Original Publication
Open Access

Cognitive Apprenticeship: A Roadmap to Improve Clinical Teaching

Published: October 27, 2015 | 10.15766/mep_2374-8265.10245

Included in this publication:

  • Instructor's Guide Cognitive Apprenticeship.docx
  • Cognitive Apprenticeship - A Roadmap to Improve Clinical Teaching.pptx
  • Cognitive Apprenticeship Pocket Guide.docx
  • Cognitive Apprenticeship Clinical Teaching Self-Assessment.docx
  • Cognitive Apprenticeship Student Feedback Form.docx
  • Emergency Medicine Specific Case Vignettes.docx
  • Answer Key to Emergency Medicine Specific Case Vignettes.docx
  • Specialty Inclusive Case Vignettes.docx
  • Answer Key to Specialty Inclusive Case Vignettes.docx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

The medical profession uses an apprenticeship model to train future generations of physicians. What sets medicine apart from traditional observation-based apprenticeships, however, is the need for clinician educators to externalize their heuristics to make their internal thought processes explicit and visible for a wide range of learners to observe and implement. This form of thinking out loud does not necessarily come naturally to physicians but can be enhanced through training and practice. This resource describes a faculty development workshop to improve the workplace-based teaching skills of physician educators using a cognitive apprenticeship model. Recent studies demonstrate how this theory resonates with actual practice in medical education and highlight areas for improvement in clinical teaching. The model uses six teaching methodologies (modeling, coaching, scaffolding, articulation, reflection, and exploration) situated in a safe learning environment to address clinical instruction across a broad range of learner levels from preclerkship medical students to PGY 1-4 residents training in professional practice. During this highly interactive workshop, physicians discuss case vignettes to identify gaps in common teaching-learning scenarios and work together to develop solutions by applying the cognitive apprenticeship model. This workshop was first developed for emergency medicine physicians. It has since been modified and refined for use as a workshop in several other local, regional, and national education settings. More than 100 faculty have attended the workshop in these varied venues. There was general recognition among participants that the cognitive apprenticeship model was a useful framework for clinical teaching. Evaluations (on a scale from poor to excellent) have been uniformly excellent for quality of handouts, summarizing key points, active learning, and audience participation, and good to excellent for the quality of the background information, clearly presented goals, organization of the activities, and easy to read visuals.


Educational Objectives

By the end of this module, learners will be able to:

  1. Describe the six main teaching methodologies associated with cognitive apprenticeship (CA) theory.
  2. Apply CA theory in the analysis of common teaching and learning scenarios in clinical practice, identifying instructional strengths and weaknesses.
  3. Utilize the six instructional methods of CA theory to formulate solutions to improve clinical teaching using case vignettes directed at varying learner levels.

Author Information

  • Michelle Daniel, MD: University of Michigan Medical School
  • Brian Clyne, MD: The Warren Alpert Medical School of Brown University
  • Rachel Fowler, MD, MPH: The Warren Alpert Medical School of Brown University
  • Elizabeth Sutton, MD: The Warren Alpert Medical School of Brown University
  • Steven Rougas, MD: The Warren Alpert Medical School of Brown University
  • Sarita Warrier, MD: The Warren Alpert Medical School of Brown University
  • Katherine Farmer, MD: The Warren Alpert Medical School of Brown University
  • Ankur Doshi, MD: University of Pittsburgh School of Medicine

Disclosures
None to report.

Funding/Support
None to report.


References

  1. Collins A, Brown J, Newman S. Cognitive apprenticeship: teaching the crafts of reading, writing, and mathematics. In: Resnick LB, ed. Knowing, Learning, and Instruction: Essays in Honor of Robert Glaser. Hillsdale, NJ: Lawrence Erlbaum Associates; 1989:453-494. 
  2. Dolmans DHJM, Wolfhagen IHAP, Essed GGM, Scherpbier AJJA, van der Vleuten CPM. The impacts of supervision, patient mix, and numbers of students on the effectiveness of clinical rotations. Acad Med. 2002;77(4):332-335. http://doi.org/10.1097/00001888-200204000-00016 
  3. Stalmeijer RE, Dolmans DHJM, Snellen-Balendong HAM, van Santen-Hoeufft M, Wolfhagen IHAP, Scherpbier AJJA. Clinical teaching based on principles of cognitive apprenticeship: views of experienced clinical teachers. Acad Med. 2013;88(6):861-865. http://doi.org/10.1097/ACM.0b013e31828fff12 
  4. Stalmeijer RE, Dolmans DHJM, Wolfhagen IHAP, Peters WG, van Coppenolle L, Scherpbier AJJA. Combined student ratings and self-assessment provide useful feedback for clinical teachers. Adv Health Sci Educ Theory Pract. 2010;15(3):315-328. http://doi.org/10.1007/s10459-009-9199-6 
  5. Stalmeijer RE, Dolmans DHJM, Wolfhagen IHAP, Scherpbier AJJA. Cognitive apprenticeship in clinical practice: can it stimulate learning in the opinion of students? Adv Health Sci Educ Theory Pract. 2009;14(4):535-546. http://doi.org/10.1007/s10459-008-9136-0


Citation

Daniel M, Clyne B, Fowler R, et al. Cognitive apprenticeship: a roadmap to improve clinical teaching. MedEdPORTAL. 2015;11:10245. https://doi.org/10.15766/mep_2374-8265.10245