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Background: To date, studies that have investigated the bonds between students and their institution have emphasized the importance of student–staff relationships. Measuring the quality of those relationships (i.e., relationship quality) appears to help with investigating the relational ties students have with their higher education institutions. Growing interest has arisen in further investigating relationship quality in higher education, as it might predict students' involvement with the institution (e.g., student engagement and student loyalty). So far, most studies have used a cross‐sectional design, so that causality could not be determined. Aims: The aim of this longitudinal study was twofold. First, we investigated the temporal ordering of the relation between the relationship quality dimensions of trust (in benevolence and honesty) and affect (satisfaction, affective commitment, and affective conflict). Second, we examined the ordering of the paths between relationship quality, student engagement, and student loyalty. Our objectives were to gain a deeper understanding of the relationship quality construct in higher education and its later outcomes. Sample: Participants (N = 1649) were students from three Dutch higher education institutions who were studying in a technology economics or social sciences program. Methods: Longitudinal data from two time points were used to evaluate two types of cross‐lagged panel models. In the first analysis, we could not assume measurement invariance for affective conflict over time. Therefore, we tested an alternative model without affective conflict, using the latent variables of trust and affect, the student engagement dimensions and student loyalty. In the second type of model, we investigated the manifest variables of relationship quality, student engagement, and student loyalty. The hypotheses were tested by evaluating simultaneous comparisons between estimates. Results: Results indicated that the relation between relationship quality at Time 1 with student engagement and loyalty at Time 2 was stronger than the reverse ordering in the first model. In the second model, results indicated that cross‐lagged relations between trust in benevolence and trust in honesty at Time 1 and affective commitment, affective conflict, and satisfaction at Time 2 were more likely than the reverse ordering. Furthermore, cross‐lagged relations from relationship quality at Time 1 to student engagement and student loyalty at Time 2 also supported our hypothesis. Conclusions: This study contributes to the existing higher education literature, indicating that students' trust in the quality of their relationship with faculty/staff is essential for developing students' affective commitment and satisfaction and for avoiding conflict over time. Second, relationship quality factors positively influence students' engagement in their studies and their loyalty towards the institution. A relational approach to establishing (long‐lasting) bonds with students appears to be fruitful as an approach for educational psychologists and for practitioners' guidance and strategies. Recommendations are made for future research to further examine relationship quality in higher education in Europe and beyond. [ABSTRACT FROM AUTHOR]

Objective General guidelines for teaching clinical reasoning have received much attention, despite a paucity of instructional approaches with demonstrated effectiveness. As suggested in a recent experimental study, self-explanation while solving clinical cases may be an effective strategy to foster reasoning in clinical clerks dealing with less familiar cases. However, the mechanisms that mediate this benefit have not been specifically investigated. The aim of this study was to explore the types of knowledge used by students when solving familiar and less familiar clinical cases with self-explanation. Methods In a previous study, 36 third-year medical students diagnosed familiar and less familiar clinical cases either by engaging in self-explanation or not. Based on an analysis of previously collected data, the present study compared the content of self-explanation protocols generated by seven randomly selected students while solving four familiar and four less familiar cases. In total, 56 verbal protocols (28 familiar and 28 less familiar) were segmented and coded using the following categories: paraphrases, biomedical inferences, clinical inferences, monitoring statements and errors. Results Students provided more self-explanation segments from less familiar cases ( M = 275.29) than from familiar cases ( M = 248.71, p = 0.046). They provided significantly more paraphrases (p = 0.001) and made more errors (p = 0.008). A significant interaction was found between familiarity and the type of inferences (biomedical versus clinical, p = 0.016). When self-explaining less familiar cases, students provided significantly more biomedical inferences than familiar cases. Conclusions Lack of familiarity with a case seems to stimulate medical students to engage in more extensive thinking during self-explanation. Less familiar cases seem to activate students' biomedical knowledge, which in turn helps them to create new links between biomedical and clinical knowledge, and eventually construct a more coherent mental representation of diseases. This may clarify the previously found positive effect that self-explanation has on the diagnosis of unfamiliar cases. [ABSTRACT FROM AUTHOR]

