Medical education increasingly stresses that medical students should be prepared to take up multiple roles as a health professional. This requires the integrated acquisition of multiple competences such as clinical reasoning and decision making, communication skills and management skills. To promote such complex learning, instructional design has focused on the use of authentic, real-life learning tasks that students perform in a real or simulated task environment. The four-component instructional design model (4C/ID) model is an instructional design model that starts from the use of such tasks and provides students with a variety of learning tools facilitating the integrated acquisition of knowledge, skills and attitudes. In what follows, we guide the reader on how to implement educational programs based on the 4C/ID model and illustrate this with an example from general practice education. The developed learning environment is in line with the whole-task approach, where a learning domain is considered as a coherent, integrated whole and where teaching progresses from offering relatively simple, but meaningful, authentic whole tasks to more complex tasks. We describe the steps that were taken, from prototype over development to implementation, to build five learning modules (patient with diabetes; the young child with fever; axial skeleton; care for the elderly and physically undefined symptoms) that all focus on the integrated acquisition of the Canadian Medical Education Directives for Specialists roles in general practice. Furthermore, a change cycle for educational innovation is described that encompasses practice-based challenges and pitfalls about the collaboration between different stakeholders (students, developers and teachers) and the transition from traditional, fragmented and classroom-based learning to integrated and blended learning based on sound instructional design principles.
First aid programs that also train participants to overcome inhibitors of emergency helping behavior could lead to better help and higher helping rates.
Objectives-based instructional design approaches break down tasks into specific learning objectives and prescribe that instructors should choose the optimal instructional method for teaching each respective objective until all objectives have been taught. This approach is appropriate for many tasks where there is little relation between the objectives, but less effective for teaching complex professional tasks that require the integration of knowledge, skills, and attitudes and the coordination of different skills. For the latter, a task-centred approach that starts designing instruction from whole, real-life tasks, is more appropriate. This article describes one task-centred instructional design model, namely the Four-Component Instructional Design (4C/ID) model and illustrates its application by reflecting on three educational programs in higher education designed with 4C/ID. The first case presents a design for a course that focuses on the development of mobile apps at the Amsterdam University of Applied Sciences in the Netherlands. The second case illustrates the integration of information problem-solving skills at Iselinge University of Professional Teacher Education, a teacher training institute in the Netherlands. The third case is an example from general practice education at the KU Leuven, Belgium. Future developments and issues concerning the implementation of taskcentred educational programmes are discussed.
IntroductionAlthough medical students are increasingly exposed to clinical experiences as part of their training, these often occur parallel with, rather than connected to, their classroom-based learning experiences. Additionally, students seem to struggle with spontaneously making the connection between these spheres of their training themselves. Therefore, this systematic review synthesized the existing evidence about educational interventions that aim to enhance the connection between learning in the classroom and its application in the workplace.MethodsElectronic databases (AMED, CINAHL, EMBASE, ERIC, Medline, RDRB, PsycINFO and WoS) were screened for quantitative and qualitative studies investigating educational interventions that referenced a connection between the classroom and workplace-based experiences within undergraduate, graduate or postgraduate medical education.ResultsThree types of interventions were identified: classroom to workplace interventions, workplace to classroom interventions, and interventions involving multiple connections between the two settings. Most interventions involved a tool (e. g. video, flow chart) or a specific process (e. g. linking patient cases with classroom-based learning content, reflecting on differences between what was learned and how it works in practice) which aimed to enhance the connection between the two settings.DiscussionSmall-scale interventions can bring classroom learning and workplace practice into closer alignment. Such interventions appear to be the necessary accompaniments to curricular structures, helping bridge the gap between classroom learning and workplace experience. This paper documents examples that may serve to assist medical educators in connecting the classroom and the workplace.Electronic supplementary materialThe online version of this article (doi: 10.1007/s40037-017-0338-0) contains supplementary material, which is available to authorized users.
The 54 participants' conceptions mainly related to their beliefs about who was responsible for (a) preparing for transfer of learning, (b) being at the workplace and connecting back to classroom-based learning, and (c) reflecting on transfer of learning and continuing the process. A continuum was recognized between those who held medical teachers/workplace supervisors responsible and those who held students responsible. Insights: There appears to be a variety of conceptions about who is responsible for enabling the transfer process. These conceptions may influence learning and instructional activities. Hence, it may be necessary to make these beliefs explicit in order to better align stakeholders' conceptions. To this end, the conceptual framework created in this study may be a useful tool.
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