DDx of Delirium: Training Medical Students to Competence

Report
Building ………
a New Approach to Medical Education
Frank Papa, DO, PhD
Associate Dean
Curricular Design and Faculty Development
Michael Oglesby, PhD
Year Two Program Director
UNTHSC
How to build ……..
 …….. a house?
 Raw materials
 Tools
 People
How to build ……..
 …..… a mind?
 What are the raw materials?
 What are the tools?
 What types of people?
How to build …….. a medical mind
A MEDED perspective
 Materials?
 Content resources (hard copy or electronic)
 Tools?
 Courses


Organization and sequencing of content
Instructional methods
 People?
 Content experts
How to build …….. a medical mind
A MEDED perspective
 Curricular models guide institutions in how to utilize
content, courses and experts in the construction of medical
minds




Discipline-based (1870’s – current)
Systems-based (1950’s – current)
PBL (1970’s – current)
Presentation (1990’s – current)
 Papa FJ, Harasym PH. Medical curriculum reform in North America, 1765 to the present: A
cognitive science perspective. Acad Med. 1999;74:154–64
How to build a Medical Mind:
Depends on the curricular model used
Content
Courses
Content
Experts
How to build a Medical Mind:
Discipline and Systems Perspective
Courses
Content
Experts
How to build a Medical Mind:
PBL and Presentation Perspective
Courses
Content
Experts
How to build a Medical Mind:
An Evolving Learning Sciences Perspective
 The development of competence depends upon…
 The construction of problem- and task-specific
knowledge bases
 The construction of problem- and task-specific
knowledge bases begins with the acquisition of
declarative knowledge followed by its progressive
transformation into procedural knowledge
 The progressive development of problem- and task-
specific procedural knowledge requires multiple
application opportunities, and, focused instructional
guidance
How to build a Medical Mind:
An Evolving Learning Sciences Perspective
 Principles used to construct a new curricular model (A Problem and
Task-focused, Application-oriented curriculum - PTAC)
 Course design elements
 Organize and teach course content within the context of clinical
problems
 Sequence problem-focused, instructional activities in a manner that
supports the progressive development of knowledge-based
competencies (Bloom’s taxonomy)




Acquisition of declarative knowledge
Comprehension (transformation into procedural knowledge)
Application (practice opportunities sufficient to develop competence)
A problem and task-focused, application-oriented curriculum: Rationale, learning sciences framework and
outcomes. Papa FJ, Oglesby M, Dubin B, Putthoff S, Martin M, Gwirtz P. In review. Academic Medicine.
How to build a Medical Mind:
Discipline and Systems Perspective
Courses
Content
Experts
How to build a Medical Mind:
PBL and Presentation Perspective
Courses
Content
Experts
How to build a mind:
A learning Sciences Perspective
Content
Courses
Experts
How to build a mind:
A learning Sciences Perspective
Content
Courses
Experts
How to build a mind:
A learning Sciences Perspective
Content
Courses
Experts
How to build a mind:
A learning Sciences Perspective
Content
Courses
Experts
How to build a mind:
A learning Sciences Perspective
Content
Courses
Experts
How to build a Medical Mind:
An Evolving Learning Sciences Perspective
 The development of competence depends upon…
 The construction of problem- and task-specific
knowledge bases
 The construction of problem- and task-specific
knowledge bases begins with the acquisition of
declarative knowledge followed by its progressive
transformation into procedural knowledge
 The progressive development of problem- and task-
specific procedural knowledge requires multiple
application opportunities, and, focused instructional
guidance
How to build a Medical Mind:
An Evolving Learning Sciences Perspective
 Course design elements
 Organize and teach course content within the context of clinical
problems
 Sequence problem-focused, instructional activities in a manner
that supports the progressive development of knowledge-based
competencies (Bloom’s taxonomy)



Acquisition of declarative knowledge
Comprehension (transformation into procedural knowledge)
Application (practice opportunities sufficient to develop competence)
 A problem and task-focused, application-oriented curriculum: Rationale, learning sciences
framework and outcomes. Papa FJ, Oglesby M, Dubin B, Putthoff S, Martin M, Gwirtz P. In
review. Academic Medicine.
How to build a mind:
A learning Sciences Perspective
Content
Courses
Experts
How to build a mind:
Adopting Principles
Content
Courses
Experts
How to build a mind:
Adopting Course Design Elements
Content
Courses
Experts
Computer Assisted Tools for
building a medical mind
 KBIT (Knowledge Based Inference Tool)
 Predicated upon three principles



Acquire problem and task (DDX) specific declarative knowledge
Transform declarative knowledge into procedural knowledge
Multiple problem and task-focused practice opportunities
under (expert/AI) guidance
 Papa FJ, Oglesby MW, Aldrich DG, Schaller F, Cipher DJ. Improving diagnostic capabilities
of medical students via application of cognitive sciences-derived learning principles.
Medical Education, 41:419-425, 2007

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