Social media, the democratisation of knowledge and physiotherapy. Can they play nice together?

I work at a university with a long history of opposing injustice and inequity, and I really do believe that working here makes a positive contribution to progress in the country. Sadly, during the last few weeks we’ve been associated less with a vision for uplifting our people, and more with chaos and dispute. I wanted to publicly share this letter to the campus community, emailed to us all yesterday from the Rector. He is a wonderful man who presents the situation with insight and personal reflection that humanises the issues we’re currently grappling with. As always, I am extremely proud to be associated with this institution.

RECTORS LETTER TO THE CAMPUS COMMUNITY – 25th AUGUST 2010

When I drove into the campus this morning just after 4:30 I experienced such profound sadness. The campus was at rest and at peace. It reminded me of how it was before that fateful day, 2 August 2010, when the SRC led a march supported by SASCO and PASMA to protest about financial aid. That day added another dimension to the history of UWC from one where our University was being hailed as a great South African success story, an institution that had courageously faced its past and turned its face to the future.  We are known as a caring university which kept its fees low and which supports students in every imaginable way, especially with respect to finances. Our processes at the start of each year to assist students to continue with their studies despite deep financial challenges marked UWC as special. Much of that changed on 2 August and today UWC is spoken of in the press, as an institution in chaos, whilst only a very small number of its students have declared war on their fellow students and the university. This is indeed reason for profound sadness.

In my letter to the Campus yesterday I gave you an insight into the problem.  At the heart of the matter is the need by a small percentage of UWC students for support from NSFAS, the national students financial aid system.  Because of the large number of students who had applied and were eligible for NSFAS, most of the R64 million granted to UWC had been allocated to those students by June of this year. Many students applied after this and the funds available to assist them were by then depleted.

The SRC was informed that UWC had approached NSFAS for additional funds and that UWC would do its best to support those students when it received additional monies from NSFAS. This message was not well received by the students concerned and more marches followed. Aspects of the demands made were dealt with but the matter of additional funds from NSFAS remained as the major concern.

To our great surprise, the demands moved away from NSFAS funds to one that called on UWC to guarantee that the University would provide the funds for each of the students who had applied in the second semester. The responsibility was now shifted from NSFAS to UWC. Our surprise was even greater when students, still under the banner of the SRC, began to attack the university physically in order to press this demand.

The analogy is that of a large family where a few members have a particular financial need and demand that the rest of the family support them or face physical attacks from them. Instead of the family working out how they might best support the need, the family’s home is attacked by the family’s own needy members, and the other family members are even prevented from going to work. This is what UWC has now experienced.

UWC is a national resource funded by the state, donors and students fees to support the high level intellectual needs of our nation within its African context. It is a precious national asset and has a very important job to do. It is unconscionable that it should come under attack from its own family members and be prevented from performing its important task. On 24 August we experienced a dark day when groups of students went as far as disrupting classes, disrupting conferences and even causing some damage, though slight, to a few buildings. This cannot be tolerated and it is clear that some of our students have divorced themselves from our fellowship and have now constructed UWC and the rest of its family as their enemy, to be attacked with impunity. This cannot continue.

We have consistently been engaging with the SRC to find a way to deal with this matter. The bottom line from the SRC has been that UWC must find the money for these students and that the attacks will continue until we do. UWC is not in the position to take on the responsibility of NSFAS and can only assist students with the help of the state or from bursaries made available by donors for needy students who excel academically. Annually UWC does set aside some of its own funds money for financial aid but this is limited. The solution that the SRC is seeking does not lie inside the UWC family and attacks on the family cannot secure the funds.

Damage has been done to the reputation of UWC and it will take hard work to restore our, but we must begin the task. To protect its staff, students and buildings from those family members who have turned against us, UWC has sought relief from the courts through a Court Order which seeks to stop the attacks. This Court Order has been granted and will come into effect today, 25 August 2010. We ask all our students (our entire family, and especially those have been moved to turn against us) to reconcile and assist with bringing peace to our campus so that we can set about the tasks of finding answers to our challenges as a family.

UWC is a beacon of light in our nation and it will continue to demonstrate what is possible under challenging circumstances. Its responsibility is to educate its students to reach the highest levels of competence in their fields of study and to serve our much challenged nation diligently. In addressing this letter to all members of our family I am asking everyone to pause, reflect and then move quickly  to becoming a family again where we seek to support one another, while each of us commit ourselves fully to the task that this family has to grow our nations store of human capital.

My short term dream is to drive into this campus tomorrow morning (26 August) and know that the family has joined hands in search of a common good future.