Medical Education 2012: 46: 464-472 Objectives Developing diagnostic competence in students is a major goal of medical education, but there is little empirical evidence on instructional strategies that foster the acquisition of this competence. The aim of this study was to investigate the effects of structured reflection compared with the generation of immediate or differential diagnosis while practising with clinical cases on learning clinical diagnosis. Methods This was a three-phase experimental study. During a learning phase, 46 Year 4 students diagnosed six clinical cases under different experimental conditions: structured reflection, immediate diagnosis, or differential diagnosis. This was followed by an immediate test and a delayed test administered 1 week later. Each test consisted of diagnosing four different cases of diseases presented in the learning phase. Performance in diagnosing these new cases was used as a measure of learning. Results Repeated-measures analysis of variance on the mean diagnostic accuracy scores (range: 0-1) showed a significant interaction between performance moment (i.e. performance in the learning phase and on each test) and instructions followed during the learning phase (p = 0.003). Follow-up analyses of this interaction showed that diagnostic performance did not differ between conditions in the learning phase. On the immediate test, scores in the reflection condition (mean = 0.48, 95% confidence interval [CI] 0.38-0.58) were significantly lower than scores in the differential diagnosis condition (mean = 0.62, 95% CI 0.54-0.70; p = 0.012) and marginally lower than those in the immediate diagnosis condition (mean = 0.61, 95% CI 0.52-0.70; p = 0.04). One week later, however, scores in the reflection condition (mean = 0.66, 95% CI 0.56-0.76) significantly outperformed those in the other conditions (differential diagnosis: mean = 0.48, 95% CI 0.37-0.58 [p < 0.01]; immediate diagnosis: mean = 0.52, 95% CI 0.43-0.60 [p = 0.01]). Comparisons within experimental conditions showed that performance from the immediate to the delayed test decreased in the immediate and differential diagnosis conditions (immediate diagnosis: p = 0.042; differential diagnosis: p = 0.012), but increased in the reflection condition (p = 0.003). Conclusions Structured reflection while practising with cases appears to foster the learning of clinical knowledge more effectively than the generation of immediate or differential diagnoses and therefore seems to be an effective instructional approach to developing diagnostic competence in students. [ABSTRACT FROM AUTHOR]

A major problem in learning from instructional animations is that the complex perceptual and cognitive processing exceeds the learner's limited processing capacities. Although attention cueing might help learners in focusing on essential parts of an animation, previous studies have shown that it does not necessarily improve learning performance. This study investigated whether generating self-explanations while studying a cued or an uncued animation might engage learners in cognitive activities necessary for learning. It was hypothesized that learning from a cued animation that reduces working memory load associated with searching for specific elements might be improved by generating self-explanations, whereas self-explaining with an uncued animation would have no positive effect on learning. The results confirmed the hypothesized interaction between cueing and self-explaining. They suggest that self-explanation enhances learning if visual cues are used to structure and highlight the essential parts of an animation. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background. Constructivist views of learning have brought conceptions of learning to attention again. Conceptions are considered important determinants of effective learning. Students can differ in their conceptions depending on their educational experience. Aims. The present study investigated students' conceptions of constructivist learning. Do students with greater experience in their academic programme differ in their conceptions of constructivist learning compared to students with less experience? In addition, to what extent are conceptions of constructivist learning different in a conventional, lecture-based curriculum compared to a constructivist, problem-based learning curriculum? Samples. Three groups (i.e. first-year, second-year, and third-year students) in two different curricula (i.e. conventional, lecture-based and constructivist, problem-based) were tested. Methods. A cross-sectional design was used. Students' conceptions of constructivist activities (i.e. knowledge construction, cooperative learning, self-regulation, use of authentic problems, self-perceived inability to learn, and motivation to learn) were measured by a questionnaire. Data were analyzed using a two-way multivariate analysis of variance (MAN OVA). Results. A significant difference in questionnaire's scores between year I and year 2 (but not between year 2 and 3) was found with respect to conceptions about knowledge construction, self-regulation, and the use of authentic problems, but not for cooperative learning and motivation to learn. For self-perceived inability, an interaction effect was found. Furthermore, results showed significant differences between both curriculum groups on all dependent measures. Conclusions. Differences in conceptions can be perceived between students who enter a new learning programme (i.e. higher education) and students who already have one year of experience in higher education. Among students with more than one year of educational experience, differences disappear. Furthermore, this study shows that the learning environment can make a difference with respect to students' conceptions of constructivist learning activities. [ABSTRACT FROM AUTHOR]

