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刻意练习在临床技能获取中的作用。

The role of deliberate practice in the acquisition of clinical skills.

机构信息

Skillslab, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

出版信息

BMC Med Educ. 2011 Dec 6;11:101. doi: 10.1186/1472-6920-11-101.

Abstract

BACKGROUND

The role of deliberate practice in medical students' development from novice to expert was examined for preclinical skill training.

METHODS

Students in years 1-3 completed 34 Likert type items, adapted from a questionnaire about the use of deliberate practice in cognitive learning. Exploratory factor analysis and reliability analysis were used to validate the questionnaire. Analysis of variance examined differences between years and regression analysis the relationship between deliberate practice and skill test results.

RESULTS

875 students participated (90%). Factor analysis yielded four factors: planning, concentration/dedication, repetition/revision, study style/self reflection. Student scores on 'Planning' increased over time, score on sub-scale 'repetition/revision' decreased. Student results on the clinical skill test correlated positively with scores on subscales 'planning' and 'concentration/dedication' in years 1 and 3, and with scores on subscale 'repetition/revision' in year 1.

CONCLUSIONS

The positive effects on test results suggest that the role of deliberate practice in medical education merits further study. The cross-sectional design is a limitation, the large representative sample a strength of the study. The vanishing effect of repetition/revision may be attributable to inadequate feedback. Deliberate practice advocates sustained practice to address weaknesses, identified by (self-)assessment and stimulated by feedback. Further studies should use a longitudinal prospective design and extend the scope to expertise development during residency and beyond.

摘要

背景

本研究旨在探讨刻意练习在医学生从新手成长为专家的过程中对基础临床技能训练的作用。

方法

1-3 年级的学生完成了 34 项李克特量表项目,这些项目改编自关于认知学习中刻意练习使用的问卷。使用探索性因子分析和可靠性分析来验证问卷的有效性。方差分析用于检验不同年级之间的差异,回归分析用于检验刻意练习与技能测试结果之间的关系。

结果

875 名学生参与了研究(90%)。因子分析得出了四个因素:计划、专注/投入、重复/修订、学习风格/自我反思。学生的“计划”得分随着时间的推移而增加,“重复/修订”子量表的得分下降。学生的临床技能测试成绩与第 1 年和第 3 年“计划”和“专注/投入”子量表的得分呈正相关,与第 1 年“重复/修订”子量表的得分呈负相关。

结论

测试结果的积极影响表明,刻意练习在医学教育中的作用值得进一步研究。横断面设计是本研究的一个局限性,而大型代表性样本是本研究的一个优势。重复/修订效果的消失可能归因于反馈不足。刻意练习提倡持续练习,以解决由(自我)评估确定的弱点,并通过反馈来激发练习。进一步的研究应该采用纵向前瞻性设计,并将范围扩展到住院医师培训及以后的专业发展。

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