Skip to main content
SpringerLink
Log in

Assessing the Quality of Expertise Differences in the Comprehension of Medical Visualizations

  • Original Paper
  • Published:
Vocations and Learning Aims and scope Submit manuscript

Abstract

Understanding how best to assess expertise, the situational variations of expertise, and distinctive qualities of expertise that arises from particular workplace experiences, presents an important challenge. Certainly, at this time, there is much interest in identifying standard occupational measures and competences, which are not well aligned with such variations and distinctiveness in performance. Therefore, this paper addresses the methodological issues posed by such a challenge through reviewing the expertise literature to identify ways forward. Based on the example of one target domain, medicine, and one criterion task, the comprehension of visualizations, the study identifies, elaborates, and evaluates assessments used to study qualitative changes in professional vision that occur as a result of extended periods of workplace learning experiences. It identifies the kinds of sample, materials, measures, and analysis methods used to assess the quality of expertise differences, as well as what elements of and differences in visual expertise are revealed in particular assessment processes. In doing this, the study seeks to illuminate how assessing the quality of expertise differences matured over the past 20 years, noting that strategies of scanning brain activity and tracking eye movements are now being used in ways that augment traditional approaches such as using verbal reports and observing representational practices. The findings demonstrate how the assessment of visual expertise has become more multidisciplinary over the past two decades. Implications for educational practice and future research directions on the development of professional vision are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. “Basic experts” had extensive diagnostic experience while “super experts” had, in addition to diagnostic experience, experience in teaching and research (Raufaste et al. 1998, p. 525).

References

  • Achtenhagen, F., & Weber, S. (2009). Transferability, flexibility, mobility as targets of vocational education and training—the COST-Action A11. In F. Rauner & R. MacLean (Eds.), Handbook of technical and vocational education and training research (pp. 683–695). Dordrecht: Springer.

    Google Scholar 

  • Augustyniak, P., & Tadeusiewicz, R. (2006). Assessment of electrocardiogram visual interpretation strategy based on scanpath analysis. Physiological Measurement, 27, 597–608. doi:10.1088/0967-3334/27/7/004.

    Article  Google Scholar 

  • Beausaert, S. A. J., Segers, M. S. R., & Gijselaers, W. H. (2011). Using a personal development plan for different purposes: its influence on undertaking learning activities and job performace. Vocations and Learning, 4, 231–252. doi:10.1007/s12186-011-9060-y.

    Article  Google Scholar 

  • Billett, S. (2004). Workplace participatory practices: conceptualising workplaces as learning environments. Journal of Workplace Learning, 16, 312–324. doi:10.1108/13665620410550295.

    Article  Google Scholar 

  • Boshuizen, H. P. A., & Schmidt, H. G. (1992). On the role of biomedical knowledge in clinical reasoning by experts, intermediates and novices. Cognitive Science, 16, 153–184. doi:10.1016/0364-0213(92)90022-M.

    Article  Google Scholar 

  • Boshuizen, H. P. A., Bromme, R., & Gruber, H. (Eds.). (2004). Professional learning: gaps and transitions on the way from novice to expert. Dordrecht: Kluwer.

    Google Scholar 

  • Bransford, J., Vye, N., Stevens, R., Kuhl, P., Schwartz, D., Bell, P., et al. (2006). Learning theories and education: toward a decade of synergy. In P. A. Alexander & P. H. Winne (Eds.), Handbook of educational psychology (2nd ed., pp. 209–244). Mahwah: Erlbaum.

    Google Scholar 

  • Büscher, M., & Jensen, G. (2007). Sound sight: seeing with ultrasound. Health Informatics Journal, 13, 23–35. doi:10.1177/1460458207073643.

    Article  Google Scholar 

  • Crowley, R. S., Naus, G. J., Stewart, J., & Friedman, C. P. (2003). Development of visual diagnostic expertise in pathology: an information-processing study. Journal of the American Medical Informatics Association, 10, 39–51. doi:10.1197/jamia.M1123.

    Article  Google Scholar 

  • De Smedt, B., Ansari, D., Grabner, R. H., Hannula-Sormunen, M. M., Schneider, M., & Verschaffel, L. (2011). Cognitive neuroscience meets mathematics education: it takes two to tango. Educational Research Review, 6, 232–237. doi:10.1016/j.edurev.2011.10.003.

    Article  Google Scholar 

  • Ericsson, K. A. (2004). Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic Medicine, 79, S70–S81.

    Article  Google Scholar 

  • Ericsson, K. A., & Kintsch, W. (1995). Long-term working memory. Psychological Review, 102, 211–245. doi:10.1037/0033-295X.102.2.211.

    Article  Google Scholar 

  • Fiorio, M., Cesari, P., Bresciani, M. C., & Tinazzi, M. (2010). Expertise with pathological actions modulates a viewer’s motor system. Neuroscience, 167, 691–699. doi:10.1016/j.neuroscience.2010.02.010.

