Investigations of expert performers across many domains have suggested the accumulation of deliberate practice over many years is a key component of developing expertise. Researchers propose deliberate practice is effective for improving performance in the long term because it includes several structured elements that facilitate learning. However, the effects of such structured practice across shorter training periods are less understood. The current study examined the acquisition of manual control skill in the experimental video game Space Fortress. Video demonstrations and continuous auditory feedback were combined in a 90-min intervention session designed to discourage behaviors correlated with low performance and encourage behaviors associated with high levels of skill. After 4 h of gameplay, the initially lower-performing participants who received the intervention displayed significantly greater manual control performance than the initially lower-performing participants who received undirected training. This performance difference corresponded with durable improvements in behaviors targeted by the intervention once feedback was removed. These findings suggest training that incorporates elements of deliberate practice can be successfully applied in short-term skill acquisition settings.

Models for diagnostic reasoning in radiology have been based on the observed behaviors of experienced radiologists but have not directly focused on the thought processes of novices as they improve their accuracy of image interpretation. By collecting think-aloud verbal reports, the current study was designed to investigate differences in specific thought processes between medical students (novices) as they learn and radiologists (experts), so that we can better design future instructional environments. Seven medical students and four physicians with radiology training were asked to interpret and diagnose pediatric elbow radiographs where fracture is suspected. After reporting their diagnosis of a case, they were given immediate feedback. Participants were asked to verbalize their thoughts while completing the diagnosis and while they reflected on the provided feedback. The protocol analysis of their verbalizations showed that participants used some combination of four processes to interpret the case:gestalt interpretation, purposeful search, rule application,andreasoning from a prior case.All types of processes except reasoning from a prior case were applied significantly more frequently by experts. Further, gestalt interpretation was used with higher frequency in abnormal cases while purposeful search was used more often for normal cases. Our assessment of processes could help guide the design of instructional environments with well-curated image banks and analytics to facilitate the novice's journey to expertise in image interpretation.

Context: The role of robot-assisted surgery continues to expand at a time when trainers and proctors have travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic. Objective: To provide guidance on setting up and running an optimised telementoring service that can be integrated into current validated curricula. We define a standardised approach to training candidates in skill acquisition via telepresence technologies. We aim to describe an approach based on the current evidence and available technologies, and define the key elements within optimised telepresence services, by seeking consensus from an expert committee comprising key opinion leaders in training. Evidence acquisition: This project was carried out in phases: a systematic review of the current literature, a teleconference meeting, and then an initial survey were conducted based on the current evidence and expert opinion, and sent to the committee. Twenty-four experts in training, including clinicians, academics, and industry, contributed to the Delphi process. An accelerated Delphi process underwent three rounds and was completed within 72 h. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. Consensus opinion was defined as >= 80% agreement. Evidence synthesis: There was 100% consensus regarding an urgent need for international agreement on guidance for optimised telepresence. Consensus was reached in multiple areas, including (1) infrastructure and functionality; (2) definitions and terminology; (3) protocols for training, communication, and safety issues; and (4) accountability including ethical and legal issues. The resulting formulated guidance showed good internal consistency among experts, with a Cronbach alpha of 0.90. Conclusions: Using the Delphi methodology, we achieved international consensus among experts for development and content validation of optimised telepresence services for robotic surgery training. This guidance lays the foundation for launching telepresence services in robotic surgery. This guidance will require further validation. Patient summary: Owing to travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic, development of remote training and support via telemedicine is becoming increasingly important. We report a key opinion leader consensus view on a standardised approach to telepresence. Crown Copyright (C) 2020 Published by Elsevier B.V. on behalf of European Association of Urology.

