IPE course project update

This post is cross-posted from the International Ethics Project site.

My 4th year students have recently completed the first writing task in the IEP course pilot project. I thought I’d post a quick update on the process using screenshots to illustrate how the course is being run. We’re using a free version of WordPress which has certain limitations. For example it’s hard to manage different cohorts of students, but there are many more advantages, which I’ll write about in another post.

My students will keep writing for their portfolios using the course website, which I’ll keep updating and refining based on our experiences. The idea is that by the end of the year we’ll have figured out how to use the site most effectively for students to work through the course for the project.

Design principles for blended learning environments: a presentation

I’m going to be at the 2015 SAAHE conference for the next couple of days, which is being held in association with The Network: Towards Unity for Health. Yesterday I gave a workshop on Setting up and running an open online course, as well as a presentation on developing Design principles for blended learning environments. These principles are the outcomes of my PhD project, as well as further studies that I’ve done in the area. Here are the slides for the presentation.

Face-to-face as a subset of virtual learning spaces?

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…educational technology is no longer a single innovation or a group of innovations but a sea change based on the awareness that face-to-face (F2F) pedagogy is a subset of the virtual learning environment — and not the other way around.

I like this quote from an old post by 21st century fluency, although I’m not sure I completely agree with it. I like the idea that we need to change our mindset and think of face-to-face spaces as a subset of learning spaces, rather than the predominant one. But, I don’t think of virtual spaces as the predominant space either. I think that learning spaces are both physical and / or virtual and that there isn’t a hierarchical structure to how these spaces are conceived. I talk about blended learning, but increasingly there is only learning, and we use a range of tools that sometimes includes digital spaces, sometimes whiteboards, sometimes models, and sometimes conversations. They’re all just ways of connecting people and ideas.

Design principles for clinical reasoning

graphic_design smallerClinical reasoning is hard to do, and even harder to facilitate in novice practitioners who lack the experience and patterns of thinking that enable them to establish conceptual relationships that are often non-trivial. Experienced clinicians have developed, over many years and many patients, a set of thinking patterns that influence the clinical decisions they make, and which they are often unaware of. The development of tacit knowledge and its application in the clinical context is largely done unconsciously, which is why experienced clinicians often feel like they “just know” what to do.

Developing clinical reasoning is included as part of clinical education, yet it is usually implicit. Students are expected to “do” clinical reasoning, yet we find it difficult to explain just what we mean by that. How do you model a way of thinking?

One of the starting points is to ask what we mean when we talk about clinical education. Traditionally, clinical education describes the teaching and learning experiences that happen in a clinical context, maybe a hospital, outpatient or clinic setting. However, if we redefine “clinical education” to mean activities that stimulate the patterns of thinking needed to think and behave in the real world, then “clinical education” is something that can happen anywhere, at any time.

My PhD was about exploring the possibilities for change that are made available through the integration of technology into clinical education. The main outcome of the project was the development of a set of draft design principles that emerged through a series of research projects that included students, clinicians and clinical educators. These principles can be used to design online and physical learning spaces that create opportunities for students to develop critical thinking as part of clinical reasoning. Each top-level principle is associated with a number of “facets” that further describe the application of the principles.

Here are the draft design principles (note that the supporting evidence and additional discussion are not included here):

1. Facilitate interaction through enhanced communication

  • Interaction can be between people and content
  • Communication is iterative and aims to improve understanding through structured dialogue that is conducted over time
  • Digital content is not inert, and can transform interactions by responding and changing over time
  • Content is a framework around which a process of interaction can take place – it is a means to an end, not an end in itself
  • When content is distributed over networks, the “learning environment” becomes all possible spaces where learning can happen
  • Interaction is possible in a range of contexts, and not exclusively during scheduled times

2. Require articulation

  • Articulation gives form and substance to abstract ideas, thereby exposing understanding
  • Articulation is about committing to a statement based on personal experience, that is supported by evidence
  • Articulation is public, making students accountable for what they believe
  • Articulation allows students’ thinking to be challenged or reinforced
  • Incomplete understanding is not a point of failure, but a normal part of moving towards understanding

