Preface
Foreword, John Flavell, PhD
Introduction

1. One: An Emerging Paradigm for Medical Education

Introduction
A Case for Lifelong Learning
Medical Expertise
Metacognition as the Foundation of Lifelong Learning
Summary

2. Two: Developing Expertise as the Aim of Medical Education

Introduction
Intelligence
Expertise
Capability and Competence
A Few Words of Wisdom
Summary

3. Metacognitive Capabilities

Introduction
Metacognition
Regulatory Capabilities

Planning
Reflection
Strategic Knowledge

Learning Style
Perspective Taking
The Risk of Too Much Metacognition

4. The Role of Intuition

Introduction
Intuition and Outcomes
Elements of Intuition
A Clinical Example
Intuition and Complexity
Developing from Novice to Expert
Summary

5. Clinical Expertise: A Blend of Intuition and Metacognition

Introduction
A Complementary Processing System
Using Metacognitive Capabilities to Develop Intuition
Intuition or Metacognition
Summary

6. Clinical Problem Solving

Introduction
The Role of Intuition in the Neonatal Intensive Care Unit
Surgical Intuition
Radiology and Search Superiority
Primary Care
Inpatient Medicine
A Metacognitive Approach

Step 1. Defining the Problem
Step 2. Mental Representation
Step 3. Planning How to Proceed
Step 4. Evaluation

Summary

7. Communication and the Physician-Patient Relationship

Introduction
Metacognition and Communication
Perspective Taking as the Foundation of "Metacommunication"
An Example of Poor Perspective Taking in the Clinical Encounter
Emotional Intelligence
The Example of Apology
A Word about Teamwork
Intuition and the Doctor-Patient Relationship
Concept of "Thin Slices"
Summary

8. Professionalism

Introduction
Professionalism Revisited
Professional Identity
Collective Perspective Taking and Regulation
Self-Assessment and Reflection Applied to Social Behavior
Cultural Awareness

Intuition and Stereotyping
Respect
Honesty and Integrity
Altruism
Summary

9. Teaching Expertise

Introduction
Teaching Strategies
Teaching from Text

Experiential Narratives
Metacognitive Scripts
Surgical Case Description
Discussion and Metacognitive Analysis
Interacting with the Learner

Role Play
Teaching Style
Modeling
Faculty Development

10. Self-Directed Learning

Introduction
Learning Strategies
Planning and Controlling the Learning Process

Goals
Needs
Objectives
Methods
Evaluation
Strategies for Self-Directed Learning
Self-Questioning
Reading for Comprehensive
Learning Portfolios
Review of Patient's Perspective (RPP)
Summary: Integrating Metacognitive Skill-Building into the Curriculum

11. A New Curricular Paradigm for Medical Education

Introduction
A New Paradigm
Culture of Medical Education
The Formal Curriculum

Competencies and Objectives
Focus on Experience
Evaluation
Summary
References
Index

[A] wonderful presentation... I have been working on several cognitive projects with students including attempts to overcome pre-mature closure and biases using several cognitive forcing strategies including the incorporation of cross word puzzles. It was enlightening to me to consider the expansion of the definition of metacognition to include the feelings of both physician and patient and the idea that intution is actually modulated by metacognition. These ideas have opened up some new avenues for me in teaching and evalution. "
--William D. Barnhart, MD MBA FACP,
Department of Internal Medicine,
University of Illinois College of Medicine-Rockford

"...the author shows in fascinating detail how metacognition and intuition can be used to enhance the teaching of medical faculty and the lifelong learning of their students. The book abounds with useful, concrete suggestions for student activitiesas well as insightful cautions about possible over reliance on these processes. I believe that fostering metacognition in medical teachers and students is both worth doing and feasible."

I enjoyed and learned a tremendous amount from Intuition and Metacognition in Medical Education. I frequently teach trainees about metacognition and effective reading/learning strategies to refine and continually update their clinical knowledge and promote clinical reasoning skills. It became clear (through great examples) how those same methods and efforts can promote communication skills, compassion, and professionalism. I have already modified my teaching and supervision based on this book and have recommended it to colleagues. ----Gurpreet Dhaliwal, M.D., Assistant Clinical Professor of Medicine, University of California San Francisco, San Francisco VA Medical Center

Mark Quick, EdD, is professor of family medine and community health at the University of Massachusetts Medical School (UMMS) and has published numerous articles related to behavioral and social science research and medical education. His research has focused on faculty developement, psysician-patient communication, disease prevention, evaluation, cognitive development, and health education. His articles appear in journals such as Family Medicine, Radiology, Teaching and Learning in Medicine, Social Science in Medicine, Health Psychology, Academic Medicine, International Journal of Psychology, Enrivonment and Behavior, Preventive Medicine, and Merrill Palmer Quarterly. He initiated the first required course at the University of Massachusetts Medical School on communication skills in 1982. He is the 2006 recipient of the STFM Excellence in Education Award, which recognizes leadership in support of teaching curriculum development and research in medical education.

Dr. Quirk has delivered invited keynote addresses on doctor-patient communication and on teaching to the Group on Educational Affairs, the International Association of Health Psychologists, and the Nordic Network for Education in Medical Communications. He has published a book on teaching and learning in medical education titled How to Learn and Teach in Medical School. He is an executive leader of the Macy Health Care Communication Initiative and the author of an Arthur Vining Davis Foundation Grant to develop caring attitudes among physicians.

The Clinical Faculty Development Center (CFDC) that Dr. Quirk directs has enrolled more than 800 primary care physicians from 15 medical schools in the northeastern United States. In the core program, Teaching of Tomorrow, 15 faculty members at UMMS share their educational expertise during a series of three weekend conferences each year. The CFDC also offers national workshops on medical education.

Numerous medical schools, hospitals, and professional organizations have sought consultation from Dr. Quirk in the areas of faculty development and physician communication. In addition, he has authored or coauthored successful training grants that have been funded for more than $4,000,000 since 1978. At UMMS, he is the assistant dean for academic achievement. In this role, he directs the Center for Academic Achievement (CAA), which focuses on teaching and learning in the preclinical and clinical years. Specific programs of the CAA include clinical skills electives, individual tutorials, and learning workshops for medical students, residents, and practicing physicians.

In his role as associate chair in family medicine and community health, Dr. Quirk assists the department in academic developement efforts. He chairs the Department Personnel Action Committee and is a member of the school's Basic and Clinical Science Academic Evaluation Boards and the Educational Policy Committee.