In their commentary, Macnamara and Hambrick (Psychol Res, 2017) accused my colleagues and me of systematically changing the definition of the concept of deliberate practice. Deliberate practice was the result of a search for characteristics of effective practice in the laboratory that was shown to improve expert professional performance in domains, such as music. In this reply, I will first describe five different criteria that defined the original concept of deliberate practice and each of them is presented with directly supporting quotes from Ericsson, Krampe, and Tesch-Römer (Psychol Rev 100:396–406, 10.1037/0033-295X.87.3.215, 1993) paper. Unfortunately, Macnamara, Hambrick, and Oswald (Psychol Sci 25:1608–1618, 10.1177/0956797614535810, 2014) misinterpreted our concept of deliberate practice, and defined it much more broadly: “as engagement in structured activities created specifically to improve performance in a domain” (p. 914). This definition led them to include activities, such as attending lectures, studying alone by students, and group activities led by a coach, where each activity does not meet one or more of our criteria for deliberate practice. In this commentary, I will argue that Macnamara and Hambrick (2020) became aware of some of the original criteria for deliberate practice, such as the role of individualized training by a teacher, and these discoveries misled them to assume that we had changed our definition. The intended meaning of sentences that Macnamara and Hambrick (2020) had carefully selected is shown to have an appropriate interpretation in Standard English that is consistent with our original definition of deliberate practice. In conclusion, I will give a proposal for how the different perspectives can be reconciled.

In two studies, the SCRABBLE skill of male and female participants at the National SCRABBLE Championship was analyzed and revealed superior performance for males. By collecting increasingly detailed information about the participants’ engagement in practice-related activities, we found that over half of the variance in SCRABBLE performance was accounted for by measures of starting ages and the amount of different types of practice activities. Males and females did not differ significantly in the benefits to their performance derived from engagement in SCRABBLE-specific practice alone (purposeful practice). However, gender differences in performance were fully mediated by lower engagement in purposeful practice by females and by their rated preference for playing games of SCRABBLE—an activity where more extended engagement is not associated with increased SCRABBLE performance. General implications from our account of gender differences in skill acquisition are discussed, and future research is proposed for how the duration of engagement in effective deliberate practice can be experimentally manipulated.

This study examined attention allocation in 30 marksmen categorized into 3 skill levels ranging from expert to novice. Each shooter performed 336 shooting trials. Half of the trials were performed under an occluded-vision condition and the rest under regular, unoccluded conditions. Immediately after completion of a random subset of shots (96 trials), shooters estimated the actual location of each shot, and on a random subset of trials (48 trials), shooters gave retrospective verbal reports. A mixed 3 × 2 factorial analysis of variance revealed that the expert marksmen performed and estimated their shots more accurately than the intermediate and novice marksmen, the intermediates performed like the experts under the full-vision condition and like novices under the occluded-vision condition, and the experts reported attending more to nonvisual information while they estimated their shots than did the novices. The findings advance our understanding of the mechanisms mediating expertise.

Over 25 years ago Ericsson et al. (1993) published the results of their search for the most effective forms of training in music, a domain where knowledge of effective training has been accumulated over centuries. At music academies master teachers provide students individualized instruction and help them identify goals and methods for their practice sessions between meetings - this form of solitary practice was named deliberate practice, and its accumulated duration during development was found to distinguish groups with differing levels of attained music performance. In an influential meta-analysis Macnamara et al. (2014) identified studies that had collected estimates of practice accumulated during development and attained performance and reported that individual differences in deliberate practice accounted for only 14% of variance in performance. Their definition of "deliberate practice" differs significantly from the original definition of deliberate practice and will henceforth be referred to as structured practice. We explicate three criteria for reproducible performance and purposeful/deliberate practice and exclude all effect sizes considered by Macnamara et al. (2014) that were based on data not meeting these criteria. A reanalysis of the remaining effects estimated that accumulated duration of practice explained considerably more variance in performance (29 and 61% after attenuation correction). We also address the argument that the limited amount of variance explained by the duration of practice necessarily implies an important role of genetic factors, and we report that genetic effects have so far accounted for remarkably small amounts of variance - with exception of genetic influences of height and body size. The paper concludes with recommendations for how future research on purposeful and deliberate practice can go beyond recording only the duration of practice to measuring the quality of practice involving concentration, analysis, and problem solving to identify conditions for the most effective forms of training.

Ericsson, Krampe, and Tesch- Römer published their research on "The role of deliberate practice in the acquisition of expert performance" over 25 years ago. Since then, hundreds of new articles have been published with findings regarding the effects of practice on performance in sports. The original paper searched for conditions underpinning optimal acquisition of reproducibly superior (expert) performance in domains, where methods for producing such performance had been refined over centuries. At an elite music academy, superior music students were found to have engaged for longer periods in solitary practice guided by their music teachers - an explication of the conditions of this type of practice led to a definition of deliberate practice. When other researchers in sports started searching for optimal practice, they could not find any practice activities meeting all the criteria for "deliberate practice", yet referred to somewhat similar activities using that same term. This paper shows that the effects of these different types of practice activities on attained performance differ from those of deliberate practice and should be given different distinct names. The paper concludes with recommendations for how future research on purposeful and deliberate practice can inform, not just athletes and their coaches, but all adults about how their achievements can be improved with individualized forms of effective practice.

