Lim-Dunham Jennifer E, Ensminger David C, McNulty John A, Hoyt Amy E, Chandrasekhar Arcot J
Stritch School of Medicine, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60546.
School of Education, Loyola University Chicago, Chicago, Illinois.
Acad Radiol. 2016 Feb;23(2):252-61. doi: 10.1016/j.acra.2015.09.018. Epub 2015 Dec 21.
The principles of Collins' cognitive apprenticeship model were used to design a radiology curriculum in which medical students practice radiological skills using online case-based modules. The modules are embedded within clinical third-year clerkships, and students are provided with personalized feedback from the instructors. We describe the development of the vertical online radiology curriculum and evaluate its impact on student achievement and learning process using a mixed method approach.
The curriculum was developed over a 2-year period. Student participation was voluntary in the first year and mandatory in the second year. For quantitative curriculum evaluation, student metrics for voluntary versus mandatory groups were assessed using independent sample t tests and variable entry method regression analysis. For qualitative analysis, responses from a survey of students about the value of the curriculum were organized into defined themes using consensus coding.
Mandatory participation significantly improved (p = .001) the mean radiology examination score (82 %) compared to the voluntary group (73%), suggesting that mandatory participation had a beneficial effect on student performance. Potential preexisting differences in underlying general academic performance were accounted for by including mean basic science grades as the first variable in the regression model. The significant increase in R(2) from .16 to .28 when number of radiology cases completed was added to the original model, and the greater value of the standardized beta for this variable, suggest that the curriculum made a significant contribution to students' radiology examination scores beyond their baseline academic performance. Five dominant themes about curricular characteristics that enhanced student learning and beneficial outcomes emerged from consensus coding. These themes were (1) self-paced design, (2) receiving feedback from faculty, (3) clinical relevance of cases, (4) gaining confidence in interpreting radiological images, and (5) transfer of conceptual knowledge to actual practice.
The vertically integrated online radiology curriculum can positively impact student performance and learning process in the context of the cognitive apprenticeship model.
采用柯林斯认知学徒制模型的原则来设计放射学课程，医学生通过在线案例模块练习放射学技能。这些模块嵌入临床三年级实习课程中，学生可获得教师的个性化反馈。我们描述了纵向在线放射学课程的开发过程，并采用混合方法评估其对学生成绩和学习过程的影响。
该课程历时两年开发完成。第一年学生参与是自愿的，第二年变为强制参与。对于课程的定量评估，使用独立样本t检验和变量进入法回归分析来评估自愿组与强制组的学生指标。对于定性分析，通过共识编码将学生对课程价值的调查回复整理成明确的主题。
与自愿组（73%）相比，强制参与显著提高了（p = 0.001）放射学考试平均成绩（82%），表明强制参与对学生表现有有益影响。通过将基础科学平均成绩作为回归模型的第一个变量，可解释潜在的基础总体学术表现方面预先存在的差异。当将完成的放射学病例数添加到原始模型时，R²从0.16显著增加到0.28，且该变量的标准化β值更大，这表明该课程对学生放射学考试成绩的贡献超出了他们的基线学术表现。通过共识编码出现了五个关于增强学生学习和有益结果的课程特征的主导主题。这些主题分别是：（1）自主进度设计，（2）获得教师反馈，（3）病例的临床相关性，（4）在解读放射图像方面获得信心，以及（5）将概念知识应用于实际实践。
在认知学徒制模型的背景下，纵向整合的在线放射学课程可对学生成绩和学习过程产生积极影响。
