ABSTRACT
For several years, we have been trying to understand what constitutes radiological expertise and how that expertise is acquired. Our goal is to understand the learning of a complex skill and thereby to stretch the limits of existing knowledge about expertise and its acquisition. This chapter is a progress report on that work. Radiological diagnosis is a particularly complex and difficult skill. It has a substantial perceptual component that is different in character from that of other domains, such as chess and physics, that have been previously studied: It involves substantial amounts both of principled knowledge that is already formalized and of knowledge that can be gained only from clinical experience, going far beyond the formal scientific knowledge underlying medicine. It involves the integration of several distinct bodies of knowledge with separate organizing principles, including physiology, anatomy, medical theories of disease, and the projective geometry of radiography. Moreover, formal training in the domain is relatively standardized through residency programs, so that it is possible to trace some aspects of the course of acquisition of the skill as well as the course of instruction.
