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Application of Social Constructivism in Medical Education

의학교육에서의 사회적 구성주의의 활용

  • Kim, Youngjon (Department of Medical Education, Wonkwang University College of Medicine)
  • 김영전 (원광대학교 의과대학 의학교육학교실)
  • Received : 2020.04.29
  • Accepted : 2020.06.12
  • Published : 2020.06.30

Abstract

The purpose of this study is to discuss the main principles and concepts of social constructivism, examine the literature on the application of social constructivism in medical education, and explore the meaning and limitations of the utilization of social constructivism with learning theory. A literature search was carried out in two stages, utilizing PubMed, CINAHL and Education Source databases. The first search included both fields (social constructivism AND medical education), while the second search was performed by subject (Vygotsky or ZPD or zone of proximal development or scaffolding AND medical education). A total of 96 papers were found through the first and second searches, and after reviewing the abstracts of all 96 papers, 41 papers were deemed suitable for research purposes. In medical education, social constructivism is applied in areas such as (1) social and cultural behaviors (hidden curriculum), (2) social construct of "meaning" (dialogue and discourse), (3) learner's identity transformation (expert), and (4) instructional intervention (ZPD and scaffolding). Social constructivism has provided many ideas to explore in terms of the composition of knowledge in the sociocultural context of health care, but it has not demonstrated an explicit instructional method or educational effects.

