2. Cognitive psychological views on expertise development; a review Els Boshuizen Educational Technology Expertise Centre Ounl Heerlen

3. Maastricht University, Open University, Erasmus University Rotterdam Henk Schmidt, Els Boshuizen, Pie Hobus, Metta Hofstra, Eugène Custers, Margje van de Wiel, Rina Vaatstra, Remy Rikers, Jos Arts, Ilse van Eekelen, Agnes Wagenaar, Fleurie Nievelstein, and more In cooperation with Geoff Norman, Vimla Patel, Paul Feltovich, et al.

4. Cognitive psychological views on professional expertise development; a review

5. Professions, professionals and professional expertise l How professions develop l Developments in the profession, work place and society l How professionals do their work l ‘Disciplined’ by the peer group and law l Features of the workplace l Whole group (variability) l How they become good at it (or not) l How education is/should be organised l Tensions between individual goals and professional claims

6. Difference with Deliberate Practice tradition l Teaching for the profession has been starting point, not excellent performance l But we do use performance indicators and criteria

7. Cognitive psychological approach

8. Cognitive psychological theory on expertise development l ‘Stage’ theory l Knowledge increase, validation and integration l Knowledge encapsulation l (Illness) script formation l Episodes l l Reasoning and decision making l Performance

9. Exper- tise level Knowledge structure Change process Problem solving based on Cognitive control required in clinical reasoning Demand on cognitive capacity NoviceNetworks (incomplete and loosely linked) Knowledge accretion, integration and validation Long chains of detailed reasoning steps through networks Active monitoring of each reasoning step High Inter- media- te Networks (tightly linked and integrated) Encapsulation Reasoning through encapsulated network; abbreviated Active monitoring of each reasoning step Medium ExpertIllness scriptsIllness script formation Illness script activation and instantiation Monitoring of the level of script instantiation Low Memory traces of previous cases Instantiated scripts Automatic reminding Check relevance Low

10. What is not described? l Learning processes undertaken l How people organise these learning processes l How the excellent differ from the rest (although)

11. four studies l Jos Arts (management) l Margje van de Wiel (medicine) l Agnes Wagenaar (clinical psychology) l Fleurie Nievelstein (private law)

12. Jos Arts 0,0 1,0 2,0 3,0 4,0 5,0 6,0 novices 1 st yr students 2 nd yr students 3 rd yr students 4 th yr students 2 yr exp5 yr exp12.5 yr exp 25 yr exp expertise level quality of solution universityworkplace

13. Subdivided into:

14. Van de Wiel study l Micro-proceses of knowledge encapsulation l Multiple cases multiple disease processes

18. Further analysis on l Kind cognitive of activity l Nature and quality of knowledge used l Metacognitive remarks on status of knowledge l --> Conclusion faster, but not better diagnosis and decrease in elaborate and detailed (biomedical) reasoning l Very detailed analysis of selected protocols on how these lines of reasoning developed over time

19. Agnes Wagenaar l Knowledge in action l Video-stimulated post hoc think aloud protocols

20. Knowledge in action 0 10 20 30 40 50 60 70 studentsinternspost graduatesexperts expertise level average number of thoughts experience with patients patient relation countertransference interview skills time/interview structure time management hypothesis evaluation history taking in relation with hypothesis hypothesis formulation

21. Additional studies on Learning from experience Stress, coping and learning

22. Nievelstein l Knowledge structure and reasoning l Encapsulations/intermediary concepts l Ontological change l Reasoning style (adversarial reasoning)

23. Difference with Deliberate Practice tradition l Focus on development of knowledge structures and reasoning l With the aim of improving education l How plus how well tasks are performed l No differentiation within groups so far

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