In this study, the longitudinal relation between deliberate practice and performance in chess was examined using a linear mixed models analysis. The practice activities and performance ratings of young elite chess players, who were either in, or had dropped out of the Dutch national chess training, were analysed since they had started playing chess seriously. The results revealed that deliberate practice (i.e. serious chess study alone and serious chess play) strongly contributed to chess performance. The influence of deliberate practice was not only observable in current performance, but also over chess players' careers. Moreover, although the drop-outs' chess ratings developed more slowly over time, both the persistent and drop-out chess players benefited to the same extent from investments in deliberate practice. Finally, the effect of gender on chess performance proved to be much smaller than the effect of deliberate practice. This study provides longitudinal support for the monotonic benefits assumption of deliberate practice, by showing that over chess players' careers, deliberate practice has a significant effect on performance, and to the same extent for chess players of different ultimate performance levels. The results of this study are not in line with critique raised against the deliberate practice theory that the factors deliberate practice and talent could be confounded. [ABSTRACT FROM AUTHOR]

The spacing effect refers to the commonly observed phenomenon that memory for spaced repetitions is better than for massed repetitions. In the present study, we examined this effect in students' memory for a lengthy expository text. Participants read the text twice, either in immediate succession (massed repetition), with a 4-day interstudy interval (spaced short), or with a 3.5-weeks interstudy interval (spaced long). Two days after the second study trial, all participants were tested. The results demonstrated that students in the spaced-short condition remembered more of the content than those in the massed condition. By contrast, students in the spaced-long condition remembered as much as students in the massed condition. These results were interpreted in terms of a theoretical framework, which combines mechanisms of encoding variability and study-phase retrieval to account for the spacing effect. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Context For over 30 years, research has focused on the question of how knowledge is organised in the doctor’s mind. The development of encapsulated knowledge, followed by the formation of illness scripts, may both be considered as important stages in the development of medical expertise. Methods This paper reviews research on the knowledge encapsulation and illness script hypotheses since their initial formulation. Findings in support of these views of expertise development are reported and conflicting data are discussed. Results A great deal of empirical data have been collected over the years to investigate the view that, through clinical experiences, biomedical knowledge becomes encapsulated and eventually integrated into illness scripts. The findings of most studies, which have used various techniques to probe the ways by which students and doctors mentally represent clinical cases, are in line with this view of expertise development. However, there is still debate concerning the role of biomedical knowledge in clinical case processing. Conclusions To facilitate the development of expertise in medical school, it is important to teach the basic sciences in a clinical context, and to introduce patient problems early in the curriculum in order to support the processes of encapsulation and illness script formation. In addition, during clerkships ample time should be devoted to enabling reflection on patient problems with peers and expert doctors. [ABSTRACT FROM AUTHOR]

Context Most studies on medical expertise research have focused on diagnostic performance, whereas patient management has been largely ignored. According to knowledge encapsulation theory, applying encapsulated knowledge is a characteristic of expert doctors’ diagnostic reasoning, but it is unclear whether or not encapsulated knowledge also plays a prominent role when processing a clinical case with a management focus. Methods The participants were 40 medical students (20 in Year 4 and 20 in Year 6) and 20 expert doctors (internists). Participants were asked to study the cases with either a diagnostic (Dx) or a management (Mx) focus. Subsequently, participants were asked to write down what they remembered from the case. Results In both conditions, experts recalled fewer propositions and used more high-level inferences than medical students. Furthermore, they processed the cases faster and more accurately than medical students, but no significant difference between Mx and Dx conditions was found. Year 4 students also showed no significant differences in recall and processing speed between conditions. By contrast, Year 6 students recalled more in a Dx than in an Mx condition, but there was no significant difference in processing speed between conditions. Conclusions In both conditions, findings indicate that the experts’ and Year 4 students’ performance was not affected by processing focus. The fact that only Year 6 students were affected by processing focus might be explained by the assumption that their diagnostic knowledge and management knowledge are not fully integrated yet, a process that has already taken place in the expert’s knowledge structure. [ABSTRACT FROM AUTHOR]

