Developing mobile apps for clinical educators

I’m happy and proud to announce that my first app has been released into the App store. I’ve been working on this project for a few months now, in collaboration with the excellent team at Snapplify, in order to get this release out the door. The name of the app is The Clinical Teacher, and it’s available for download in the app store.

The Clinical Teacher is a mobile reference app (currently only for the iPad and iPhone but soon for Android as well) aimed at clinicians, clinical supervisors and clinical educators who are interested in improving their teaching practices. The idea is to develop short summaries (5-10 pages) of concepts related to teaching and learning practice in the clinical context, integrating rich media with academic rigor. Think of the app as a library within which various articles will be published and made available for download.

Each article within the app is based on evidence and provides insight into teaching and learning strategies in the clinical context. The articles are developed from the ground up by domain experts, making use of peer-reviewed publications and open educational resources to deliver a concise summary of the topic being explored. Articles are comprehensive enough to give you a better understanding of the topic but concise enough to cover in one sitting. However, additional resources are also provided so that you can explore the topics in even more depth.

At the moment, the content is available for purchase for a minimal fee (e.g. the Peer Review of Teaching article is $0.99), although we will push out some articles for free as we move forward. We’re inviting clinical educators to consider publishing through The Clinical Teacher with the idea of developing content that is more “academic” than a blog post, but less so than a peer-reviewed publication. Apple and Snapplify both receive 30% of the cost of the article, meaning that the author receives 40% of whatever the article makes. And you get to have your content in the app store. This may change over time, depending on how much editorial and layout of articles we have to do before work can be published. If you’d like to write a short piece for The Clinical Teacher, submit your idea here.

The idea is that over time we’ll work with Snapplify to develop features in the app that move it beyond a content delivery app and integrate social features which we can use to create a community around teaching and learning practices in clinical education. But that’s for later. Right now it’s just great to see the app available after all the effort. I’d love to hear any feedback or suggestions for improvement.

Keep up to date on further development at   Google+   |   Twitter   |   Facebook

Developing compassion and empathy as part of a Professional Ethics module

I’ve been spending some time this week working with our 4th year students in the Professional Ethics module. One of our biggest challenges is that our students (and most other students in healthcare programmes) see characteristics like compassion, empathy, courage, shame, and emotional response as something that they need to “have”, like a stethoscope or comfortable shoes. I’m trying to get them to see that these are really “ways of being”. Being a caring person isn’t part of your job, it’s a part of who you are. Perceiving and responding to the suffering of others isn’t something that a professional code of conduct can help you with.

I’ve been trying to explore these ideas using music and videos in the classroom, along with reflective writing exercises and, as I’m such a big fan of two of the videos I used recently, I thought I’d share them here.

Neuroplasticity in rehabilitation

Taken from Wikimedia Commons

A few weeks ago I attended a short presentation by Professor Meena Iyer from Missouri University. Her lecture was on the role of neuroplasticity in occupational therapy rehabilitation, although the principles of her talk apply across all of the allied health sciences. Here are the notes I took:

Plasticity: brain structure and function can be influenced throughout life by experiences i.e. it is flexible, and it has a clear age-dependant determinant, includes several morphological changes and many types of brain cells

 

 

 

Occurs under 2 primary conditions:

  • Normal brain development within normal individuals: performance shapes plasticity
  • As as adaptive mechanism to compensate for lost function and/or to maximise remaining functions in the event of brain injury

The environment and actions of an individual play a key role in influencing plasticity, but not as a result of desire

Is plasticity related to functional outcome?

Example of plasticity: the visual cortex is involved in the sense of touch in people who are blind (even if only blinded for a few days) i.e. the cells in the visual cortex take over the responsibility for “seeing” what the fingers feel. In addition, disrupting the visual cortex (with magnetic stimulation) has a negative impact on people’s ability to read braille. See PBS video – Changing your mind (2000). Scientific American Frontiers (www.pbs.org)

When areas of the brain are not stimulated (e.g. when the visual cortex isn’t stimulated in people who are blinded), those areas very soon take over other functions that were not necessarily related to their original function i.e. dormant pathways are activated