3. Build relationships

  • Knowledge can be developed through the interaction between people, content and objects, through networks
  • Relationships can be built around collaborative activity where the responsibility for learning is shared
  • Facilitators are part of the process, and students are partners in teaching and learning
  • Facilitators are not gatekeepers – they are locksmiths
  • Create a safe space where “not knowing” is as important as “knowing”
  • Teaching and learning is a dynamic, symbiotic relationship between people
  • Building relationships takes into account both personal and professional development
  • Building relationships means balancing out power so that students also have a say in when and how learning happens

4. Embrace complexity

  • Develop learning spaces that are more, not less, complex
  • Change variables within the learning space, to replicate the dynamic context of the real world
  • Create problems that have poorly defined boundaries and which defy simple solutions

5. Encourage creativity

  • Students must identify gaps in their own understanding, and engage in a process of knowledge creation to fill those gaps
  • These products of learning are created through an iterative activity that includes interaction through discussion and feedback
  • Learning materials created should be shared with others throughout the process, to enable interaction around both process and product
  • Processes of content development should be structured according to the ability of the students

6. Stimulate reflection

  • Learning activities should have reflection built in
  • Completing the reflection should have a real consequence for the student
  • Reflection should be modelled for students
  • Reflections should be shared with others
  • Feedback on reflections should be provided as soon after the experience as possible
  • Students need to determine the value of reflection for themselves, it cannot be told to them

7. Acknowledge emotion

  • Create a safe, non­judgemental space for students to share their personal experiences and thoughts, as well as their emotional responses to those experiences
  • Facilitators should validate students’ emotional responses
  • These shared experiences can inform valuable teaching moments
  • Facilitators are encouraged to share personal values and their own emotional responses to clinical encounters, normalising and scaffolding the process
  • Sensitive topics should be covered in face­to­face sessions
  • Facilitators’ emotional responses to teaching and learning should be acknowledged, as well their emotional responses to the clinical context

8. Flexibility

  • The learning environment should be flexible enough to adapt to the changing needs of students, but structured enough to scaffold their progress
  • The components of the curriculum (i.e. the teaching strategies, assessment tasks and content) should be flexible and should change when necessary
  • Facilitators should be flexible, changing schedules and approaches to better serve students’ learning

9. Immersion

  • Tasks and activities should be “cognitively real”, enabling students to immerse themselves to the extent that they think and behave as they would be expected to in the real world
  • Tasks and activities should use the “tools” of the profession to expose students to the culture of the profession
  • Technology should be transparent, adding to, and not distracting from the immersive experience

We have implemented these draft design principles as part of a blended module that made significant use of technology to fundamentally change teaching and learning practices in our physiotherapy department. We’re currently seeing very positive changes in students’ learning behaviours, and clinical reasoning while on placements, although the real benefits of this approach will only really emerge in the next year or so. I will continue to update these principles as I continue my research.

Note: The thesis is still under examination, and these design principles are still very much in draft. They have not been tested in any context other than in our department and will be undergoing refinement as I continue doing postdoctoral work in this area.

Blended learning in clinical education

Later today I’m presenting a progress report on my PhD, at the UWC “Innovations in Teaching and Learning” colloquium. Here is the presentation:

Twitter Weekly Updates for 2012-06-04

Twitter Weekly Updates for 2012-02-20

Posted to Diigo 01/16/2012

    • the CoI theoretical framework is essentially incompatible with traditional distance education approaches that value independence and autonomy over collaborative discourse in purposeful communities of inquiry (Garrison, 2009)
    • the explanatory value of a CoI approach depends on the educational purpose and context
    • it is very difficult to achieve deep understanding without discourse
    • While this may be accomplished through Socratic dialogue or in a one-to-one tutorial with a qualified instructor, it is totally impractical in most educational contexts (especially scalable distance education)
    • Discounting SP is to discount the importance of critical discourse in a connected, knowledge based society
    • It is also difficult to see how one gains metacognitive awareness and ability without sustained discourse and feedback (Akyol & Garrison, 2011). This may well be one of the great weaknesses of independent study and didactic approaches.
    • The CoI is a generic theoretical framework that must be viewed as a means to study collaborative constructivist educational transactions – be they in online, blended or face-to-face environments
    • The validation of this framework would also suggest that it can also be used as a rubric to test for functioning communities of inquiry
    • I think one of the main problems with CoI research is the tendency to consider every online/blended learning environment is a true community of inquiry design when, in fact, there is little teaching, cognitive or social presence (students are reliant on independent activities and tests)
    • the categories of SP are open to refinement but are not necessarily compatible with independent (or informal) learning activities and should not be critiqued from this perspective
    • revised definition of SP “as the ability of participants to identify with the group or course of study, communicate purposefully in a trusting environment, and develop personal and affective relationships progressively by way of projecting their individual personalities” (Garrison, 2011, p.34)

