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Using the cognitive apprenticeship model to identify learning strategies that learners view as effective in ward rounds
  1. Muhammad Tariq1,
  2. Sundus Iqbal1,
  3. Sonia Ijaz Haider2,
  4. Aamir Abbas1
  1. 1 Medicine, The Aga Khan University, Karachi, Pakistan
  2. 2 Department of Educational Development, Faculty of Health Sciences, The Aga Khan University, Karachi, Pakistan
  1. Correspondence to Muhammad Tariq, Department of Medicine, The Aga Khan University Hospital, National Stadium Road, Karachi, Sindh, 74800, Pakistan; muhammad.tariq{at}


Background Cognitive apprenticeship model (CAM) is an instructional model for situated learning. There is limited data available on application of the CAM in clinical settings. The aim of the study was to identify learning strategies using CAM, which in the opinion of learners are effective in ward rounds.

Methods Participants were residents and medical students who rotated through internal medicine at Aga Khan University Hospital, Karachi. We sought learners’ opinion on a structured questionnaire based on four principal dimensions of cognitive apprenticeship. A previously determined set of 10 defined competencies were compared with CAM’s six teaching/learning (T/L) methods (modelling, coaching, scaffolding, articulation, reflection and exploration) as well. Mean and SD were calculated. Mann-Whitney test was used to compare scores.

Results Of 195 participants, there were 100 men (51.3%) and 95 women (48.7%). Perceived learning for six T/L methods, ranged from 3.7 to 3.9 (max=5). Coaching and scaffolding had the highest scores. Statistically significant difference between the student and resident groups was noted. Medical students perceived coaching and scaffolding (4.1 and 4.05) and residents rated coaching, articulation and exploration as most effective (3.9 and 3.8). Majority (82.1%) reported a positive learning environment in wards.

Conclusions CAM enabled to identify two T/L methods (scaffolding and coaching) that are important for learning in ward round. Limited differences in perceived effectiveness of the T/L methods indicate that variety can be used to sustain interest in learners. Positive learning environment, team diversity and tasks of increasing complexity contribute to learning.

  • Medical education & training
  • internal medicine

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  • Contributors MT designed the study and written and revised the manuscript; SI collected the data and helped in designing the study. SIH analysed the results and drafted the manuscript. AA analysed the result.

  • Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.