cognitive psychological views on expertise development; a review els boshuizen educational...
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Cognitive psychological views on expertise
development; a reviewEls Boshuizen
Educational Technology Expertise CentreOunl
Heerlen
Maastricht University, Open University, Erasmus University RotterdamHenk Schmidt, Els Boshuizen, Pie Hobus, Metta Hofstra, Eugène Custers, Margje van de Wiel, Rina Vaatstra, Remy Rikers, Jos Arts, Ilse van Eekelen, Agnes Wagenaar, Fleurie Nievelstein, and moreIn cooperation with Geoff Norman, Vimla Patel, Paul Feltovich, et al.
Cognitive psychological views on professional
expertise development; a review
Professions, professionals and professional expertisel How professions develop
l Developments in the profession, work place and society
l How professionals do their workl ‘Disciplined’ by the peer group and lawl Features of the workplacel Whole group (variability)
l How they become good at it (or not)l How education is/should be organisedl Tensions between individual goals and
professional claims
Difference with Deliberate Practice tradition
l Teaching for the profession has been starting point, not excellent performance
l But we do use performance indicators and criteria
Cognitive psychological approach
Cognitive psychological theory on expertise developmentl ‘Stage’ theory
l Knowledge increase, validation and integrationl Knowledge encapsulationl (Illness) script formationl Episodes
l l Reasoning and decision makingl Performance
Exper-tise level
Knowledge structure
Change process
Problem solving based on
Cognitive control required in clinical reasoning
Demand on cognitive capacity
Novice
Networks (incomplete and loosely linked)
Knowledge accretion, integration and validation
Long chains of detailed reasoning steps through networks
Active monitoring of each reasoning step
High
Inter-media-te
Networks (tightly linked and integrated)
Encapsulation
Reasoning through encapsulated network; abbreviated
Active monitoring of each reasoning step
Medium
Expert Illness scripts Illness script formation
Illness script activation and instantiation
Monitoring of the level of script instantiation
Low
Memory traces of previous cases
Instantiated scripts
Automatic reminding
Check relevance
Low
What is not described?
l Learning processes undertakenl How people organise these learning
processesl How the excellent differ from the rest
(although)
four studiesl Jos Arts (management)l Margje van de Wiel (medicine)l Agnes Wagenaar (clinical psychology)l Fleurie Nievelstein (private law)
Jos Arts
0,0
1,0
2,0
3,0
4,0
5,0
6,0
novices 1 st yrstudents
2 nd yrstudents
3 rd yrstudents
4 th yrstudents
2 yr exp 5 yr exp 12.5 yr exp
25 yr exp
expertise level
qu
alit
y o
f so
luti
on
university
workplace
Subdivided into:
0
0,5
1
1,5
2
2,5
Novices 1st yr
Stud
2nd yr
Stud
3rd yr
Stud
4th yr
Stud
2 yr
Experts
5th yr
Experts
12? yr
Experts
25 yr
Experts
Level of expertise
Mean number of case solutions
Correct
Partially
Incorrect
Van de Wiel study
l Micro-proceses of knowledge encapsulation
l Multiple cases multiple disease processes
Diagnostic accuracy
Case order
987654321
10
9
8
7
6
5
4
3
2
Case type
Kidney failure
Liver cirrhosis
Heart failure
Fillers
Processing time
Case order
987654321
900
800
700
600
500
400
Case type
Kidney failure
Liver cirrhosis
Heart failure
Fillers
Number of words in protocols
Case order
987654321
1300
1200
1100
1000
900
800
700
600
500
Case type
Kidney failure
Liver cirrhosis
Heart failure
Fillers
Further analysis onl Kind cognitive of activityl Nature and quality of knowledge usedl Metacognitive remarks on status of
knowledge l --> Conclusion faster, but not better
diagnosis and decrease in elaborate and detailed (biomedical) reasoning
l Very detailed analysis of selected protocols on how these lines of reasoning developed over time
Agnes Wagenaar
l Knowledge in actionl Video-stimulated post hoc think aloud
protocols
Knowledge in action
0
10
20
30
40
50
60
70
students interns post graduates experts
expertise level
avera
ge n
um
ber
of
thoughts
experience with patients
patient relationcountertransferenceinterview skillstime/interview structuretime management
hypothesis evaluation
history taking in relation with hypothesis
hypothesis formulation
Additional studies on
•Learning from experience
•Stress, coping and learning
Nievelstein
l Knowledge structure and reasoningl Encapsulations/intermediary conceptsl Ontological changel Reasoning style (adversarial reasoning)
Difference with Deliberate Practice tradition
l Focus on development of knowledge structures and reasoning
l With the aim of improving educationl How plus how well tasks are
performedl No differentiation within groups so far
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