“It appears that in the blind, brains areas commonly associated with the processing of visual information are not rendered “silent” by visual deprivation but rather are recruited in a compensatory cross-modal manner” – Theoret, Merabet, Pascual-Leone (2004). J Physi Paris, 221

There are changes in:

  • Dendritic morphology
  • cortical maps
  • Synaptic strength
  • Neurogenesis
  • Axonal trajectory
  • Synpatic morphology
  • Synaptogenesis
  • Gene expression

The brain adapts in response to injury

When a nerve is injured, the areas of the brain responsible for movement and sensation of the injured part starts to change i.e. cortical reorganisation

Constraint induced therapy: impair the unaffected side so that the patient must use the affected side for function (accepted rehabilitation method, although original work had no control group, and no controlled study has been done since)

Promoting plasticity – principles of treatment

  • Use it or lose it
  • Use it and improve it
  • Plasticity is experience specific
  • Repetition matters (corollary: changes may not appear in the early stages of rehabilitation)
  • Intensity (time) matters: continuous training over long periods is needed to change the neural substrate of behaviour
  • Time matters: different forms of plasticity may occur at different times in recovery after an injury → plasticity may involve a sequence of phenomena
  • Salience matters: activity should be meaningful to the person
  • Age matters (change occurs more readily in younger people, so it’s important to build up “cognitive reserve’)
  • Transference is possible: training in one area may enhance behaviour in related areas
  • Interference can occur: some changes in plasticity may disrupt or limit certain behaviours or skills

 

SAAHE conference, 2011 – day 2

Social accountability: the mark of excellence in health professional education by Charles Boelen

Moved from interrogation → an assertion

What is a health professional?

Flexner’s report changed the scope of medical education by introducing a scientific background, especially in education

Medical education should be patriotic (Flexner)

Educating → health professionals → for a strategy → to meet people’s needs (must begin with identifying people’s needs); the 4 layers are not necessarily closely correlated

There are many influences on the process, besides the input we provide in our HEIs

What are people’s needs and values today? What will they be in 20 years time? We’re training professionals for today and tomorrow

Not teaching for health professionals, but change agents

Social accountability: the obligation to direct their education, research and service activities towards addressing the priority health concerns of the community, region and / or nation they have the mandate to serve. The priority health concerns are to be identified jointly by governments, health care organisations, health professionals and the public”

Priority health concerns:

  • quality (ideally, we provide the best to everyone)
  • equity (who are the most vulnerable?)
  • cost-benefit (resources are fixed and we have to work within them)
  • relevance (what are the most relevant problems to address?)

As educators, we can’t achieve the values above on our own, we need to work with others

Functions of a school:

  • Education
  • Research
  • Service

Stakeholders (Boelen, 2000, Towards unity for health, WHO):

  • Policy makers
  • Health professions
  • Academic institutions
  • Health managers
  • Communities

Social accountability (evaluate impact of commitments)

Social responsiveness (more explicitly aware, use data to drive action)

Social responsibility (awareness)

We should accompany our graduates when they leave our schools

Be critical of the health system

Conceptualisation of professional (role of the school) → production of professional (educational interventions) → usability of professional (society’s satisfaction). Using a commercial model to explore ideas

Pay more attention before beginning training, as well as afterwards

Boelen & Woollard, 2009. The CPU model: conceptualisation-production-usability. Medical Education, 43: 887-894

The concept of social accountability helps us to answer the question: “Why are we doing all of this?”

Global consensus for social accountability of medical schools (www.healthsocialaccountability.org)

A socaily accountable medical shool should:

  • respond to current and future health needs
  • reorient education, research and service accordingly
  • strengthen governance and partnership with other stakeholders
  • use evaluation and accreditation to determine impact

Preparing for the future:

  • ethics → impact
  • democracy → transparency
  • globalisation → competition
  • public support → synergy

What is our common purpose?”

