19 SES 08 A, Ethnography and New Tools for Teaching and Learning
This poster is based on a Ph.D. project about the education of medical students and doctors in the field of psychiatry. We created a video library of clinical interviews with psychiatric patients as a supplementary learning tool to the traditional training at a psychiatric hospital.
Inspired by ethnographic methods medical students and doctors are observed during introduction days, students clinical placement and junior residents first weeks of training at a psychiatric hospital and are interviewed about the training.
The focus of the poster is to explore apprenticeship, situated learning and the use of video as a supplementary tool in the context of traditional education of medical students and junior residents at the psychiatric hospital.
How does the video library work in the real life setting of clinical psychiatry and how does the video library supplement the training of medical students and junior residents at the psychiatric hospital? How will the implementation of the video library affect the overall context of learning in psychiatry?
The quality and the possibility of learning in the health sector is challenged by a decrease in numbers of inpatients, a growing conflict of time and demands and a shortage of doctors. This is in particular a challenge in the field of psychiatry because the core concepts of psychiatry are known to be highly complicated, harder to understand and less tangible, than many somatic syndromes(Chur-Hansen, 2005, Parnas, 2013).
At the medical education at University of Copenhagen the module of Psychiatry is a mandatory. The module runs for four weeks, one week is structured as traditional academic lectures and three weeks are structured as a placement at a psychiatric hospital. A shortage of senior doctors in psychiatry and a management focus on efficiency challenges the quality of the placement. Some students describes idle time when waiting for doctors to take the student along or an absence of feedback on tasks. Also junior residents who are training to be psychiatrist or general practitioners point out, that there is a lack of focus on their learning progress in psychiatry( Holm-Petersen et al., 2006, Varma et al., 2012).
In other medical specialties studies shows that videos a supportive potential when used in learning situations at hospitals. Video can help to break down complex parts to less complicated bits and help to take a closer look at signs and symptoms (Hammoud, 2012¸Muench, 2013, Roeske, 1979. Earlier we have tested videos of patient interviews made by the students as a foundation for feedback. Various barriers stopped the students from recording their patient interviews (Fog-Petersen,2014), instead the students requested video clips of symptoms, interview situations ect. To meet these requests we created a library with videos of patients being interviewed by a doctor and a short description of the patient as well as a mental status examination. The video library is used for both medical students and junior residents in psychiatry.
The theory by Lave and Wenger, who define the main elements of learning in apprenticeship as social interaction and collaboration is foundation for the understanding of apprenticeship in the study. Lave and Wenger points out social relations as the essentials components for learning with their concept, situated learning(Nielsen,2003, Lave, 1999, Lave 2003). Furthermore their thoughts are related to Dewey’s ideas about learning by doing. The understanding of the principle of progression of apprenticeship in the project is based on Dreyfus’ concepts and models for skill acquisition(Borgnakke 2005, Borgnakke 2013), describing the progression of learning through a series of levels from the stages of a novice to the stage of an expert.
Borgnakke, K., Læringsdiskurser og praktikker. 2005, Kbh.: Akademisk Forlag. 263 sider. Borgnakke, K. and Københavns Universitet. Institut for Medier Erkendelse og Formidling., Etnografiske metoder i uddannelsesforskningen : mellem klassiske traditioner og senmoderne udfordringer. 2013, Kbh.: Institut for Medier, Erkendelse og Formidling, Københavns Universitet. 116 sider. Nielsen, K. and S. Kvale, Praktikkens læringslandskab : at lære gennem arbejde. 2003, Kbh.: Akademisk. 367 sider. Muench, J., D. Sanchez, and R. Garvin, A review of video review: new processes for the 21st century. Int J Psychiatry Med, 2013. 45(4): p. 413-22. Roeske, N.C., The medium and the message: development of videotapes for teaching psychiatry. Am J Psychiatry, 1979. 136(11): p. 1391-7. Fog-Petersen, C., Arnfred, S. Bedside iPad videooptagelser som læringsredskab i klinisk psykiatri. 2014. Chur-Hansen, A. and D. Parker, Is psychiatry an art or a science? The views of psychiatrists and trainees. Australas Psychiatry, 2005. 13(4): p. 415-8. En psykiatri i verdensklasse - regionernes visioner for fremtidens psykiatri. 2009 [cited 2016 05.02.]; Available from: http://www.regioner.dk/publikationer/psykiatri/en+psykiatri+i+verdensklasse+-+regionernes+visioner+for+fremtidens+psykiatri. Benchmarking af psykiatrien 2014. 2015 [cited 2016 05.02.]; Available from: http://www.regioner.dk/psykiatri/tal+og+fakta/~/media/9D9F5532FDF24246A09DF9C29BE69197.ashx. Hammoud, M.M., et al., Is video review of patient encounters an effective tool for medical student learning? A review of the literature. Adv Med Educ Pract, 2012. 3: p. 19-30. Holm-Petersen, C., Hansen, J.; Vinge, S., Medicinstuderende og yngre lægers valg af speciale. Udfordringer og muligheder i psykiatrien. 2006, DSI Institut for Sundhedsvæsen. Varma, A., Bonde, J.P. og Esbensen, L. Yngre Lægers Arbejdsvilkår 2012. En spørgeskemaundersøgelse af medlemmer i Foreningen af Yngre Læger. 2012 [cited 2016 05.02.]; Available from: http://www.laeger.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=10072978.PDF. Parnas, J., L.A. Sass, and D. Zahavi, Rediscovering psychopathology: The epistemology and phenomenology of the psychiatric object. Schizophrenia Bulletin, 2013. .39(2): p. pp. Lave, J., Læring, mesterlære, social praksis, in Mesterlære. Læring som social praksis., K. Nielsen and S. Kvale, Editors. 1999, Hans Reitzels Forlag: København. p. 35-53. Lave, J.o.W., Etienne, Situeret læring - og andre tekster. 2003, Kbh.: Hans Reitzel. 247 sider.
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