Centre for Advancing Collaborative Healthcare and Education, University of Toronto, Toronto, Canada.
Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.
Adv Health Sci Educ Theory Pract. 2022 Dec;27(5):1265-1281. doi: 10.1007/s10459-022-10178-8. Epub 2022 Nov 9.
Adaptive expertise (AE) and reflective practice (RP), two influential and resonant theories of professional expertise and practice in their own right, may further benefit health professions education if carefully combined. The current societal and systemic context is primed for both AE and RP. Both bodies of work position practitioners as agentive, learning continually and thoughtfully throughout their careers, particularly in order to manage unprecedented situations well. Similar on the surface, the roots and practices of AE and RP diverge at key junctures and we will focus on RP's movement toward critically reflective practice. The roots of AE and RP, and how they relate to or diverge from present-day applications matter because in health professions education, as in all education, paradigmatic mixing should be undertaken purposefully. This paper will explore the need for AE and RP, their shared commitments, distinctive histories, pedagogical possibilities both individually and combined, and next steps for maximizing their potential to positively impact the field. We argue that this exploration is urgently needed because both AE and RP hold much promise for improving health care and yet employing them optimally-whether alone or together-requires understanding and intent. We build an interprofessional education case situated in long-term care, throughout the paper, to demonstrate the potential that AE and RP might offer to health professions education individually and combined. This exploration comes just in time. Within the realities of uncertain practice emphasized by the pandemic, practitioners were also called to act in response to complex and urgent social movements. A combined AE and RP approach, with focus on critically reflective practice in particular, would potentially prepare professionals to respond effectively, compassionately, and equitably to future health and social crises and challenges.
适应专长 (AE) 和反思性实践 (RP) 是两个具有影响力和共鸣的专业专长和实践理论，如果能谨慎结合，可能会进一步有益于健康专业教育。当前的社会和系统环境为 AE 和 RP 提供了条件。这两个理论都将从业者定位为有能动性的个体，在整个职业生涯中不断地、深思熟虑地学习，特别是为了更好地应对前所未有的情况。表面上看，AE 和 RP 有相似之处，但它们的根源和实践在关键节点上存在分歧，我们将重点关注 RP 向批判性反思实践的转变。AE 和 RP 的根源，以及它们与当今应用的关系或分歧为何重要，原因在于在健康专业教育中，就像在所有教育中一样，范式混合应该有目的地进行。本文将探讨 AE 和 RP 的必要性、它们的共同承诺、独特的历史、单独和结合使用的教学可能性，以及最大限度地发挥它们的潜力以积极影响该领域的下一步措施。我们认为，这种探索是紧迫需要的，因为 AE 和 RP 都有很大的潜力来改善医疗保健，但要想充分利用它们——无论是单独使用还是一起使用——都需要理解和意图。我们在整篇论文中构建了一个以长期护理为背景的跨专业教育案例，以展示 AE 和 RP 单独和结合使用时可能为健康专业教育带来的潜力。这种探索恰逢其时。在大流行所强调的不确定实践的现实中，从业者也被要求针对复杂而紧迫的社会运动采取行动。AE 和 RP 的结合方法，特别是对批判性反思实践的关注，有可能使专业人员为未来的健康和社会危机和挑战做好有效、富有同情心和公平的应对准备。
