I keep coming back to a few central insights that have — in the best sense of the word — disturbed my world view. These are from a wonderful article in a journal I had never heard of, written by Frank Davidoff. (But I do not buy the term ‘revolution’)
Competence, in contrast, is like “dark matter” in astronomy: although it makes up most of the universe of working knowledge, we understand relatively little about it. What does it really consist of? Which of its components are most important? How do people acquire it? What’s the best way to measure it? And how can you tell when they have enough of it?
Most importantly, it is increasingly clear that competence is acquired primarily through experiential learning – a four-element cycle (or spiral) in which learners move from direct personal involvement in experiences, to reflection on those experiences, integration of their observations with sense-making concepts and mental models, and finally back to more experiences. Formal training for all high-performance (applied) professions, for example, music, architecture, theater, and athletics, is grounded in the unique requirements of experiential learning: case-based coaching, rather than lectures by content experts; hands-on, practicum experiences (including simulations, if necessary) in addition to written end-objectives; repeated experiences and outcome evaluations over time rather than initial, one- shot exercises; and, ultimately, acquisition of the advanced skills of “reflection-in-action,” which is required for high-level performance and “reflection-on-action,” which is required for continued self-evaluation and self- instruction (Schon, 1987).
Mens Sana Monographs:2008 | Volume:6 | Issue:1 | Page:29–40
Focus on Performance: The 21 st Century Revolution in Medical Education