Introduction:

Some studies on academic half days (AHDs) suggest that learning in this context is associated with a lack of educational engagement. This challenge may be amplified in distributed campus settings, where geographical disadvantages demand reliance on videoconferencing or considerable time spent travelling to in-person learning events. Concerns about the educational effectiveness of AHDs by learners within our distributed campus setting led to the development and evaluation of the One Room Schoolhouse (ORS), a unique, evidence-informed, community-based curriculum that partially replaced the AHD sessions delivered at the main campus. It was hypothesized that creating an AHD experience that was clinically reflective of the community in which residents practiced and where residents were given the autonomy to implement novel pedagogical elements would result in better test scores and improved learner satisfaction among ORS learners.

Methods:

The ORS was implemented at McMaster University’s Waterloo Regional Campus in 2017. Residents across training cohorts (N = 9) engaged in co-learning based on scenarios co-developed from clinical experiences within the region. The learning approach relied on multiple, evidence-informed pedagogical strategies. A multi-method approach was used to evaluate the ORS curriculum. Between-subject analyses of variance were used to compare scores on practice exams (COPE and PRITE), in-training assessment reports (ITARs), and objective structured clinical exams (OSCEs) between learners who took part in the ORS and learners at the main campus. A semi-structured focus group probing residents’ experiences with the ORS was analyzed using interpretive description.

Results:

ORS learners significantly outperformed learners at the main campus on the November OSCE (p = .02), but not on the COPE, PRITE, ITARs, or September OSCE (p’s < .05). Qualitative themes suggested advantages of the ORS in inspiring learning, engaging learners, and improving self-confidence in knowledge acquisition. These findings are aligned with the broader literature on learner agency, social development, and communities of practice.

Conclusion:

While the quantitative data only showed a significant difference between the 2 curricula on 1 measure (ie, the November OSCE), the qualitative findings offered an opportunity for educators to reimagine what medical education might consist of beyond the confines of a “traditional” AHD. Creating opportunities to enhance personal agency when acquiring knowledge, inspiring engagement about patient-related problems, and incorporating interdisciplinary learning through community engagement were critical pedagogical elements that were attributed to the success of the ORS.

中文翻译：

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一个房间的校舍：分布式校园环境中启发式学术半日学习的新干预

介绍：

一些关于学术半天 (AHD) 的研究表明，在这种情况下学习与缺乏教育参与有关。这一挑战在分布式校园环境中可能会被放大，因为地理上的劣势需要依赖视频会议或花费大量时间前往现场学习活动。在我们的分布式校园环境中，学习者对 AHD 教育效果的担忧导致开发和评估 One Room Schoolhouse (ORS)，这是一种独特的、以证据为基础的、以社区为基础的课程，部分取代了主要的 AHD 课程校园。

方法：

ORS 于 2017 年在麦克马斯特大学滑铁卢地区校区实施。培训队列（N = 9）的居民根据该地区临床经验共同开发的情景进行共同学习。学习方法依赖于多种循证教学策略。使用多方法方法来评估 ORS 课程。受试者间方差分析用于比较参加 ORS 的学习者和主要学习者在实践考试（COPE 和 PRITE）、培训中评估报告 (ITAR) 和客观结构化临床考试 (OSCE) 上的分数校园。使用解释性描述分析了一个半结构化的焦点小组，探讨居民对 ORS 的体验。

结果：

在 11 月的 OSCE（ p = .02）上， ORS 学习者的表现明显优于主校区的学习者 ，但在 COPE、PRITE、ITAR 或 9 月的 OSCE（p < .05）上则不然。定性主题表明 ORS 在激发学习、吸引学习者和提高知识获取自信心方面的优势。这些发现与更广泛的关于学习者能动性、社会发展和实践社区的文献相一致。

结论：

虽然定量数据仅显示 2 门课程与 1 项措施（即 11 月的欧安组织）之间存在显着差异，但定性研究结果为教育工作者提供了一个机会，让他们重新构想超越“传统”AHD 范围的医学教育可能包括哪些内容。在获取知识时创造机会以增强个人能动性，激发对患者相关问题的参与，以及通过社区参与整合跨学科学习是 ORS 成功的关键教学要素。