Prof Brian OConnell

Rector & Vice-Chancellor

25 August 2010

Presented by Professor Debbie Murdoch-Eaton.

If you don’t know where you’re going, you’re probably not going to get there. A clear vision of the intended outcomes should drive every aspect of teaching, learning and assessment

Outcomes must be clear because they will determine your teaching methods, and will also direct assessment

Preparing students for their final assessments should be very similar to what they will be doing when they graduate i.e. what the students are focussing on in their final weeks of being a student, should be very much like what they will do in their first jobs

Recent teaching activity (groupwork exercise). Do you:

• Teach what students needed to know
• Teach for assessment
• Give facts
• Consider how you will teach the class?

What sort of learning does your assessment generate?

Miller’s pyramid. What is the level you’re trying to teach at?

3P model of learning:

• Presage – the “raw materials” you start with. Students e.g. background, culture, literacy, motivations, language, experience, expectations, gender i.e. know your learners’ variables. Learning environment / teachers – resources, experience, background, structure i.e. what is the educational climate? What sort of tasks are appropriate for these variables?
• Process of learning – How can this be structured so that it will generate…
• Product – learning outcomes (facts, skills, structure, transferability) relate back to Miller’s pyramid

Another groupwork exercise – Choose 1 competency from a teaching session you are responsible for. Plan how you would ensure that outcome would be met, considering these aspects:

• Student/environment
• Methods of teaching
• Appropriate assessment

Presentation by Professor Herman von Rossum.

In preclinical years, you insert learning stimuli from the context of application (i.e. a clinical environment) into the educational learning environment. In clinical years, you insert education moments into the healthcare environment

In constructing a curriculum, you must first determine the health needs of a society, then determine the tasks of the doctors. From the tasks, what are the required competencies (knowledge, skills, behaviour) → final requirements of the programme

students → metamorphosis → doctor → fills health needs of society

Curriculum philosophy:

• Competency orientated
• Task driven
• Learning in context
• Teaching facilitates the learning
• Assessment guides the learner and evaluates the outcome

Medical curricula have evolved over time:

• Discipline or system based, (knowledge of teachers define content)
• Thematic or integrated (teachers co-ordinated and optimised content for students)
• Problem solving / skills lab (learning process of student became the issue)
• Patient used as stimulus for learning moments, hybrid programmes (what is the right mix?)
• Outcome orientated, learning in context, healthcare learning environment (competencies and learning stimuli in relevant context)

How do you translate the philosophy and structure / framework into a programme? Define the programme (e.g. CanMEDS, Tomorrows Doctors) using a blueprint determined by authority (final outcome is a legal guideline)

How do you design the learning path? Should view the pathway at a macro level (the course or the degree), a meso level (semesters), and micro level (weekly, educational structures) → real patients are introduced into the learning process at the basic structural level, and used as context for exploring concepts during that week. This would be a major challenge for us, without a link to a teaching hospital.

What “tasks in practice” (theory and practical) can be formulated from the clinical conditions, competencies and concepts involved?

One of the major differences in medical education compared to our curriculum is that the doctors can implement curricular activity directly on the wards. We can’t pull students off block to attend to these issues.

Hard concepts are “developed in dialogue” between students and clinicians

Learning rhythm: stimuli (patient introduction) → learning (engagement with patient and colleagues) → reflection on the process (in tutorials with roles rotating between students)

How do you develop a narrative between teachers and clinicians to construct learning tasks with patients? Involves meeting with patients and family to construct the problem, and content cleared with stakeholders (informed consent).

In addition to working through the actual problem-based case, the staff also provide students with a list of questions specific to the condition, that require them to follow up and in some cases, make personal reflections on the narrative.

How can you insert an educational moment in a healthcare setting? Apparently the healthcare setting must be “transformed” into an educational setting. How do you do this?

How do you select suitable healthcare events (intake, intervention, follow-up, discharge) to transform into an educational moment? What can be learned at each of these events? How do you lead one educational moment into the next?

We need to think long and hard about a better integration of clinical practice / events into our curriculum. We do suffer from the lack of partnership with a teaching hospital and having ready access to patients. How can this be addressed?

I’m going to split my blog posts up according to the different sessions, just for ease of reference i.e. a few posts, rather than one very long one. Here are my notes from the first keynote of the day, from Professor Bill Burdick.

If you don’t continue the momentum for change, you’re going to be left behind

We need to start system capacity building at the undergraduate level

Presentation made good use of Gapminder (started by Hans Rosling to track human development trends)

It turns out that GDP isn’t the most important factor in determining life expectancy, nor is the number of doctors / 1000 population, nor is sanitation and literacy, although there is an increasing trend for each of these variables. Health spending as a % of GDP also isn’t the major factor. Changing each of these independent variables isn’t going to necessarily enhance life expectancy, but changing all of them will.

