• LIC의 key feature
    • The key features of LICs include continuity with clinical teachers, patients and settings
  • students who undertake an LIC: (The international Consortium of Longitudinal Integrated Clerkships)
    • 1 participate in the comprehensive care of patients over time;
    • 2 participate in continuing learning relationships with these patients’ clinicians and the community, and
    • 3 meet the majority of the year’s core clinical competencies, across multiple disciplines simultaneously through  these experiences.2
  • LIC를 뒷받침하고 있는(underpinning) 이론들
    • Symbiotic model
    • Social Learning theory
    • Transformative learning theory
  • LIC에서 학생은 community of practice의 합당한 일원으로서 역할을 부여 받는다.
  • LIC의 foundation value
    • Social learning theory
    • Continuity
  • LIC의 장점
    • 분절화된 clinical training의 negative impact를 완화하는 역할
      • 학생이 marginalize 되는 것
      • Ethical erosion
      • 환자중심적 진료를 못 하는 것
      • 피드백의 문제
    • 전통적 방법의 문제
      • Cognitive learning approach를 강조한다 : clinical reasoning, 지식과 기술의 습득, 진단과 치료.
    • LIC 특징
      • 사회적 community에서 transformative learning experience를 할 수 있다.
      • 환자와 환자의 가족을 follow-up 하면서 사회적 context에서 health issue를 바라볼 수 있게 해준다.
      • 'good company'
      • LICs foster a social system in which learners can critically reflect on, question, challenge and rejuvenate their personal values
    • 특징(1) : Integrated learning을 가능케 한다 : formal and informal or opportunistic learning experience
    • 특징(2) : 환자 연속성 - 복통 환자라고 했을 때 외과, 부인과, 내과를 모두 갈 수 있으나 BC에서는 한 과에 한정된 discipline-specific lens로만 바라보게 된다. Encountering greater diversity and differing perspectives.
    • 특징(3) : 실습 마무리 시점에서 peak knowledge에 도달한다. BC는 한 과가 끝날 때 peak에 도달했다가 다시 초보자가 됨. 

Transformative Learning (http://en.wikipedia.org/wiki/Transformative_learning)


At the core of Transformative Learning theory, is the process of "perspective transformation", with three dimensions: psychological (changes in understanding of the self), convictional (revision of belief systems), and behavioral (changes in lifestyle).[1]

"Transformative learning is the expansion of consciousness through the transformation of basic worldview and specific capacities of the self; transformative learning is facilitated through consciously directed processes such as appreciatively accessing and receiving the symbolic contents of the unconscious and critically analyzing underlying premises."[2]

Perspective transformation leading to transformative learning occurs infrequently. Mezirow believes that it usually results from a disorienting dilemma, which is triggered by a life crisis or major life transition, although it may also result from an accumulation of transformations in meaning schemes over a period of time.[3] Less dramatic predicaments, such as those created by a teacher, also promote transformation.[4]

An important part of transformative learning is for individuals to change their frames of reference by critically reflecting on their assumptions and beliefs and consciously making and implementing plans that bring about new ways of defining their worlds. This process is fundamentally rational and analytical.[5][6] 



 2013 Apr;47(4):336-9. doi: 10.1111/medu.12139.

Transformative learning through longitudinal integrated clerkships.

Greenhill J, Poncelet AN.

Source

Rural Clinical School, Flinders University, PO Box 852, Renmark, South Australia 5341, Australia. jennene.greenhill@flinders.edu.au

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