 

Developing enterprising health care professionals. How should we meet the challenge? By Prof. Deborah Murdoch-Eaton

Enterprise:

  • making the most of opportunities
  • identifying areas for improvement
  • developing innovative solutions
  • implementing and refining strategies

Health professionals will always work in a business, whether private or public. A business is only as good as it’s employees

Need confidence to implement changes

Reference to “Health professionals for a new century. Frenk et al, The Lancet”

Provoke” global reforms in all health professions

Core role of universities as social institutions

Need to be effective in an ever-changing environment and knowledge-base

Change in accordance with local needs

Graduate attributes = set of core skills that are not discipline-specific, “meta-skils”

  • Communication
  • Higher order reasoning
  • Critical thinking
  • Ability to use technology

Students should not all fit into the “same box”, need to develop those who can lead and innovate

Structured (and repeated) opportunities to practice skills

Incorporate self-reflection and appraisal of own abilities, provide evidence of own learning / experiences

Soft skills:

  • teamwork
  • creativity
  • project planning
  • presentation skills
  • IT skills
  • time management
  • networking
  • negotiating
  • leadership

Be enterprising in teaching style and assessment

Embedding of enterprise:

  • strands
  • blocks / modules
  • extra-curricular

How do we colleagues to collaborate?

What are the persuasive arguments?

Fit for (whose) purpose?

Empower students to help retain them in the country

Need to give guidance and time to think and reflect deeply, not related to “competence-driven outcomes”

Values, cultures and ethics are hard to measure

new knowledge is regulated by measuring it against exising scholarship through the process of peer review, rather than the extent to which it meets the needs of those external to the field”

Teach students to ask relevant questions, empower them to become change agents

 

Blackboard training initiative by A Botha

Staff training using Blackboard within institution

(People think that) Blackboard can:

  • support good teaching practice
  • support learning styles
  • encourage collaboration
  • keep abreast of learning technologies

Staff were overwhelmed and reported needing extra time for training

Trying to improve quality of people trained, rather than getting numbers through the system

The problem with LMSs is that they don’t take the student into account, the focus is on the lecturer, the content and the course

What is the relationship between activity on the LMS and the throughput?

 

E-learning: student’s perspective by G Sinombe

Used to increase access to course materials and information, increase contact and participation in courses and enhance variety of learning styles ← blended approach

Courses (reading material, notes, assignments, etc.) uploaded ← not e-learning (by whatever definition you choose to use for “e-learning”)

Student responses differed, some attempted to use, some didn’t try at all

Why do some students not try? Study aimed to determine student perceptions and challenges that impacted on their use

Student responses:

  • good tool
  • good for slow learners
  • enhances communication between lecturer and student
  • flexibility in time and place
  • easy access to courses
  • hard to find unoccupied computer
  • network slow, when available
  • hard to access off-campus
  • helps me to share ideas outside of the classroom
  • enhances sharing of ideas

Is “e-learning” necessary? How does it improve performance? This has to be taken in context…what is the context in which you want to use it?

 

Students’ approaches to learning disciplines in an integrated curriculum by D Manning

How many students achieve pass marks while scoring below the minimum in individual subjects?

In how many disciplines are passing students scoring below the pass mark

Students going into clinical years with substantial gaps in their knowledge

What is going to be done about this?

Is there a need for discipline based subminimums and consideration of logistical solutions

 

Ready for the catwalk? By what criteria should a new model be judged? By F Cilliers

How does assessment influence learning? Cilliers et al, AHSE, 2010, December

One or more sources of impact, through one or more mechanisms, leading to one or more learning effects

Test the model in a different context to what it was designed for i.e. model developed in theory, then evaluated in clinical practice

Quality of learning” ← how was this defined?

Interaction with preceptors:

  • regular accountability
  • personal consequences
  • emotional valence

Preparing out of a fear of humiliation, rather than a desire for understanding. Just wanted to “survive” the ward round

“You will learn because you don’t want to continue to live in fear”

Tyrants” and “teddy bears” ← categories of supervisors

You don’t want to disappoint the “teddy bears”, go out of your way to participate, gather more information

But they are still motivated by others, rather than for themselves. Did any students report a desire for understanding based on what it would mean for their own clinical practice?

