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Developing expertise in gynecologic surgery: reflective perspectives of international experts on learning environments and processes

Authors Hardre PL, Nihira M, LeClaire EL

Received 27 April 2016

Accepted for publication 22 August 2016

Published 5 January 2017 Volume 2017:10 Pages 17—30

DOI https://doi.org/10.2147/PRBM.S111488

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Igor Elman


Patricia L Hardré,1 Mikio Nihira,2 Edgar L LeClaire3

1Department of Educational Psychology, University of Oklahoma College of Education, Norman, 2Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, OK, 3Department of Obstetrics and Gynecology, University of Kansas College of Medicine, Kansas City, KS, USA


Abstract: Research in medical education does not provide a clear understanding of how professional expertise develops among surgeons and what experiential factors contribute to that development. To address this gap, the researchers interviewed 16 international experts in female pelvic medicine and reconstructive surgery to assess their reflective perceptions of what specific opportunities and experiences initiated and supported their development toward expertise in their field. Characteristics and influences explaining the speed and quality of expertise development were sorted into the following themes: the dynamic process of expertise development, internal and personal characteristics, general aptitudes and preparatory skills, role modeling and interpersonal influences, opportunities to learn and practice, and roles and reference points. Across the narratives and perspectives of these expert surgeons, both individual characteristics and choices, and contextual activities and opportunities were necessary and important. Experiences with greatest impact on quality of expertise development included those provided by the environment and mentors, as well as those sought out by learners themselves, to elaborate and supplement existing opportunities. The ideal combination across experts was interaction and integration of individual characteristics with experiential opportunities. Grounded in theory and research in expertise development, these findings can support improvement of medical education, both for individual mentors and strategic program development. As surgery evolves at a continuously increasing pace, effective mentoring of promising surgical trainees will be critical to ensure that future generations of gynecologic surgeons will remain excellent. Effective, efficient surgical expertise development requires identifying trainees with the appropriate characteristics and providing them with the best development opportunities.

Keywords: expertise development, female pelvic surgery, learning environments

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