Scaffolding knowledge building in a web-based communication and cultural competence program for international medical graduates. Lax, L. R, Russell, M L., Nelles, L. J, & Smith, C. M Academic Medicine, 84(10 Suppl):S5–8, October, 2009.
Scaffolding knowledge building in a web-based communication and cultural competence program for international medical graduates [link]Paper  doi  abstract   bibtex   
BACKGROUND: Professional behaviors, tacitly understood by Canadian-trained physicians, are difficult to teach and often create practice barriers for IMGs. The purpose of this design research study was to develop a Web-based program simulating Canadian medical literacy and culture, and to evaluate strategies of scaffolding individual knowledge building. METHOD: Study 1 (N = 20) examined usability and pedagogic design. Studies 2 (N = 39) and 3 (N = 33) examined case participation patterns. RESULTS: Model design was validated in Study 1. Studies 2 and 3 demonstrated high levels of participation, on unprompted third tries, on knowledge tests. Recursive patterns were strongest on Reflective Exercises. Five strategies scaffolded knowledge building: (1) video simulations, (2) contextualized resources, (3) concurrent feedback, (4) Reflective Exercises, and (5) commentaries prompting "reflection on reflection." CONCLUSIONS: Scaffolded design supports complex knowledge building. These findings are concurrent with educational research on the importance of recursion and revision of knowledge for improvable and relational understanding.
@article{lax_scaffolding_2009,
	title = {Scaffolding knowledge building in a web-based communication and cultural competence program for international medical graduates},
	volume = {84},
	issn = {1938-808X},
	url = {http://www.ncbi.nlm.nih.gov/pubmed/19907385},
	doi = {10.1097/ACM.0b013e3181b37b4d},
	abstract = {BACKGROUND: Professional behaviors, tacitly understood by Canadian-trained physicians, are difficult to teach and often create practice barriers for IMGs. The purpose of this design research study was to develop a Web-based program simulating Canadian medical literacy and culture, and to evaluate strategies of scaffolding individual knowledge building. METHOD: Study 1 (N = 20) examined usability and pedagogic design. Studies 2 (N = 39) and 3 (N = 33) examined case participation patterns. RESULTS: Model design was validated in Study 1. Studies 2 and 3 demonstrated high levels of participation, on unprompted third tries, on knowledge tests. Recursive patterns were strongest on Reflective Exercises. Five strategies scaffolded knowledge building: (1) video simulations, (2) contextualized resources, (3) concurrent feedback, (4) Reflective Exercises, and (5) commentaries prompting "reflection on reflection." CONCLUSIONS: Scaffolded design supports complex knowledge building. These findings are concurrent with educational research on the importance of recursion and revision of knowledge for improvable and relational understanding.},
	number = {10 Suppl},
	journal = {Academic Medicine},
	author = {Lax, Leila R and Russell, M Lynn and Nelles, Laura J and Smith, Cathy M},
	month = oct,
	year = {2009},
	pmid = {19907385},
	keywords = {Canada, Clinical Competence, Communication, Cultural Competency, Curriculum, Foreign Medical Graduates, Internet},
	pages = {S5--8},
}

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