Teddy bears” = scope and safety to ask questions and explore areas of personal interest

 

Reviewing assessment to promote medical student engagement in basic sciences to cure and care better by C Brand

Curricula are living, self-organising organic systems

De-load” some of the course content

Threshold concepts = conceptual gateway that opens up previously inaccessible domains

All change begins with conversation

 

Introduction of a new clinical assessment: did it achieve it’s aim? by L Green-Thompson

Students arrive in the clinical environment unprepared

Introduced an observed examination (mini-CEX) and then evaluated student perceptions of the exam

Landscape of assessment”

Students reported that the clinical exam was a valuable experience: “a good opportunity to see how far I had come”

Assessments are theoretical events, rather than clinical events”

 

Workshop: Making use of adult learning theories by Dr. David Taylor

Theories not mutually exclusive, each have something to recommend them

Instrumental learning theories:

  • Behaviourist → stimulus – response (e.g. Skinner)
  • Cognitive → mental process not behaviour (e.g. Piaget, constructivism)
  • Experiential → behaviour in practice (e.g. Kolb)

Humanistic theories:

  • Andragogy → need, readiness, motivation (e.g. Knowles)
  • Self-directed learning → what about the social context?
  • Transformative learning → disorienting dilemma that drives learning, context, critical reflection (e.g. Mezirow)

Situated cognition (e.g. communities of practice):

  • Learning and thinking are social
  • Structured by tools available
  • Dependant on situation
  • Knowing is supported by doing (e.g. Wenger)

How difficult it is to “get into” a new discipline. Need to acquire an understanding of the profession before you can “be in it”

The challenge for a learner is to find out enough about the subject to enable learning

Expectancy valence theory: low expectation of success results in poor motivation for learn, unless rewards are overwhelming → can’t give students tasks that they can’t achieve

  • You need to recognise what you already know
  • You need to know how the new knowledge fits in
  • Dialogue makes it easier

Feedback will drive future learning

What are the responsibilities of the learner and teacher respectively in each phase of a learning cycle?

Dissonance (putting the cat among the pigeons):

  • Teacher’s responsibility to challenge student to move outside of their comfort zone
  • Learner needs to be open to being challenged, need to identify their own gaps, pre-conceived perspectives impact on worldview

Critical friendship”

Teachers don’t need to be responsible for the answers, but they need to enable the discovery

Hypotheses that can’t be tested are useless (Poppper)

It’s possible to be critically reflective on your own but feedback is important for error correction → create your own dissonance

Laurillard: feedback is a continuous process that occurs as part of a 2-way dialogue (“conversation”)

Feedback sandwich” 🙂

SAAHE conference, 2011 – day 1

Introduction by Dr. Lionel Green-Thompson

A country whose health is fragile

The future of health science education: 2020 vision by Prof. Athol Kent

“After an introduction like that I can’t wait to hear myself speak”

It’s not the strongest or fittest who survive but the ones who are most adaptable to change

  • Who will our students be?
  • How many of them will we need?
  • Who will their teachers be?
  • What will we teach them?
  • How will we teach them?

They will be smarter, better prepared, more IT literate, more women, more black students

We need far more than are currently graduated, more from rural areas, more mid-level workers, clinical assistants

“Innovation through diversity”

Why do health professionals leave? Political, security, working conditions, financial reasons

Makes reference to Freni, et al, Health Professionals for a new century, The Lancet

30% of all posts are unfilled

Need to increase intake & satellite campuses must evolve

All service posts should have a teaching component

Doctors who want part-time work (e.g. mothers) can be integrated as clinical teachers

Generalists who teach as opposed to specialists

Peer teaching should become a core, significant component of clinical teaching (“the mark you get will be the same mark your students get”)

Syllabus will change from curative to preventative → PHC, lifelong learning, less factual, more core and process orientated (“we can’t possibly teach all the facts”, “teach how to learn”)

“The world is flat” → information is everywhere

Move from university → centres → health/education system-based

Teach students HOW to learn

Move from assessment of learning → assessment for learning

“A lecture without a story is like an operation without an anaesthetic”

800 specialised language forms in O&G alone ← imagine what this must look like to a new clinical student

Is the gap between secondary education and health science education going to increase?

The content we give students today is based on work that was done 5 years ago. In 10 years time that content will be less valuable even than today. For all intents and purposes, the content is irrelevant. We need to give students the tools to identify gaps in their own knowledge, and the skills to find the answers to the questions that will help fill those gaps.


