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Open Access Highly Accessed Research article

The role of deliberate practice in the acquisition of clinical skills

Robbert J Duvivier1*, Jan van Dalen1, Arno M Muijtjens2, Véronique RMP Moulaert3, Cees PM van der Vleuten2 and Albert JJA Scherpbier4

Author Affiliations

1 Skillslab, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands

2 Department of Educational Development and Research, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands

3 Rehabilitation Foundation Limburg, Adelante Rehabiliation Centre, Hoensbroek, the Netherlands

4 Institute for Medical Education, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands

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BMC Medical Education 2011, 11:101  doi:10.1186/1472-6920-11-101

Published: 6 December 2011

Abstract

Background

The role of deliberate practice in medical students' development from novice to expert was examined for preclinical skill training.

Methods

Students in years 1-3 completed 34 Likert type items, adapted from a questionnaire about the use of deliberate practice in cognitive learning. Exploratory factor analysis and reliability analysis were used to validate the questionnaire. Analysis of variance examined differences between years and regression analysis the relationship between deliberate practice and skill test results.

Results

875 students participated (90%). Factor analysis yielded four factors: planning, concentration/dedication, repetition/revision, study style/self reflection. Student scores on 'Planning' increased over time, score on sub-scale 'repetition/revision' decreased. Student results on the clinical skill test correlated positively with scores on subscales 'planning' and 'concentration/dedication' in years 1 and 3, and with scores on subscale 'repetition/revision' in year 1.

Conclusions

The positive effects on test results suggest that the role of deliberate practice in medical education merits further study. The cross-sectional design is a limitation, the large representative sample a strength of the study. The vanishing effect of repetition/revision may be attributable to inadequate feedback. Deliberate practice advocates sustained practice to address weaknesses, identified by (self-)assessment and stimulated by feedback. Further studies should use a longitudinal prospective design and extend the scope to expertise development during residency and beyond.