I had the great fortune of working to help create an entirely new series of Clinical Reasoning courses for a Doctoral of Veterinary Medicine degree program. These courses were part of a dramatic shift in the curriculum away from didactic lectures towards more active learning. In this case, the SMEs were a broad collection of practicing clinicians in the teaching hospital. While some clinicians were directly involved in delivering live presentations of content. The majority of the courses were to be made up of asynchronous activities. The series of courses was to be designed to bridge the gap between two year classroom experience and the beginning of clinical rotations.
The Problem
Given the technical nature of the content, the clinicians were vitally important in the course creation process. The challenge is that the pedagogical structure of the content (active learning) and the topic itself (clinical reasoning) were both generally outside of the clinicians experience as students. Many believed that clinical reasoning was either something you had or didn’t have or that you only learned it in practice.
This could easily push us down two undesirable paths:
- A deep internalization of a single, rigid procedure for clinical reasoning that led students in a very linear way which did not adequately prepare students for the variability they would encounter in the clinic.
- A shallow overview of multiple approaches to clinical reasoning, each unique to the clinician presenting or creating the content. While this approach is more likely to capture the variability of actual practice, it gives students no framework on which to build their own understanding. Additionally, this approach runs the risk of missing many key distinctions that a novice must make, which have become second nature to the clinician.
The Solution
We chose to use Four Component Instructional Design (4C/ID). This model was chosen because it has proven effective for clinical reasoning courses. In order to develop this content with a number of faculty members using a new model, we held live workshops, supported by a design hub and numerous design documents. For more information on 4C/ID and how it was used, please explore the resource below.
Tools
- 4C/ID – This was the design model that was used. It allowed us to create coherent courses that were centered on a presenting complaint, keeping students fully engaged in the CR process while providing diminishing scaffolding and wide variability
- SharePoint – This was a central organizing place for our course development.
- D2L – This was the learning management system which was used
- Qualtrics – This informal survey tool allowed us to create quick formative quizzes which helped teach learners and simultaneously allowed us to collect formative data on student understanding
- Adobe Captivate – I used captivate to create the information hub below and similar tools for the course
- PowerPoint – While Captivate is awesome, our faculty may not have the time to learn it, so we leveraged PPT by creating templates for elaborate presentations that included some branching and locking navigation through master slides. Present only versions of the cases were uploaded to the LMS so students got each case as a present only file.
Example
Below is the Course Development Hub that faculty used to learn more about the project and how to contribute: