Instruction to the Double: a promising socio-constructivist method for medical education
DOI:
https://doi.org/10.36834/cmej.80740Abstract
Instruction to the Double is a method used in work psychology. Its key interest is that it bridges the gap between real and prescribed work. From a theoretical standpoint, Instruction to the Double is embedded in Vygotskian socio-constructivism. It aims at developing the learners’ power to act. In practice, learners select a practical situation from their work experience and participate in an interview where the learner presents step-by-step instructions to a facilitator as to how intervene in that situation. The facilitator must focus on the how, rather than the why. Learners subsequently access the recorded interview and transcript. The method’s potential for development resides in surprising learners with the discrepancy between what they think they do, and what they say they do. Such discrepancy facilitates learner’s development of their power to act. Instruction to the Double can be a promising learning method in medical education, especially for post-graduate and continuing professional development learners.
References
1. Vanpee D, Frenay M, Godin V, Bédard D. Ce que la perspective de l’apprentissage et de l’enseignement contextualisés authentiques peut apporter pour optimaliser la qualité pédagogique des stages d’externat. Pédagogie Médicale. 2010;10(4):253-266. https://doi.org/10.1051/pmed/20090330
2. Situated learning. An Instructional guide for university faculty and teaching assistants. DeKalb (IL): Northern Illinois University Center for Innovative Teaching and Learning; 2012. Available from: https://www.niu.edu/citl/resources/guides/instructional-guide. [Accessed May 16, 2023].
3. Ryall T, Judd BK, Gordon CJ. Simulation-based assessments in health professional education: a systematic review. J Multidiscip Healthc. 2016;9:69-82. https://doi.org/10.2147/JMDH.S92695.
4. Al-Elq AH. Simulation-based medical teaching and learning. J Fam Comm Med. 2010;17(1):35-40. https://doi.org/10.4103/1319-1683.68787.
5. Durand-Moreau Q, Le Deun C, Loddé B, Dewitte JD. The framework of clinical occupational medicine to provide new insight for workaholism. Ind Health. 2018;56(5):441-451. https://doi.org/10.2486/indhealth.2018-0021
6. Pena Bedin E, Martins Fontes AR, Braatz D. Discrepancy between prescribed and real work: the case of outsourced service contract supervisors at federal universities in the state of São Paulo. Revista Brasileira de Gestão de Negócios. 2019;22(2):232-249. https://doi.org/10.7819/rbgn.v22i2.4055
7. Lawrence C, Mhlaba T, Stewart KA, Moletsane R, Gaede B, Moshabela M. The hidden curricula of medical education: a scoping review. Acad Med. 2018 Apr;93(4):648-656. https://doi.org/10.1097/ACM.0000000000002004.
8. Yardley S, Teunissen PW, Dornan T. Experiential learning: Transforming theory into practice. Med Teach. 2012;34(2):161-164. https://doi.org/10.3109/0142159X.2012.643264
9. Dornan T, Scherpbier A, Boshuizen E. Supporting medical students’ workplace learning: experience-based learning (ExBL). Clin Teach. 2009;6(3):167-171. https://doi.org/10.1111/j.1743- 498X.2009.00305.x
10. Wickström G, Bendix T. The "Hawthorne effect"--what did the original Hawthorne studies actually show? Scand J Work Environ Health. 2000;26(4):363-367. http://dx.doi.org/10.5271/sjweh.555
11. Clot Y. De Mayo à Oddone, l’instruction au sosie. In: Oddone I, editor. Redécouvrir l’expérience du travail. Paris. Editions sociales, les parallèles / biographie; 2015. p.7-39.
12. Bandura A. Self-efficacy: the foundation of agency. In: Perrig W, Grob A, editors. Control of human behavior, mental processes, and consciousness. Mahwah (NJ). Lawrence Erlbaum Associates, Publishers; 2000. p. 16-30.
13. Canguilhem G. Écrits sur la médecine. Paris: Le Seuil; 2002
14. Clot Y. Travail et pouvoir d’agir. Presses Universitaires de France. Collection Le Travail Humain. Paris 2008.
15. Clot Y and Kostulski K, Intervening for transforming, the horizon of action in the clinic of activity. ISTP. 2011 ;21(5) :681-696. https://doi.org/10.1177/0959354311419253
16. Ouvrier-Bonnaz, R, Werthe C. L’instruction au sosie en formation, le collectif dans l'individuel. Carriérologie. 2012;12(3-4):509-521.
