LeClair Renée J, Cleveland Jennifer L, Eden Kristin, Binks Andrew P
Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, VA, United States.
Front Physiol. 2023 Mar 16;14:1148916. doi: 10.3389/fphys.2023.1148916. eCollection 2023.
Both physiology and pathophysiology are essential disciplines in health professional education however, clinicians do not use this knowledge in isolation. Instead, physicians use inter-disciplinary concepts embedded within integrated cognitive schema (illness scripts) established through experience/knowledge that manifest as expert-level thinking. Our goal was to develop a pre-clerkship curriculum devoid of disciplinary boundaries (akin to the physician's illness script) and enhance learners' clerkship and early clinical performance. As well as developing curricular content, the model considered non-content design elements such as learner characteristics and values, faculty and resources and the impact of curricular and pedagogical changes. The goals of the trans-disciplinary integration were to develop deep learning behaviors through, 1) developing of integrated, cognitive schema to support the transition to expert-level thinking, 2) authentic, contextualization to promote knowledge transfer to the clinical realm 3) allowing autonomous, independent learning, and 4) harnessing the benefits of social learning. The final curricular model was a case-based approach with independent learning of basic concepts, differential diagnosis and illness scripting writing, and concept mapping. Small-group classroom sessions were team-taught with basic scientists and physicians facilitating learners' self-reflection and development of clinical reasoning. Specifications grading was used to assess the products (written illness scripts and concept maps) as well as process (group dynamics) while allowing a greater degree of learner autonomy. Although the model we adopted could be transferred to other program settings, we suggest it is critical to consider both content and non-content elements that are specific to the environment and learner.
生理学和病理生理学都是健康专业教育中的重要学科，然而，临床医生并非孤立地运用这些知识。相反，医生会运用嵌入在通过经验/知识建立的综合认知模式（疾病脚本）中的跨学科概念，这些概念表现为专家级思维。我们的目标是开发一门无学科界限的预科课程（类似于医生的疾病脚本），并提高学习者的见习和早期临床表现。除了开发课程内容外，该模式还考虑了非内容设计元素，如学习者特征和价值观、教师和资源以及课程和教学变革的影响。跨学科整合的目标是通过以下方式培养深度学习行为：1）开发综合认知模式以支持向专家级思维的转变；2）进行真实情境化以促进知识向临床领域的转移；3）允许自主、独立学习；4）利用社会学习的优势。最终的课程模式是一种基于案例的方法，包括对基本概念的自主学习、鉴别诊断和疾病脚本撰写以及概念图绘制。小组课堂教学由基础科学家和医生共同授课，促进学习者的自我反思和临床推理能力的发展。采用规格评分来评估产品（书面疾病脚本和概念图）以及过程（小组动态），同时给予学习者更大程度的自主性。尽管我们采用的模式可以转移到其他项目环境中，但我们建议，考虑特定于环境和学习者的内容和非内容元素至关重要。
