Abstract
BackgroundPrevious work has shown that a programme that draws on a blend of theories makes a positive difference to outcomes for students who fail and repeat their first semester at medical school. Exploration of student and teacher perspectives revealed that remediation of struggling medical students can be achieved through a cognitive apprenticeship within a small community of inquiry. This community needs expert teachers capable of performing a unique combination of roles (facilitator, nurturing mentor, disciplinarian, diagnostician and role model), with high levels of teaching presence and practical wisdom. Yet, despite participants’ convergent opinions on the elements of effective remediation, significant differences were found between outcomes of students working with experienced and inexperienced teachers. The current study explores the actual practice of teachers on this remediation course, aiming to exemplify elements of our theory of remediation and explore differences between teachers.MethodsSince it is in the classroom context that the interactions that constitute the complex process of remediation emerge, this practice-based research has focused on direct observation of classroom teaching. Nineteen hours of small group sessions were recorded and transcribed. Drawing on ethnography and sociocultural discourse analysis, selected samples of talk-in-context demonstrate how the various elements of remediation play out in practice, highlighting aspects that are most effective, and identifying differences between experienced and novice teachers.ResultsLong-term student outcomes are strongly correlated to teacher experience (r, 0.81). Compared to inexperienced teachers, experienced teachers provide more challenging, disruptive facilitation, and take a dialogic stance that encourages more collaborative group dynamics. They are more expert at diagnosing cognitive errors, provide frequent metacognitive time-outs and make explicit links across the curriculum.ConclusionsRemediation is effective in small groups where dialogue is used for collaborative knowledge construction and social regulation. This requires facilitation by experienced teachers who attend to details of both content and process, and use timely interventions to foster curiosity and the will to learn. These teachers should actively challenge students’ language use, logical inconsistencies and uncertainties, problematize their assumptions, and provide a metacognitive regulatory voice that can generate attitudinal shifts and nurture the development of independent critical thinkers.
Highlights
Previous work has shown that a programme that draws on a blend of theories makes a positive difference to outcomes for students who fail and repeat their first semester at medical school
Likewise experiencing an upsurge in enrolment [3], this has been accompanied by increased research into the efficacy of remediation for underperforming students, with a recent review noting the need for further development and examination of the details of complex interventions [4]
In attempting to address this challenge, we have developed an Essential Lifelong Learning Skills (ELLS) course, a programme drawing on a blend of constructivist, sociocultural and complexity theories that has resulted in significantly improved long-term outcomes for medical students who fail and repeat their first semester [5]
Summary
Previous work has shown that a programme that draws on a blend of theories makes a positive difference to outcomes for students who fail and repeat their first semester at medical school. Exploration of student and teacher perspectives [6,7] enabled us to build a theory of successful remediation: participation needs to be mandated [6], and should provide cognitive and affective support within a small community of inquiry that motivates and challenges the students using a syllabus engendering self-regulatory, metacognitive, and dialogic techniques in small stable groups that meet a sufficient number of times to establish the trusting relationships necessary for the provision and acceptance of effective feedback and the development of more effective academic practices This community needs a student-centred environment that fosters curiosity and joy for learning with teachers capable of performing a unique combination of roles: facilitator, mentor, disciplinarian, diagnostician and role model [7]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have