The role of deliberate practice in the acquisition of clinical skills.
The role of deliberate practice in the acquisition of clinical skills.
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DOI：
10.1186/1472-6920-11-101
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发表时间：
2011-12-06
影响因子：
3.6
通讯作者：
Scherpbier AJ
中科院分区：
文献类型：
--
作者：
Duvivier RJ;van Dalen J;Muijtjens AM;Moulaert VR;van der Vleuten CP;Scherpbier AJ
针对临床前技能培训，研究了刻意练习在医学生从新手到专家发展过程中的作用。
1 - 3年级的学生完成了34个利克特式项目，这些项目改编自一份关于在认知学习中使用刻意练习的调查问卷。通过探索性因素分析和信度分析对问卷进行了验证。方差分析检验了不同年级之间的差异，回归分析则研究了刻意练习与技能测试结果之间的关系。
875名学生参与了研究（占比90%）。因素分析得出四个因素：规划、专注/投入、重复/复习、学习风格/自我反思。学生在“规划”方面的得分随时间推移而增加，在“重复/复习”子量表上的得分则下降。在临床技能测试中，1年级和3年级学生的测试结果与“规划”和“专注/投入”子量表的得分呈正相关，1年级学生的测试结果还与“重复/复习”子量表的得分呈正相关。
对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，而具有代表性的大样本则是一个优势。重复/复习的效果消失可能是由于反馈不足。刻意练习提倡持续练习以解决通过（自我）评估确定的弱点，并由反馈激发。进一步的研究应采用纵向前瞻性设计，并将范围扩大到住院医师期间及之后的专业技能发展。
The role of deliberate practice in medical students' development from novice to expert was examined for preclinical skill training. 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. 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. 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.