An excellent example is the second year Introduction to Clinical Medicine course at the University of Virginia, in which lectures are limited in number and students learn primarily through a problem oriented approach. The responsible faculty members develop a set of clinically based problems which represent core material to be learned or applied. The cases are coordinated with lectures and readings in pathology and pharmacology. Students address the clinical cases individually and in small groups. The cases serve as a nidus for the application of information learned in the basic science courses, and they stimulate the quest for new information from learning resources which include notes, textbooks, and on occasion, journal articles identified from computerized literature searches.
Student learn and integrate new information, and most importantly, they learn how to learn.
Although faculty are appropriately called on for expert advice and clinical judgment, students, residents and faculty learn best when educated in a socratic manner. Questions should be asked in a clinical context in a supportive and collegial manner. Identification of these gaps provides the motivation and focus for learning. Skills and procedures should be learned by explanation, observation and participation, and must be done with support and in a safe environment until competence is attained. An introduction to procedures with opportunities to practice on mannequins or fellow students is provided for University of Virginia students in an introductory course prior to the clerkships and in a surgical techniques laboratory during the surgery clerkship.