Previous research has indicated positive relations between a curricular emphasis during college and improvements in GRE performance for content that matches that emphasis. However, measurement issues and a lack of a theoretical approach have contributed to a lack of precision and detail in the estimates of the relation between college experiences and performance for relevant content. In the current study, we hypothesized that differences in training between students majoring in math related majors and students majoring in reading and writing related majors would be differentially related to the size of the changes on GRE performance. Further, we hypothesized the gender gap in GRE-Quant performance would be reduced when the higher likelihood of males majoring in math related majors was modelled. The expert performance approach was used to develop three path models (including curricular emphasis, college grade performance, previous performance on the SAT, and gender) to compare the effects of the relation of a curricular emphasis in math on GRE-Quant performance to the effects of the relation of an emphasis in reading and writing on GRE-Verbal performance. The results indicated support for our predictions that a math course emphasis was related to larger GRE performance gains and that gender differences in curricular emphasis during college partially mediated the large gender gap in GRE-Quant performance. Additionally, higher grade performance average was found to positively predict GRE performance with college experiences and previous performance statistically controlled. Implications for the relation between training accrued during college courses and changes in GRE performance are discussed.

As the role of robot-assisted surgery continues to expand, development of standardised and validated training programmes is becoming increasingly important. To provide guidance on an optimised “train-the-trainer” (TTT) structured educational programme for surgical trainers, in which delegates learn a standardised approach to training candidates in skill acquisition. We aim to describe a TTT course for robotic surgery based on the current published literature and to define the key elements within a TTT course by seeking consensus from an expert committee formed of key opinion leaders in training. The project was carried out in phases: a systematic review of the current evidence was conducted, a face-to-face meeting was held in Philadelphia, and then an initial survey was created based on the current literature and expert opinion and sent to the committee. Thirty-two experts in training, including clinicians, academics, and industry, contributed to the Delphi process. The Delphi process underwent three rounds of survey in total. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. Consensus opinion was defined as ≥80% agreement. There was 100% consensus that there was a need for a standardized TTT course in robotic surgery. A consensus was reached in multiple areas, including the following: (1) definitions and terminologies, (2) qualifications to attend, (3) course objectives, (4) precourse considerations, (5) requirement of e-learning, (6) theory and course content, and (7) measurement of outcomes and performance level verification. The resulting formulated curriculum showed good internal consistency among experts, with a Cronbach alpha of 0.90. Using the Delphi methodology, we achieved an international consensus among experts to develop and reach content validation for a standardised TTT curriculum for robotic surgery training. This defined content lays the foundation for developing a proficiency-based progression model for trainers in robotic surgery. This TTT curriculum will require further validation. As the role of robot-assisted surgery continues to expand, development of standardised and validated training programmes is becoming increasingly important. There is currently a lack of high-level evidence on how best to train trainers in robot-assisted surgery. We report a consensus view on a standardised “train-the trainer” curriculum focused on robotic surgery. It was formulated by training experts from the USA and Europe, combining current evidence for training with experts’ knowledge of surgical training.

In the mid-1980s, Dario Donatelli (DD) participated in a laboratory study of the effects of around 800h of practice on digit-span and increased his digit-span from 8 to 104 digits. This study assessed changes in the structure of his memory skill after around 30years of essentially no practice on the digit-span task. On the first day of testing, his estimated span was only 10 digits, but over the following 3 days of testing it increased to 19 digits. Further analyses of his recall performance and verbal reports identified which mechanisms of the original memory skill he could retrieve or reacquire over the 3days of practice. We discuss theoretical implications for the retention of skilled memory performance, the effects of age-related changes in memory on it, and for the future study of the effects of disuse on exceptional performance and complex skill.

How do I do it? Expert Practice helps you improve your skills—no matter what it is you're trying to master. There are three steps you follow in order, and then repeat, repeat, repeat: First, identify a specific sub-skill that incrementally challenges you. Second, practice that skill with full effort. Third, seek feedback on what you could do better. How does it work? The opposite of Expert Practice is mindless practice—just going through the motions without a real goal in mind, without concentration, and without meaningful feedback on how you can improve. When you practice like an expert, you make the most of your practice time. The same three-step process applies whether you want to become a better trumpet player, a better writer, or a better student.

