Home > Research > Project 4

Theory driven designs to support international medical communities of practice: Fostering emotional regulation and cultural diversity using a problem based learning approach


  • Susanne P. Lajoie (McGill U., Theme 1)
  • Cindy Hmelo-Silver (Indiana U., Theme 1)
  • Jeff Wiseman (McGill U., Theme 1)
  • Ricki Goldman (NYU, Theme 2)
  • James Lester (North Carolina State U., Theme 2)

Research Assistants:

  • Peter Hogaboam (Indiana U.)
  • Ofelia Mangen Sypher (NYU)
  • Ruth Kimberly Sherman (NYU)
  • Jiyoon Jung (Indiana U.)
  • Maedeh Kazemitabar (McGill U.)
  • Lila Lee (McGill U.)
  • Tenzin Doleck (McGill U.)


All students need to learn to monitor and manage their emotions in academic settings. However, medical students must manage both their own emotions as well as their patients’ emotions when communicating bad news. This proposal will extend our pilot research where we created a technology rich learning environment that connected an international community of medical students and tutors from Canada and Hong Kong who interacted simultaneously using Adobe Connect. Our learning environment is a hybrid approach to instruction that combines cognitive and affective models of instruction with a “communities of practice” approach that is supported by a problem-based learning framework. Video cases served as triggers for the PBL dialogue about appropriate communication strategies using the medical interview protocol known as SPIKES. Medical students participated in a video-supported problem-based learning unit to learn about the emotion-laden task of delivering bad news. Because this is an emotionally and culturally-laden phenomenon, we had all students view video from the two national contexts (with a facilitator from each of the countries facilitating the appropriate video). In addition, the technology allowed an expert facilitator to support the physician’s who were facilitating the group. PBL helps individuals develop skills of critical analysis, problem solving, and confidence when guided with appropriate feedback by facilitators who help guide the learning process around patient cases. The international context provides a way to facilitate multiple perspective-taking about how to communicate bad news to patients from different cultural backgrounds.

We propose to build on the findings from the pilot by expanding on the theoretical, methodological and instructional implications of this type of research. In terms of theoretical contributions we will pursue several avenues, i.e., problem based learning, emotional regulation, collaborative learning and perspectivity theory.  More broadly we are examining the intersection between emotional regulation, decision-making and communication in culturally diverse groups in medical contexts. In terms of methodology we will refine our mixed methods approach to examine changes in student communication with patients as a function of the problem based learning environment. Discourse analyses and video ethnographic tools will be used to code the verbal and behavioral data on a number of topics: emotional regulation of medical students and patients, communication pattern changes pertaining to knowledge and empathy, tutoring styles of PBL tutors and resulting changes in student discourse pertaining to the PBL learning objectives and SPIKES model as well as perspectivity theory.We also examine student self-efficacy and motivation toward this task before and after the intervention. Instructionally, Wiseman will work closely with our partners at IMHS in creating appropriate instruction based on medical competencies and will work closely with Hmelo-Silver and Lajoie with regard to tutorial scaffolding. The entire team will consider scalability issues.