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13 Utilising the ‘cognitive constructivism’ educational theory to inform a lesson plan for final-year medical students on the management of terminal agitation
  1. Anna Gray
  1. Cardiff University


Introduction Foundation doctors are required to provide individualised care for dying patients and manage common symptoms, including terminal agitation. Education of final-year medical students on terminal agitation management is therefore important, but how should this be done? A lesson plan with an evidence-based design is required, such as the cognitive constructivism educational theory applied here.

Aim To incorporate cognitive constructivism into a lesson plan for final-year medical students on the management of terminal agitation.

Methods Lesson plan design took place in December 2022. Given its alignment with the constructivist approach, the ASSURE model was chosen (Analyse; Standards and objectives; Select and Utilise strategy, technology, media, and materials; Require learner participation; and Evaluation and revise.) The students’ learning needs were identified from the Foundation Programme curriculum. The revised Bloom’s Taxonomy was also used to write learning outcomes. The cognitive constructivism theories by Dewey and Piaget informed appropriate lesson activities that help achieve learning outcomes.

Results Three domains of the revised Bloom’s Taxonomy (‘remember’, ‘understand’ and ‘apply’) were used to formulate five learning outcomes relating to the identification of reversible causes of, and management of, terminal agitation. Cognitive constructivist approaches were embedded in the lesson plan design by use of suitable learning activities for students to participate in. Theory-based learning preceded problem-based learning, thereby applying Piaget’s concept of ‘schema’. Further, to include Dewey’s principle of collaborative working on real-world problems, the activities of case-based discussions and communication skills role play were included. Finally, a class quiz was used to establish if learning outcomes were met.

Conclusion This lesson plan aims to support medical students in preparing to care for dying patients when qualified as foundation doctors. Lesson activities align with theoretical principles from Dewey and Piaget which appropriately challenge the students’ clinical knowledge, judgement, and reasoning through participating in realistic learning activities.

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