Some have explained large sex differences in visuospatial abilities by genetic adaptations to different roles in primitive hunter-gatherer societies and the interaction of innate biological differences and environmental factors. We explored the extent to which variations in behavior and acquired skills can provide alternative accounts for sex differences in the performance of a complex spatially-demanding video game (Space Fortress). Men and women with limited video game experience were given 30 hours of training, and latent curve analyses examined the development of their ship control performance and behavior. Men had significantly better control performance than women before and after training, but differences diminished substantially over the training period. An analysis of participants’ joystick behaviors revealed that initially men and women relied on different patterns of control behaviors, but changes in these behaviors over time accounted for the reduced sex differences in performance. When we controlled for these differences in behavior, sex effects after training were no longer significant. Finally, examining the development of control performance and control behaviors of men and women categorized as initially high and low performers revealed the lower-performing women may have been controlling their ship using an approach that was very different from the men and higher-performing women. The potential problems of analyzing men and women’s spatial performance as homogenous groups are discussed, as well as how these issues may account for sex differences in skilled video game performance and perhaps other domains involving spatial abilities.

Abstract Context As the role of robot-assisted surgery continues to expand, development of standardised and validated training programmes is becoming increasingly important. Objective To provide guidance on an optimised “train-the-trainer” (TTT) structured educational programme for surgical trainers, in which delegates learn a standardised approach to training candidates in skill acquisition. We aim to describe a TTT course for robotic surgery based on the current published literature and to define the key elements within a TTT course by seeking consensus from an expert committee formed of key opinion leaders in training. Evidence acquisition The project was carried out in phases: a systematic review of the current evidence was conducted, a face-to-face meeting was held in Philadelphia, and then an initial survey was created based on the current literature and expert opinion and sent to the committee. Thirty-two experts in training, including clinicians, academics, and industry, contributed to the Delphi process. The Delphi process underwent three rounds of survey in total. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. Consensus opinion was defined as ≥80% agreement. Evidence synthesis There was 100% consensus that there was a need for a standardized TTT course in robotic surgery. A consensus was reached in multiple areas, including the following: (1) definitions and terminologies, (2) qualifications to attend, (3) course objectives, (4) precourse considerations, (5) requirement of e-learning, (6) theory and course content, and (7) measurement of outcomes and performance level verification. The resulting formulated curriculum showed good internal consistency among experts, with a Cronbach alpha of 0.90. Conclusions Using the Delphi methodology, we achieved an international consensus among experts to develop and reach content validation for a standardised TTT curriculum for robotic surgery training. This defined content lays the foundation for developing a proficiency-based progression model for trainers in robotic surgery. This TTT curriculum will require further validation. Patient summary As the role of robot-assisted surgery continues to expand, development of standardised and validated training programmes is becoming increasingly important. There is currently a lack of high-level evidence on how best to train trainers in robot-assisted surgery. We report a consensus view on a standardised “train-the trainer” curriculum focused on robotic surgery. It was formulated by training experts from the USA and Europe, combining current evidence for training with experts’ knowledge of surgical training.

Laboratory studies have investigated how individuals with normal memory spans attained digit spans over 80 digits after hundreds of hours of practice. Experimental analyses of their memory skills suggested that their attained memory spans were constrained by the encoding time, for the time needed will increase if the length of digit sequences to be memorised becomes longer. These constraints seemed to be violated by a world-class memorist, Feng Wang (FW), who won the World Memory Championship by recalling 300 digits presented at 1 digit/s. In several studies we examined FW's memory skills underlying his exceptional performance. First FW reproduced his superior memory span of 200 digits under laboratory condition, andwe obtained his retrospective reports describing his encoding/retrieval processes (Experiment 1). Further experiments used self-paced memorisation to identify temporal characteristics of encoding of digits in 4-digit clusters (Experiment 2), and explored memory encoding at presentation speeds much faster than 1 digit/s (Experiment 3). FW's superiority over previous digit span experts is explained by his acquisition of well-known mnemonic techniques and his training that focused on rapid memorisation. His memory performance supports the feasibility of acquiring memory skills for improved working memory based on storage in long-term memory.