Should we teach using schemas? Evidence from a randomised trial

Medical Education 2012: 46: 815–822 Context  Schema‐based instruction may alter knowledge organisation and diagnostic reasoning strategies through the provision of structured knowledge to novice trainees. The effects of schema‐based instruction on diagnostic accuracy and knowledge organisation have...

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Bibliographic Details
Published in:Medical education 2012-08, Vol.46 (8), p.815-822
Main Authors: Blissett, Sarah, Cavalcanti, Rodrigo B, Sibbald, Matthew
Format: Article
Language:English
Subjects:
Algorithms
Analysis of Variance
Biological and medical sciences
Canada
Education, Medical - methods
Education, Medical - standards
Educational Measurement - methods
Educational Measurement - standards
Health participants
Humans
Medical sciences
Miscellaneous
Public health. Hygiene
Public health. Hygiene-occupational medicine
Students, Medical - psychology
Teaching - methods
Teaching - standards
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Summary:Medical Education 2012: 46: 815–822 Context  Schema‐based instruction may alter knowledge organisation and diagnostic reasoning strategies through the provision of structured knowledge to novice trainees. The effects of schema‐based instruction on diagnostic accuracy and knowledge organisation have not been rigorously tested. Methods  Year 2 medical students were randomised to learn four cardiac diagnoses using schema‐based instruction (n = 26) or traditional instruction (n = 27) on a high‐fidelity cardiopulmonary simulator (CPS). Students completed case‐based learning in groups of two to five and underwent individual written and practical tests. The written test consisted of questions testing features that linked or distinguished diagnoses (structured knowledge) and questions testing features of individual diagnoses (factual knowledge). A practical test of diagnostic accuracy on the CPS was performed for two diagnoses present in the learning phase (taught lesions) and two untaught lesions. A majority of students (n = 37, 70%) voluntarily returned for follow‐up written testing 2–4 weeks later. Results  Learning time and accuracy did not differ between students on schema‐based and those on traditional instruction. Students receiving schema‐based instruction performed better on structured knowledge questions (p 
ISSN:0308-0110
1365-2923
DOI:10.1111/j.1365-2923.2012.04311.x