Book Reviews: Expertise & Resilience

In this post, Felix (@felixankel) suggests two more (related) books for your CE library.  Do you have other recommendations?  Send it to us!

–   Jonathan

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Mind over machine.  The power of human intuition and expertise in the era of the computer.

Dreyfus H, Dreyfus S.  Mind over machine.  The power of human intuition and expertise in the era of the computer.  The Free Press. 1986.

This book provides an interesting historical context for competency based medical education. Before there were real estate and a dot com bubbles, there was an artificial intelligence (AI) bubble in the late 1980s with the rise and fall of companies such as Symbolics and Lisp machines.  Dreyfus and Dreyfus, brothers from UC-Berkeley – one an existential philosopher, the other an industrial engineer – predicted the AI bubble. They suggested that humans had innate decision-making skills in the domains of autonomy, managing context, and dealing with complexity that could not be replicated by computers.  The Dreyfus brothers collaborated with the Accreditation Council for Graduate Medical Education (ACGME) during their internal review of graduate medical education in the 1990s. Their model of skill acquisition from novice to expert serves as the foundation for the ACGME’s milestones project. One way to subdivide systems expertise is in the domains of autonomy, complexity and context.

Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S. General competencies and accreditation in graduate medical education. Health Aff (Millwood). 2002;21(5):103-111

Want to know more? A longer review of this book appeared in the December 2012 version of the ICENet newsletter.

 Finding Balance in a Medical Life

Lipsenthal, L.  Finding Balance in a Medical Life. Finding Balance, Inc. 2007

In an increasingly interconnected world, modern medicine and education have shifted away from an emphasis on autonomy.1 I suggest that it is resilience, not autonomy, that most benefits CEs and education systems

Finding Balance in a Medical Life is a well-referenced, practical book that discusses specific tools to foster individual and system resilience. These include a deliberate identification of values, developing skills to bend, accelerating connections and having a systematic approach to reflective practice.

1 Reinertsen JL. Zen and the art of physician autonomy maintenance. Annals of Internal Medicine. 2003; 138(12):992-5.

Want to know more? A longer review of  this book appeared in the October 2012 version of the ICENet newsletter.