Preparing Future Adaptive Experts: Why It Matters and How It Can Be Done
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MEETING REPORT
Preparing Future Adaptive Experts: Why It Matters and How It Can Be Done Maria Mylopoulos 1 Accepted: 21 September 2020 # International Association of Medical Science Educators 2020
In order to meet the evolving healthcare needs of today’s society, health professionals must have the capacity to handle situations involving novelty, ambiguity, and complexity. However, traditional approaches to health professions education (HPE) tend to emphasize the acquisition and assessment of isolated knowledge and skills as the gold standard. As a result, learners are often unprepared to for the realities of clinical work. This growing gap between what society needs experts to do and the training experts typically receive has resulted in the urgent need for a shift in the pedagogical focus of HPE. “Adaptive expertise” is an emerging model of expertise in health professions education that directly addresses the challenge of preparing learners for an unknown future [1, 2]. Models of adaptive expertise emphasize the reproduction of effective performance where applicable (efficiency), alongside the capability to “to learn new information, to use resources effectively and innovatively, and to invent new strategies for learning and problem solving in practice” (innovation) [3–5]. The latter capability is defined as “preparation for future learning” (PFL) and is the focus of pedagogical models that emphasize development of adaptive expertise [6, 7]. Critically, education for adaptive expertise requires developing both the efficiency and innovation dimensions of expert practice. This ensures that students acquire procedural fluency, i.e., reproducing effective solutions, as well as conceptual understanding, i.e., knowing the rationale and mechanisms for an action or decision. Adaptive experts are then able to draw on both procedural and conceptual knowledge in their problem solving as needed. This frees the expert from being tied to a single solution in novel or complex situations, as they are able to maintain the rationale but change the action when necessary[3–5]. Educational interventions that have been * Maria Mylopoulos [email protected] 1
Faculty of Medicine, The Wilson Centre, University of Toronto, Toronto, Ontario, Canada
shown to develop adaptive expertise include the use of productive failure [8–10], contrasting cases [11] and guided discovery [4]. Extensive evidence across the continuum of education has demonstrated that students who receive these forms of instruction perform significantly better on PFL outcome measures (i.e., assessments that require new learning) with no accompanying detriment to performance on more traditional tests of acquisition and application. Adding to the evidence base for educational interventions in HPE that support the development of adaptive expertise is research exploring the impact of “integrated instruction” on PFL assessments. Integrated instruction is an instructional design framework for diagnostic reasoning that encompasses any pedagogical tool/approach that e
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