Building Clinical Skills Teaching Materials: A Study of Cognitive Task Analysis Versus Free Recall Instruction to Teach Canine Indirect Ophthalmoscopy

Ophthalmoscopy is a core component of a complete ophthalmic examination. Due to its complex technical aspects and patients becoming uncooperative if the procedure is prolonged, it can be a difficult skill for a novice to learn and develop proficiency in. Skills instruction is typically provided by subject matter experts (SMEs) through free recall without an agreed-upon instructional framework. This can lead to unintentional omission of essential steps and knowledge required to perform skills correctly. Cognitive task analysis (CTA) allows for construction of standardized instructional protocols that encompass the knowledge and skills experts apply when performing tasks. The objectives of this study were to (a) develop a CTA-based teaching protocol for canine indirect ophthalmoscopy and (b) compare the steps verbalized or demonstrated by SMEs during free recall instruction versus those ultimately identified by CTA. Four SMEs participated in free recall instructional sessions and interviews used for the development of a CTA-based teaching protocol for novice learners. The CTA-based protocol identified 66 steps and sub-steps considered essential for successfully performing canine indirect ophthalmoscopy. During instructional sessions, SMEs on average failed to verbalize 57.1% of clinical knowledge steps, did not verbalize or demonstrate 68.3% and 9.5% of action steps and did not verbalize or demonstrate 73.2% and 40.4% of decision steps, respectively. This study demonstrates that SMEs teaching indirect ophthalmoscopy by free recall may unintentionally omit important steps, suggesting that compared with free recall, CTA may generate more comprehensive and thus potentially more effective instructional materials for teaching technical skills in veterinary medicine.

Facilitating Retention through Instruction about Text Structure

In an attempt to investigate the effectiveness of instruction in the use of text structure for comprehending and recalling textual information, ninety college students received one of three treatments. They received either a brief description of the organization of a text immediately prior to reading the text, after reading but before recalling the text, or they received no text-organization instruction. Research report and journalism structures were employed. For both text structures, subjects who received instruction prior to reading performed better on a delayed free recall test than subjects who received instruction prior to recall or than subjects who received no instruction. Subjects who received instruction prior to reading also had better recognition scores than subjects who received instruction prior to recall. Instruction prior to recall had no facilitative effect relative to the no-instruction control treatment. The research report structure led to better performance than the journalism structure. Results suggest that, when encountering well-organized text, skilled readers can profit from instruction about the structure of written materials.