1. Training Implications of Deliberate Practice
John Pelley, PhD
Texas Tech University HSC School of Medicine

2. What Is Involved In Training?
Instruction: Provides information on goals and objectives of a procedure
Demonstration (teacher): Provides information on achieving objectives
Application (learner): Provides information on limitations
Deliberate Practice: Provides practice focused on limitation in skill

3. Deliberate Practice Characteristics
Discovered in human performance research
Evaluated factors that contribute to expert skill
Not correlated with IQ! …with work experience
Always correlated with Deliberate Practice
Applied to limitation in skill; seeking superior skill
Not aimed at minimum standards
Self-actualization is the standard
Expert skill = Performance x Professionalism
If either is zero, it’s all zero
Professionalism – unrelenting desire for DP skill

4. Deliberate Practice Characteristics
Can be repeated a lot
Feedback continuously available
Most effective with experienced teacher
Not work, not play – focused effort; demanding
Need to avoid automated behavior
Not much fun; motivation critical
Mentally highly demanding; tiring
10 years, 10,000 hours – Gladwell, “Outliers”

5. Questions/Comments?

6. Mindset Comparison Fixed Mindset Growth Mindset
Success based on innate ability
Failure is dreaded, feared.
Least likely to succeed
Success based on hard work and learning
Failure is a challenge to adapt.
Most likely to succeed

7. Growth Mindset Through Deliberate Practice
Designed specifically to improve performance
Myth: “Practice makes perfect.”
Reality: “Perfect practice makes perfect.”
Reality: “Deliberate practice is perfect practice.”
Deliberate Practice: Practice correcting weaknesses.
Deliberate practice requires self-awareness … and self-acceptance.
No fear!
(K. Anders Erickson, “Deliberate Practice and the Acquisition and Maintenance of Expert Performance in Medicine and Related Domains.” Academic Medicine, 2004;79:October Suppl.70-S81.)

8. Counteracting Automaticity
Cognitive learning followed by experience in application (“associative”)

9. Is Learning A Skill? Learning style as a preference
Learning style as a component of experiential learning
Experiential learning as critical thinking
Experiential learning as whole brain learning
Whole brain learning as multiple skill application
Question/case analysis is complete whole brain learning

10. Sense-Integrate-Act Some Motor Skills Sensory Skills Thinking Skills
Thinking and memory skills are what we evaluate on written tests. We think that if students remember information that they can think with it.
Motor and sensory are also learned skills.
Active testing eventually becomes an exam, usually MCQ.
The results of the exam become concrete experience.
Memory Skills
Zull, 2002, The Art of Changing the Brain

11. Speaking and Hearing Roles

12. Clinical Skill = Learning Skill
Any part of the brain can grow more intelligent
Sensory (history and physical, other data)
Recognition (meaning of patient data)
Creativity (differential diagnosis)
Analysis (diagnosis, taking certification exams)
Motor function (physical exam, medical procedures)
Emotion (communication, values for you and others)

13. Importance of Continued Training
Working with known diagnostic or procedural outcomes