Cognitive Apprenticeship Learning in Paediatric Clinical Settings

Objectives: Cognitive apprenticeship learning focuses on improving understanding and clinical diagnostic reasoning 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 diagnostic 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 departments. Median 9 (range 2-120) minutes were used for the encounters. Almost all learners reported being challenged during the encounter. Almost half of the encounters included a joint teacher and learner examination of a patient.