The 4 I’s of Dialogue Education

The medical education environment offers a variety of opportunities for dialogue education learning tasks.  Dialogue education is an intentional design framework that fosters communication, reflection, and community in the learning environment.   Using this framework, educators can structure dialogue with students through learning experiences or “tasks” designed to assess prior knowledge, introduce new content, give learners a chance to practice, and then help them integrate the new knowledge or skill (Vella, 2000).   Jane Vella’s concept of learning task design includes what she refers to as the 4 I’s:


Inductive—connect learners to what they already know

An Inductive learning task helps the learner create a point of reference for the concept:  “Tell me what you know about cardiovascular disease risk factors?”


Input—course content, new material

Input tasks can be a mini-lecture, demonstration, video, or presentation done to introduce new content.


Implementation—try it out!

Implementation tasks ask learners to do something directly with the new content:  “After viewing this video clip, what stands out for you about this patient’s description of __(medical topic)__?


Integration—asks learners how they will integrate new learning into their developing knowledge of medicine and medical practice

Integration tasks happen at the end of the learning encounter and give the learner an opportunity to organize new knowledge into the prior knowledge base:  “Now that you have learned about __(medical topic)__, what are the implications of this for what you already know about cardiovascular disease risk factors?”

(Vella, 2008)

In what ways do you structure dialogue using learning tasks?  Share your ideas at #MedEdPearls.

To find out more, check out the following resources:

Vella, J.K. (2000).  Taking Learning to Task:  Creative strategies for Teaching Adults.  Ann Arbor: Wiley.

Vella, J. K. (2008). On teaching and learning: Putting the principles and practices of dialogue education into action. San Francisco: Jossey-Bass.


Special thanks to Dr. Terry Carter, Professor and Associate Dean for Professional Instruction and Faculty Development at the Virginia Commonwealth University School of Medicine, for her contribution to this topic!

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