Clinicians' purposeful improvement of practice is vital to maintaining excellence in patient care. This activity is understood as a core competency of adaptive expertise. As part of a broader program of research exploring adaptive expertise in healthcare, this study explored purposeful improvement in paediatric minimally invasive surgery. A…

This dissertation is motivated by two problems. First, existing literature characterizes patient handoff as an information transfer activity in which safety and quality are compromised by practice variation. This has prompted a movement to standardize practice. However, existing research has not closely examined how practice variations may be…