learning methods. Students completed surveys and optional prequiz questions throughout the term to provide data regarding their learning approaches. Our results showed that the majority of students completed their prework in one sitting just before class. Students reported performing less multitasking behavior in the flipped classroom compared with lecture-based courses. Students valued opportunities for peer-peer and peer-instructor interactions and also valued having multiple modes of assessment. Overall, this work suggests that there is the potential for greater educational gains from the flipped classroom than the modest improvements in grades previously demonstrated in the literature; in this implementation of the flipped classroom, students reported that they developed independent learning strategies, spent more time on task, and engaged in deep and active learning.

Flipped Classrooms and Student Learning: Not Just Surface Gains.

Background
Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the two phenomena.

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Measuring Resident Well-Being: Impostorism and Burnout Syndrome in Residency

OBJECTIVE: To determine the referral practices, perceived usefulness, knowledge, prior training and desire for training of general practitioners (GPs) in Quebec with regard to complementary health care services such as acupuncture, chiropractic and hypnosis. DESIGN: Cross-sectional mail survey. SETTING: Province of Quebec. PARTICIPANTS: Random sample of 200 GPs. Of the 146 who responded, 25 were excluded because they were no longer in practice; this left 121 (83%). OUTCOME MEASURES: Self-reported referral practices for complementary health care services, perceived usefulness and self-assessed knowledge of such services, and prior training and desire for training in these services. RESULTS: Sixty percent (72/121) of the GPs knew at least one practitioner of a complementary health care service for referral; 59% (70/119) reported referring patients to physicians who practise such services and 68% (80/118) to nonmedical practitioners. At least one of the three services studied were regarded as having some use by 83% (101/121). Overall, self-reported knowledge was poor: the proportions of GPs who reported knowing a lot about acupuncture, chiropractic and hypnosis were 11% (13/121), 10% (12/121) and 8% (10/121) respectively. Prior training was also lacking: only 8% (9/118) of the GPs had received previous training in acupuncture, 2% (2/111) in chiropractic and 3% (3/103) in hypnosis. In all, 48% (57/118) indicated that they would like further training in at least one of the services studied, and 13% (16/121) indicated that they currently provided one service. CONCLUSIONS: Referral of patients by GPs to practitioners of complementary health care services is common in Quebec. Although self-assessed knowledge about such services is relatively poor, interest in learning more about them is high. These findings identify a demand for future educational initiatives.

Complementary health care services: a survey of general practitioners' views

Background In-training evaluation reports (ITERs) often fall short of their goals of promoting resident learning and development. Efforts to address this problem through faculty development and assessment-instrument modification have been disappointing. The authors explored residents' experiences and perceptions of the ITER process to gain insight into why the process succeeds or fails. Method Using a grounded theory approach, semistructured interviews were conducted with 20 residents. Constant comparative analysis for emergent themes was conducted. Results All residents identified aspects of "engagement" in the ITER process as the dominant influence on the success of ITERs. Both external (evaluator-driven, such as evaluator credibility) and internal (resident-driven, such as self-assessment) influences on engagement were elaborated. When engagement was lacking, residents viewed the ITER process as inauthentic. Conclusions Engagement is a critical factor to consider when seeking to improve ITER use. Our articulation of external and internal influences on engagement provides a starting point for targeted interventions.

Rules of engagement: residents' perceptions of the in-training evaluation process.

OBJECTIVES Although lack of time has been frequently cited as a barrier to scholarship, there has been little inquiry into what specific factors medical faculty staff perceive as contributing to this dilemma. The purpose of the present study was to explore, in greater detail, lack of time as a barrier for faculty interested in pursuing education scholarship. METHODS In 2004, as part of a cross-sectional, mixed-methods needs assessment, 73 (67.6%) medical faculty completed a questionnaire probing areas related to education scholarship. Additionally, one year later, 16 respondents (60% of those invited) each participated in one of three focus groups. RESULTS Despite their interest and regardless of their background training in education, faculty were able, on average, to devote only negligible amounts of time to education scholarship. The most commonly reported barrier to these pursuits was lack of protected time. Further analysis revealed that the time-related factor appeared to involve three themes: fragmentation (where opportunities to work on education projects are sporadic); prioritisation (where work responsibilities including after-hours work and administrative workload complete for time, and where there is difficulty in securing financially remunerated time), and motivation (where the degree of recognition and support for education work by both the department and colleagues is limited). CONCLUSIONS With respect to education scholarship, the dilemma caused by lack of time involves a complex, multi-faceted set of issues which extends beyond the number of hours available in a day. Personal interest and having background training in education do not appear to be sufficient to encourage involvement. Multiple institutional support mechanisms are necessary.

Mark Goldszmidt

Papers

Flipped Classrooms and Student Learning: Not Just Surface Gains.

Measuring Resident Well-Being: Impostorism and Burnout Syndrome in Residency

Complementary health care services: a survey of general practitioners' views

Rules of engagement: residents' perceptions of the in-training evaluation process.

'I don't have time': issues of fragmentation, prioritisation and motivation for education scholarship among medical faculty.