Technology-Enhanced Medical Reasoning: An Interactional Ethnography

• In Event: 56.058 - The Discursive Construction of Learning Opportunities: Developing an Interdisciplinary/Interprofessional Ethnographic Research Agenda for Postsecondary Education

Abstract

Objectives/goals
Qualitative investigations in problem-based learning (PBL) in higher education are limited with even fewer interactional studies drawing upon ethnographic, discourse-based designs. Given the sociocognitive foundations of PBL with collaborative disciplinary knowledge co-construction occurring in small group dialogues, conducting discourse-based studies to capture and analyze learning interactions in-situ is both logical and compelling. Of particular interest to our nationally-funded Interactional Ethnography (IE) in the medical and health sciences in Hong Kong, is the consequential role of educational technologies for learning in small group, problem-based inquiry (Bridges, 2015).

Theoretical framework
The orienting framework for the study is a view of learning as socially-situated aligned to sociocultural views seeking to understand the relationship between social activity and individual thinking (Mercer & Howe, 2012). An interactional ethnographic (IE) logic of inquiry working from this theoretical perspective enabled the systematic collection and archiving of records of classroom learning as it was constructed within and across contexts and over time. Of particular interest became the role of visualizations within a theory of semiosis (Kress, 2010)

Methods
An Interactional Ethnography (IE) was conducted to structure and manage data collection with the aim of exploring the key interplay between student interactions with technologies. By tracing key events surrounding the use of visual representations and technologies (student devised digital texts and learning objects), and discourse surrounding these visualizations across a PBL problem cycle, we examined how a facilitator co-ordinated student knowledge building using large screen visualizations and open-access resources to support group and individual semiosis, and asked how and in what ways the integration of learning technologies and digital resources with face-to-face learning shaped the conditions for learning in PBL tutorials?

Data sources
The data archive across three programmes was collected in 2014-16. A telling case of one PBL cycle from the 5-year MBBS programme formed the anchor point for analysis. Video-recordings of in-class interactions (3 tutorials, ~ 6 hours) between 10 Second-Year students and their PBL facilitator, archived student materials and two post hoc student interviews formed the basis for complex interdisciplinary analysis of classroom discourse and interactions.

Results and conclusions
IE video and textual analysis across the four events (3 tutorials and 1 interview) indicated the centrality of visualizations mediated through technologies both within tutorials and during self-directed learning phases. Two significant findings were: a) the ties between intervisuality and PBL facilitation strategies; and b) how self-regulated learning across a PBL problem cycle is supported by face-to-face facilitation and actualized during students’ out-of-class learning.

Scientific or scholarly significance
In seeking the ethnographic goal of achieving emic understandings, particular challenges existed across all contexts. This is not only in terms of access and recruitment but, more challengingly, in terms of analysis. Of interest to this study was not only the centrality of multimodal visual representations within PBL interactions but also the synergistic, symbiotic relationship with the study’s cultural guide – a medical PBL facilitator – in gaining emic understandings during iterative and recursive video analysis of PBL learning across contexts and over time.

Authors

• Susan Bridges, The University of Hong Kong

• Lap Ki Chan, University of Hong Kong