Swipe om te navigeren naar een ander artikel
The online version of this article (https://doi.org/10.1007/s40037-018-0443-8) contains supplementary material, which is available to authorized users.
Medical students must gain proficiency with the complex skill of case presentations, yet current approaches to instruction are fragmented and often informal, resulting in suboptimal transfer of this skill into clinical practice. Whole task approaches to learning have been proposed to teach complex skill development. The authors describe a longitudinal case presentation curriculum developed using a whole task approach known as four-component instructional design (4-C/ID). 4‑C/ID is based on cognitive psychology theory, and carefully attends to titrating a learner’s cognitive load, aiming to always keep students in their zone of proximal development. A multi-institutional group of medical educators convened to develop expert consensus regarding case presentation instruction using the 4‑C/ID model. A curriculum consisting of 1) learning tasks, 2) supportive information, 3) just-in-time information, and 4) part-task practice was developed. Domains were identified that make the task of delivering a case presentation complex. A simplifying conditions approach was applied to each domain to develop sequential task class descriptions. Examples of the four components are given to facilitate understanding of the 4‑C/ID model, making it more accessible to medical educators. Applying 4‑C/ID to curriculum development for the complex skill of case presentation delivery may optimize instruction. The provision of the complete curricular outline may facilitate transfer and implementation of this case presentation curriculum, as well as foster the application of 4‑C/ID to other complex skill development in medical education.
Supplementary Figure 1: Schematic to represent “what makes a case presentation complex?”40037_2018_443_MOESM1_ESM.docx
Supplementary Table 1: 4‑C/ID Outline for Task Class 140037_2018_443_MOESM2_ESM.docx
Supplementary Table 2: 4‑C/ID Outline for Task Class 240037_2018_443_MOESM3_ESM.docx
Supplementary Table 3: 4‑C/ID Outline for Task Class 340037_2018_443_MOESM4_ESM.docx
Supplementary Table 4: 4‑C/ID Outline for Task Class 440037_2018_443_MOESM5_ESM.docx
Englander R, Aschenbrener C, Call S, et al. Core entrustable professional activities for entering residency curriculum developer’s guide. Association of American Medical Colleges iCollaborative. 2014. https://www.mededportal.org/icollaborative/resource/887. Accessed 20 Nov 2017.
Daniel M, Rougas S, Warrier S, et al. Teaching oral presentation skills to second-year medical students. MedEdPORTAL. 2015. https://www.mededportal.org/publication/10017. Accessed 20 Nov 2017.
Daniel M, Heney R, Kwan B, et al. Preparing for clerkships: learning to deliver specialty-specific oral presentations. MedEdPORTAL. 2015. https://www.mededportal.org/publication/10261. Accessed 20 Nov 2017.
Heiman HL, Uchida T, Adams C, et al. E‑learning and deliberate practice for oral case presentation skills: a randomized trial. Med Teach. 2012;34:e820–e6. CrossRef
Wiese J, Varosy P, Tierney L. Improving oral presentation skills with a clinical reasoning curriculum: a prospective controlled study. Am J Med. 2002;112:212–8. CrossRef
Vandewaetere M, Manhaeve D, Aertgeerts B, Clarebout G, Van Merriënboer JJ, Roex A. 4C/ID in medical education: how to design an educational program based on whole-task learning: AMEE guide no. 93. Med Teach. 2015;37:4–20. CrossRef
Van Merriënboer JJ, Kirschner PA. Ten steps to complex learning: a systematic approach to four-component instructional design. Oxon: Routledge; 2013.
Merrill MD. First principles of instruction. Educ Technol Res Dev. 2002;50:43–59. CrossRef
Susilo AP, van Merriënboer J, van Dalen J, Claramita M, Scherpbier A. From lecture to learning tasks: use of the 4C/ID model in a communication skills course in a continuing professional education context. J Contin Educ Nurs. 2013;44:278–84. CrossRef
Postma TC, White JG. Developing clinical reasoning in the classroom–analysis of the 4C/ID-model. Eur J Dent Educ. 2015;19:74–80. CrossRef
Maggio LA, Ten Cate O, Irby DM, O’Brien BC. Designing evidence-based medicine training to optimize the transfer of skills from the classroom to clinical practice: applying the four-component instructional design model. Acad Med. 2015;90:1457–61. CrossRef
McLeod SA. Zone of proximal development. Simply psychology. 2010. https://www.simplypsychology.org/Zone-of-Proximal-Development.html. Accessed 20 Nov 2017.
Van Merriënboer JJ, Clark RE, De Croock MB. Blueprints for complex learning: the 4C/ID-model. Educ Technol Res Dev. 2002;50:39–61. CrossRef
Van Merriënboer JJ, Kester L, Paas F. Teaching complex rather than simple tasks: Balancing intrinsic and germane load to enhance transfer of learning. Appl Cogn Psychol. 2006;20:343–52. CrossRef
Lingard L, Garwood K, Schryer CF, Spafford MM. A certain art of uncertainty: case presentation and the development of professional identity. Soc Sci Med. 2003;56:603–16. CrossRef
Gordon M, Findley R. Educational interventions to improve handover in healthcare: a systematic review. Med Educ. 2011;45:1081–9. CrossRef
Dolmans D. When I say … whole-task curricula. Med Educ. 2015;49:457–8. CrossRef
Van Merriënboer JJ, Kester L. Whole-task models in education. In: Spector JM, Merrill MD, Elen J, Bishop MJ, editors. Handbook of research on educational communications and technology. New York: Springer; 2007. pp. 441–56.
- Applying four-component instructional design to develop a case presentation curriculum
- Bohn Stafleu van Loghum