The informed professor: Clinical instruction of breast disease diagnosis and management

This paper describes a learning environment in the domain of breast disease and discusses some of the issues in designing a system cooperatively with content, pedagogical, and computer programming experts. The environment uses curricular content, presented in a non-linear fashion, from third and fourth year medical school; all aspects of the curriculum are available simultaneously to enhance the integration of declarative and procedural knowledge necessary in skilled clinical performance. The system represents an interactive, authentic environment where learners construct knowledge, develop higher order cognitive skills such as diagnosis, reasoning, and decision making, apply knowledge and skills, interact with patients, and receive appropriate feedback. The design of the learning environment is based on the theory of cognitive apprenticeship, thus the type and level of information and feedback provided by the system is dependent up on the learner's input. The system also allows learners to evaluate themselves by comparing their actions and decisions to those of experts in the field. The collaboration of experts from different disciplines in designing this environment has resulted in a greater degree of sophistication in ways in which the project has been conceptualized and reified. By focusing all experts on the learning goals of the environment and by cooperatively assisting each type of expert to extend their knowledge of the other areas, we have been able to create a system that incorporates the key theoretical principles from each area. The result is a learning environment that emphasizes meaningful learning of knowledge and skills that learners can apply when they are confronted with similar situations in the real world.