The Implications of Research on Expertise for Curriculum and Pedagogy

Evaluating the effectiveness of different perceptual training methods in a difficult visual discrimination task with ultrasound images

Recent work has shown that perceptual training can be used to improve the performance of novices in real-world visual classification tasks with medical images, but it is unclear which perceptual training methods are the most effective, especially for difficult medical image discrimination tasks. We investigated several different perceptual training methods with medically naïve participants in a difficult radiology task: identifying the degree of hepatic steatosis (fatty infiltration of the liver) in liver ultrasound images. In Experiment 1a (N = 90), participants completed four sessions of standard perceptual training, and participants in Experiment 1b (N = 71) completed four sessions of comparison training. There was a significant post-training improvement for both types of training, although performance was better when the trained task aligned with the task participants were tested on. In both experiments, performance initially improves rapidly, with learning becoming more gradual after the first training session. In Experiment 2 (N = 200), we explored the hypothesis that performance could be improved by combining perceptual training with explicit annotated feedback presented in a stepwise fashion. Although participants improved in all training conditions, performance was similar regardless of whether participants were given annotations, or underwent training in a stepwise fashion, both, or neither. Overall, we found that perceptual training can rapidly improve performance on a difficult radiology task, albeit not to a comparable level as expert performance, and that similar levels of performance were achieved across the perceptual training paradigms we compared.

Bridging simulation technology with positive behavioral supports to promote student engagement and behavior

Simulation technology provides opportunities for teachers to engage in extended practice using positive behavioral supports to promote student engagement and behavior. These training models are rapidly emerging and if effective, create an infrastructure for scaling up positive behavioral supports in classrooms and schools. However, there is limited research examining teacher skill transfer or student outcomes. This study examined the incremental benefits of Interactive Virtual Training for Teachers (IVT-T) in combination with professional learning communities (PLCs) in one high poverty school district. Using a quasi-experimental design, teachers (N = 90; n = 52 IVT-T + PLC condition; n = 38 PLC condition) and students (N = 100; n = 60 IVT-T + PLC condition; n = 40 PLC only) participated across six K-8 schools. Both training conditions were rated as moderately acceptable. One and two-level generalized linear models indicated teachers who used IVT-T increased their use of praise (b = 0.75, p = .03) and decreased their use of behavioral corrective feedback (b = -0.32, p = .02). Their students were also more passively engaged (b = 0.42, p = .05) and showed fewer inappropriate physical behaviors (b = -0.87, p = .002). IVT-T hours predicted increases in praise statements (b = 0.07, p < .001) and decreases in vague directives (b = -0.07, p = .006) whereas PLC hours predicted increases in teachers' use of vague directives (b = 0.07, p = .05). There was a significant positive effect of IVT-T hours on student passive engagement (b = 0.04, p = .01) and a negative effect of PLC hours on rates of inappropriate physical behaviors (b = 0.1, p = .04). Study limitations and future directions for research and practice are discussed.

A Systematic Meta-analysis of the Reliability and Validity of Subjective Cognitive Load Questionnaires in Experimental Multimedia Learning Research

For more than three decades, cognitive load theory has been addressing learning from a cognitive perspective. Based on this instructional theory, design recommendations and principles have been derived to manage the load on working memory while learning. The increasing attention paid to cognitive load theory in educational science quickly culminated in the need to measure its types of cognitive load — intrinsic, extraneous, and germane cognitive load which additively contribute to the overall load. In this meta-analysis, four frequently used cognitive load questionnaires were examined concerning their reliability (internal consistency) and validity (construct validity and criterion validity). Results revealed that the internal consistency of the subjective cognitive load questionnaires can be considered satisfactory across all four questionnaires. Moreover, moderator analyses showed that reliability estimates of the cognitive load questionnaires did not differ between educational settings, domains of the instructional materials, presentation modes, or number of scale points. Correlations among the cognitive load types partially contradict theory-based assumptions, whereas correlations with learning-related variables support assumptions derived from cognitive load theory. In particular, results seem to support the three-factor model consisting of intrinsic cognitive load, extraneous cognitive load, and germane cognitive load. Results are discussed in relation to current trends in cognitive load theory and recommendations for the future use of cognitive load questionnaires in experimental research are suggested.