Context Two modes of case processing have been shown to underlie diagnostic judgements: analytical and non-analytical reasoning. An optimal form of clinical reasoning is suggested to combine both modes. Conditions leading doctors to shift from the usual mode of non-analytical reasoning to reflective reasoning have not been identified. This paper reports a study aimed at exploring these conditions by investigating the effects of ambiguity of clinical cases on clinical reasoning. Methods Participants were 16 internal medicine residents in the Brazilian state of Ceará. They were asked to diagnose 20 clinical cases and recall case information. The independent variable was the degree of ambiguity of clinical cases, with 2 levels: straightforward (i.e. non-ambiguous) and ambiguous. Dependent variables were processing time, diagnostic accuracy and proposition per category recalled. Data were analysed using a repeated measures design. Results Participants processed straightforward cases faster and more accurately than ambiguous ones. The proportion of text propositions recalled was significantly lower ( t[15] = 2.29, P = 0.037) in ambiguous cases, and an interaction effect between case version and proposition category was also found ( F[5, 75] = 4.52, P = 0.001, d = 0.232, observed power = 0.962). Furthermore, participants recalled significantly more literal propositions from the ambiguous cases than from the straightforward cases ( t[15] = 2.28, P = 0.037). Conclusions Ambiguity of clinical cases was shown to lead residents to switch from automatic to reflective reasoning, as indicated by longer processing time, and more literal propositions recalled in ambiguous cases. [ABSTRACT FROM AUTHOR]

The question how animations should be designed so that learning is optimised, is still under discussion. Animations are often cognitively very demanding, resulting in decreased learning outcomes. In this study, we tried to prevent cognitive overload and foster learning by focusing the learners' attention to one element (i.e. process) of an animation using a cueing technique. Psychology students viewed an animation of the cardiovascular system and were subsequently given a comprehension test and a transfer test. One group studied the animation without a visual cue, while for another group a visual cue was added to the animation. Results indicated that cueing not only enhanced comprehension and transfer performance for cued information, but also for uncued information. It is concluded that cueing can be used as a technique to improve learning from an animation. Results are interpreted in terms of cognitive load theory (CLT). Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Discusses various articles published within the issue, including one on the influence of instructional design on younger and older adults and another on an alternative method for diagnosing the acquisition of domain-specific knowledge.

The present study investigated the role of biomedical knowledge in clinical case representations of experienced family physicians and advanced medical students. Two views on the role of biomedical knowledge were compared: The knowledge encapsulation and the two-worlds view. According to the knowledge encapsulation view, biomedical knowledge still plays a role in the physician's clinical case representation, whereas the two-worlds view assumes that it does not. In order to investigate this issue, participants were instructed to carefully study a short case description that was associated with a particular disease. Subsequently, medical students and family physicians were instructed to judge whether or not a presented target item was related to the case description. Targets were biomedical or diagnostic items that were either related or unrelated to the case. Findings were more in line with the knowledge encapsulation than with the two-worlds view, in that physicians judged related biomedical items faster than unrelated items, and physicians outperformed medical students in judging related biomedical and diagnostic items. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

During the 55th meeting of the American Educational Research Association (AERA, 2004) in San Diego, a symposium was organized on Recent Advances in Expertise Research. Most papers in this special issue of Applied Cognitive Psychology were presented in this symposium. The aim of this special issue is to provide a representative overview of recent developments and current directions in expertise research and to discuss their implications for theoretical and applied cognitive psychology, particularly, for learning and instruction. In addition, it covers some new and innovative theoretical and methodological approaches to the study of expertise. This introductory paper presents a short introduction on expertise research, and provides an overview of the contributions to the special issue. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

