Noncompliance and Decision-Making of Airline Pilots: An Analysis of Narratives From the Aviation Safety Reporting System

The purpose of this study was to identify self-reported flight deck noncompliance in aviation safety reports and explore the relationship between adaptive expertise, deliberate vs. non-deliberate actions (errors), and intentional vs. unintentional noncompliance. The heuristics for assessing adaptive thinking and behavior were based on subscales of the Adaptive Expertise Survey (AES; Fisher & Peterson, 2001). We analyzed a random sample of 200 ASRS reports from 2019 and coded them with respect to (a) whether they described intentional or unintentional noncompliance by one or more flightcrew members, (b) whether the decision making was deliberate, and (c) whether the decision-making process involved correlates of adaptive or routine (non-adaptive) expertise. We found that unintentional noncompliance was associated most frequently with non-deliberate actions and non-adaptive behaviors. Adaptive behaviors were strongly associated with deliberate actions and intentional noncompliance. Our on-going research to investigate adaptive expertise and its relationship with predictors of noncompliance is discussed.

Training official statisticians for adaptive statistical practice

Statistics is undergoing what feels like an evolutionary jump, i.e., a period of rapid and sweeping developments brought about by dramatic shifts in its environment. The repercussions are felt strongly by official statistics, which operates at the forefront of societal and economic change. In this paper, we look at the implications of the recent developments for the training of official statisticians and highlight key knowledge areas for successfully navigating the emerging landscape. In addition, we employ the concept of adaptive expertise to help us identify three qualities that support the independent and lifelong development of practicing statisticians, and propose five teaching strategies for fostering these qualities in the classroom.

Training Future Family Physicians to Become Master Adaptive Learners

This article examines the use of a concept that teaches learners how to learn in the context of family medicine residency training. We describe the four phases of this master adaptive learning framework and its place in educational theory and adaptive expertise, its implications for graduate medical education training and Accreditation Council for Graduate Medical Education competencies, as well as its role in imprinting family medicine residents for career-long learning. We lay out pragmatic strategies supporting this concept with a proposed curricular format for training in family medicine, including small group teaching methods, didactics, the clinic visit, faculty development and an optimal learning environment.

The Johns Hopkins Molecular Tumor Board Precision Oncology elective for Medical Oncology fellows.

11035 Background: The accelerated impact of next generation sequencing (NGS) in clinical decision making requires the integration of cancer genomics and precision oncology focused training into medical oncology education. The Johns Hopkins Molecular Tumor Board (JH MTB) is a multi-disciplinary effort focused on integration of NGS findings with critical evidence interpretation to generate personalized recommendations tailored to the genetic footprint of individual patients. Methods: The JH MTB and the Medical Oncology Fellowship Program have developed a 3-month precision oncology elective for fellows in their research years. Commencing fall of 2020, the goals of this elective are to enhance the understanding of NGS platforms and findings, advance the interpretation and characterization of molecular assay outputs by use of mutation annotators and knowledgebases and ultimately master the art of matching NGS findings with available therapies. Fellow integration into the MTB focuses on mentored case-based learning in mutation characterization and ranking by levels of evidence for actionability, with culmination in form of verbal presentations and written summary reports of final MTB recommendations. A mixed methods questionnaire was administered to evaluate progress since elective initiation. Results: Three learners who have participated as of February 2021 were included. Of the two who had completed the MTB elective, each have presented at least 10 cases, with at least 1 scholarly publication planned. All indicated strong agreement that MTB elective had increased their comfort with interpreting clinical NGS reports as well as the use of knowledgebases and variant annotators. Exposure to experts in the field of molecular precision oncology, identification of resources necessary to interpret clinical NGS reports, development of ability to critically assess various NGS platforms, and gained familiarity with computational analyses relevant to clinical decision making were noted as strengths of the MTB elective. Areas of improvement included ongoing initiatives that involve streamlining variant annotation and transcription of information for written reports. Conclusions: A longitudinal elective in the JHU MTB has been found to be preliminarily effective in promoting knowledge mastery and creating academic opportunities related to the clinical application of precision medicine. Future directions will include leveraging of the MTB infrastructure for research projects, learner integration into computational laboratory meetings, and expansion of the MTB curriculum to include different levels of learners from multiple medical education programs. Continued elective participation will be key to understanding how best to facilitate adaptive expertise in assigning clinical relevance to genomic findings, ultimately improving precision medicine delivery in patient care and trial development.

Integration of medical device design training in clinical teaching - A case study

Dental practitioners often encounter situations that require customising the prosthesis to satisfy the needs of patients. Artificial devices called dental appliances or prosthesis is custom fabricated for the functional, aesthetic, and psychological wellbeing of patients (Chu et al. 2013). The patient’s complaints may vary from missing natural teeth to extensive maxillofacial defects, and there is no single best rehabilitative therapy for these conditions. Designing our product is the choice, and this demands adaptive expertise, i.e., the ability to generate potential solutions (Mylopoulos et al. 2018). Maxillofacial Prosthodontics applies a variety of learning methods like systematic simulation laboratory exercises, See One, Do One, Teach One (SODOTO method), and supervised clinical practice to train the routine technical skills and clinical practice. To maximise the outcomes in the complex prosthetic treatment, the course specialists designed an “Interdisciplinary Device Development program (IDDP)”—a value-added course for the postgraduates in collaboration with the Biomedical Instrumentation Engineering Faculty of our Institution. IDDP is the first of its kind challenge-based learning model in Dentistry that uses innovations to deal with rehabilitation care beyond routine practice. This paper aims to present our IDDP model and programme outcomes.

The Inclusion of a Student Voice in Teacher Professional Learning to Create Relevance in Science Education

Students' perceptions of a lack of relevance in science and technology (S&T) education have been reported in research and policies for a long time. In many countries this is a problem that is not decreasing despite numerous measures to address it. In the study presented here a new approach to the problem was developed and empirically tested. The study targets the theoretical development of "teacher professional learning". Key elements of the approach include distributed leadership with adaptive expertise, boundary spanners to relate leadership structures to student learning, and facilitators to initiate such work. Five Swedish municipalities were involved in this approach, from a model where 10 core concepts were adapted to the Swedish educational context and incorporated in a professional learning model. The model suggests including two initial steps to create a professional learning cycle, e.g. students' and teachers' needs together with leadership structures. The empirical evidence comes from pre-studies investigating these two initial steps with a qualitative research design. The results are compiled in five themes showing that learners, teachers and school leaders perceive S&T education to be 'special' and describe progression, organization and beneficial changes. Facilitators were found to be important and organizational relationships were described and discussed. Differences in the nature of the relevance problem between students and their teachers and in different parts of the educational system were also identified, which have consequences for the progression in a professional learning cycle. This is discussed and pointed out as important for future research. Overall, the results indicate that published notions regarding teacher professional learning and students' perceptions of S&T education, can be combined to formulate a robust new approach to address the relevance problem.