Stemming the tide: Cognitive aging theories and their implications for continuing education in the health professions
Journal of Continuing Education in the Health ProfessionsPublished 1 January 2003
Kevin W. Eva
Citations33
SJR quartileQ2
SJR score0.54
SNIP0.89
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TL;DR
Evidence from the medical education literature and psychological theory suggest the importance of increased environmental supports, decreased time demands, and peer review programs as barriers against the impact of aging.
Abstract
As demographic drift among health care providers mimics that of the larger population, it becomes increasingly clear that theory pertaining to the impact of aging on cognitive processing should inform the continuing education efforts designed for health care professionals. The purpose of this article is to offer a critical review of the major theories in this area and outline a sample of the implications that can be derived from these views. Research articles examining the relationship between age and physician performance were identified using MEDLINE, PsychLit, and ERIC. In addition, the psychology literature on age-related changes in cognitive processing was reviewed. Evidence from the medical education literature and psychological theory suggest the importance of increased environmental supports, decreased time demands, and peer review programs as barriers against the impact of aging. The implications of these findings include the potential to tailor continuing education (and physician remediation) efforts toward the age-related abilities/deficiencies of individual physicians.
Keywords
Medicine
Journal of Personality and Social PsychologyUnskilled and unaware of it: How difficulties in recognizing one's own incompetence lead to inflated self-assessments.
6,908 Citations1999Justin Kruger, David Dunning
Across 4 studies, the authors found that participants scoring in the bottom quartile on tests of humor, grammar, and logic grossly overestimated their test performance and ability.
Psychological ReviewThe processing-speed theory of adult age differences in cognition.
5,465 Citations1996Timothy A. Salthouse
A theory is proposed that increased age in adulthood is associated with a decrease in the speed with which many processing operations can be executed and that this reduction in speed leads to impairments in cognitive functioning because of what are termed the limited time mechanism and the simultaneity mechanism.
Journal of Memory and LanguageA process dissociation framework: Separating automatic from intentional uses of memory
3,691 Citations1991Larry L. Jacoby
American PsychologistExpert performance: Its structure and acquisition.
1,993 Citations1994K. Anders Ericsson, Neil Charness
Psychology and AgingEmergence of a powerful connection between sensory and cognitive functions across the adult life span: A new window to the study of cognitive aging?
1,125 Citations1997Paul B. Baltes, Ulman Lindenberger
It is argued that the increase in the age-associated link between sensory and intellectual functioning may reflect brain aging and that the search for explanations of cognitive aging phenomena would benefit from attending to factors that are shared between the 2 domains.
Psychology and AgingSensory functioning and intelligence in old age: A strong connection.
968 Citations1994Ulman Lindenberger, Paul B. Baltes
Psychology Press eBooksTheoretical Perspectives on Cognitive Aging
948 Citations2016Timothy A. Salthouse
Medical Entomology and ZoologyIntellectual Development in Adulthood: The Seattle Longitudinal Study
689 Citations1996K. Warner Schaie, Paul B. Baltes
Journal of Experimental Psychology Learning Memory and CognitionAge and inhibition.
643 Citations1991Lynn Hasher, Ellen R. Stoltzfus +2 more
Two experiments assess adult age differences in the extent of inhibition or negative priming generated in a selective-attention task within the Hasher-Zacks (1988) framework, which proposes inhibition as a central mechanism determining the contents of working memory and consequently influencing a wide array of cognitive functions.
Cognitive ScienceOn the Role of Biomedical Knowledge in Clinical Reasoning by Experts, Intermediates and Novices
541 Citations1992Henny P. A. Boshuizen, Henk G. Schmidt
It was shown that experts have more in-depth biomedical knowledge than novices and subjects at intermediate levels of expertise and generally support a three-stage model of expertise development in medicine consisting of acquisition of biomedical knowledge, practical experience, and integration of theoretical and experientall knowledge resulting in knowledge encapsulation.
Aging and Cognitive Deficits
535 Citations1982Fergus I. M. Craik, Mark Byrd
Psychology and AgingMediators of long-term memory performance across the life span.
523 Citations1996Denise C. Park, Anderson D. Smith +3 more
Advances in Health Sciences EducationHow Can I Know What I Don't Know? Poor Self Assessment in a Well-Defined Domain
300 Citations2004Kevin W. Eva, John Cunnington +3 more
SurgeryPatient outcomes for segmental colon resection according to surgeon's training, certification, and experience
235 Citations2002Jay B. Prystowsky, Georges Bordage +1 more
A retrospective study of 15,427 admissions of northern Illinois residents who underwent segmental colon resection as their primary operation from 1994 to 1997 was able to link patient outcomes with surgeon's training, suggesting a continued learning curve subsequent to residency.
The Journals of Gerontology Series BCognitive Gerontology and Attentional Inhibition: A Reply to Burke and McDowd
216 Citations1997Rose T. Zacks, Lynn Hasher
This response to the Burke and McDowd critiques (in this issue) begins with a history of the origins of the inhibitory deficit view and of its development since 1988 as well as with an account of some particularly useful findings.
Academic MedicineHelping students learn to think like experts when solving clinical problems
215 Citations1997Henry Mandin, Andrew Jones +2 more
The “hypothetico-deductive” strategy traditionally used in PBL should be replaced by scheme-driven search strategies so that students develop a more organized and logical approach to problem solving.
