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"I can do better": exploring purposeful improvement in daily clinical work
Maria Mylopoulos1, Walid Farhat
1Department of Paediatrics and the Wilson Centre, University of Toronto, Toronto, ON, Canada, maria.mylopoulos@utoronto.ca.
Advances in Health Sciences Education : Theory and Practice
|August 11, 2014
Summary
Purposeful improvement in pediatric minimally invasive surgery is a distributed activity, integrating individual skills with social and material contexts. This adaptive expertise enhances patient care and informs training for future specialists.
Area of Science:
- Healthcare Improvement
- Adaptive Expertise
- Surgical Practice
Background:
- Clinicians' purposeful improvement is essential for patient care excellence.
- This activity is a core competency of adaptive expertise in healthcare.
- Research is exploring adaptive expertise in healthcare settings.
Purpose of the Study:
- To explore purposeful improvement in pediatric minimally invasive surgery.
- To identify and elaborate distributed cognitive processes in clinical improvement.
- To understand how adaptive expertise manifests in surgical practice.
Main Methods:
- Cognitive ethnography over 6 months.
- Data collection included pre-operative meetings, observed surgeries, and interviews.
- Inductive analysis of field notes and interview transcripts.
Main Results:
- Purposeful improvement is a socially and materially distributed activity.
- Improvement processes occur before, during, and after surgical procedures.
- Identified integration of individual competencies and context.
Conclusions:
- Purposeful improvement is a distributed cognitive activity in clinical settings.
- Findings enhance understanding of adaptive expertise in healthcare.
- Results inform training for future adaptive experts in surgery.
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