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Representational fluency in HIV clinical practice: a model of instructor discourse
Mary A Banach1, Bernard R Gifford, Mark Holodniy
1Stroke Sciences Group and the Clinical and Translational Science Institute, University of California San Francisco, San Francisco, CA, USA. mary.banach@ucsfmedctr.org
The Journal of Continuing Education in the Health Professions
|September 19, 2007
Summary
HIV continuing medical education (CME) instructors model clinical decision-making strategies through interactive case discussions. This approach enhances knowledge transfer and provides a safe space for clinicians to clarify misunderstandings in HIV management.
Area of Science:
- Medical Education
- Infectious Diseases
- Clinical Practice
Background:
- Clinicians require continuous updates on human immunodeficiency virus (HIV) management due to rapidly evolving knowledge.
- Continuing medical education (CME) programs are crucial for disseminating new HIV clinical practice information.
- Limited understanding exists regarding instructor-participant interactions and decision-making modeling in HIV CME.
Purpose of the Study:
- To analyze instructor-participant discourse in HIV CME activities.
- To investigate how instructors model cognitive processing and decision-making strategies during HIV clinical case discussions.
Main Methods:
- Videotaping, transcription, segmentation, and coding of discussions from HIV CME programs.
- Focus on participant questions and instructor responses during clinical case studies.
- Analysis of 24 case studies involving 4 instructors and 45 participants (infectious disease clinicians and general practitioners).
Main Results:
- Five case studies illustrate instructors modeling cognitive processing and decision-making in HIV treatment.
- Instructors effectively utilize participant questions and case details to demonstrate clinical reasoning.
- Analysis reveals patterns in how instructors guide participants through complex HIV management scenarios.
Conclusions:
- A model of interactive, practice-based teaching discourse for HIV CME is presented.
- Instructors demonstrate fluent use of representations to facilitate learning for CME participants.
- HIV CME activities can provide a safe environment for participants to express and resolve misunderstandings in clinical practice.
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