Cognitive Apprenticeship Learning in Paediatric Clinical Settings

Objectives: Cognitive apprenticeship learning focuses on improving understanding and clinical diagnostic rea- soning among learners. The aim of this study was to describe the feasibility of cognitive apprenticeship encounters in clinical paediatric settings in terms of time consumption; and to describe the encounters in terms of learner and teacher behavior. Methods: This study was based on data from 485 self-reports filled in by participating learners during a 3-month quality improvement project conducted at three Danish paediatric departments. Teacher and learner cognitive apprenticeship skills training took place at repeated workshops. A total of 59 different learners participated, 4 were medical students, 49 were residents, and 6 were specialists in pediatrics. A total of 75 different teachers participated. Results: Apprenticeship encounters between teachers and learners lasted median 9 (range 2-120) minutes. In 47% of the encounters, the teacher and learner examined the child together. In 91% of the encounters, the learner reported that his or her knowledge was challenged and in 92% of the encounters, the learners and the teachers verbalized their clinical diag- nostic reasoning processes. Educational strategies to reach learning objectives were reported in 77%. Conclusions: Cognitive apprenticeship learning was a feasible approach to teaching and learning in paediatric depart- ments. Median 9 (range 2-120) minutes were used for the encounters. Almost all learners reported being challenged dur- ing the encounter. Almost half of the encounters included a joint teacher and learner examination of a patient.