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A better understanding of the factors influencing medical team performance and accounting for expert medical team performance should benefit medical practice. Therefore, the aim here is to highlight key issues with using deliberate practice to improve medical team performance, especially given the success of deliberate practice for developing individual expert performance in medicine and other domains. Highlighting these issues will inform the development of training for medical teams. The authors first describe team coordination and its critical role in medical teams. Presented next are the cognitive mechanisms that allow expert performers to accurately interpret the current situation via the creation of an accurate mental “model” of the current situation, known as a situation model. Following this, the authors propose that effective team performance depends at least in part on team members having similar models of the situation, known as a shared situation model. The authors then propose guiding principles for implementing team deliberate practice in medicine and describe how team deliberate practice can be used in an attempt to reduce barriers inherent in medical teams to the development of shared situation models. The paper concludes with considerations of limitations, and future research directions, concerning the implementation of team deliberate practice within medicine.

Documentation of the acquisition of surgical skills is mandated during and after training. Assessment-driven feedback interspersed during Fundamentals of Laparoscopic Surgery (FLS) training is expected to improve the quality of practice and increase skill acquisition. But the direct observation of FLS task performance by experts required to form this feedback is not feasible because of staffing and cost limits. Video recordings can reproduce a display of FLS task performance identical to the original camera view and can provide the critical observations needed for FLS assessment. We report the design and operation of an automated system for the capture of digital video clips of all FLS practice trials and for the support of remote, distributed assessments. Advantages included permanent documentation of performance, quality controlled assessment by non-Medical Doctor personnel, accurate quantification of practice frequency, and emergence of new observations on patterns of intermediate skill development. The completeness and accuracy of the dataset support analyses of group learning rates and lay the foundation for scientific training curriculum development. We conclude that video documentation of FLS training is feasible and worthwhile.

Leveraging a scientific infrastructure for exploring how students learn, we have developed cognitive and statistical models of skill acquisition and used them to understand fundamental similarities and differences across learners. Our primary question was why do some students learn faster than others? Or, do they? We model data from student performance on groups of tasks that assess the same skill component and that provide follow-up instruction on student errors. Our models estimate, for both students and skills, initial correctness and learning rate, that is, the increase in correctness after each practice opportunity. We applied our models to 1.3 million observations across 27 datasets of student interactions with online practice systems in the context of elementary to college courses in math, science, and language. Despite the availability of up-front verbal instruction, like lectures and readings, students demonstrate modest initial prepractice performance, at about 65% accuracy. Despite being in the same course, students’ initial performance varies substantially from about 55% correct for those in the lower half to 75% for those in the upper half. In contrast, and much to our surprise, we found students to be astonishingly similar in estimated learning rate, typically increasing by about 0.1 log odds or 2.5% in accuracy per opportunity. These findings pose a challenge for theories of learning to explain the odd combination of large variation in student initial performance and striking regularity in student learning rate.

More than 20 years ago, researchers proposed that individual differences in performance in such domains as music, sports, and games largely reflect individual differences in amount of deliberate practice, which was defined as engagement in structured activities created specifically to improve performance in a domain. This view is a frequent topic of popular-science writing—but is it supported by empirical evidence? To answer this question, we conducted a meta-analysis covering all major domains in which deliberate practice has been investigated. We found that deliberate practice explained 26% of the variance in performance for games, 21% for music, 18% for sports, 4% for education, and less than 1% for professions. We conclude that deliberate practice is important, but not as important as has been argued.

Why are some people more skilled in complex domains than other people? According to one prominent view, individual differences in performance largely reflect individual differences in accumulated amount of deliberate practice. Here, we investigated the relationship between deliberate practice and performance in sports. Overall, deliberate practice accounted for 18% of the variance in sports performance. However, the contribution differed depending on skill level. Most important, deliberate practice accounted for only 1% of the variance in performance among elite-level performers. This finding is inconsistent with the claim that deliberate practice accounts for performance differences even among elite performers. Another major finding was that athletes who reached a high level of skill did not begin their sport earlier in childhood than lower skill athletes. This finding challenges the notion that higher skill performers tend to start in a sport at a younger age than lower skill performers. We conclude that to understand the underpinnings of expertise, researchers must investigate contributions of a broad range of factors, taking into account findings from diverse subdisciplines of psychology (e.g., cognitive psychology, personality psychology) and interdisciplinary areas of research (e.g., sports science).

