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在课堂中培养临床推理能力——4C/ID 模型分析

Developing clinical reasoning in the classroom - analysis of the 4C/ID-model.

作者信息

Postma T C, White J G

机构信息

Department of Dental Management Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa.

出版信息

Eur J Dent Educ. 2015 May;19(2):74-80. doi: 10.1111/eje.12105. Epub 2014 May 9.

Abstract

OBJECTIVES

The purpose of this study is to provide a theoretical rationale for the implementation of the four-component instructional design model for complex learning (4C/ID-model) at the University of Pretoria with the aim of systematically developing the clinical reasoning of undergraduate dental students in a classroom setting.

METHODS

Recent literature provides a rationale for the use of the 4C/ID-model to teach clinical reasoning in terms of four strategic teaching and learning needs: (i) the need for authenticity in the learning process; (ii) the need to manage cognitive load during the learning process; (iii) the need for repeated practice; (iv) a need for valid assessment, feedback and reflection.

RESULTS AND DISCUSSION

The literature review indicated that the 4C/ID-model makes provision for teaching and learning in an authentic context and proposes systematically structured methods that could be practically applied to manage cognitive load during repetitive exercises. The model also makes provision for cognitive feedback following assessment in order to eliminate misconceptions about content and to develop the cognitive strategies of the learner.

CONCLUSIONS

On the basis of the literature review above, it is recommended that the 4C/ID-model be considered as a basis for classroom teaching and learning to develop competence in clinical reasoning in undergraduate dental students, even at pre-clinical level. The model may also have an application in medical education.

摘要

目标

本研究的目的是为比勒陀利亚大学实施复杂学习的四组件教学设计模型(4C/ID模型)提供理论依据,旨在在课堂环境中系统地培养本科牙科学生的临床推理能力。

方法

近期文献从四个战略教学需求方面为使用4C/ID模型教授临床推理提供了理论依据:(i)学习过程中对真实性的需求;(ii)学习过程中管理认知负荷的需求;(iii)反复练习的需求;(iv)有效评估、反馈和反思的需求。

结果与讨论

文献综述表明,4C/ID模型为在真实情境中教学和学习提供了条件,并提出了可实际应用于在重复练习中管理认知负荷的系统结构化方法。该模型还为认知反馈提供了条件,以消除对内容的误解并培养学习者的认知策略。

结论

基于上述文献综述,建议将4C/ID模型作为课堂教学的基础,以培养本科牙科学生临床推理能力,即使在临床前阶段。该模型在医学教育中也可能有应用。

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