951 resultados para expertise


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This study investigates decision making in mental health care. Specifically, it compares the diagnostic decision outcomes (i.e., the qualityof diagnoses) and the diagnostic decision process (i.e., pre-decisional information acquisition patterns) of novice and experienced clinicalpsychologists. Participants’ eye movements were recorded while they completed diagnostic tasks, classifying mental disorders. In line withprevious research, our findings indicate that diagnosticians’ performance is not related to their clinical experience. Eye-tracking data pro-vide corroborative evidence for this result from the process perspective: experience does not predict changes in cue inspection patterns. Forfuture research into expertise in this domain, it is advisable to track individual differences between clinicians rather than study differenceson the group level.

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Mode of access: Internet.

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Background and Objectives: Peripheral nerve blockade requires regional anesthesia skills that trainees learn in several formats. Technical proficiency has shifted from a quota to comprehensive procedural evaluation. Successful nerve blockade is the clinical endpoint validating proficiency but patient, technical and procedural factors influence this result. The purpose of this study was to determine if procedural expertise for sciatic nerve blockade influenced postoperative pain scores and opioid requirements and if patient factors, technique and repetition influenced this outcome. Method: Sciatic nerve blockade by nerve stimulation and ultrasound guidance and training level of the resident performing the procedure were recorded. Patient obesity, trauma, chronic pain, opioid use and preoperative pain scores were compared to post-procedure pain scores and opioid analgesic requirements. Results: 102 patients received sciatic nerve blockade from 47 trainees over a 36 month interval. A significant relation between training level and improved pain scores was not demonstrated but transition from nerve stimulation to ultrasound guidance lowered scores in all groups. Nerve blockade failure was frequent with chronic opioid use and trauma. Conclusion: Analgesic outcomes should be an integral part of assessment of proficiency in regional anesthesia techniques. Evaluating outcomes of procedures throughout training will longitudinally assess technical expertise.

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In this study, we assessed whether contextual factors related to where or when an athlete is born influence their likelihood of playing professional sport. The birthplace and birth month of all American players in the National Hockey League, National Basketball Association, Major League Baseball, and Professional Golfer's Association, and all Canadian players in the National Hockey League were collected from official websites. Monte Carlo simulations were used to verify if the birthplace of these professional athletes deviated in any systematic way from the official census population distribution, and chi-square analyses were conducted to determine whether the players' birth months were evenly distributed throughout the year. Results showed a birthplace bias towards smaller cities, with professional athletes being over-represented in cities of less than 500,000 and under-represented in cities of 500,000 and over. A birth month/relative age effect (in the form of a distinct bias towards elite athletes being relatively older than their peers) was found for hockey and baseball but not for basketball and golf. Comparative analyses suggested that contextual factors associated with place of birth contribute more influentially to the achievement of an elite level of sport performance than does relative age and that these factors are essentially independent in their influences on expertise development.

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