Medical EducationClinical problem‐solving by medical students: a cross‐sectional and longitudinal analysis
215 Citations1981V R Neufeld, Geoffrey R. Norman +2 more
The evolution of clinical reasoning in medical students was studied and subjects were observed in a clinical examination of a simulated patient, and their thought processes were abstracted from a 'stimulated recall' of the videotaped encounter.
Academic MedicineThe Aging Physician
189 Citations2002Kevin W. Eva
This paper systematically examines the small amount of evidence available in medical education that highlights the issue of aging and attempts to reconcile contradictory findings by drawing on the much larger psychological literature on pre-senile aging.
Psychology and AgingSeparating habit and recollection in young and older adults: Effects of elaborative processing and distinctiveness.
182 Citations1999Janine F. Hay, Larry L. Jacoby
An extension of L. L. Jacoby's (1991) process-dissociation procedure was used to examine the effects of aging on recollection and automatic influences of memory (habit) and showed that older adults were impaired in their ability to engage in recollection but did not differ from young adults in their reliance on habit.
The Journals of Gerontology Series BLanguage, Aging, and Inhibitory Deficits: Evaluation of a Theory
177 Citations1997Deborah M. Burke
This article evaluates the success of Inhibitory Deficit theory in addressing two basic functions of a theory: explaining available results and predicting new findings, and Modification of the theory is required to bring it in line with empirical findings on language and aging.
The Journals of Gerontology Series BInhibition in Attention and Aging
173 Citations1997Joan M. McDowd
The role of inhibitory mechanisms in selective attention and aging is evaluated and an evaluation of inhibition as a theoretical concept in theories of cognitive aging is provided, with a specific focus on attention and Aging.
Advances in Health Sciences EducationThe Non-Analytical Basis of Clinical Reasoning
157 Citations1997Geoffrey R. Norman, Lee R. Brooks
It is concluded that amassing prior instances is an important component of expertise, and education should recognize this element.
Psychology and AgingMemory for pictures: Does an age-related decline exist?
150 Citations1986Denise C. Park, J. Thomas Puglisi +1 more
Medical EducationThe life long challenge of expertise
137 Citations2001Cameron B. Guest, Glenn Regehr +1 more
The development and maintenance of expertise in any domain requires extensive, sustained practice of the necessary skills; the quantity of time spent is not the only factor in achieving expertise; the quality of this time is at least as important.
Academic MedicineMental representations of medical diagnostic knowledge
133 Citations1996Eugène J. F. M. Custers, Glenn Regehr +1 more
JAMANonsteroidal Anti-inflammatory Drug—Associated Azotemia in the Very Old
125 Citations1990Jerry H. Gurwitz
It is suggested that reversible azotemia develops in a sizable proportion of the very old who are treated with short-term NSAID therapy, and two factors were significantly predictors of a greater than 50% increase in the serum urea nitrogen level: concurrent loop diuretic therapy and high NSAID dose.
JAMACompetency Assessment of Primary Care Physicians as Part of a Peer Review Program
124 Citations1993Geoffrey R. Norman
The study demonstrated the feasibility, reliability, and validity of a multicomponent examination in the peer review process and to design and test a program that assesses clinical competence as a second stage in apeer review process.
PubMedFive-year results of the peer assessment program of the College of Physicians and Surgeons of Ontario.
118 Citations1990R. G. McAuley, William Paul
The findings demonstrate the need, feasibility and acceptance of a peer assessment program of office practices in Ontario and find three statistically significant predictors of physician performance: age, CFPC membership status and type of practice.
Psychology and AgingA systemic-wholistic view of psychological functioning in very old age: Introduction to a collection of articles from the Berlin Aging Study.
76 Citations1997Paul B. Baltes, Jacqui Smith
Although the BASE sample is positively biased, it is not restricted in heterogeneity and does not exhibit major differences in patterns of covariation among variables, which supports the use of BASE data for the intended systemic-wholistic analyses.
Psychology and AgingHow aging affects the reading of words in noisy backgrounds.
62 Citations2000Filippo Speranza, Meredyth Daneman +1 more
The difference in the number of correct identifications between predictable and unpredictable conditions was higher for the older observers than for the younger observers, indicating that older observers benefit from context more.
Academic MedicineThe effect of presentation order in clinical decision making
59 Citations1997John Cunnington, John Turnbull +3 more
Cognitive SciencePropositional Versus Structural Semantic Analyses of Medical Diagnostic Thinking
55 Citations1992Madeleine E. Lemieux, Georges Bordage
Psychology and AgingAge and experience effects on the interpretation of orthographic drawings of three-dimensional objects.
34 Citations1991Timothy A. Salthouse
The results seem to imply that experience neither mediates nor moderates age-related influences on certain measures of relatively basic cognitive processes.
Academic MedicineAgreement among medical experts about the structure of concepts in pulmonary physiology
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PubMedParticipation in CME activities.
29 Citations1998F Goulet, Robert Gagnon +3 more
Older physicians maintained their clinical competence by participating in different CME activities from younger physicians, and participated in as many CME Activities as their younger colleagues.
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