    Article  Google Scholar 

  • Gartmeier, M., Bauer, J., Gruber, H., & Heid, H. (2008). Negative knowledge: understanding professional learning and expertise. Vocations and Learning, 1, 87–103. doi:10.1007/s12186-008-9006-1.

    Article  Google Scholar 

  • Gegenfurtner, A. (2012). Dimensions of motivation to transfer: a longitudinal analysis of their influences on retention, transfer, and attitude change. Vocations and Learning. doi:10.1007/s12186-012-9084-y.

  • Gegenfurtner, A. (2011). Motivation and transfer in professional training: a meta-analysis of the moderating effects of knowledge type, instruction, and assessment conditions. Educational Research Review, 6, 153–168. doi:10.1016/j.edurev.2011.04.001.

    Article  Google Scholar 

  • Gegenfurtner, A., Festner, D., Gallenberger, W., Lehtinen, E., & Gruber, H. (2009a). Predicting autonomous and controlled motivation to transfer training. International Journal of Training and Development, 13, 124–138. doi:10.1111/j.1468-2419.2009.00322.x.

    Article  Google Scholar 

  • Gegenfurtner, A., Lehtinen, E., & Säljö, R. (2011). Expertise differences in the comprehension of visualizations: a meta-analysis of eye-tracking research in professional domains. Educational Psychology Review, 23, 523–552. doi:10.1007/s10648-011-9174-7.

    Article  Google Scholar 

  • Gegenfurtner, A., & Vauras, M. (2012). Age-related differences in the relation between motivation to learn and transfer of training in adult continuing education. Contemporary Educational Psychology, 37, 33–46. doi:10.1016/j.cedpsych.2011.09.003.

    Article  Google Scholar 

  • Gegenfurtner, A., Veermans, K., Festner, D., & Gruber, H. (2009b). Motivation to transfer training: an integrative literature review. Human Resource Development Review, 8, 403–423. doi:10.1177/1534484309335970.

    Article  Google Scholar 

  • Gegenfurtner, A., Veermans, K., & Vauras, M. (2012). Effects of computer support, collaboration, and time lag on performance self-efficacy and transfer of training: a longitudinal meta-analysis. Educational Research Review. doi:10.1016/j.edurev.2012.04.001.

  • Gilhooly, K. J., McGeorge, P., Hunter, J., Rawles, J. M., Kirby, I. K., Green, C., et al. (1997). Biomedical knowledge in diagnostic thinking: the case of electrocardiogram (ECG) interpretation. European Journal of Cognitive Psychology, 9, 199–223. doi:10.1080/713752555.

    Article  Google Scholar 

  • Goodwin, C. (1994). Professional vision. American Anthropologist, 96, 606–633. doi:10.1525/aa.1994.96.3.02a00100.

    Article  Google Scholar 

  • Gross, S. (2009). Experts and ‘knowledge that counts’: a study into the world of brain cancer diagnosis. Social Science & Medicine, 69, 1819–1826. doi:10.1016/j.socscimed.2009.09.017.

    Article  Google Scholar 

  • Gruber, H., Jansen, P., Marienhagen, J., & Altenmüller, E. (2010). Adaptations during the acquisition of expertise. Talent Development & Excellence, 2, 3–15.

    Google Scholar 

  • Haider, H., & Frensch, P. A. (1999). Eye movement during skill acquisition: more evidence for the information reduction hypothesis. Journal of Experimental Psychology: Learning, Memory, and Cognition, 25, 172–190. doi:10.1037/0278-7393.25.1.172.

    Article  Google Scholar 

  • Haier, R. J., Siegel, B. V., Nuechterlein, K. H., Hazlett, E., Wu, J. C., Paek, J., et al. (1988). Cortical glucose metabolic rate correlates of abstract reasoning and attention studied with positron emission tomography. Intelligence, 12, 199–217. doi:10.1016/0160-2896(88)90016-5.

    Article  Google Scholar 

  • Haller, S., & Radue, E. W. (2005). What is different about a radiologist’s brain? Radiology, 236, 983–989. doi:10.1148/radiol.2363041370.

    Article  Google Scholar 

  • Harley, E. M., Pope, W. B., Villablanca, J. P., Mumford, J., Suh, R., Mazziotta, J. C., et al. (2009). Engagement of fusiform cortex and disengagement of lateral occipital cortex in the acquisition of radiological expertise. Cerebral Cortex, 19, 2746–2754. doi:10.1093/cercor/bhp051.

    Article  Google Scholar 

  • Harris, L. R. (2011). Phenomenographic perspectives on the structure of conceptions. The origins, purposes, strengths, and limitations of the what/how and referential/structural frameworks. Educational Research Review, 6, 109–124. doi:10.1016/j.edurev.2011.01.002.