Evidence-based practice: how can we facilitate student learning? by Prof. Robin Watts

Practice = EBP is nothing if concepts are not implemented in clinical practice

Evidence-informed practice? More inclusive in that it implies that evidence isn’t the only factor in clinical decision-making, and that practice knowledge is an important component to take into account

Different language roots have an impact on how EBP is understood by people from different parts of the world

EBP steps:

  • Asking (Population, phenomenon of Interest, Context, Outcome)
  • Acquiring
  • Appraising (levels of evidence – hard for students to conduct appraisals of online sources)
  • Applying
  • Assessing

Is evidence derived from medical research directly generalisable to other health disciplines? Should be be modified? Avoid making assumptions of transferability

Springer, “7 pillars of information literacy”

Discrete subject (EBP separate from other modules), or integrated throughout and within other modules? Standalone courses appear to be less effective than integrated. Discrete modules found improvement in basic knowledge, but no impact on appraisal ability. It integrated into clinical practice, improvements occur throughout. Integration should be well-designed.

Content in EBP module should be sequenced, building on previous content / components

Benefits of EBP enhanced when modelled by clinicians

Integrating EBP into the curriculum requires a culture and mindset change

 

Morning POEMs (Patient Oriented Evidence that Matters) – Teaching Point-of-care, patient centred, evidence-based medicine by Dr. Eamon C. Armstrong

Patient presentation followed by real-time internet search for best available evidence → discussion of patient management using those sources

EBM triad:

  • good clinical expertise
  • best external evidence
  • patient values and expectations

POEM = valid:

  • information that patient will care about i.e. has positive patient outcomes
  • addresses a common problem
  • should require a change in practice

How do you brindge the growing knowledge “chasm”

Change the paradigm from “just-in-case” (learn everything in case it comes up) to “just-in-time” (learn what you need, when you need it)

Negotiate common ground around medical decision-making

Prior to the introduction of POEMs, use of electronic sources was scant (study done in US hospital)

Led to fundamental change in prevailing teaching and learning practice

 

The use of reflective journaling in the training of play therapy students by Isabella Jacobs

Reflection used to raise personal awareness, and integrate theory into practice

Students find that ideas become clearer when they write them down, they have to declare concepts in concrete form

Existential dialogue = ways of being, reflective journal may help to implement

Students must receive guidance regarding expectations for jounnaling i.e. must be structured

Role of the self in patient encounters

Journals not assessed, although a random selection of journals were analysed

Students not informed prior to journaling that the journals would be researched, so as not to influence their responses. Informed consent obtained from students after assignments were completed

Students initially reluctant to participate in journaling, but awareness of self began to emerge over time

“as we write conscious thoughts, useful associations and new ideas begin to emerge” (Miller, in Moon, 2006)

“regain my balance by losing my mind” (student quote)

“I do not want to be in unawareness anymore” (student quote)

Some students referred to the process as “a life changing experience”

 

Selective alignment as an applied education and research tool by Sophia Fourie

Assingment which served as an educational tool and research project

Students gained research experience, improved knowledge, and encountered principles of rational drug prescription

 

Do emergency medical care student’s perceptions of their educational environment predict academic performance? by Benjamin van Nugteren

Role of the academic environment in student success?

Identify areas of student dissatisfaction / satisfaction

Used the DREEM questionnaire: 50 statements based on 5 point Likert scale

Looked at:

  • perceptions of learning
  • perceptions of teachers
  • academic self-perception
  • atmosphere
  • social self-perception

Associated above outcomes with academic performance

Noticed a trend of decreasing satisfaction in all of the above components from 1st – 4th year medical students, even though overall satisfaction was reasonably high. What are the implications considering these students are going straight into clinical practice? Is burnout beginning already?

When the data is connected relative to final exams / other stressors might make a difference to student perceptions

 

Workshop: Concept maps and cognition by Dr. Stephen Walsh

Here’s the basic concept map I made during the short workshop:

 

Developing cases for Problem-Based Learning

Workshop on the development of case-based studies

Facilitators: Dr. Ethel Stanley, Dr. Margaret Waterman

Part of my PhD will be to look at alternative approaches to clinical education, including uses cases in problem-based learning (PBL). My specific interest is in the use of emerging technology to design and teach with those cases in small groups. Unfortunately I was only able to attend the first half of the workshop, and didn’t get the opportunity to develop my own case.

