Expertise in clinical pathology: combining the visual and cognitive perspective
Expertise in clinical pathology: combining the visual and cognitive perspective
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DOI：
10.1007/s10459-015-9589-x
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发表时间：
2015-10-01
影响因子：
4
通讯作者：
Boshuizen, Henny P. A.
中科院分区：
文献类型：
--
作者：
Jaarsma, Thomas;Jarodzka, Halszka;Boshuizen, Henny P. A.
医学领域的专业知识研究通常集中在视觉或认知方面的专业知识。因此，专家行为的特征通常被描述为认知能力或视觉能力。本研究着重于这两个方面的专业知识，并分析他们沿着三个总体结构：（1）认证，（2）效率，（3）假设检验。这项研究是在执行真实任务的临床病理学家中进行的：诊断显微镜载玻片。参与者包括13名临床病理学家（专家），12名病理学居民（中间体）和13名医学生（新手）。他们都在虚拟显微镜下诊断了七个病例，并对他们的诊断进行了事后解释。收集的数据包括眼球运动，显微镜导航和口头协议。结果显示，专家们使用较低的放大倍数，并将他们的发现描述为诊断。此外，他们的诊断路径更有效，包括更少的显微镜运动和更短的推理链。专家们在诊断过程中较晚才进入相关领域，访问的地区较少。中间人使用相对较高的放大倍数，并根据特定的异常进行诊断。此外，他们花了更长的时间来达到他们的诊断和检查更多的相关领域。初学者会详细地搜索，通过他们的外表描述发现，并说出长长的推理链。这些结果表明，总体结构可以公正地确定：在视觉和认知方面的专业知识，是显而易见的。
Expertise studies in the medical domain often focus on either visual or cognitive aspects of expertise. As a result, characteristics of expert behaviour are often described as either cognitive or visual abilities. This study focuses on both aspects of expertise and analyses them along three overarching constructs: (1) encapsulations, (2) efficiency, and (3) hypothesis testing. This study was carried out among clinical pathologists performing an authentic task: diagnosing microscopic slides. Participants were 13 clinical pathologists (experts), 12 residents in pathology (intermediates), and 13 medical students (novices). They all diagnosed seven cases in a virtual microscope and gave post hoc explanations for their diagnoses. The collected data included eye movements, microscope navigation, and verbal protocols. Results showed that experts used lower magnifications and verbalized their findings as diagnoses. Also, their diagnostic paths were more efficient, including fewer microscope movements and shorter reasoning chains. Experts entered relevant areas later in their diagnostic process, and visited fewer of them. Intermediates used relatively high magnifications and based their diagnoses on specific abnormalities. Also, they took longer to reach their diagnosis and checked more relevant areas. Novices searched in detail, described findings by their appearances, and uttered long reasoning chains. These results indicate that overarching constructs can justly be identified: encapsulations and efficiency are apparent in both visual and cognitive aspects of expertise.