Didactic and Dialectic Teaching Rationale for Team-Based Learning In Nursing Education

April 7, 2025 by AfzaLalDin

In Didactic and Dialectic Teaching Rationale for Team-Based Learning In Nursing Education describe in detail about the effectiveness for both methods and their link to Team Based Learning.

Nursing Education and Didactic and Dialectic Teaching Rationale for Team-Based Learning

Many new trends in education have been introduced and used during the past four decades. These have included (but are certainly not limited to:

(a) the use of educational objectives

(b) core curriculum

(d) programmed textbooks

(e) team teaching

(f) computer-aided instruction

(g) learning portfolios

All of these have been claimed to improve learning; However, many have failed from their initial acceptance and have been replaced with more recent fads in education. Why do we have this continuous turnover in educational approaches? While the answer is not always clear, it appears that lasting techniques focus on the learner instead of the educator, and on the process rather then the content. Team-based learning (TBL) is a recent addition to the pedagogical approaches used in medical education. What does this technique offer that separates it from other approaches used in the past?

Teaching in Medical Schools

Medical schools of all places should stress the development of a student’s learning process. It appears obvious that the symptoms and treatment for each patient will be somewhat different. Rarely will any two patients have a routine textbook case presentation. As a result, medical school education should prepare the students to adapt to each new situation rather than memorize how a disease process appears in the classical ”70 kg man” that exists only in the physiology textbook.

The Flexner (1910) report recognized that medical education should teach students to use problem-solving techniques instead of simply to learn content by rotate memory. Flexner proposed to accomplish this by promoting active learning and hands-on practical experience rather than traditional lectures. According to Flexner, didactic teaching in a lecture hall should be reserved for the introduction of new material or the presentation of summary material near the end of a section.

Once the physician was in the clinic, he proposed that the physician should address the patient’s medical condition using steps similar to those used by the scientist. The lab data and patient’s progress would confirm or refute the initial diagnosis and suggest alterations in treatment protocol. Recently the Liaison Committee on Medical Education (LCME) reaffirmed Flexner’s recommendations. The new accreditation standards indicate that medical schools must teach students to ”collect or utilize data to test and/or verify hypotheses or to address questions about biomedical principles and/or phenomena” (LCME, 2007).

This recent alteration in accreditation standards indicates the recognition that we have to shift from a content-driven curriculum (didactic) to one that teaches thought processes (dialectic). The recognition that the scientific method is an important tool for the medical practitioner is a significant step forward for the medical school accreditation process, even if it is finally being implemented almost a century after it was originally suggested.

Didactic Teaching

Didactic is defined in medical terms as ”conveying instruction by lectures and books rather than by practice” (Barnhart, 1872). It is derived from the Greek word didakikos meaning ”apt at teaching” (Taylor, 1974). As the Greek word implies, the focus is on teaching not learning. During the last century, medical education has moved more to the use of didactic teaching as its primary method of instruction. This method focuses the educational process on the instructor.

In this setting, the student can memorize content without having to engage the information at a level needed to truly understand its practical application. A somewhat sarcastic definition of didactic instruction states, ”Information is transferred from the notes of the lecturer to the notes of the student without passing through the mind of either.” In this transfer little or nothing occurs that improves the students’ understanding of the material.

Didactic teaching makes the assumption that the teacher is correct and the students cannot question the information. Often little time is allowed for students to question the authority of the instructor. This type of teaching encourages complacency and replaces curiosity with the desire to achieve a higher grade instead of a higher level of knowledge. Students assume that their ability to recall facts is equivalent to a true understanding of the material.

Students learn to accept an instructor’s point of view and mistakenly assume they have gained independent knowledge without having to mentally engage the material. This type of teaching is similar to cult indoctrination that controls cult members by demanding adherence to the doctrine provided to them by the leader. When coupled with sleep deprivation and fatigue, the individual (student or cultured inductee) loses any interest in pursuing additional knowledge or thinking independently.