Fewer children per woman = greater life expectancy, also the younger a woman is at marriage, the earlier she dies

Taking these factors into account, what must we as health educators do to have an impact on improving health?

Academics have the skills to pull in, analyse and interpret data, and to disseminate the resultant new knowledge, which clinicians need to make evidence based decisions to enhance clinical care.

It is important for academics / health educators to integrate with the public sector by engaging with the community, training other health workers, incorporate health professionals in the management sector, and to engage with public policy makers

Ruth Levine – Case studies in global health: millions saved (freely available report):

• Health interventions have worked even in poor countries
• Donor funding saves lives
• Saving lives saves money
• Partnership is powerful
• National governments can get the job done
• Health behaviours can be changed\
• Successful programmes can take many forms

Health education by itself cannot improve health

Is our curriculum aligned with any of the following factors?

• Water
• Sanitation
• Fertility
• Literacy
• Social integration
• Access to healthcare
• Nutrition

Discussion of the above can easily be integrated into any case study but faculty may need support during the change

Start system capacity building with undergraduates

• Teach leadership and management skills → students can be better at facilitating community change with these skills
• Add interdisciplinary education to improve subsequent team work
• Integrate rural practitioners into the faculty role
• Create systems for knowledge sharing (academia ↔ community)

Positive deviance inquiry – technique to introduce behavioural change in communities

Lessons to learn from the Brazilian health education system

• Curriculum guidelines should emphasise local needs
• Government and medical school leaders attend educational meetings together (integration of ministry of health and ministry of education)

If any of this is to make an impact in health outcomes, institutions must have institutional goals that reflect a desire to improve health → then faculty promotion can be linked to institutional goals

I thought I’d make some notes while listening to this podcast interview from Stephen Downes., where he talks about personal learning environments, problems with e-learning and open vs. closed educational content.

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Mentions Plearn as part of the opening discussion and bio.

What is a PLE? Compares LMS to PLE. LMS is based around the institution, and when the student leaves the system, they lose access to that learning. Same applies when changing institutions, or learning in different environments. PLE provides access to services and educational services from a personal space, rather than an institutional one.

Very new category of “learning system” right now, so there are no applications that exist that define a PLE. Rather, it’s a generic collection of tools and concepts.

Most resources are accessed on the fly, through the browser. Some people have small libraries that they keep locally, but only for backup purposes or content they need to access offline. Students will access lectures as audio and video streams if available. I disagree with the assumption that we’re all connected all the time and that there is no longer a need to download content to be kept locally.

There’s always going to be a mix of local and remote content that’s relevant for learning. A PLE should support whatever works best / whatever the learner needs in whatever context.

Discussed the Khan academy and the role of online video (YouTube) as an educational resource. Quality of the video production isn’t as important as the quality of the video content. The problem is that the video format is linear, which means that it consumes time, it isn’t searchable (it’s not random access). You can’t find the specific piece of information you’re looking for. Content can be more efficiently acquired through text and images.

Videos are also not social or interactive (although video conferences are). Skype conferencing mentioned. Contextual, flexible teaching and learning isn’t really possible when watching video.

Classrooms are not especially well designed for personal learning “1 size fits 30+”.

Is artificial intelligence a viable approach to education? “Going to be tricky”. Some components of the concept available in primitive recommender algorithms currently present in Amazon, iTunes, etc. But going to be a long time before true AI is going to be able to truly personalise the learning experience.

Software will continue to get smarter and understand more and more about what we want to do. It will be able to aggregate, filter, categorise content dynamically.

Discussion on online identity as a tangent to the above point i.e. that your point of entry into the network (i.e. the browser) would be the software that would aggregate, etc. the content you’re interested in. Downes created a tool that did something like this, but which was subsequently superseded by OpenID. Also a brief mention of OAuth.

Briefly talked about SCORM / IMS and the Common Cartridge format (i.e. learning objects). Useful for closed organisations’ learning requirements e.g. the military. Not useful for learning content that needs to be interactive and to engage with other environments / scenarios. Doesn’t do much for the social component and is unnecessarily complex in trying to create “units of knowledge”. The best model is the open web. Many companies trying to create common formats, but also lock consumers in.

Not an easy, decentralised way to create a “learning” management system. But the context there is in managing students or content, not learning. Nothing wrong with the LMS to manage students, but it’s not about learning. How do you give people the freedom to learn in a personal way?

Ends with some discussion on revenue, profit and commercial aspects of education.