Keywords

References

  1. Rees CE, Crampton PE, Monrouxe LV. Re-visioning academic medicine through a constructionist lens. Acad Med. 2020;95(6):846-50. https://doi.org/10.1097/ACM.0000000000003109
  2. Kang I. A brief reflection on cognitive and social constructivism. Korean J Educ Technol. 1995;11(2):3-20. https://doi.org/10.17232/KSET.11.2.3
  3. Cobb P, Yackel E. Constructivist, emergent, and sociocultural perspectives in the context of developmental research. Educ Psychol. 1996;31(3-4):175-90. https://doi.org/10.1207/s15326985ep3103&4_3
  4. Colliver JA. Constructivism: the view of knowledge that ended philosophy or a theory of learning and instruction? Teach Learn Med. 2002;14(1):49-51. https://doi.org/10.1207/S15328015TLM1401_11
  5. Kolb AY, Kolb DA. Learning styles and learning spaces: Enhancing experiential learning in higher education. Acad Manag Learn Educ. 2005;4(2):193-212. https://doi.org/10.5465/AMLE.2005.17268566
  6. Dennick R. Constructivism: reflections on twenty five years teaching the constructivist approach in medical education. Int J Med Educ. 2016;7:200-5. https://doi.org/10.5116/ijme.5763.de11
  7. Brown JS, Collins A, Duguid P. Situated cognition and the culture of learning. Educ Res. 1989;18(1):32-42. https://doi.org/10.3102/0013189X018001032
  8. Hirshfield LE, Underman K. Empathy in medical education: a case for social construction. Patient Educ Couns. 2017;100(4):785-7. https://doi.org/10.1016/j.pec.2016.10.027
  9. Hamdy H. Medical college of the future: from informative to transformative. Med Teach. 2018;40(10):986-9. https://doi.org/10.1080/0142159x.2018.1498628
  10. Philpott J, Batty H. Learning best together: social constructivism and global partnerships in medical education. Med Educ. 2009;43(9):923-4. https://doi.org/10.1111/j.1365-2923.2009.03436.x
  11. Rees CE, Ajjawi R, Monrouxe LV. The construction of power in family medicine bedside teaching: a video observation study. Med Educ. 2013;47(2):154-65. https://doi.org/10.1111/medu.12055
  12. Veen M, de la Croix A. The swamplands of reflection: using conversation analysis to reveal the architecture of group reflection sessions. Med Educ. 2017;51(3):324-36. https://doi.org/10.1111/medu.13154
  13. Dube T, Schinke R, Strasser R. It takes a community to train a future physician: social support experienced by medical students during a community-engaged longitudinal integrated clerkship. Can Med Educ J. 2019;10(3):e5-16.
  14. Frost HD, Regehr G. "I am a doctor": negotiating the discourses of standardization and diversity in professional identity construction. Acad Med. 2013;88(10):1570-7. https://doi.org/10.1097/ACM.0b013e3182a34b05
  15. Gordon LJ, Rees CE, Ker JS, Cleland J. Dimensions, discourses and differences: trainees conceptualising health care leadership and followership. Med Educ. 2015;49(12):1248-62. https://doi.org/10.1111/medu.12832
  16. Van der Zwet J, Zwietering PJ, Teunissen PW, van der Vleuten CP, Scherpbier AJ. Workplace learning from a socio-cultural perspective: creating developmental space during the general practice clerkship. Adv Health Sci Educ Theory Pract. 2011;16(3):359-73. https://doi.org/10.1007/s10459-010-9268-x
  17. Gleeson C. Education beyond competencies: a participative approach to professional development. Med Educ. 2010;44(4):404-11. https://doi.org/10.1111/j.1365-2923.2009.03601.x
  18. Andrews T. What is social constructionism? Grounded Theory Rev. 2012;11(1):39-46.
  19. Ritchie C, Gum L, Brewer M, Sheehan D, Burley M, Saunders-Battersby S, et al. Interprofessional collaborative practice across Australasia: an emergent and effective community of practice. Focus Health Prof Educ Multi-Discip J. 2013;14(2):71-80.
  20. Jacobs F, Stegmann K, Siebeck M. Promoting medical competencies through international exchange programs: benefits on communication and effective doctor-patient relationships. BMC Med Educ. 2014;14:43. https://doi.org/10.1186/1472-6920-14-43
  21. Sales CS, Schlaff AL. Reforming medical education: a review and synthesis of five critiques of medical practice. Soc Sci Med. 2010;70(11):1665-8. https://doi.org/10.1016/j.socscimed.2010.02.018
  22. Russell DR. Vygotsky, Dewey, and externalism: beyond the student/discipline dichotomy. J Adv Compos. 1993;13(1):173-97.
  23. Shin J. Implications of social constructivism on special education: focusing on Vygotsky's defectology. Asian J Educ. 2001;2(1);37-54.
  24. Rieber RW, Carton AS. The collected works of LS Vygotsky. Probl Gen Psychol. 1987;1:325-39.
  25. Vygotsky LS. Tool and symbol in child development. In: Cole M, Jolm-Steiner V, Scribner S, Souberman E, editors. Mind in society: development of higher psychological processes. Cambridge (MA): Harvard University Press; 1978. p. 19-31.
  26. Wood D, Bruner JS, Ross G. The role of tutoring in problem solving. J Child Psychol Psychiatry. 1976;17(2):89-100. https://doi.org/10.1111/j.1469-7610.1976.tb00381.x
