Re-examining the integration of routine and adaptive expertise: there is no such thing as routine from a motor control perspective

Measuring adaptive expertise and adaptive performance in (becoming) healthcare professionals: a scoping review of measurement instruments

Professional work in healthcare is increasingly disruptive, requiring professionals to be flexible and adaptable. Research on adaptive expertise and adaptive performance in healthcare has grown, and operationalisation and measurement of these concepts are crucial to meet professionals' evolving needs. This study provides an overview of measurement instruments for adaptive expertise and adaptive performance in (becoming) healthcare professionals, including an evaluation of their operationalisations and the amount of evidence supporting their quality. A scoping review was conducted, including an analysis of operationalisations and the amount of evidence supporting the quality of instruments, based on the criteria outlined in the Standards for Educational and Psychological Testing (2014). Seventeen articles were included, comprising nineteen measurement instruments, three of which were specifically developed for the healthcare domain. The instruments, categorized into six types, varied in the nature and volume of evidence supporting their quality. Analysis of the operationalisations led to a clearer understanding of the concepts, with themes emerging around adaptive expertise and adaptive performance. The study reveals a dominance of self-evaluation and job requirement instruments, while other methods, such as design scenarios, mixed-methods instruments, and collegial verbalization, are underrepresented. Instruments developed specifically for healthcare need further validation and reliability testing. The categorization of subscales into 13 themes provides further clarification of the concepts and suggestions for future research. Instruments to measure adaptive expertise and adaptive performance are limited and vary in conceptualisation, operationalisation and quality. Further research is needed to improve the validity and reliability of healthcare-specific instruments.

Training technical or non-technical skills: an arbitrary distinction? A scoping review

INTRODUCTION

Medical education often aims to improve either technical skills (TS) or 'non-technical skills' (NTS) and how these skills influence adverse events and patient safety. The two skill sets are often investigated independently, and little is known about how TS and NTS influence each other. In this scoping review, we therefore aim to investigate the association between TS and NTS.

METHOD

We conducted a scoping review of four databases in order to summarize, analyse, and collate findings from the included studies.

RESULTS

In total, 203 of 2676 identified studies were included in the final analysis. The first study was published in 1991, but the majority of studies were published in the last decade. The majority were intervention studies including 41 randomized controlled trials. The the objective structured assessment of technical skills (OSATS) was the most common assessment tool with strong validity evidence within TS, but many variations without validity evidence were used. Conversely, Non-Technical Skills for Surgeons (NOTSS) was the most used tool with strong validity evidence for assessing NTS. However, the majority of studies used non-validated self-assessment tools to investigate NTS. The correlation between TS and NTS was assessed in 46 of 203 studies, whereof 40 found a positive correlation.

DISCUSSION

Our findings echo previous literature suggesting that empirical literature investigating the interaction between TS and NTS lack methodological depth. In this review only a minority of the identified studies (n = 46) investigated this correlation. However, the results strongly indicate a correlation between TS and NTS skills, suggesting that physicians who are proficient in their NTS, also perform well on their TS. Thus, the distinction between them in learning designs may seem arbitrary. While this result is promising, the limited methodological rigour indicates a lack of proper understanding of NTS and how to properly assess them.

On a Corresponsive Sport Science

In our societally extractive age, sport science risks being swept up in the intensifying desire to commodify the experiences of those that scientists proclaim to study. Coupled with the techno-digital revolution, this stems from a vertical (onto)logic that frames the sporting landscape as a static space filled with discrete objects waiting for us to capture, analyse, re-present and sell on as knowledge. Not only does this commodification degrade primary experience in the false hope of epistemological objectivity, it reinforces the unidirectionality of extractivism by setting inquirer apart from, and above of, inquiry. Here, we advocate for a different, more sentient logic grounded in the relationality of gifting as understood in indigenous philosophies. This foregrounds an ecological orientation to scholarship that sets out neither to objectify or describe that which is of concern, but to correspond with its becoming. On this, there are three threads we cast forward. First, in a corresponsive sport science, inhabitants are not objects of analysis, but lines in-becoming, who in answering to others, form knots in a meshwork. These knots constitute communal places in which inhabitants have joined with the differentiating coming-into-being of others. Second, knowledge is not authoritatively (re)cognitive, but humbly ecological; not produced vertically through imposition, but grown longitudinally in responsively moving from place to place. Third, research does not follow a vertically extractive (onto)logic, but is a practice of participant observation. This perspective appreciates that we, sport scientists, are also lines in-becoming that form parts of the knots in which we seek to know. In coda, our thesis is not a call for more qualitative or applied research in the sport sciences. It is a call to response-ably open up to that which sparks our curiosity, answering to what is shared with care, sensitivity and sincerity.

The imperative for (and opportunities of) research on adaptive expertise in health professions education

In this editorial, three Advances in Health Sciences Education editors argue for the importance and impact of adaptive expertise on the future of health professions education and work. They present a sample of the broad range of theory-informed research currently contributing to understanding and applying adaptive expertise in health professions education. They reflect on the unique opportunities that interdisciplinarity offers this endeavour. Finally they offer potential ways forward for continued efforts to advance collective understanding of education, expert development and health professions practice.