Hines Stephen A, Collins Peggy L, Quitadamo Ian J, Brahler C Jayne, Knudson Cameron D, Crouch Gregory J
College of Veterinary Medicine, P.O. Box 647040, Washington State University, Pullman, WA 99164-7040, USA.
J Vet Med Educ. 2005 Spring;32(1):103-12. doi: 10.3138/jvme.32.1.103.
A case-based program called ATLes (Adaptive Teaching and Learning Environments) was designed for use in a systemic pathology course and implemented over a four-year period. Second-year veterinary students working in small collaborative learning groups used the program prior to their weekly pathology laboratory. The goals of ATLes were to better address specific learning objectives in the course (notably the appreciation of pathophysiology), to solve previously identified problems associated with information overload and information sorting that commonly occur as part of discovery-based processes, and to enhance classroom discussion. The program was also designed to model and allow students to practice the problem-oriented approach to clinical cases, thereby enabling them to study pathology in a relevant clinical context. Features included opportunities for students to obtain additional information on the case by requesting specific laboratory tests and/or diagnostic procedures. However, students were also required to justify their diagnostic plans and to provide mechanistic analyses. The use of ATLes met most of these objectives. Student acceptance was high, and students favorably reviewed the online ''Content Links'' that made useful information more readily accessible and level appropriate. Students came to the lab better prepared to engage in an in-depth and high-quality discussion and were better able to connect clinical problems to underlying changes in tissue (lesions). However, many students indicated that the required time on task prior to lab might have been excessive relative to what they thought they learned. The classroom discussion, although improved, was not elevated to the expected level-most likely reflecting other missing elements of the learning environment, including the existing student culture and the students' current discussion skills. This article briefly discusses the lessons learned from ATLes and how similar case-based exercises might be combined with other approaches to enhance and enliven classroom discussions in the veterinary curriculum.
一个名为ATLes（自适应教学环境）的基于案例的程序被设计用于系统病理学课程，并在四年时间里实施。二年级兽医专业学生以小组协作学习的方式，在每周的病理学实验室课程之前使用该程序。ATLes的目标是更好地实现课程中的特定学习目标（特别是对病理生理学的理解），解决先前发现的与基于发现的过程中常见的信息过载和信息分类相关的问题，并加强课堂讨论。该程序还旨在模拟并让学生练习针对临床病例的问题导向方法，从而使他们能够在相关的临床背景下学习病理学。其特点包括学生有机会通过要求进行特定的实验室测试和/或诊断程序来获取关于病例的更多信息。然而，学生也需要为他们的诊断计划提供理由并进行机制分析。ATLes的使用实现了大部分这些目标。学生的接受度很高，他们对在线“内容链接”给予了好评，这些链接使有用信息更容易获取且难度适中。学生们在进入实验室时准备得更充分，能够进行更深入、高质量的讨论，并且能够更好地将临床问题与组织的潜在变化（病变）联系起来。然而，许多学生表示，相对于他们认为自己学到的东西，在实验室之前所需的任务时间可能过长。课堂讨论虽然有所改善，但并未提升到预期水平——很可能反映出学习环境中其他缺失的要素，包括现有的学生文化和学生当前的讨论技能。本文简要讨论了从ATLes中学到的经验教训，以及类似的基于案例的练习如何与其他方法相结合，以加强和活跃兽医课程中的课堂讨论。
