Department of Medical Education, MMC Academy, Máxima Medical Center, De Run 4600, 5500 MB, Veldhoven, the Netherlands.
BMC Med Educ. 2012 Aug 20;12:79. doi: 10.1186/1472-6920-12-79.
Medical students in clerkship are continuously confronted with real and relevant patient problems. To support clinical problem solving skills, students perform a Critical Appraisal of a Topic (CAT) task, often resulting in a paper. Because such a paper may contain errors, students could profit from discussion with peers, leading to paper revision. Active peer discussion by a Computer Supported Collaborative Learning (CSCL) environment show positive medical students perceptions on subjective knowledge improvement. High students' activity during discussions in a CSCL environment demonstrated higher task-focussed discussion reflecting higher levels of knowledge construction. However, it remains unclear whether high discussion activity influences students' decisions revise their CAT paper. The aim of this research is to examine whether students who revise their critical appraisal papers after discussion in a CSCL environment show more task-focussed activity and discuss more intensively on critical appraisal topics than students who do not revise their papers.
Forty-seven medical students, stratified in subgroups, participated in a structured asynchronous online discussion of individual written CAT papers on self-selected clinical problems. The discussion was structured by three critical appraisal topics. After the discussion, the students could revise their paper. For analysis purposes, all students' postings were blinded and analysed by the investigator, unaware of students characteristics and whether or not the paper was revised. Postings were counted and analysed by an independent rater, Postings were assigned into outside activity, non-task-focussed activity or task-focussed activity. Additionally, postings were assigned to one of the three critical appraisal topics. Analysis results were compared by revised and unrevised papers.
Twenty-four papers (51.6%) were revised after the online discussion. The discussions of the revised papers showed significantly higher numbers of postings, more task-focussed activities, and more postings about the two critical appraisal topics: "appraisal of the selected article(s)", and "relevant conclusion regarding the clinical problem".
A CSCL environment can support medical students in the execution and critical appraisal of authentic tasks in the clinical workplace. Revision of CAT papers appears to be related to discussions activity, more specifically reflecting high task-focussed activity of critical appraisal topics.
实习中的医学生不断面临真实且相关的患者问题。为了支持临床问题解决能力，学生需要执行一项主题关键评估（CAT）任务，通常会生成一篇论文。由于这样的论文可能存在错误，因此学生可以从与同行的讨论中受益，从而对论文进行修订。计算机支持的协作学习（CSCL）环境中的主动同伴讨论显示，学生对主观知识提高的感知呈积极态势。在 CSCL 环境中，学生在讨论中的高活跃度表明任务聚焦的讨论较多，反映出更高水平的知识构建。然而，目前尚不清楚高讨论活跃度是否会影响学生修订 CAT 论文的决定。本研究旨在检验在 CSCL 环境中讨论后修订关键评估论文的学生，其在关键评估主题上的讨论是否比未修订论文的学生更具有任务聚焦性和更深入。
47 名医学生按亚组分层，参与针对自我选择的临床问题的个人书面 CAT 论文的结构化异步在线讨论。讨论由三个关键评估主题来组织。讨论结束后，学生可以修订论文。为了分析目的，所有学生的帖子均被研究者掩盖，且在不知道学生特征以及论文是否修订的情况下进行分析。帖子由独立的评分员进行计数和分析，帖子被分配到外部活动、非任务聚焦活动或任务聚焦活动中。此外，帖子被分配到三个关键评估主题之一。通过修订和未修订的论文比较分析结果。
24 篇论文（51.6%）在在线讨论后进行了修订。修订后的论文讨论显示出更高的帖子数量、更多的任务聚焦活动，以及更多关于两个关键评估主题的帖子：“对所选文章的评估”和“与临床问题相关的结论”。
CSCL 环境可以支持医学生在临床工作场所执行和进行真实任务的关键评估。CAT 论文的修订似乎与讨论活动有关，更具体地反映了对关键评估主题的高任务聚焦活动。
