Henk Schmidt
Henk Schmidt is a professor of psychology at Erasmus University’s faculty of social sciences and founding dean of its problem-based psychology curriculum. Between 2009 and 2013, he was the Vice-Chancellor (“Rector Magnificus”) of Erasmus University Rotterdam. Previously, Schmidt held academic positions as professor of cognitive psychology, faculty of psychology, Maastricht University, and as professor of health professions education at the same university. His research areas of interest are learning and memory, and he has published on problem-based learning, long-term memory, and the development of expertise in medicine.
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Papers by Henk Schmidt
Although team-based learning is a popular instructional approach, little is known about its psychological foundation. In this Perspective, the authors propose a theoretical account of the psychological mechanisms through which team-based learning works. They suggest a knowledge reconsolidation hypothesis to explain how the distinct phases of team-based learning enable students to learn. Knowledge reconsolidation is the process whereby previously consolidated knowledge is retrieved from memory with the purpose of actively consolidating it again. Reconsolidation aims to preserve, strengthen, and adjust knowledge that is already stored in long-term memory. This process is generally considered an important reason why people who reactivate what they have previously learned many times develop knowledge structures that are extremely stable and easily retrieved.
The authors propose that four psychological mechanisms enable knowledge reconsolidation, each of which is tied to a district phase of team-based learning: retrieval practice, peer elaboration, feedback, and transfer of learning. Before a team-based learning session, students engage in independent, self-directed learning that is often followed by at least one night of sleep. The latter is known to facilitate synaptic consolidation in the brain. During the actual team-based learning session, students are first tested individually on what they learned, then they discuss the answers to the test with a small group of peers, ask remaining “burning questions” to the teacher, and finally engage in a number of application exercises.
This knowledge reconsolidation hypothesis may be considered a framework to guide future research into how team-based learning works and its outcomes.
Method. An experimental paradigm was applied that consisted of a learning and a test phase. During the learning phase, 22 medical students were trained in diagnosing chest x-rays. Four of these eight cases were presented repeatedly, to develop a high level of expertise for these cases. During the test phase, all eight cases were presented and the participants’ prefrontal cortex was scanned using functional near-infrared spectroscopy. Response time and diagnostic accuracy were recorded as behavioural indicators.
Results. The results revealed that participants’ diagnostic accuracy in the test phase was significantly higher for the trained cases as compared to the untrained cases F(1, 21) = 138.80, P < 0.001, η2 = 0.87. Also, their response time was significantly shorter for these cases F(1, 21) = 18.12, P < 0.001, η2 = 0.46. Finally, the results revealed that only for the untrained cases, a significant activation of the anterolateral prefrontal cortex could be observed F(1, 21) = 21.00, P < 0.01, η2 = 0.34.
Conclusion. The fact that only untrained cases triggered higher levels of blood oxygenation in the prefrontal cortex is an indication that system-2 thinking is a cognitive process distinct from system 1. Implications of these findings for the validity of dual-process theory are discussed.
Studies suggest time pressure has negative effects on physicians' working conditions and may lead to suboptimal patient care and medical errors. Experimental evidence supporting this is lacking, however. This study investigated the effect of time pressure on diagnostic accuracy.
METHOD:
In 2013, senior internal medicine residents at three hospitals in Saudi Arabia were divided randomly into two groups: a time-pressure condition and a control condition without time pressure. Both groups diagnosed eight written clinical cases presented on computers. In the time-pressure condition, after completing each case, participants received information that they were behind schedule. Response time was recorded, and diagnostic accuracy was scored.
RESULTS:
The 23 participants in the time-pressure condition spent significantly less time diagnosing the cases (mean = 96.00 seconds) than the 19 control participants (mean = 151.97 seconds) (P < .001). Participants under time pressure had a significantly lower diagnostic accuracy score (mean = 0.33; 95% CI, 0.23-0.43) than participants without time pressure (mean = 0.51; 95% CI, 0.42-0.60) (F[1, 41] = 6.90, P = .012, η = 0.15). This suggests participants in the time-pressure condition made on average 37% more errors than control participants.
