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Letters to the Editor

In Reply to Udani et al

Cohen, Elaine R. MEd; Barsuk, Jeffrey H. MD, MS; McGaghie, William C. PhD; Wayne, Diane B. MD

Author Information
doi: 10.1097/ACM.0000000000001198
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We appreciate the feedback from Dr. Udani and colleagues about our recent publication.1 We agree that comparison groups are critical to test new hypotheses. However, a comparative effectiveness meta-analytic review has already demonstrated unequivocally, without exception, that deliberate practice is superior to traditional clinical education for the acquisition of a wide range of clinical skills.2 Literature supporting deliberate practice for the acquisition of expertise is extensive. Compelling evidence shows that deliberate practice, combined with instructor feedback, is more effective than passive educational strategies. The power of deliberate practice for the acquisition of expertise has been demonstrated in medicine and many other domains.3

Control groups are not always needed to document the effectiveness of an educational intervention like deliberate practice.4 We suggest that investigators study other elements critical to skill acquisition and mastery learning including varied doses of deliberate practice, feedback strategies, and skill retention. Medical educators must acknowledge that the time-based model of medical education is ineffective and obsolete. Use of mastery learning with deliberate practice ensures that medical school and residency program graduates have acquired necessary clinical skills and are competent to care for patients.

Elaine R. Cohen, MEd
Research associate, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; [email protected]

Jeffrey H. Barsuk, MD, MS
Associate professor, Department of Medicine, Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

William C. McGaghie, PhD
Professor of medical education and preventive medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Diane B. Wayne, MD
Vice dean for education and Dr. John Sherman Appleman Professor of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

References

1. Cohen ER, McGaghie WC, Wayne DB, Lineberry M, Yudkowsky R, Barsuk JH. Recommendations for reporting mastery education research in medicine (ReMERM). Acad Med. 2015;90:15091514.
2. McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011;86:706711.
3. Ericsson KA. Acquisition and maintenance of medical expertise: A perspective from the expert-performance approach with deliberate practice. Acad Med. 2015;90:14711486.
4. Kratochwill TR, Levin JR. Single-Case Intervention Research: Methodological and Statistical Advances. 2014.Washington, DC: American Psychological Association.
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