  27. Yardley S, Teunissen PW, Dornan T. Experiential learning: AMEE guide no. 63. Med Teach. 2012;34(2):e102-15. https://doi.org/10.3109/0142159X.2012.650741
  28. Kaufman D, Mann KV. Teaching and learning in medical education: how theory can inform practice. In: Swanwick T, editor. Understanding medical education: evidence, theory and practice. 2nd ed. Chichester: Wiley-Blackwell; 2014. p. 7-29.
  29. Kay D, Kibble J. Learning theories 101: application to everyday teaching and scholarship. Adv Physiol Educ. 2016;40(1):17-25. https://doi.org/10.1152/advan.00132.2015
  30. Cantillon P. Becoming a better teacher. In: Cantillon P, Wood DF, Yardley S, editors. ABC of learning and teaching in medicine. 3rd ed. Hoboken (NJ): John Wiley & Sons; 2017. p. 1-2.
  31. Mahood SC. Medical education: beware the hidden curriculum. Can Fam Physician. 2011;57(9):983-5.
  32. Doja A, Bould MD, Clarkin C, Eady K, Sutherland S, Writer H. The hidden and informal curriculum across the continuum of training: a cross-sectional qualitative study. Med Teach. 2016;38(4):410-8. https://doi.org/10.3109/0142159X.2015.1073241
  33. Bryden P, Ginsburg S, Kurabi B, Ahmed N. Professing professionalism: are we our own worst enemy?: faculty members' experiences of teaching and evaluating professionalism in medical education at one school. Acad Med. 2010;85(6):1025-34. https://doi.org/10.1097/acm.0b013e3181ce64ae
  34. Binder R, Friedli A, Fuentes-Afflick E. Preventing and managing unprofessionalism in medical school faculties. Acad Med. 2015;90(4):442-6. https://doi.org/10.1097/ACM.0000000000000592
  35. Reddy ST, Farnan JM, Yoon JD, Leo T, Upadhyay GA, Humphrey HJ, et al. Third-year medical students' participation in and perceptions of unprofessional behaviors. Acad Med. 2007;82(10 Suppl):S35-9. https://doi.org/10.1097/ACM.0b013e3181405e1c
  36. Spiwak R, Mullins M, Isaak C, Barakat S, Chateau D, Sareen J. Medical students' and postgraduate residents' observations of professionalism. Educ Health (Abingdon). 2014;27(2):193-9. https://doi.org/10.4103/1357-6283.143790
  37. Lee SH, Shin YH, Kim SS. Comparing attitudes toward disclosing medical errors between medical students and interns. Korean J Med Educ. 2012;24(3):247-58. https://doi.org/10.3946/kjme.2012.24.3.247
  38. Franco RS, Franco CA, Kusma SZ, Severo M, Ferreira MA. To participate or not participate in unprofessional behavior: is that the question? Med Teach. 2017;39(2):212-9. https://doi.org/10.1080/0142159x.2017.1266316
  39. Welsh D, Zephyr D, Pfeifle AL, Carr DE, Fink JL 3rd, Jones M. Development of the barriers to error disclosure assessment tool. J Patient Saf. 2017 Jun 30 [Epub]. https://doi.org/10.1097/PTS.0000000000000331.
  40. Vall Castello B. Bridging constructivism and social constructionism: the journey from narrative to dialogical approaches and towards synchrony. J Psychother Integr. 2016;26(2):129. https://doi.org/10.1037/int0000025
  41. Stergiopoulos E, Fernando O, Martimianakis MA. "Being on both sides": Canadian medical students' experiences with disability, the hidden curriculum, and professional identity construction. Acad Med. 2018;93(10):1550-9. https://doi.org/10.1097/acm.0000000000002300
  42. Maudsley G, Strivens J. Promoting professional knowledge, experiential learning and critical thinking for medical students. Med Educ. 2000;34(7):535-44. https://doi.org/10.1046/j.1365-2923.2000.00632.x
  43. Collins A. Cognitive apprenticeship and instructional technology. Educ Values Cogn Instr Implic Reform. 1991;1991:121-38.
  44. Hansen SE, Mathieu SS, Biery N, Dostal J. The emergence of family medicine identity among first-year residents: a qualitative study. Fam Med. 2019;51(5):412-9. https://doi.org/10.22454/FamMed.2019.450912
  45. McConnaughey S, Freeman R, Kim S, Sheehan F. Integrating scaffolding and deliberate practice into focused cardiac ultrasound training: a simulator curriculum. MedEdPORTAL. 2018;14:10671. https://doi.org/10.15766/mep_2374-8265.10671
  46. Nivala M, Saljo R, Rystedt H, Kronqvist P, Lehtinen E. Using virtual microscopy to scaffold learning of pathology: a naturalistic experiment on the role of visual and conceptual cues. Instr Sci. 2012;40:799-811. https://doi.org/10.1007/s11251-012-9215-8
  47. Braun LT, Borrmann KF, Lottspeich C, Heinrich DA, Kiesewetter J, Fischer MR, et al. Scaffolding clinical reasoning of medical students with virtual patients: effects on diagnostic accuracy, efficiency, and errors. Diagnosis (Berl). 2019;6(2):137-49. https://doi.org/10.1515/dx-2018-0090
  48. Braun LT, Zottmann JM, Adolf C, Lottspeich C, Then C, Wirth S, et al. Representation scaffolds improve diagnostic efficiency in medical students. Med Educ. 2017;51(11):1118-26. https://doi.org/10.1111/medu.13355
  49. Hmelo C, Day R. Contextualized questioning to scaffold learning from simulations. Comput Educ. 1999;32(2):151-64. https://doi.org/10.1016/S0360-1315(98)00062-1