Eye-Tracking in Educational Practice: Investigating Visual Perception Underlying Teaching and Learning in the Classroom

Classrooms full of pupils can be very overwhelming, both for teachers and students, as well as for their joint interactions. It is thus crucial that both can distil the relevant information in this complex scenario and interpret it appropriately. This distilling and interpreting happen to a large extent via visual perception, which is the core focus of the current Special Issue. Six empirical studies present examples of how to capture visual perception in the complexity of a classroom lesson. These examples open up new avenues that go beyond studying perception in restricted and artificial laboratory scenarios: some using video recordings from authentic lessons to others studying actual classrooms. This movement towards more realistic scenarios allows to study the visual perception in classrooms from new perspectives, namely that of the teachers, the learners, and their interactions. This in turn enables to shed novel light onto well-established theoretical concepts, namely students’ engagement during actual lessons, teachers’ professional vision while teaching, and establishment of joint attention between teachers and students in a lesson. Additionally, one theoretical contribution provides the very first model of teachers’ cognitions during teaching in relation to their visual perception, which in turn will allow future research to move beyond explorations towards hypothesis testing. However, to fully thrive, this field of research has to address two crucial challenges: (i) the heterogeneity of its methodological approaches (e.g., varying age groups, subjects taught, lesson formats) and (ii) the recording and processing of personal data of many people (often minors). Hence, these new approaches bear not only new chances for insights but also new responsibilities for the researchers.

Applying the science of learning to the teaching and learning of surgical skills: The basics of surgical education

The changing climate of surgical education has led to a renewed interest in the process of learning. Research from the fields of cognitive and educational psychology, neuroscience, sociology, and behavioral economics have clear implications for the teaching and learning of psychomotor skills. This article summarizes how key learning theories impact the field of surgical education and proposes practical tips, supported by the science of learning, that can be applied to optimize resident and fellow education.

A Problem-Sorting Task Detects Changes in Undergraduate Biological Expertise over a Single Semester

Calls for undergraduate biology reform share similar goals: to produce people who can organize, use, connect, and communicate about biological knowledge. Achieving these goals requires students to gain disciplinary expertise. Experts organize, access, and apply disciplinary knowledge differently than novices, and expertise is measurable. By asking introductory biology students to sort biological problems, we investigated whether they changed how they organized and linked biological ideas over one semester of introductory biology. We administered the Biology Card Sorting Task to 751 students enrolled in their first or second introductory biology course focusing on either cellular-molecular or organismal-population topics, under structured or unstructured sorting conditions. Students used a combination of superficial, deep, and yet-uncharacterized ways of organizing and connecting biological knowledge. In some cases, this translated to more expert-like ways of organizing knowledge over a single semester, best predicted by whether students were enrolled in their first or second semester of biology and by the sorting condition completed. In addition to illuminating differences between novices and experts, our results show that card sorting is a robust way of detecting changes in novices' biological expertise-even in heterogeneous populations of novice biology students over the time span of a single semester.

Mobile learning devices in the workplace: 'as much a part of the junior doctors' kit as a stethoscope'?

BACKGROUND

Smartphones are ubiquitous and commonly used as a learning and information resource. They have potential to revolutionize medical education and medical practice. The iDoc project provides a medical textbook smartphone app to newly-qualified doctors working in Wales. The project was designed to assist doctors in their transition from medical school to workplace, a period associated with high levels of cognitive demand and stress.

METHODS

Newly qualified doctors submitted case reports (n = 293) which detail specific instances of how the textbook app was used. Case reports were submitted via a structured online form (using Bristol Online Surveys - BOS) which gave participants headings to elicit a description of: the setting/context; the problem/issue addressed; what happened; any obstacles involved; and their reflections on the event. Case reports were categorised by the purpose of use, and by elements of the quality improvement framework (IoM 2001). They were then analysed thematically to identify challenges of use.

RESULTS

Analysis of the case reports revealed how smartphones are a viable tool to address clinical questions and support mobile learning. They contribute to novice doctors' provision of safe, effective, timely, efficient and patient-centred care. The case reports also revealed considerable challenges for doctors using mobile technology within the workplace. Participants reported concern that using a mobile phone in front of patients and staff might appear unprofessional.

CONCLUSION

Mobile phones blur boundaries between the public and private, and the personal and professional. In contrast to using a mobile as a communication device, using a smartphone as an information resource in the workplace requires different rituals. Uncertain etiquette of mobile use may reduce the capacity of smartphone technology to improve the learning experience of newly qualified doctors.

Systematic viewing in radiology: seeing more, missing less?

