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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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| Published in: | Medical education 2012-08, Vol.46 (8), p.815-822 |
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| container_issue | 8 |
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| container_title | Medical education |
| container_volume | 46 |
| creator | Blissett, Sarah Cavalcanti, Rodrigo B Sibbald, Matthew |
| description | 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 |
| doi_str_mv | 10.1111/j.1365-2923.2012.04311.x |
| format | article |
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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 < 0.001) and no differently on factual knowledge questions (p = 0.7). Relative differences between groups remained unchanged on follow‐up testing. Diagnostic success was higher in the schema‐based instruction group for taught lesions (mean difference = 38%, 95% confidence interval [CI] 20–56; p < 0.001) and untaught lesions (mean difference = 31%, 95% CI 15–48; p < 0.001).
Conclusions Schema‐based instruction was associated with improved retention of structured knowledge and diagnostic performance among novices. This study provides important proof‐of‐concept for a schema‐based approach and suggests there is substantial benefit to using this approach with novice trainees.
Discuss ideas arising from this article at ‘discuss’</description><identifier>ISSN: 0308-0110</identifier><identifier>EISSN: 1365-2923</identifier><identifier>DOI: 10.1111/j.1365-2923.2012.04311.x</identifier><identifier>PMID: 22803759</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>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</subject><ispartof>Medical education, 2012-08, Vol.46 (8), p.815-822</ispartof><rights>Blackwell Publishing Ltd 2012</rights><rights>2015 INIST-CNRS</rights><rights>Blackwell Publishing Ltd 2012.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4171-6cc0352d822fd7ef93abe231cedd2a615901c093d678fb4d14638e405b24113c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26142012$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22803759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Blissett, Sarah</creatorcontrib><creatorcontrib>Cavalcanti, Rodrigo B</creatorcontrib><creatorcontrib>Sibbald, Matthew</creatorcontrib><title>Should we teach using schemas? Evidence from a randomised trial</title><title>Medical education</title><addtitle>Med Educ</addtitle><description>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 < 0.001) and no differently on factual knowledge questions (p = 0.7). Relative differences between groups remained unchanged on follow‐up testing. Diagnostic success was higher in the schema‐based instruction group for taught lesions (mean difference = 38%, 95% confidence interval [CI] 20–56; p < 0.001) and untaught lesions (mean difference = 31%, 95% CI 15–48; p < 0.001).
Conclusions Schema‐based instruction was associated with improved retention of structured knowledge and diagnostic performance among novices. This study provides important proof‐of‐concept for a schema‐based approach and suggests there is substantial benefit to using this approach with novice trainees.
Discuss ideas arising from this article at ‘discuss’</description><subject>Algorithms</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Canada</subject><subject>Education, Medical - methods</subject><subject>Education, Medical - standards</subject><subject>Educational Measurement - methods</subject><subject>Educational Measurement - standards</subject><subject>Health participants</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Students, Medical - psychology</subject><subject>Teaching - methods</subject><subject>Teaching - standards</subject><issn>0308-0110</issn><issn>1365-2923</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNpdkV1v0zAUhi3ExMrgLyBLCImbhHOOHSe5YZpGGWgbIG0D7izXdmhKPkbcsO7f46ylSPjGls6jR6_PyxhHSDGeN6sUhcoSKkmkBEgpSIGYbh6x2X7wmM1AQJEAIhyypyGsACDPZPGEHRIVIPKsnLHjq2U_No7feb72xi75GOruBw926VsTjvn8d-18Zz2vhr7lhg-mc31bB-_4eqhN84wdVKYJ_vnuPmI37-fXpx-Si89nH09PLhIrMcdEWQsiI1cQVS73VSnMwpNA650jozArAS2Uwqm8qBbSoVSi8BKyBUlEYcURe7313g79r9GHtY4hrG8a0_l-DBqBcpAoSEb05X_oqh-HLqbTKAUJQlVQpF7sqHHReqdvh7o1w73-u5oIvNoBJljTVPHntg7_OIVyWn3k3m65u7rx9_s5gp6q0is9NaKnRvTE64eq9EZfzt_dTM8oSLaCOqz9Zi8ww0-t8hhFf_t0FnXXV-fq63f9RfwBrdiSzg</recordid><startdate>201208</startdate><enddate>201208</enddate><creator>Blissett, Sarah</creator><creator>Cavalcanti, Rodrigo B</creator><creator>Sibbald, Matthew</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201208</creationdate><title>Should we teach using schemas? Evidence from a randomised trial</title><author>Blissett, Sarah ; Cavalcanti, Rodrigo B ; Sibbald, Matthew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4171-6cc0352d822fd7ef93abe231cedd2a615901c093d678fb4d14638e405b24113c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Algorithms</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Canada</topic><topic>Education, Medical - methods</topic><topic>Education, Medical - standards</topic><topic>Educational Measurement - methods</topic><topic>Educational Measurement - standards</topic><topic>Health participants</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Students, Medical - psychology</topic><topic>Teaching - methods</topic><topic>Teaching - standards</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blissett, Sarah</creatorcontrib><creatorcontrib>Cavalcanti, Rodrigo B</creatorcontrib><creatorcontrib>Sibbald, Matthew</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Medical education</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blissett, Sarah</au><au>Cavalcanti, Rodrigo B</au><au>Sibbald, Matthew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Should we teach using schemas? Evidence from a randomised trial</atitle><jtitle>Medical education</jtitle><addtitle>Med Educ</addtitle><date>2012-08</date><risdate>2012</risdate><volume>46</volume><issue>8</issue><spage>815</spage><epage>822</epage><pages>815-822</pages><issn>0308-0110</issn><eissn>1365-2923</eissn><abstract>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 < 0.001) and no differently on factual knowledge questions (p = 0.7). Relative differences between groups remained unchanged on follow‐up testing. Diagnostic success was higher in the schema‐based instruction group for taught lesions (mean difference = 38%, 95% confidence interval [CI] 20–56; p < 0.001) and untaught lesions (mean difference = 31%, 95% CI 15–48; p < 0.001).
Conclusions Schema‐based instruction was associated with improved retention of structured knowledge and diagnostic performance among novices. This study provides important proof‐of‐concept for a schema‐based approach and suggests there is substantial benefit to using this approach with novice trainees.
Discuss ideas arising from this article at ‘discuss’</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22803759</pmid><doi>10.1111/j.1365-2923.2012.04311.x</doi><tpages>8</tpages></addata></record> |
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| 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 |
| title | Should we teach using schemas? Evidence from a randomised trial |
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