Exploring Residents' Perceptions of Expertise and Expert Development

Background Given the expectation that trainees develop into adaptive experts, able to effectively solve both routine and nonroutine problems of practice, and that they do so by actively guiding and shaping their own learning, the purpose of this study was to explore how residents at the postgraduate level of training conceptualize expertise, expert development, and their own learning in the developing expert trajectory. Method This research was a grounded theory study conducted during an 11-month period at a large, urban, Canadian university. Results Three major themes were identified from the data analysis: (1) the dominance of routinization as the pathway to expert practice, (2) a sophisticated conceptualization of the role and complexity of routine practice, and (3) a recognition that nonroutine problems are an important part of physician practice. Conclusions The results highlight our participants' emerging understanding of the complementary nature of routine and nonroutine problem solving by demonstrating their engagement in a process of progressive problem solving, as well as their inclusion of nonroutine problem solving as a crucial part of expert practice.