Here are my notes from the workshop:

Biology is an important topic for everyone to understand, as it impacts on every major health-related decision that has to be made, so we used biological case studies as working examples

Students must be able to ask good questions in order to solve their own problems in preparation for the types of adult learning (androgogy, as opposed to pedagogy) behaviour we’d expect to see in practice. Memorising content isn’t a good strategy for learning how to solve problems like “Why is this patient walking in a way that is different from “normal”?”

A lecture is a good method to deliver content, but is a poor method for active learning around problem solving

Case-based learning (CBL) is a good way to explore realistically complex situations

Begin by introducing a problem with no expectation that the student can solve the problem. Use that as a springboard to explore their ability to develop good research questions

CBL requires the confidence from teachers to give up control, but giving up control is the only way to get students to actively construct their own learning experiences by asking questions, gathering information, testing hypotheses, and convince others of their findings

Structure for working through a basic case

  • Define the boundaries / outline of the case
  • What do you already know (group knowledge, as well as information that can be obtained from the case study) / what do you still need to know (this can be used as a basis for a short lecture) in order to answer the question
  • Choose the most important questions to explore
  • Get into small groups and discuss / share information, knowledge, assumptions
  • Go away and try to answer the questions that were generated
  • Come back and only then get the teachers objectives
  • Then go away again and refine the questions and information collected

Why use cases?

  • To initiate investigations
  • To use new technologies and resources to solve problems
  • Develop local and international / global perspectives
  • Emphasise the value of interdisciplinary and collaborative approaches
  • Structure student assessment through student products
  • Support diverse objectives within a shared workspace (would be interesting to investigate the possibility of using a wiki to develop and build on cases using this approach)

Used Gapminder to demonstrate alternative ways of visually representing data while working through a case study. See Hans Rosling (founder of Gapminder) on the Joy of Statistics, and his TED presentations.

The teacher can set the context of the class, and the depth to which students should explore questions, by using an appropriate framework / case. Can also decide which questions are prioritised, and which ones can be answered via different methods e.g. lecture, essay, assignment, etc.

Highlight the fact that, as the teacher, you don’t have all the answers and that you’re a co-learner in the classroom. Students should understand that the teacher isn’t a font of all knowledge on the subject, and that it’s acceptable and appropriate for the teacher to have to also do research on the topic

Using social networks to develop reflective discourse in the context of clinical education

My SAFRI project for 2010 looked at the use of a social network as a platform to develop clinical and ethical reasoning skills through reflective discussion between undergraduate physiotherapy students. Part of the assignment was to prepare a poster for presentation at the SAAHE conference in Potchefstroom later this year, which I’ve included below.

I decided to use a “Facebook style” layout to illustrate the idea that research is about participating in a discussion, something that a social network user interface is particularly well-suited to. I also like to try and change perceptions around academic discourse and do things that are a little bit different. I hate the general idea that “academic” equals “boring” and think that this is such an exciting space to work in.

 

I also included a handout with additional information (including references) that I thought the audience might find interesting, but which couldn’t fit onto the poster.

One of the major challenges I experienced during this project was that I didn’t realise how much time it’d take to complete. I’d thought that the bulk of my time would be used on building and maintaining the social network and facilitating discussion within in, but the assignment design (see handout) took a lot more effort than I expected. I had to make sure that it was aligned with the module learning objectives, as well as the university graduate attributes.

In terms of moving this project forward, I think that it might be possible to use a social network as a focus for other activities that might contribute towards a more blended approach to learning and clinical education. For example:

  • Moving online discussions into physical spaces, either in the classroom or clinical environment
  • Sharing and highlighting student and staff work
  • Sharing social and personal experiences that indicate personal development, or provide platforms for supportive engagement
  • Extensions of classroom assignments
  • Connecting and collaborating with students and staff from other physiotherapy departments, both local and international
  • Helping students to acquire skills to help them navigate an increasingly digital world

I think that one of the most difficult challenges to overcome as I move forward with this project is going to be getting students and staff to embrace the idea that the academic and social spaces aren’t necessarily separate options. Informal learning often happens within social contexts, but universities are about timetables and schedules. How do you convince a staff member that logging into a social network at 21:00 on a Saturday evening might be a valuable use of their time?