CONCLUSIONS:
Time pressure has a negative impact on diagnostic performance. The authors propose that the effect of time pressure on diagnostic accuracy is moderated by both the case difficulty level and the physician's level of experience. Post hoc analyses demonstrated that time pressure affects diagnostic accuracy only if cases are not too difficult and physicians' expertise level is intermediate.
Although team-based learning is a popular instructional approach, little is known about its psychological foundation. In this Perspective, the authors propose a theoretical account of the psychological mechanisms through which team-based learning works. They suggest a knowledge reconsolidation hypothesis to explain how the distinct phases of team-based learning enable students to learn. Knowledge reconsolidation is the process whereby previously consolidated knowledge is retrieved from memory with the purpose of actively consolidating it again. Reconsolidation aims to preserve, strengthen, and adjust knowledge that is already stored in long-term memory. This process is generally considered an important reason why people who reactivate what they have previously learned many times develop knowledge structures that are extremely stable and easily retrieved.
The authors propose that four psychological mechanisms enable knowledge reconsolidation, each of which is tied to a district phase of team-based learning: retrieval practice, peer elaboration, feedback, and transfer of learning. Before a team-based learning session, students engage in independent, self-directed learning that is often followed by at least one night of sleep. The latter is known to facilitate synaptic consolidation in the brain. During the actual team-based learning session, students are first tested individually on what they learned, then they discuss the answers to the test with a small group of peers, ask remaining “burning questions” to the teacher, and finally engage in a number of application exercises.
This knowledge reconsolidation hypothesis may be considered a framework to guide future research into how team-based learning works and its outcomes.
Method. An experimental paradigm was applied that consisted of a learning and a test phase. During the learning phase, 22 medical students were trained in diagnosing chest x-rays. Four of these eight cases were presented repeatedly, to develop a high level of expertise for these cases. During the test phase, all eight cases were presented and the participants’ prefrontal cortex was scanned using functional near-infrared spectroscopy. Response time and diagnostic accuracy were recorded as behavioural indicators.
Results. The results revealed that participants’ diagnostic accuracy in the test phase was significantly higher for the trained cases as compared to the untrained cases F(1, 21) = 138.80, P < 0.001, η2 = 0.87. Also, their response time was significantly shorter for these cases F(1, 21) = 18.12, P < 0.001, η2 = 0.46. Finally, the results revealed that only for the untrained cases, a significant activation of the anterolateral prefrontal cortex could be observed F(1, 21) = 21.00, P < 0.01, η2 = 0.34.
Conclusion. The fact that only untrained cases triggered higher levels of blood oxygenation in the prefrontal cortex is an indication that system-2 thinking is a cognitive process distinct from system 1. Implications of these findings for the validity of dual-process theory are discussed.
Studies suggest time pressure has negative effects on physicians' working conditions and may lead to suboptimal patient care and medical errors. Experimental evidence supporting this is lacking, however. This study investigated the effect of time pressure on diagnostic accuracy.
METHOD:
In 2013, senior internal medicine residents at three hospitals in Saudi Arabia were divided randomly into two groups: a time-pressure condition and a control condition without time pressure. Both groups diagnosed eight written clinical cases presented on computers. In the time-pressure condition, after completing each case, participants received information that they were behind schedule. Response time was recorded, and diagnostic accuracy was scored.
RESULTS:
The 23 participants in the time-pressure condition spent significantly less time diagnosing the cases (mean = 96.00 seconds) than the 19 control participants (mean = 151.97 seconds) (P < .001). Participants under time pressure had a significantly lower diagnostic accuracy score (mean = 0.33; 95% CI, 0.23-0.43) than participants without time pressure (mean = 0.51; 95% CI, 0.42-0.60) (F[1, 41] = 6.90, P = .012, η = 0.15). This suggests participants in the time-pressure condition made on average 37% more errors than control participants.
CONCLUSIONS:
Time pressure has a negative impact on diagnostic performance. The authors propose that the effect of time pressure on diagnostic accuracy is moderated by both the case difficulty level and the physician's level of experience. Post hoc analyses demonstrated that time pressure affects diagnostic accuracy only if cases are not too difficult and physicians' expertise level is intermediate.