    Article  Google Scholar 

  • Harteis, C., Morgenthaler, B., Kugler, C., Ittner, K.-P., Roth, G., & Graf, B. (2012). Professional competence and intuitive decision-making: a simulation study in the domain of emergency medicine. Vocations and Learning, 5, 119–136. doi:10.1007/s12186-011-9070-9.

    Article  Google Scholar 

  • Helle, L., Nivala, M., Kronqvist, P., Gegenfurtner, A., Björk, P., & Säljö, R. (2011). Traditional microscopy instruction versus process-oriented virtual microscopy instruction: a naturalistic experiment with control group. Diagnostic Pathology, 6, S8. doi:10.1186/1746-1596-6-S1-S8.

    Article  Google Scholar 

  • Henderson, A. J., Alexander, H., Haywood, A., Stapleton, P., Cooke, M., Patterson, E., et al. (2010). Promoting and providing expert guidance in work-intensive clinical settings. Vocations and Learning, 3, 141–156. doi:10.1007/s12186-010-9036-3.

    Article  Google Scholar 

  • Krupinski, E. A. (2005). Visual search of mammographic images: influence of lesion subtlety. Academic Radiology, 12, 965–969. doi:10.1016/j.acra.2005.03.071.

    Article  Google Scholar 

  • Krupinski, E. A. (2010). Current perspectives in medical image perception. Attention, Perception, & Psychophysics, 72, 1205–1217. doi:10.3758/APP.72.5.1205.

  • Krupinski, E. A., Tillack, A. A., Richter, L., Henderson, J. T., Bhattacharyya, A. K., Scott, K. M., et al. (2006). Eye-movement study and human performance using telepathology virtual slides. Implications for medical education and differences with experience. Human Pathology, 37, 1543–1556. doi:10.1016/j.humpath.2006.08.024.

    Article  Google Scholar 

  • Kundel, H. L., Nodine, C. F., Conant, E. F., & Weinstein, S. P. (2007). Holistic component of image perception in mammogram interpretation: gaze-tracking study. Radiology, 242, 396–402. doi:10.1148/radiol.2422051997.

    Article  Google Scholar 

  • Lesgold, A., Rubinson, H., Feltovich, P., Glaser, R., Klopfer, D., & Wang, Y. (1988). Expertise in a complex skill: diagnosing X-ray pictures. In M. T. H. Chi, R. Glaser, & M. J. Farr (Eds.), The nature of expertise (pp. 311–342). Hillsdale: Erlbaum.

    Google Scholar 

  • Litchfield, D., Ball, L. J., Donovan, T., Manning, D. J., & Crawford, T. (2010). Viewing another person’s eye movements improves identification of pulmonary nodules in chest X-ray inspection. Journal of Experimental Psychology. Applied, 16, 251–262. doi:10.1037/a0020082.

    Article  Google Scholar 

  • Manning, D., Ethell, S., Donovan, T., & Crawford, T. (2006). How do radiologists do it? The influence of experience and training on searching for chest nodules. Radiography, 12, 134–142. doi:10.1016/j.radi.2005.02.003.

    Article  Google Scholar 

  • Måseide, P. (2007). Discourses of collaborative medical work. Text & Talk, 27, 611–632. doi:10.1515/TEXT.2007.028.

    Article  Google Scholar 

  • Mondada, L. (2003). Working with video: how surgeons produce video records of their actions. Visual Studies, 18, 58–73. doi:10.1080/1472586032000100083.

    Article  Google Scholar 

  • Morita, J., Miwa, K., Kitasaka, T., Mori, K., Suenaga, Y., Iwano, S., et al. (2008). Interactions of perceptual and conceptual processing: expertise in medical image diagnosing. International Journal of Human Computer Studies, 66, 370–390. doi:10.1016/j.ijhcs.2007.11.004.

    Article  Google Scholar 

  • Nodine, C. F., & Krupinski, E. A. (1998). Perceptual skill, radiology expertise, and visual test performance with NINA and WALDO. Academic Radiology, 5, 603–612. doi:10.1016/S1076-6332(98)80295-X.

    Article  Google Scholar 

  • Nodine, C. F., Kundel, H. L., Lauver, S. C., & Toto, L. C. (1996). Nature of expertise in searching mammograms for breast masses. Academic Radiology, 3, 1000–1006. doi:10.1016/S1076-6332(96)80032-8.

    Article  Google Scholar 

  • Nodine, C. F., Mello-Thoms, C., Kundel, H. R., & Weinstein, S. P. (2002). Time course of perception and decision making during mammographic interpretation. American Journal of Roentgenology, 179, 917–923.

    Article  Google Scholar 

  • Norman, G. R., Coblentz, C. L., Brooks, L. R., & Babcook, C. J. (1992). Expertise in visual diagnosis: a review of the literature. Academic Medicine, 67, S78–S83.