TEDxStellenbosch: designing spaces

A few months ago I attended TEDxStellenbosch at Spier wine farm near Stellenbosch. It was one of the better TEDx events I’ve been to during past few years and I enjoyed it immensely. During the day I re-tweeted comments from other participants, mainly as a record of speakers and the comments that resonated with me. As with most TEDx events, it was such a whirlwind that a lot of what happened was gone before I’d had an opportunity to reflect on it. During the event, attendees were asked to doodle their solutions to problems on large whiteboards placed throughout the venue (see pics). Anyway, I just wanted to mention it here.

 

Problem based learning: transitioning to an online / hybrid learning environment

A few weeks ago I attended a short presentation by Prof. Meena Iyer from Missouri University. Prof. Iyer spoke about how she moved her PBL module from using a traditional, mainly face-to-face approach, to an online / hybrid approach. Here are my notes.

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“All life is problem solving” – Karl Popper

How do we get students to think like professionals in the field?
How do we foster group interaction in online spaces?
How do I assess learning in online spaces?

PBL addresses the content issue, as well as enhancing critical thinking through the collaborative solving of authentic, real-world problems

Mismatch:

  • PBL → solving problems is the tool, learning is the goal
  • Traditional → content is the tool, problem solving is the goal

PBL is all unstructured (but it can be scaffolded), and there’s not necessarily a right/wrong answer

Six steps to problem solving (IDEALS):

  • Identify the problem (What is the real question we are facing?)
  • Define the context (What are the facts that frame this problem?)
  • Enumerate the choices (What are the plausible actions?)
  • Analyse the options (What is the best course of action?)
  • List reasons explicitly (why is this the best course of action?)
  • Self-correct (What did we miss?)

The problem should be authentic and appealing (a mystery to solve)
Clearly outline expectations for each step of the process

Why move from face-to-face to online?

  • In F2F, you can only move forward at the speed of the slowest learner
  • Significant time requirements for F2F
  • Identify…can be anonymous online → fewer preconceived biases among students

Challenges:

  • How do you transition F2F to online
  • What tools are appropriate / feasible / viable / affordable?
  • How do you do collaborative work when everyone is online at different times?

Format:

  • Cases are presented in multiple formats / media
  • Introductory week to familiarise students with online environment. In addition to learning the content and critical thinking, students also have to learn about PBL
  • Scenarios are released in 2 stages over a 2 week period
  • Scenarios are accompanied by a set of probing questions to stimulate discussion
  • Teacher provides support during the discussions
  • Students must also design their own case
  • Assessment is based on content and depth
  • Wiki used for question / answer. Each student must answer each of the questions, each answer must be different i.e. must add to what has already been added (this means that the question can’t just be a knowledge question)
  • Discussion boards are used for students to dissect the cases (All and Group)
  • Each group assesses their own knowledge base, and define what the gaps are, and therefore what they need to find out (who provides the links to the resources, or can students use any resources?)
  • At least 3 posts per student, including: Summarise and question one citation; Answer another students’ question; Follow up any discussion on their own posts
  • Reading assignment: written, critial appraisal of a published article relevant to the case study. This summary must be posted online.

Important for students to learn how to share information in supportive environments

Assessment:

  • What parts of the process need to be assessed?
  • What parts can be graded as a group?
  • What needs to be submitted for individual assessment?
  • What are the time constraints for the grading?
  • How do you balance grading workload with the need to externally motivate student performance?
  • There is also a syllabus quiz to ensure the students actually know the content

Design:

  • Make the problem compelling
  • Outline expectations
  • The problem analysis should relate to the professoinal field
  • As student proficiency develops, withdraw support
  • Use learning issues to encourage EBP
  • Ensure that solution development is based on critical appraisal

Resources

  • Barrows, HS (1996). Problem based learning in medicine and beyond: a brief overview. New directions for teaching and learning
  • Barrows HS & Tamblyn, RM (1980). Problem based learning: an approach to medicla education. New York, Springer Pub. Co.
  • Hmelo-Silver, C (2004). Problem based learning: what and how do students learn? Educational Psychology Review, 16(3)
  • www.criticalthinking.org