Evidence map›Paper›PMID 41245766›Full record

ArticlePerspectives on medical education2025

"Some Kind of Magic?" How Adaptive Experts Navigate Complexity in Pediatric Ultrasound-Guided Vascular Access.

Martien H Humblet, J Mesman, L Lingard, J Frèrejean, W N K A van Mook, P L J M Leroy

Abstract read
In one paragraph

Article in Perspectives on medical education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Martien H HumbletDepartment of Pediatrics, Division of Pediatric Intensive Care, Maastricht University Medical Center MUMC+, The Netherlands.ORCID 0000-0002-4930-2582
J MesmanFaculty of Arts and Culture, Department of Technology and Society Studies, University Maastricht, The Netherlands.ORCID 0000-0001-6721-2719
L LingardCentre for Education Research & Innovation, Department of Medicine, Schulich School of Medicine & Dentistry and Faculty of Education, Western University, London, Canada.ORCID 0000-0002-4150-3355
J FrèrejeanFaculty of Health, Medicine and Life Sciences, School of Health Professions Education, Maastricht University, The Netherlands.ORCID 0000-0002-3026-3624
W N K A van MookSchool of Health Professions Education, Maastricht University, The Netherlands.ORCID 0000-0003-2398-8878
P L J M LeroyDepartment of Pediatrics, Division of Pediatric Intensive Care, Maastricht University Medical Center MUMC+, The Netherlands.ORCID 0000-0001-8443-1913

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Technological innovations hold great promise for enhancing clinical practice, especially in high-stakes settings. Although simulation-based education can help to develop skill proficiency, transferring skills into real-world high-stakes settings remains challenging. By investigating 'super-users'-exceptional performers who have successfully implemented new technologies in demanding contexts-this study zooms in on ultrasound-guided vascular access (UGVA) in young, awake, and often non-compliant children and aims to unravel complexities and strategies for successful performance in complex contexts. Methods: Using a constructivist grounded theory approach, sensitized by concepts from expertise theory, we conducted incident-based interviews with 11 experts in pediatrics. Results: Two main results were identified through theoretical sampling, thematic and conceptual analysis, and constant comparison within a multidisciplinary research team. First, participants described multiple, intersecting dimensions of complexity: conceptual, psychomotor, contextual, and educational. Second, experts articulated their largely tacit knowledge and collaborative dynamics for navigating these complexities metaphorically. Successful pediatric UGVA was likened to a "choreography", where "orchestration" of dynamic socio-material aspects was perceived to yield "some kind of magic" engagement and synergy of the collective. Discussion: This study's conceptualization of dynamic, high-stakes, and morally charged performance reflects adaptive expertise and illustrates how motor skill expertise is intertwined with cognitive, social, and contextual aspects. Hence, in helping to demystify the "magic" in expert performance, this work discusses insights to advance adaptive expertise theory and motor learning theory, particularly on how to prepare future adaptive experts for the inherent complexities and transfer challenges of procedural performance in clinical practice. The findings underscore the need for training approaches that move beyond routine skill acquisition towards dynamic, context-rich learning environments that foster perceptual-motor adaptability, collaborative coordination, and moral readiness for high-stakes performance.

Indexed as

PediatricsUltrasonography, InterventionalChildClinical CompetenceFemaleGrounded TheoryHumansInterviews as TopicMaleQualitative Research

Identifiers

PMID41245766
PMCPMC12617406

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.