    Article  Google Scholar 

  • Noroozi, O., Weinberger, A., Biemans, H. J. A., Mulder, M., & Chizari, M. (2012). Argumentation-based computer supported collaborative learning (ABCSCL): a synthesis of 15 years of research. Educational Research Review, 7, 79–106. doi:10.1016/j.edurev.2011.11.006.

    Article  Google Scholar 

  • Paloniemi, S., & Collin, K. (2012). Discursive power and creativity in inter-professional work. Vocations and Learning, 5, 23–40. doi:10.1007/s12186-011-9064-7.

    Article  Google Scholar 

  • Raufaste, E., Eyrolle, H., & Mariné, C. (1998). Pertinence generation in radiological diagnosis: spreading activation and the nature of expertise. Cognitive Science, 22, 517–546. doi:10.1016/S0364-0213(99)80048-2.

    Article  Google Scholar 

  • Segers, M., & Gegenfurtner, A. (in press). Transfer of training: new conceptualizations through integrated research perspectives. Educational Research Review, 8.

  • Seppänen, M., & Gegenfurtner, A. (2012). Seeing through teacher’s eyes improves students’ imaging interpretation. Medical Education, 46. doi:10.1111/medu.12041.

  • Simpson, S. A., & Gilhooly, K. J. (1997). Diagnostic thinking processes: evidence from a constructive interaction study of electrocardiogram (ECG) interpretation. Applied Cognitive Psychology, 11, 543–554. doi:10.1002/(SICI)1099-0720(199712)11:6<543::AID-ACP486>3.0.CO;2-C.

    Article  Google Scholar 

  • Stürmer, K., Könings, K. D., & Seidel, T. (2012). Declarative knowledge and professional vision in teacher education: effect of courses in teaching and learning. British Journal of Educational Psychology. doi:10.1111/j.2044-8279.2012.02075.x.

  • Svensson, M. S. (2007). Monitoring practice and alarm technology in anaesthesiology. Health Informatics Journal, 13, 9–21. doi:10.1177/1460458207073649.

    Article  Google Scholar 

  • Turner, D. A. (2011). Which part of ‘two way street’ did you not understand? Redressing the balance of neuroscience and education. Educational Research Review, 6, 223–231. doi:10.1016/j.edurev.2011.10.002.

    Article  Google Scholar 

  • Tynjälä, P. (2008). Perspectives into learning at the workplace. Educational Research Review, 3, 130–154. doi:10.1016/j.edurev.2007.12.001.

    Article  Google Scholar 

  • Van de Wiel, M. W. J., Szegedi, K. H. P., & Weggeman, M. C. D. P. (2004). Professional learning: deliberate attempts at developing expertise. In H. P. A. Boshuizen, R. Bromme, & H. Gruber (Eds.), Professional learning: gaps and transitions on the way from novice to expert (pp. 181–206). Dordrecht: Kluwer.

    Chapter  Google Scholar 

  • Van Merriënboer, J. J. G., & Sweller, J. (2010). Cognitive load theory in health professional education: design principles and strategies. Medical Education, 44, 85–93. doi:10.1111/j.1365-2923.2009.03498.x.

    Article  Google Scholar 

  • Wilson, M., McGrath, J., Vine, S., Brewer, J., Defriend, D., & Masters, R. (2010). Psychomotor control in a virtual laparoscopic surgery training environment: gaze control parameters differentiate novices from experts. Surgical Endoscopy, 24, 2458–2464. doi:10.1007/s00464-010-0986-1.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. TUM School of Education, Technische Universität München, Schellingstrasse 33, 80799, Munich, Germany

    Andreas Gegenfurtner

  2. Institute of Behavioral Sciences, University of Helsinki, Siltavuorenpenger 3A, FI-00014, Helsinki, Finland

    Anna Siewiorek

  3. Centre for Learning Research and Department of Teacher Education, University of Turku, Assistentinkatu 5, FI-20014, Turku, Finland

    Erno Lehtinen

  4. Department of Education, Communication and Learning, University of Gothenburg, Box 100, SE-405030, Gothenburg, Sweden

    Roger Säljö

  5. School of Education, Stanford University, 210 Panama Street, 94305, Stanford, CA, USA

    Anna Siewiorek

Authors
  1. Andreas Gegenfurtner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anna Siewiorek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erno Lehtinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roger Säljö
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andreas Gegenfurtner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gegenfurtner, A., Siewiorek, A., Lehtinen, E. et al. Assessing the Quality of Expertise Differences in the Comprehension of Medical Visualizations. Vocations and Learning 6, 37–54 (2013). https://doi.org/10.1007/s12186-012-9088-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12186-012-9088-7

Keywords

Search

Navigation