Psychologist K. Anders Ericsson, a professor of Psychology at Florida State University, has been a pioneer in researching deliberate practice and what it means. According to Ericsson:
People believe that because expert performance is qualitatively different from normal performance the expert performer must be endowed with characteristics qualitatively different from those of normal adults. […] We agree that expert performance is qualitatively different from normal performance and even that expert performers have characteristics and abilities that are qualitatively different from or at least outside the range of those of normal adults. However, we deny that these differences are immutable, that is, due to innate talent. Only a few exceptions, most notably height, are genetically prescribed. Instead, we argue that the differences between expert performers and normal adults reflect a life-long period of deliberate effort to improve performance in a specific domain.
One of Ericsson’s core findings is that how expert one becomes at a skill has more to do with how one practices than with merely performing a skill a large number of times. An expert breaks down the skills that are required to be expert and focuses on improving those skill chunks during practice or day-to-day activities, often paired with immediate coaching feedback. Another important feature of deliberate practice lies in continually practising a skill at more challenging levels with the intention of mastering it. Deliberate practice is also discussed in the books Talent is Overrated by Geoff Colvin and The Talent Code by Daniel Coyle, among others.
Two recent articles in Current Directions in Psychological Science criticize deliberate practice and argue that, while it is necessary for reaching high levels of performance, it is not sufficient, with other factors such as talent being important as well.
Behavioral versus cognitive theories of deliberate practice
Behavioral theory would argue that deliberate practice is facilitated by feedback from an expert that allows for successful approximation of the target performance. Feedback from an expert allows the learner to minimize errors and frustration that results from trial-and-error attempts. Behavioral theory does not require delivery of rewards for accurate performance; the expert feedback in combination with the accurate performance serve as the consequences that establish and maintain the new performance.
In cognitive theory, excellent performance results from practising complex tasks that produce errors. Such errors provide the learner with rich feedback that results in scaffolding for future performance. Cognitive theory explains how a learner can become an expert (or someone who has mastered a domain).
Deliberate practice in medical education
Duvivier et al. reconstructed the concept of deliberate practice into practical principles to describe the process as it relates to clinical skill acquisition. They defined deliberate practice as:
repetitive performance of intended cognitive or psychomotor skills.
rigorous skills assessment
specific information feedback
better skills performance
They further described the personal skills learners need to exhibit at various stages of skill development in order to be successful in developing their clinical skills. This includes:
planning (organize work in a structured way).
concentration/dedication (higher attention span)
repetition/revision (strong tendency to practice)
study style/self reflection (tendency to self-regulate learning)
While the study only included medical students, the authors found that repetitious practice may only help the novice learner (year 1) because as expertise is developed, the learner must focus and plan their learning around specific deficiencies. Curriculum must be designed to develop students’ ability to plan their learning as they progress in their careers.
Finally, the findings in the study also have implications for developing self-regulated behaviors in students. Initially, a medical student may need focused feedback from instructors; however, as they progress, they must develop the ability to self-assess.
Practice as maintenance
Skills fade with non-use. The phenomenon is often referred to as being “out of practice”. Practice is therefore performed (on a regular basis) to keep skills and abilities honed.