Biomedical Communications, Faculty of Medicine, University of Toronto, 1 King's College Circle, Room 3259, Toronto, ON, Canada.
Acad Med. 2009 Oct;84(10 Suppl):S5-8. doi: 10.1097/ACM.0b013e3181b37b4d.
Professional behaviors, tacitly understood by Canadian-trained physicians, are difficult to teach and often create practice barriers for IMGs. The purpose of this design research study was to develop a Web-based program simulating Canadian medical literacy and culture, and to evaluate strategies of scaffolding individual knowledge building.
Study 1 (N = 20) examined usability and pedagogic design. Studies 2 (N = 39) and 3 (N = 33) examined case participation patterns.
Model design was validated in Study 1. Studies 2 and 3 demonstrated high levels of participation, on unprompted third tries, on knowledge tests. Recursive patterns were strongest on Reflective Exercises. Five strategies scaffolded knowledge building: (1) video simulations, (2) contextualized resources, (3) concurrent feedback, (4) Reflective Exercises, and (5) commentaries prompting "reflection on reflection."
Scaffolded design supports complex knowledge building. These findings are concurrent with educational research on the importance of recursion and revision of knowledge for improvable and relational understanding.
加拿大培训的医生心照不宣的职业行为很难教授，并且常常为 IMG （国际医学毕业生）的实践带来障碍。本设计研究的目的是开发一个基于网络的程序，模拟加拿大的医学素养和文化，并评估个体知识构建的支架策略。
研究 1（N = 20）考察了可用性和教学设计。研究 2（N = 39）和 3（N = 33）考察了案例参与模式。
模型设计在研究 1 中得到验证。研究 2 和 3 表明，在未经提示的第三次尝试中，参与者在知识测试中表现出较高的参与度。在反思练习中，递归模式最强。有五种策略可以支持知识构建：（1）视频模拟，（2）情境化资源，（3）并发反馈，（4）反思练习，以及（5）评论提示“反思的反思”。
支架设计支持复杂的知识构建。这些发现与教育研究中关于递归和知识修订对可改进和关系理解的重要性是一致的。
