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This chapter is part of a book that is no longer available to purchase from Cambridge Core

19 - Expertise in Medicine and Surgery

from PART V.A - PROFESSIONAL DOMAINS

By
Geoff Norman ,
Kevin Eva ,
Lee Brooks  and
Stan Hamstra
Edited by
K. Anders Ericsson ,
Neil Charness ,
Paul J. Feltovich  and
Robert R. Hoffman
Geoff Norman
Affiliation:
Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University
Kevin Eva
Affiliation:
Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University
Lee Brooks
Affiliation:
Department of Psychology, McMaster University
Stan Hamstra
Affiliation:
Department of Surgery, University of Toronto
K. Anders Ericsson
Affiliation:
Florida State University
Neil Charness
Affiliation:
Florida State University
Paul J. Feltovich
Affiliation:
University of West Florida
Robert R. Hoffman
Affiliation:
University of West Florida
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Summary

Introduction

Expertise in medicine requires mastery of a diversity of knowledge and skills – motor, cognitive, and interpersonal – which makes it unlike many other fields of expertise, such as chess, bridge, computer programming, or gymnastics. Although some specialties such as pathology or surgery may emphasize one kind of skill or another, most clinicians must be skilled in all domains and must also master an enormous knowledge base drawn from areas as diverse as molecular biology, ethics, and psychology.

Perhaps paradoxically, despite the considerable effort required to achieve mastery, there is no formal equivalent of elite performance, which has been a topic of many other chapters in this book. Though there is stiff competition to enter medical school and only about 15% of Canadian applicants get a position, once in, better than 95% will graduate, get placement in a specialty (residency) program, and enter practice. Once certified competent, competition in practice is absent. Medicine has its legendary clinicians, but these are as rare as Olympic gold medalists and have not been systematically studied.

That is not to say that there are no measures of relative expertise. In some domains, particularly surgery, treatment success can be measured with indicators such as death, complications, or blood loss, and has been linked to physician characteristics like specialty certification (Ericsson, 2004; Norcini et al., 2002) and undergraduate training (Tamblyn et al., 2002).

Type
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Information
The Cambridge Handbook of Expertise and Expert Performance , pp. 339 - 354
Publisher: Cambridge University Press
Print publication year: 2006

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