To prevent radiologists from overlooking lesions, radiology textbooks recommend "systematic viewing," a technique whereby anatomical areas are inspected in a fixed order. This would ensure complete inspection (full coverage) of the image and, in turn, improve diagnostic performance. To test this assumption, two experiments were performed. Both experiments investigated the relationship between systematic viewing, coverage, and diagnostic performance. Additionally, the first investigated whether systematic viewing increases with expertise; the second investigated whether novices benefit from full-coverage or systematic viewing training. In Experiment 1, 11 students, ten residents, and nine radiologists inspected five chest radiographs. Experiment 2 had 75 students undergo a training in either systematic, full-coverage (without being systematic) or non-systematic viewing. Eye movements and diagnostic performance were measured throughout both experiments. In Experiment 1, no significant correlations were found between systematic viewing and coverage, r = -.10, p = .62, and coverage and performance, r = -.06, p = .74. Experts were significantly more systematic than students F2,25 = 4.35, p = .02. In Experiment 2, significant correlations were found between systematic viewing and coverage, r = -.35, p < .01, but not between coverage and performance, r = .13, p = .31. Participants in the full-coverage training performed worse compared with both other groups, which did not differ between them, F2,71 = 3.95, p = .02. In conclusion, the data question the assumption that systematic viewing leads to increased coverage, and, consequently, to improved performance. Experts inspected cases more systematically, but students did not benefit from systematic viewing training.

Using Highlighting to Train Attentional Expertise

Acquiring expertise in complex visual tasks is time consuming. To facilitate the efficient training of novices on where to look in these tasks, we propose an attentional highlighting paradigm. Highlighting involves dynamically modulating the saliency of a visual image to guide attention along the fixation path of a domain expert who had previously viewed the same image. In Experiment 1, we trained naive subjects via attentional highlighting on a fingerprint-matching task. Before and after training, we asked subjects to freely inspect images containing pairs of prints and determine whether the prints matched. Fixation sequences were automatically scored for the degree of expertise exhibited using a Bayesian discriminative model of novice and expert gaze behavior. Highlighted training causes gaze behavior to become more expert-like not only on the trained images but also on transfer images, indicating generalization of learning. In Experiment 2, to control for the possibility that the increase in expertise is due to mere exposure, we trained subjects via highlighting of fixation sequences from novices, not experts, and observed no transition toward expertise. In Experiment 3, to determine the specificity of the training effect, we trained subjects with expert fixation sequences from images other than the one being viewed, which preserves coarse-scale statistics of expert gaze but provides no information about fine-grain features. Observing at least a partial transition toward expertise, we obtain only weak evidence that the highlighting procedure facilitates the learning of critical local features. We discuss possible improvements to the highlighting procedure.

The use of cognitive task analysis to reveal the instructional limitations of experts in the teaching of procedural skills

PURPOSE

Because of the automated nature of knowledge, experts tend to omit information when describing a task. A potential solution is cognitive task analysis (CTA). The authors investigated the percentage of knowledge experts omitted when teaching a cricothyrotomy to determine the percentage of additional knowledge gained during a CTA interview.

METHOD

Three experts were videotaped teaching a cricothyrotomy in 2010 at the University of Southern California. After transcription, they participated in CTA interviews for the same procedure. Three additional surgeons were recruited to perform a CTA for the procedure, and a "gold standard" task list was created. Transcriptions from the teaching sessions were compared with the task list to identify omitted steps (both "what" and "how" to do). Transcripts from the CTA interviews were compared against the task list to determine the percentage of knowledge articulated by each expert during the initial "free recall" (unprompted) phase of the CTA interview versus the amount of knowledge gained by using CTA elicitation techniques (prompted).

RESULTS

Experts omitted an average of 71% (10/14) of clinical knowledge steps, 51% (14/27) of action steps, and 73% (3.6/5) of decision steps. For action steps, experts described "how to do it" only 13% (3.6/27) of the time. The average number of steps that were described increased from 44% (20/46) when unprompted to 66% (31/46) when prompted.

CONCLUSIONS

This study supports previous research that experts unintentionally omit knowledge when describing a procedure. CTA is a useful method to extract automated knowledge and augment expert knowledge recall during teaching.

Getting ready for simulation-based training: a checklist for nurse educators

Nurse educators are incorporating computerized patient simulators into curricula with increasing frequency. Although several studies have focused on implementation and a framework for designing simulation using patient simulation, discussion of pre-training planning for simulation is limited. This article highlights some of the seminal literature from the science of training and discusses principles most applicable to nursing education. A key principle that is critical to successful training is the pre-training analysis. A framework and checklist were derived from the training literature review and are proposed to assist nurse educators in performing a pre-training analysis when planning simulation activities. This analysis will help educators define the knowledge, skills, and attitudes appropriate for the simulation experience. The tools are intended to complement existing strategies for planning simulations to provide a more comprehensive approach to simulation, resulting in a targeted and effective use of the teaching strategy.