Intelligent Tutoring Systems for Ill-Defined Domains - Philippe ...

Using Expert Decision Maps to Promote Reflection and
Self-Assessment in Medical Case-Based Instruction
Geneviève Gauthier 1 , Laura Naismith 1 , Susanne P. Lajoie 1 , and Jeffrey Wiseman 1 ,
1 McGill University, 3700 McTavish Street
Montreal, Quebec, Canada, H3A 1Y2
{genevieve,gauthier, laura.naismith}@mail.mcgill.ca
{susanne.lajoie, jeffrey.wiseman}@mcgill.ca
Abstract. We describe a pilot study that explores whether or not medical
students can understand visual representations of expert thinking. This research
builds upon our previous work in developing a methodology to support
knowledge elicitation and knowledge validation in the ill-defined domain of
medical case-based instruction [1]. Second-year medical students were
assigned to one of two feedback conditions. They solved patient cases in
BioWorld, a computer-based learning environment. We examined their selfassessed
performance and computer logs over three cases to determine whether
the feedback condition has any effect on their ability to discern differences
between their own diagnostic reasoning patterns and those of experts. The
results from this study will be used to guide the development of cognitive tools
to support the provision of dynamic formative feedback in BioWorld. By
tapping into the students’ current understanding of expert thinking, we can
design appropriate scaffolding and feedback mechanisms to support the
students’ developing expertise.
Keywords: case-based instruction, medical education, problem solving,
formative assessment, self-assessment
1 Introduction
The formal use of cases in education is believed to help address the changes required
for more effective teaching. This approach to teaching offers the potential to meet the
challenges of increased educational goals, diversity of the student population and the
changing knowledge base [2]. Shulman and Barnett have proposed the use of cases as
a means to develop pedagogical content knowledge [3, 4]. The use of cases for the
transmission of knowledge is probably as old as storytelling [5]. The use of personal
narratives, or personal life stories that exemplify specific decisions or events have
shown to be an effective instructional strategy [6-8]. This way of encapsulating
knowledge can provide a meaningful framework to bridge the gap between theory and
practice. It can be challenging for learners to understand how abstract and crisp laws
or theories apply in a not so black and white reality that they encounter outside of the
classroom.