Thoughts on my first article for The Conversation

I pitched 3 ideas for articles to The Conversation: Africa at the end of last year, one of which was picked up to develop and publish. A few days ago I gave the go-ahead for it to be published and am happy to report that it is live. It’s called Technology is no longer a luxury for universities – It’s a necessity. My original title was a William Gibson quote: “The future is here, it’s just not evenly distributed” but I gather the editor decided on something more accessible.

There are a few things that were different to what I was expecting, in particular the amount of input that the editor provides. I was expecting something more like critical feedback in the peer review process but it was actually more like having a co-author at times. This worked out well for me since I didn’t want to feel like I had to put in the same amount of time that I would for an academic paper. It was nice to have someone else try out the ideas and to actually make the changes to the article.

I was also surprised that the editor selected the header image. When I’m blogging I’m used to spending a bit of time trying to find a good picture that works with the post, so it was strange to see the final article with an image already included. This is both positive and negative. Positive because I didn’t have to spend the time finding a graphic with the right permissions (I suppose this is the main reason the editor takes on this responsibility), and negative because I may not like the selected picture, although this is obviously something that can be discussed.

All in all, I enjoyed the process, especially the very quick turnaround time from the initial submission of the idea to the final publication, which would have been even quicker had we not had the #FeesMustFall movement at the end of 2015. I am also impressed at the reach of the publication, which you can see in the screenshot below. That’s not bad considering it was only published this morning. Finally, The Conversation makes it very simple to republish articles on your own site – providing the source code for the piece – which you can copy into your own blogging platform. I’ll be doing that in my next post on this blog.

The Conversation 2016-01-12 10-53-04



I enjoyed reading (June)

reading mountainThe internet: Everything you ever need to know (John Naughton):

A funny thing happened to us on the way to the future. The internet went from being something exotic to being boring utility, like mains electricity or running water – and we never really noticed. So we wound up being totally dependent on a system about which we are terminally incurious. The internet has quietly infiltrated our lives, and yet we seem to be remarkably unreflective about it.

We really need to pay more attention to the internet and the impact it’s having on our lives. It’s not just another way to pay your bills, it’s a profoundly important . Related: Time to start taking the internet seriously (David Gelernter).


The coming war on general purpose computing (Cory Doctorow):

…it doesn’t take a science fiction writer to understand why regulators might be nervous about the user-modifiable firmware on self-driving cars, or limiting interoperability for aviation controllers, or the kind of thing you could do with bio-scale assemblers and sequencers…Regardless of whether you think these are real problems or merely hysterical fears, they are nevertheless the province of lobbies and interest groups that are far more influential than Hollywood and big content are on their best day, and every one of them will arrive at the same place — “can’t you just make us a general purpose computer that runs all the programs, except for the ones that scare and anger us? Can’t you just make us an Internet that transmits any message over any protocol between any two points, unless it upsets us?”

Here is a transcript of Cory’s presentation.

Bloom and bust (Steve Wheeler): Bloom’s taxonomy was my first introduction to the idea that teaching and learning could be better understood through the use of frameworks and theories. For that reason, it has a place in my heart but I’ve since come around to the fact that it is too simplistic and structured to really represent any form of meaningful learning.

And yet Bloom’s taxonomy raised some serious issues. How relevant is it in the digital age? Should we still be organising learning experiences as a gradient of ‘terminal learning objectives’ in an age where learning is changing, and where personal technologies and social media are increasingly significant? Learning is changing, because the boundaries between discrete learning activities are blurring.

Creating classrooms we need: 8 ways into Inquiry Learning

Teachers teach kids, not subjects.

I often fall into the trap of thinking about the subjects I teach, rather than the people I teach. This reminded me of the difference.


What is transhumanism, or, what does it mean to be human? (Sebastian Anthony):  I’m increasingly interested in how the integration of technology into our lives seems to be a first step towards integrating it into our bodies. What happens when I can jack directly into the internet? Or store all digital texts in my augmented brain? What does it mean for testing when our students are able to do exactly that?