In order to examine the effect of monitoring and self-regulation on skill acquisition, the present study asked novice chess players to provide judgments of learning (JOLs) and to select moves for restudy after studying an endgame of chess. In four groups, we varied the JOL instruction (present versus absent) and the selection instruction (free number of move selections versus selection of at least two moves per chess exercise). After four learning trials, participants were required to play against a chess computer. In the learning phase, participants who were forced to select moves for restudy outperformed those who were free to select moves for restudy when predicting the next computer move, even after controlling for the actual number of restudied moves. Although the groups that did provide JOLs showed better self-regulatory behaviour, there were no or even negative performance differences between the groups that did provide JOLs and the groups that did not provide JOLs. This same pattern emerged in the test phase: Although no differences were found between the groups with and without JOLs, the groups that were forced to select moves for restudy outperformed the groups that were free in the number of move selections. These data show that, for novice chess players, the instruction to provide JOLs possibly places a high and ineffective load on working memory and therefore has no effect on learning a chess endgame. To examine the relation between prior knowledge and quality of self-regulation, further research is needed that examines the effect of the JOL and selection instruction in groups that differ in chess experience. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Previous studies on the development of medical expertise, predominantly using measures of free recall and pathophysiological explanations, have shown ambiguous results concerning the relationship between expertise level and encapsulated knowledge.To investigate differences in clinical case representations by medical students and family doctors. In particular, the role of encapsulated knowledge in clinical case representations was investigated.Year 2 (n = 15) and Year 4 (n = 15) medical students and family doctors (n = 15) were instructed to study carefully 2 case descriptions associated with a particular disease. After each case description participants were asked to provide a diagnosis. Subsequently, they judged whether or not a target item presented on a computer screen was related to the case description. Target items consisted of literally stated signs and symptoms, inferred encapsulated items and filler items.Family doctors provided more accurate diagnoses than Year 2 and Year 4 medical students. Furthermore, family doctors were faster and made fewer errors in judging the relatedness of all item types than Year 2 and 4 medical students. In particular, family doctors showed their best performance on the encapsulated items.The present study showed that encapsulated knowledge becomes increasingly more prominent as expertise develops. For experienced doctors, encapsulated concepts function as the most important building blocks of clinical case representations. [ABSTRACT FROM AUTHOR]

Based on cognitive psychological research, a number of theoretical frameworks have been put forward to describe the structure of experts’ medical knowledge and to explain experts’ case-processing. To provide evidence for the theory of knowledge encapsulation, which states that medical knowledge constitutes of interlinked biomedical and clinical knowledge. Fourth-year medical students, clerks and medical experts evaluated six case descriptions, consisting of laboratory data either with or without a clinical context. For each case description, the participants were required to study the case, to formulate a diagnosis, and to write down everything they could remember of the case. When the laboratory data were not embedded within a clinical context, medical experts’ case-processing increased and their diagnostic accuracy became worse. Furthermore, laboratory data recall of medical experts was more elaborate in cases where the laboratory data were presented without a clinical context. Similar results were obtained for students and clerks. The findings are only partially consistent with a prediction made by the theory of knowledge encapsulation. Further research, using a different paradigm than the traditionally used method of free recall, is required to unearth whether medical experts use qualitatively different knowledge structures than novices while solving cases. [ABSTRACT FROM AUTHOR]

The author reflects on the challenges for future research into medical expertise. He stresses that the challenges will no longer involve identifying and describing differences between expertise levels and skills, but also in determining how expert characteristics can be effective in handling to medical students. Moreover, the author highlights difficulties in all areas of expertise research, to identify characteristics that are essential to the development of expertise.

In this study, the longitudinal relation between deliberate practice and performance in chess was examined using a linear mixed models analysis. The practice activities and performance ratings of young elite chess players, who were either in, or had dropped out of the Dutch national chess training, were analysed since they had started playing chess seriously. The results revealed that deliberate practice (i.e. serious chess study alone and serious chess play) strongly contributed to chess performance. The influence of deliberate practice was not only observable in current performance, but also over chess players' careers. Moreover, although the drop-outs' chess ratings developed more slowly over time, both the persistent and drop-out chess players benefited to the same extent from investments in deliberate practice. Finally, the effect of gender on chess performance proved to be much smaller than the effect of deliberate practice. This study provides longitudinal support for the monotonic benefits assumption of deliberate practice, by showing that over chess players' careers, deliberate practice has a significant effect on performance, and to the same extent for chess players of different ultimate performance levels. The results of this study are not in line with critique raised against the deliberate practice theory that the factors deliberate practice and talent could be confounded.