Professors, who attempt to teach logic and reasoning skills, must first undo the student’s preconceived notion that rotate memory is equivalent to learning and understanding. Reasoning skills can only be taught after the student rejects the notion that memorization is equivalent to true knowledge and embraces the need to actively engage the material from one’s own point of view. Previous researchers have clearly demonstrated that didactic teaching is limited in its usefulness.

John Dewey recognized the need to teach students the ability to think. While reviewing the shortcomings of teaching facts without thinking ability he stated, ”And skill obtained apart from thinking is not connected with any sense of purpose for which it is to be used. It consequently leaves a man at the mercy of his routine habits and of the authoritative control of others, who know what they are about and are not especially scrupulous as to their means of achievement” (Dewey, 2002).

Humbling information for the professor who steadily holds to the use of the lecture can be found in the following research:

1. During lecture, students are not attending to what is being presented 40% of the time ( Pollio , 1984, p. 11).

2. Students retain 70% of the material in the first 10 minutes of a lecture and 20% in the last 10 minutes ( McKeachie , 1986, p. 72).

3. Students lose their initial interest and attention levels continue to drop as a lecture proceeds ( Verner & Dickinson, 1967, pp. 85–90).

4. Four months after taking an introductory psychology course, only 8% have more information than a control group that never had the course (Rickard, Rogers, Ellis, & Beidleman , 1988, pp. 151–152).

Lujan and DiCarlo (2006) argue that there is entirely too much content being taught, thus inhibiting the student’s ability to actively think about the material presented in the curriculum. Two main goals of the professional school education are to prepare the student to pass the licensing exams and to function as independent thinkers in their clinical practice. Teaching students using a curriculum based on rotate memory accomplishes neither.

Dialectic Teaching

The word dialectic comes from the Greek word dialectic meaning ”art of reasoning.” Dialectic is defined as the art or practice of logical discussion employed in finding out the truth of a theory or opinion (Taylor, 1974). In about 400 BC, Socrates introduced an approach that continually reappears as one of the most influential educational strategies ever used. He is remembered primarily for how he taught rather than what he taught.

His approach of answering a question with a question required his students to evaluate any response they provided and reevaluate their viewpoint based on opinions and information provided by others. They were required to produce a logical rationale for each statement they made and consider the effect it might have if implemented as they proposed. The Socratic method of teaching focuses on the student, requiring one to think independently and to examine and reexamine each assertion.

Each individual is required to carefully examine the logic of each statement and to reevaluate that logic based on input from other individuals and other sources. The leader provides questions rather than answers. These continually refocus the group toward an ultimate conclusion that can stand the test of logical examination.

This approach has become known as Socratic dialogue and is based on the use of questions rather than answers to stimulate discussion. The method is called dialectic, from the Greek, meaning ”art of debate.” Socrates’ development and use of the technique has established him as one of the greatest educators of all times, not for what he taught but for altering the thought patterns of the students.

While he helped direct the discussions, the student’s ability to engage the topic and logically address each issue was the ultimate goal. This teaching/learning paradigm helped each person develop a process of thought that could be used throughout a lifetime. Socrates reportedly referred to himself as a midwife, not producing ideas by himself but drawing them from the minds of his students ( Mannion , 2002). Kant (1781/2003) stated.

Without sensibility no object would be given to us, without understanding no object would be thought. Thoughts without content are empty, intuitions without concepts are blind. It is, therefore, just as necessary to make our concepts sensible, that is, to add the object to them in intuition, as to make our intuitions intelligible, that is, to bring them under concepts. These two powers or capacities cannot exchange their functions. The understanding can intuit nothing, the senses can think nothing.

Only through their union can knowledge arise. (p. 93) Dewey believed that reflective thinking should be a significant outcome of the curriculum and the teaching-learning process ( Axtelle & Burnett, 1970).

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Didactic and Dialectic Teaching Rationale for Team-Based Learning

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