17. Bonnemain A, Bonnefond JY, Fernandes Fontes F, Clot Y. Vygotsky and work: an activity clinic to change the organization. In: Bendassolli PF (Editor), Culture, work, and psychology: invitations to dialogue. Information Age Publishing, Inc. 2019. p. 59-81
18. Vygotski L. Conscience, inconscient, émotions. Paris. Editions La Dispute; 1925
19. Lefrançois, J., Simonet, P. Chapitre 8. L’instruction au sosie : une méthode au service du développement de l’expérience professionnelle. In: Guibert, P. (dir.), Manuel de sciences de l'éducation et de la formation. (143 -155). De Boeck Supérieur. 2008 https://doi.org/10.3917/dbu.guibe.2021.01.0143.
20. Simonet P. L’hypo-socialisation du mouvement : prevention durable des troubles Musculo-squelettiques chez des fossoyeurs municipaux. Thèse de doctorat (PhD thesis) en psychologie du travail. 2011 Available at: https://theses.fr/2011CNAM0774 [Accessed on Nov 4, 2024].
21. Tomás JL, Kloetzer L, Clot, Y. Coanalyser l'activité syndicale : un référentiel d'activité entre dilemmes et acquis de l'expérience syndicale 2014;18(2):177-194 https://doi.org/10.3917/nrp.018.0177.
22. Dionne, Patricia, Viviers, Simon et Saussez, Frédéric « Discuter et réfléchir son activité par l’instruction au sosie : émergence de contradictions et débats de métier ». Nouveaux cahiers de la recherche en éducation 2019;21(2):24-42. https://doi.org/10.7202/1061838ar
23. Brignon B, Gapin M, Pantaléon N. La mobilité soignante non choisie discutée depuis l’activité managériale du cadre de santé débutant. Recherche en soins infirmiers 2022;149:19-30. https://doi.org/10.3917/rsi.149.0019
24. Goudeaux A, Stroumza K. De l’usage de l’instruction au sosie en formation initiale: les norms comme tiers dans le dialogue entre le sosie et l’instructeur. Actes du congrès de la Société d’Ergonomie de Langue Française (SELF) 2004, 493-502, Available at https://ergonomie-self.org/wp-content/uploads/2019/12/acte-50-self-2004.pdf [Accessed on Feb 10, 2025].
25. Nicolini D. Articulating practice through the interview to the double. Manag Learn. 2009;40(2):195-212. https://doi.org/10.1177/1350507608101230
26. Bekti R. Exploration of medical professionalism across postgraduate medical education in Indonesia. [PhD Dissertation]. Leeds (UK): University of Leeds; 2022. Available at https://etheses.whiterose.ac.uk/31862/1/Bekti_RS_Medicine_PhD_2022.pdf [Accessed on Dec 23, 2024].
27. Cadieux D, Mishra A, Goldszmidt M. Before the scalpel: exploring surgical residents' preoperative preparatory strategies. Med Educ. 2021;55(6):733–740. https://doi.org/10.1111/medu.14449
28. Peraya D, Viens J, Karsenti T. Introduction: formation des enseignants à l’intégration pédagogique des TIC: esquisse historique des fondements, des recherches et des pratiques. Revue des sciences de l’éducation. 2002;28(2):243-264. https://doi.org/10.7202/007353ar
29. White J, Paslawski T, Kearney R. ‘Discovery Learning’: an account of rapid curriculum change in response to accreditation. Med Teach. 2013;35:e1316-e1326 https://doi.org/10.3109/0142159X.2013.770133
30. Sanson-Fischer R, Lynagh MC. Problem-based learning: a dissemination success story? Med J Australia 2005;183(5):258-260. https://doi.org/10.5694/j.1326-5377.2005.tb07032.x.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Quentin Durand-Moreau, Pascale Abadie, François Bowen, Nicolas Fernandez
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Submission of an original manuscript to the Canadian Medical Education Journal will be taken to mean that it represents original work not previously published, that it is not being considered elsewhere for publication. If accepted for publication, it will be published online and it will not be published elsewhere in the same form, for commercial purposes, in any language, without the consent of the publisher.
Authors who publish in the Canadian Medical Education Journal agree to release their articles under the Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 Canada Licence. This licence allows anyone to copy and distribute the article for non-commercial purposes provided that appropriate attribution is given. For details of the rights an author grants users of their work, please see the licence summary and the full licence.
