LEADS (Learning Environments Across Disciplines)

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 project is working to extend our pilot research where we created a technology rich learning environment (TRE) that connected an international community of medical students and human 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 supported by a problem-based learning framework. Video cases served as triggers for PBL dialogue about appropriate communication strategies using the medical interview protocol known as SPIKES. A cross-cultural group of medical students learned 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 are currently redeveloping the TRE for to build on the findings from the pilot, leveraging recent developments in Learning Analytics Visualizations to scale-up the module to accommodate a large number of students. We will continue to pursue several avenues, i.e., problem based learning, emotional regulation, and computer- supported collaborative learning. More broadly we are examining the intersection between emotional regulation, decision-making and communication in culturally diverse groups in scaled-up 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.

Current Aims

In this second iteration, we are currently focused on informed design of technology-rich learning environments for a scaled-up, online, cross-cultural Problem-based learning module. This module is centered on helping physicians navigate the emotionally and culturally complex and challenging task of delivering life-altering bad news to patients, in a cross-cultural situation.
More specifically, we are aiming to design TRE’s to take advantage of recent technological developments in Learning Analytics, Text Mining, Natural Language Processing, and using such analysis tools to construct visualizations of collaboration. The purpose of these visualizations is to then allow an instructor to make more timely and informed decisions concerning the facilitation of student groups.


The first iteration of was implemented in the fall of 2013. Analysis and reporting took place spring 2014. For the second iteration, TRE design took place summer of 2014. Backend development is currently underway, implementation is planned for Spring of 2015.


Participants of the first iteration included medical school students from a Canadian medical school, combined in small groups with medical students from a Hong Kong University, and one physician functioning as the PBL Facilitator. In addition, one expert PBL facilitator oversaw the course, providing facilitation suggestions to each of the two physicians. In the second iteration, participants will include one physician and medical school students from a Canadian medical school, and an expert PBL facilitator to oversee the course. Selection of a cross-cultural partner school is underway.


Iteration 1:

  1. How did the Technology-Rich Cross Cultural Setting Affect the PBL Tutorial Process?

  2. To What extent can technology be used to create a PBL community of inquiry using video cases?

  3. Can this Technology Rich Learning Environment Support a Community of Inquiry?

Iteration 2:

  1. How can big data learning analytics tools be used to support an up-scaled, online PBL community of inquiry?  

  2. Can automated content analysis of student’s text based collaborative whiteboarding inform instructor’s facilitation practices?

  3. How can instructor’s access to automated analysis of student collaborations affect student learning?

Presentations & Publications

Key Findings from iteration 1 have been published in the Interdisciplinary Journal of Problem-Based Learning (click here), and presented at the 46the Hawaii Internation Conference on System Sciences (click here)

Project Members

Dr. Cindy Hmelo-Silver

Peter Hogaboam

Jean Jung

Maedeh Kazemi

Dr. Susanne Lajoie

Ofelia Mangen

Dr. Eric Portias

Dr. Jeffry Wiseman