What Kind of Curriculum Can Better Address Community Needs? Problems Arisen by Hypothetical-Deductive Reasoning

The aim of this study was to identify problems arisen by conventional curricula, the guidelines for development of an appropriate educational model for 21st century, and the advantages and disadvantages of the last two curricular models. The medical education literature published from 1995 through 2002 of four reputable journals in medical education were searched (Academic Medicine, Teaching and Learning in Medicine, Medical Education, and Medical Teacher). First the possibly best articles were identified. During the second screening process 76 of 180 articles were found to be highly relevant to our questions. A review of the chosen articles revealed a concept map which starts from currently applied hypothetical-deductive reasoning (HDR)-based curricula in many medical schools all around the world. Results revelaed that continuing cyclical process might be time consuming, enhance burden of faculty and might be stressful for students involved. Current issues in health care system are possibly attributable to current HDR-based curricular models including PBL. Advantages of reiterative PBL theory can not be denied, but it appears that its limited application should be mainly seen in some academic classes to develop some generic transferable skills simultaneously with other teaching methods. Therefore vast application of HDR in clinical settings is not recommended according to our study. However the relationships demonstrated between factors and outcomes mentioned in the concept map can be used to run some new studies to test some hypotheses.

[1]  C. Griffith,et al.  A Pilot Study Assessing the Influences of Charge Data and Group Process on Diagnostic Test Ordering by Residents , 2001, Academic medicine : journal of the Association of American Medical Colleges.

[2]  Gerd Gigerenzer,et al.  Bounded Rationality : Models of Fast and Frugal Inference , 1997 .

[3]  M. Cusimano,et al.  An analysis of attrition from Canadian neurosurgery residency programs. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[4]  The availability of diseases for medical students in a university hospital , 2001, Medical teacher.

[5]  D. Vinson,et al.  What do family medicine patients think about medical students' participation in their health care? , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[6]  V L Patel,et al.  Effects of conventional and problem‐based medical curricula on problem solving , 1991, Academic medicine : journal of the Association of American Medical Colleges.

[7]  L. Lingard,et al.  What do we mean by "relevance"? A clinical and rhetorical definition with implications for teaching and learning the case-presentation format. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[8]  P H Harasym,et al.  Diagnostic reasoning strategies and diagnostic success , 2003, Medical education.

[9]  P. Harasym,et al.  Medical curriculum reform in North America, 1765 to the present: a cognitive science perspective. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[10]  D. Wood,et al.  Problem based learning , 2008, BMJ : British Medical Journal.

[11]  H. Barrows,et al.  Developing Clinical Problem-Solving Skills: A Guide to More Effective Diagnosis and Treatment , 1991, Annals of Internal Medicine.

[12]  B Jolly,et al.  The assessment of poorly performing doctors: the development of the assessment programmes for the General Medical Council’s Performance Procedures , 2001, Medical education.

[13]  J. Tritter,et al.  Medical error: a discussion of the medical construction of error and suggestions for reforms of medical education to decrease error , 2001, Medical education.

[14]  S. Mangione The teaching of cardiac auscultation during internal medicine and family medicine training--a nationwide comparison. , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[15]  S. Abrahamson Time to return medical schools to their primary purpose: education , 1996, Academic medicine : journal of the Association of American Medical Colleges.

[16]  P. Harasym,et al.  Helping students learn to think like experts when solving clinical problems , 1997, Academic medicine : journal of the Association of American Medical Colleges.

[17]  P. Mercer A survey of the basic practical skills of final-year medical students in one UK medical school , 1998 .

[18]  J. Colliver Effectiveness of Problem‐based Learning Curricula: Research and Theory , 2000, Academic medicine : journal of the Association of American Medical Colleges.

[19]  K W Kizer The National Quality Forum seeks to improve health care. , 2000, Academic medicine : journal of the Association of American Medical Colleges.

[20]  J. Ockene,et al.  A longitudinal study of students' depression at one medical school , 1997, Academic medicine : journal of the Association of American Medical Colleges.

[21]  P. Harasym,et al.  Developing a “clinical presentation” curriculum at the University of Calgary , 1995, Academic medicine : journal of the Association of American Medical Colleges.

[22]  G. Makoul,et al.  The evolution of courses in professional skills and perspectives for medical students , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[23]  R. Robbs,et al.  A Comparison of Problem-Based Learning and Standard Curriculum Students: Three Years of Retrospective Data , 1998 .

[24]  L. Berkson Problem‐based learning: have the expectations been met? , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[25]  A. Shalita Acne: clinical presentations. , 2004, Clinics in dermatology.

[26]  P. Harasym,et al.  Use of scheme‐based problem solving: an evaluation of the implementation and utilization of schemes in a clinical presentation curriculum , 2000, Medical education.

[27]  S. Azer,et al.  Problem-based learning. Challenges, barriers and outcome issues. , 2001, Saudi medical journal.

[28]  J. Sinacore,et al.  Medical student errors in making a diagnosis. , 1998, Academic medicine : journal of the Association of American Medical Colleges.