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ABS441 - A look at changes in teaching approaches at medical school through the lens of activity theory.

1.3 Learning, knowledge and agency
Paper in a Working Group Roundtable (WGRT)
1:30 PM, Tuesday 29 Aug 2017 (1 hour)
Reflecting on six years of medical training, thirty years of medical practice and ten years of teaching and tutoring medical students, we build on some third generation CHAT concepts in order to better understand some inner contradictions in the process of training physicians from first year medical school to professional licensure. Engeström describes dialectical contradictions as the motor of self-development in real activity systems. Medical training and the practice of medicine are examples of such real activity systems that exist as dialectics. Over the last few decades, medical education has shifted from a system based on a mastery of basic medical classroom and laboratory sciences before ever entering a clinical environment with real patients to a system that exposes the medical student to the clinical environment at the outset, with concurrent instruction in relevant basic science. The new curriculum was implemented in 2000 at Laval University. Classical medical subjects such as anatomy, normal physiology, pathology, and biochemistry are introduced to the medical student only insofar as they are relevant to their clinical teaching activities. Modern medical students are directly introduced into practical application of their growing knowledge base through the use of such mediating artefacts as clinical “vignette” scenarios as well as real clinical situations with real patients. They are presented basic scientific concepts as a secondary and tertiary concept in the hierarchy of learning. Active clinical practice in the form of problem solving is now the primary object of their learning activity.
Université Laval
Université Laval
Full Professor
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