摘要：Background: The role of deliberate practice in medical students’ development from novice to expert was
examined for preclinical skill training.
Methods: Students in years 1-3 completed 34 Likert type items, adapted from a questionnaire about the use of
deliberate practice in cognitive learning. Exploratory factor analysis and reliability analysis were used to validate the
questionnaire. Analysis of variance examined differences between years and regression analysis the relationship
between deliberate practice and skill test results.
Results: 875 students participated (90%). Factor analysis yielded four factors: planning, concentration/dedication,
repetition/revision, study style/self reflection. Student scores on ‘Planning’ increased over time, score on sub-scale
‘repetition/revision’ decreased. Student results on the clinical skill test correlated positively with scores on subscales
‘planning’ and ‘concentration/dedication’ in years 1 and 3, and with scores on subscale ‘repetition/revision’ in year
1.
Conclusions: The positive effects on test results suggest that the role of deliberate practice in medical education
merits further study. The cross-sectional design is a limitation, the large representative sample a strength of the
study. The vanishing effect of repetition/revision may be attributable to inadequate feedback. Deliberate practice
advocates sustained practice to address weaknesses, identified by (self-)assessment and stimulated by feedback.
Further studies should use a longitudinal prospective design and extend the scope to expertise development
during residency and beyond.
