How Doctors Think and Learn
This book describes the theoretical basis for the acquisition; development and refining of professional medical skills from entry level into professional training to those developing specialist expertise. Chapters review the presently available literature
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How Doctors Think and Learn
Derek Burke
How Doctors Think and Learn
Derek Burke Head of Clinical Governance and General Medical Council Suitable Person Gibraltar Health Authority St Bernard’s Hospital Gibraltar Gibraltar
ISBN 978-3-030-46278-9 ISBN 978-3-030-46279-6 (eBook) https://doi.org/10.1007/978-3-030-46279-6 © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
To my mother and father who taught me the value of learning To my wife who, with good humour year on year, accepted my assurance that it was “nearly there”.
Preface
When I graduated from medical school in 1983, medicine was a science based craft acquired through apprenticeship. There was no formal system of competency-based training or assessment. Skills were acquired on the basis of “see one, do one, teach one”. At the end of higher specialist training, a system of accreditation determined successful completion of training. There was no system of appraisal or annual review. Since then, medical training has become highly structured and comprehensively assessed. Achieving competence is now seen as the measure of medical attainment. But competence was not a term which would have been in general use in medical practice in 1983. The graph below shows a plot of Medline citations for the term "clinical competence” for the period 1980–2018 (the last full year of citations available). From reviewing that graph and from my own personal experience of training and practising in that period, I have set the start date for competency-based medical practice in the UK as 1990. Clinical Competence C
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