If we can soften the boundary between “social” and “academic”, I think that there’s a lot of potential to engage in the type of informal discussion I see during clinical supervision, and which students have reported to really enjoy. I think that the social, cognitive and teacher presences from the Community of Inquiry model may help me to navigate this space.

If you can think of any other ways that social networks might have a role to play in facilitating the clinical education of healthcare professional students, please feel free to comment.

SAAHE – Social networks and reflective practice in clinical education

Here is my presentation from the SAAHE conference.

SAAHE workshop – Curricular alignment. What does it mean?

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

SAAHE – short oral presentations

Assessment challenges in UG medical education (GG Mokane)

Medical school in Botswana is spiral, integrated, community based and problem-based, but the rest of the university is didactic

Format, content, timing and feedback are important components of assessment

Assessment in this course has an emphasis on 3 types of MCQ’s

  1. Matching
  2. Single best answer
  3. True/false (multiple answer) – study was based on evaluating this specific format

How should these questions be used, and what instructions issued when they are?

Retrospective analysis of students performance in cumulative and non-cumulative formative assessment methods (AA Adebesin)

If students consistently score above 60%, they are exempt from the final summative exam (university rule). This had implicit problems in that students couldn’t graduate with distinction because they scored high enough to not write the summative exam.

Introduced a cumulative assessment process that carried formative assessment marks over from block to block

How do you objectively measure student progress and understanding?

A student portfolio: the golden key to reflective, experiential and evidence-based learning (G Muubuke)

Portfolios are useful evidence of learning and reflective processes

Logbooks are not good indicators of learning

Portfolio content included bio-data, radiological images, critical learning incident, clinical evaluation forms, logbook – with guiding questions to assist reflection

Portfolio assessed formatively and summatively

Found initially that students and teachers had only limited knowledge of portfolios, although training workshops helped in this regard

Stakeholders welcomed the introduction of the tool

Assessment whittled down to 2 items, rather than whole portfolio (1 item selected by student, the other by the teacher)

Students learn and develop by reflecting on experiences

Unfair to judge learning based only on exam marks

Students should see portfolio management as on ongoing practice, and not just a “task” to be completed

The purpose of the portfolio must be defined at the outset (i.e. what is the benefit to the student?), and it should be simple to complete, students should not see it as additional work

It should be aligned with institutional goals and learning activities

There’s a lot of effort and time involved in assessing portfolios, and rubrics may help to assist marking (adds standardisation)

Making assessment matter: does a novel model of the pre-assessment effects of summative assessment on learning also operate in clinical contexts? (F Cilliers)

There is little evidence of what the impact of assessment is on learning, as well as the mechanism of the impact

Validating a model by looking at the following 4 factors:

  • Explanatory power
  • Generalisability
  • Integration
  • Utility

Daily exposure to consequences leads to evenly distributed learning in clinical settings, but in theory modules, periodic assessment would lead to “binge learning”. However, the more relaxed nature of the clinical (evenly distributed) model might actually lead to the binge-type learning model of theory blocks.

Relaxed environments allow students to go and follow up on work after the situation, but stressful environments force students to memorise content that they forget immediately afterwards

High risk environments lead to surface cognitive processing strategies, as opposed to supportive and low risk environments leading to deeper cognitive processing

The model is useful for explaining behaviour, is generalisable, and is integrated. Not able to determine if it is useful yet

It’s about personal and academic consequences (and their imminence), not just the act of assessment. When block marks are given to students at the end of a block, that were relevant to a situation that occurred during the block, students are less likely to pay attention to the feedback (in whatever form it takes). Consequences should be immediate and not scary.

Assessors can have a powerful (and potentially negative) influence on learning

Students study more for stressful situations, but they remember less. They study less for relaxed environments, but are more likely to follow up on the situations and remember more