What Makes a Champion? Early Multidisciplinary Practice, Not Early Specialization, Predicts World-Class Performance

What explains the acquisition of exceptional human performance? Does a focus on intensive specialized practice facilitate excellence, or is a multidisciplinary practice background better? We investigated this question in sports. Our meta-analysis involved 51 international study reports with 477 effect sizes from 6,096 athletes, including 772 of the world’s top performers. Predictor variables included starting age, age of reaching defined performance milestones, and amounts of coach-led practice and youth-led play (e.g., pickup games) in the athlete’s respective main sport and in other sports. Analyses revealed that (a) adult world-class athletes engaged in more childhood/adolescent multisport practice, started their main sport later, accumulated less main-sport practice, and initially progressed more slowly than did national-class athletes; (b) higher performing youth athletes started playing their main sport earlier, engaged in more main-sport practice but less other-sports practice, and had faster initial progress than did lower performing youth athletes; and (c) youth-led play in any sport had negligible effects on both youth and adult performance. We illustrate parallels from science: Nobel laureates had multidisciplinary study/working experience and slower early progress than did national-level award winners. The findings suggest that variable, multidisciplinary practice experiences are associated with gradual initial discipline-specific progress but greater sustainability of long-term development of excellence.

Multidisciplinary Practice Variations of Anti-Thrombotic Strategies for Free Tissue Transfers

Background: Venous thrombosis, the leading cause of free flap failure, may have devastating consequences. Many anti-thrombotic agents and protocols have been described for prophylaxis and treatment of venous thrombosis in free flaps. Methods: National surveys were distributed to microsurgeons (of both Plastics and ENT training) and hematology and thrombosis specialists. Data were collected on routine screening practices, perceived risk factors for flap failure, and pre-, intra-, and post-operative anti-thrombotic strategies. Results: There were 722 surveys distributed with 132 (18%) respondents, consisting of 102 surgeons and 30 hematologists. Sixty-five surgeons and 9 hematologists routinely performed or managed patients with free flaps. The top 3 perceived risk factors for flap failure according to surgeons were medical co-morbidities, past arterial thrombosis, and thrombophilia. Hematologists, however, reported diabetes, smoking, and medical co-morbidities as the most important risk factors. Fifty-four percent of physicians routinely used unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) as a preoperative agent. Surgeons routinely flushed the flap with heparin (37%), used UFH IV (6%), or both (8%) intra-operatively. Surgeons used a range of post-operative agents such as UFH, LMWH, aspirin, and dextran while hematologists preferred LMWH. There was variation of management strategies if flap thrombosis occurred. Different strategies consisted of changing recipient vessels, UFH IV, flushing the flap, adding post-operative agents, or a combination of strategies. Conclusions: There are diverse practice variations in anti-thrombotic strategies for free tissue transfers and a difference in perceived risk factors for flap failure that may affect patient management.

Workplace Targeted Violence

The assessment and management of targeted violence risk in workplace contexts is described as a multidisciplinary practice involving assessment professionals and internal threat management teams. Recent trends are noted—the influence of the Internet on perpetrators, the increasing frequency of mass murders in public settings, and how quickly fear of harm can escalate when employees are aware of any threat scenario. Statistics on workplace homicides, assaults, and targeted venues are discussed, as are the various characteristics, motives, and risk factors for perpetrators who choose the pathway to violence. Evidence-based structured assessment tools are identified, designed for or appropriate for use in dynamic workplace contexts, and intended to be combined with but not replace the clinical or professional judgment of practitioners at all levels of competence. Legal issues are highlighted, various intervention options noted, and common process and decision-making issues described, such as information silos and unintended consequences of interventions. An extended case example demonstrates the steps in data gathering, progressive collaborative decision-making, conducting a threat assessment interview, and how a threat assessor develops a case formulation.

Social Work Practice in the Compensation Context

There are multiple synergies between social work and the law, and the two professions have common goals. The law underpins social work practice via legislation and legal processes. Despite this, social work services in a plaintiff law firm remains a unique practice setting. This chapter provides a description of the establishment of such a service in Australia. It explains the reason for it, how it was established, the practice model, spheres of influence, and reasons for its success. The service is a role model for successful multidisciplinary practice for better client outcomes.

In search of entrepreneurial competencies: Peripheral vision and multidisciplinary inspiration

This paper returns to the question of whether business schools alone can meet the challenges of enhancing creativity and innovation in entrepreneurial education. Policy makers have side-stepped definitional argumentation in order to embrace a more nuanced potential for entrepreneurial competency development, using multidisciplinary practice in learning and assessment that can be found beyond business and management discourse. Insights from other disciplines can be missed as different terminologies and definitions apply. Design education is inherently multidisciplinary and has been instrumental in facilitating significant policy-level changes. To delve more deeply into this phenomenon, the authors illustrate what actually happens in a classroom in which business and design intersect. Neuroscience research into the learning brain informs learning, teaching and assessment related to creativity, visioning and dealing with ambiguity – through the progressive development of flexibility and adaptability. The authors introduce the Crit, a common feature of Art and Design courses, as a tool of assessment, concluding that, before we dig deeper into business and management discourses, sideways glances into design education will continue to offer benefits.

Defining high-quality NSCLC care at U.S. cancer centers.

229 Background: While clinical guidelines for non-small cell lung cancer (NSCLC) provide recommendations on individual components of care and advocate multidisciplinary collaboration, guidance spanning the complete patient journey is lacking. We aimed to compile quality-focused recommendations for the multidisciplinary team and selected clinical criteria for ideal NSCLC care, and propose a new set of metrics encompassing the entire care continuum. These metrics would be used as a new benchmark for ideal NSCLC care via the Association of Community Cancer Centers’ (ACCC) national quality care initiative for patients with advanced (stage III/IV) NSCLC. Methods: The ACCC convened an expert steering committee of multidisciplinary specialists and representation from patient advocacy to compile evidence-based recommendations via a systematic search of clinical and quality care guidelines and peer-reviewed journals. Quality recommendations were organized within key care areas of the patient journey: care coordination and patient education, diagnosis and biomarker testing, staging and treatment planning, and survivorship. Results: A total of 32 recommendations were included across the 4 key NSCLC care areas. Key quality recommendations are listed (Table). Conclusions: The full set of recommendations define ideal NSCLC care and serve as a valuable guide for multidisciplinary practice and quality improvement initiatives. [Table: see text]