The teaching of procedural skills required for clinical practice remains an ongoing challenge in healthcare education. Health professionals must be competent to perform a wide range of clinical skills, and are also regularly required to teach these clinical skills to their peers, junior staff, and students. Teaching of procedural skills through the use of frameworks, observation and provision of feedback, with opportunities for repeated practice assists in the learners’ acquisition and retention of skills. With a focus on the teaching of non-complex skills, this paper explores how skills are learned; ways to improve skill performance; determining competency; and the provision of effective feedback.

New information pertinent to organizational decision making, even when publicly available, may not diffuse rapidly in the form of adoption and transformation of organizational practices. In this study, we examine how different markers of expertise, each representative of human capital at both individual and organizational levels, moderates the speed of response to new information. We do so in the context of medical device utilization, viz. stents, for the treatment of stable coronary arterial disease by physicians practicing in hospitals. Results show that physicians possessing specialized expertise developed through deliberate practice adopt new guidelines significantly faster, as compared with physicians endowed with general expertise reflected in elite schooling or tenure. Furthermore, we observe significant spillovers within organizations from expertise gained through deliberate practice, indicating that physicians with expertise markers associated with deliberate practice are able to act as influential agents and help diffuse new practices within the organization. Our study thus extends the literature on both information diffusion and expertise by providing quantitative and qualitative evidence of the mechanisms at play in the adoption of new best practices. The online appendix is available at https://doi.org/10.1287/orsc.2018.1246 .

Background Adequate clinical skills training is a challenge for present day medical education. Simulation Based Education (SBE) is playing an increasingly important role in healthcare education worldwide to teach invasive procedures. The impact of this teaching on students along with retention of what is taught is not fully understood. The purpose of this study was to evaluate the retention levels of practical skills taught and assessed by SBE and to explore the degree of re-training required to restore decayed performance. In exploring this aim, the study further investigates how skilled performance decays over time and which dimensions of clinical skills were more likely to decay. Methods Study participants were 51 final year medical students. They were provided with online pre-course videos and procedural guides asynchronously with repeatedly access. 7 of the skills taught over 2 years using task trainers were selected. Following demonstration from faculty, students practiced in small groups with faculty facilitated supervision and peer support prior to formal testing. Score sheets with itemised procedure checklists detailing the minimum passing standard (MPS) for each skill were designed. To test retention of skills, 18 months later, there was an unannounced test to demonstrate proficiency in the skills. Students were asked to complete a questionnaire indicating how many times and where they had practiced or performed the skills. Results 55% of the students were deficient in 3 or more skills and 4% were not competent in 5 or more skills. A significant number of students had never practiced some skills following the initial teaching session. A relationship was noted with the number of times students self-declared that they had practiced and their performance. Decay is evident in both psychomotor and cognitive domains of the skills. Conclusion A curriculum with deliberate practice significantly increases the competence of students in defined clinical skills. Deliberate practice of clinical skills, under supervision of an engaged instructor, is a key component of the mastery model. Experiences and assessments in the clinical setting need to be augmented with focus on direct observation and focused feedback to reinforce the skills acquired in the simulated setting.

Education for sustainable development has been regarded as a lifelong learning process and an integral part of quality education. To this end, this study aims to examine the implementation of online learning communities and deliberate practice in a blended learning context, to improve English as a foreign language (EFL) students’ learning performance and engagement. Specifically, in addition to the traditional offline courses, the online film clip watching and writing tasks were adopted to ascertain the role of deliberate practice and the dimensions of the community of inquiry (COI) framework were adopted to examine the perceived effectiveness and improved performance. A quantitative study was carried out, involving 67 undergraduate freshman English course students from one university at northeastern Taiwan. The findings of this study indicate that there is statistically significant correlation between the three dimensions of community of inquiry, perceived learning and learning engagement. Moreover, teaching and cognitive presence are more predictive of students’ perceived learning. Finally, this study also illustrates practical implications, to facilitate students’ learning for sustainable development competency in blended learning contexts.