Peak Ch. 5

Question 1

The U.S. Navy Strike Fighter Tactics Instructions Program

Answer 1

• Used elements of deliberate practice
• It allowed pilots to try different things in different situations, get feedback on their performance, and apply what they had learned
• It was highly successful at improving the U.S. force’s performance in dogfights

Question 2

how can you use deliberate practice to elevate the performance of an organization?

Answer 2

by identifying top performers and training others to bring them close to that level

Question 3

3 myths that must be dispelled to enhance performance in an organization

Answer 3

• The belief that one’s abilities are limited by one’s genetically prescribed characteristics
• Doing something for long enough results in improvement
• All it takes to improve is effort

Question 4

learning while real work gets done approach

Answer 4

• Involves turning normal business activities into opportunities for purposeful or deliberate practice
• Allows people to get into the habit of practicing and thinking about practicing

Question 5

the top gun approach to learning

Answer 5

• Involves using feedback-driven practice to lead to improvement
• Emphasizes skills and performance rather than knowledge

Question 6

American radiologists and diagnosing breast cancer study

Answer 6

• A 2004 study of 124 American radiologists found that no background factors were related to the accuracy of diagnosing breast cancer from mammograms
• The authors argue that it may be related to the quality of the training they received before starting their independent practice

Question 7

digital radiology training study

Answer 7

A 2015 study found that performance on a test set of mammograms from a digital library predicted performance at detecting cancer in the clinic

Question 8

radiology residents and ankle injuries study

Answer 8

A 2011 study found that radiology residents’ accuracy at detecting possible ankle injuries in a child improved steadily by testing themselves with a series of X-rays and case details

Question 9

how can we make radiology training more effective?

Answer 9

by making an effort up front to determine what sort of issues are likely to cause problems for new radiologists and designing the training to focus on these issues

Question 10

focus of training in the professional world

Answer 10

Training in the professional world tends to focus on knowledge rather than skills because it is more convenient and traditional

Question 11

2005 Harvard meta-analysis on doctor’s performance

Answer 11

• A 2005 Harvard meta-analysis found that doctors’ performance grew worse over time, or at best, stayed about the same
• The same trend is found in nurses

Question 12

Davis continuing medical education study

Answer 12

• Continuing professional education interventions for physicians were most effective if they had an interactive component and least effective if they didn’t
• No type of continuing medical education is effective for complex multi-step behaviours

Question 13

training in most professional fields

Answer 13

Most professional fields tend to lack the tradition of supporting the training and further development of practicing professionals

Question 14

experience vs. expertise

Answer 14

• Experience alone doesn’t equal expertise
• Experienced surgeons weren’t any better at laparoscopic surgery than surgical trainees

Question 15

how can we improve training in professional organizations?

Answer 15

by encouraging them to use skill- rather than knowledge-based training

Question 16

Birkmeyer et al. surgeons’ skill and patient outcomes study

Answer 16

• Found that there were large differences in patient outcomes among surgeons of differently rated technical skills, with patients of the more technically adept surgeons being less likely to experience complications or mortality
• This suggests that patients could greatly benefit if less technically skilled surgeons were able to improve their skills

Question 17

Vickers et al. 2007 surgeons’ skill and cancer resurgence study

Answer 17

• There was a major difference in skill between surgeons who had a great deal of experience with the surgery and those who had performed relatively fewer operations.
• A patient’s cancer was almost twice as likely to come back within 5 years if they had been operated on by a less experienced surgeon

Question 18

Vickers et al. surgeons’ skill and cancer resurgence follow-up study

Answer 18

found that cancer recurrence rates continued to decrease until a surgeon had performed 1,500-2,000 surgeries

Question 19

key difference between surgery and other parts of the medical field

Answer 19

Surgery is different from other parts of the medical field because it provides clear and immediate feedback

Question 20

radiologists and interpreting mammograms study

Answer 20

• A study of radiologists interpreting mammograms found that radiologists improved considerably in their first 3 years on the job and their rates of improvement slowed down sharply afterwards.
• Radiologists who had participated in a fellowship did not experience the learning curve and attained the same skill level as those who did not participate in the fellowship after a few months compared to their 3 years
• A well-designed training program that doesn’t require a fellowship may be able to accomplish the same thing

Question 21

the importance of recognizing unexpected situations in the professional world

Answer 21

• The ability to recognize unexpected situations, quickly consider various alternatives, and decide on the best one is important in many areas
• Ex. Most laparoscopic surgeries take an unexpected turn that requires the surgeon to determine a new approach

Question 22

what is the main way surgeons detect problems?

Answer 22

by noticing that something about the surgery doesn’t match their mental representation

Question 23

how are the world’s best doctors distinguished?

Answer 23

by their superior mental representations

Question 24

how can we study mental representations?

Answer 24

by guiding people through a task, asking them to stop in the middle, turn out the lights, and ask them to describe the current situation, what has happened, and what is about to happen

Question 25

how can we study mental representations for situations that you can’t stop in the middle of?

Answer 25

you can use a simulator or question individuals before and after