The uneasiness that surround new, paradigm-shifting technologies isn’t new, and it has only been amplified by the exponential acceleration of technology that has occurred during our lifetime. If you were born 500 years ago, odds are that you wouldn’t experience a single societal-shifting technology in your lifetime — today, a 40 year old will have lived through the creation of the PC, the internet, the smartphone, and brain implants, to name just a few life-changing technologies. It is unsettling, to say the least, to have the rug repeatedly pulled out from under you, especially when it’s your livelihood at stake. Just think about how many industries and jobs have been obliterated or subsumed by the arrival of the digital computer, and it’s easy to see why we’re wary of transhumanist technologies that will change the very fabric of human civilization.


The Internet is here to stay

Quote from Alec Couros‘ blog post, “It’s not going away“:

We live in complex, media-rich, connected environments. As adults, we have built these spaces for our kids and set them up in situations where I’ve heard members of our generation exclaim, “I’m sure glad Youtube or Facebook didn’t exist when I was a kid!” But these do exist. And no one – no one – really understands the full implications of what these devices and spaces have on the future of our children. So what are our *obligations* in all of this as administrators, parents, and educators? Do we selfishly ignore “it” because it feels uncomfortable and complex? Or do we roll-up our sleeves, embrace this discomfort, and live up to our ethical responsibilities for our kids?

We need to be comfortable with complexity.

I like the part about embracing the discomfort because I think that this is what’s really difficult for so many people. Change is hard to deal with and the Internet is changing everything. In order to move forward and really use this platform for something fundamentally different, we’re going to have to accept the disorder and discomfort, and figure out how to work within it rather than get upset because we can’t control it.


AMEE conference, 2011 (day 1)

Today was the first day of AMEE 2011, and a great start to my first international conference. Here are the notes I took.

Donald Clark – 21st century medical learning

“Death of the compliant learner” – almost all of my students are compliant, I hope Clark doesn’t buy into the idea that all of today’s students are somehow different? Even Prensky has moved on from the Digital Native debate

When the cost of education goes up, and the deliverable stays the same, you have the characteristics of a bubble → is higher education / medical education in a bubble (Malcolm Gladwell)?

Clark shows excerpt from Ferris Bueller’s day off to demonstrate poor lecturing style, gets a laugh but is caricaturing the format useful in terms of solving the actual problem?

Psychology of learning:

  • Spaced practice
  • Attention
  • Assessment
  • Learn by doing
  • Collaboration

“The internet is shaping pedagogy”, this is the wrong way around. Effective teaching practice should make effective use of the internet.

“Lectures are ineffective for teaching”

  • don’t inspire or motivate
  • no critical thinking
  • doesn’t emphasise values
  • no social adjustment
  • or behavioural skills
  • only useful for transmitting information

Student and lecturer’s attention begins to fall off after 25 minutes, yet lectures often continue for much longer. Clark’s solution → record lectures! OR…change teaching practice to make use of that time more effectively

Cultural reasons for not changing teaching practice

Assessment is skewed towards favouring cramming

Is technology supporting assessment?

Surgeons who play video games perform better with laparoscopic procedures than those who don’t

I think Clark’s emphasis on technology misses the point. This isn’t the right audience to make assumptions about what technology should be used with what teaching approach. The message he’s sending is that we should use digital tools because they’re better. But he hasn’t spent enough time explaining what it’s better for and how.


The future of online continuing medical education: towards more effective approaches
Panel discussion (John Sandars, Pat Kokotailo, Gurmit Singh)

How do we get the new evidence base to change behaviour in health professionals? By delivering content and hoping → behavioural change

Online CME is about transmitting content from an “expert” to the person at home, and competing with their social lives. Does this have the intended impact of actually changing clinician’s behaviour? Sandars says “No”

How can the intended impact be achieved?

CME process whereby people keep updated regarding medical information
CPD includes CME but is more broad

e-learning implies that technology is used to enhance T&L but no definition of what technology is. I wish people would stop talking about e-learning until we demonstrate that it’s fundamentally different in terms of changing learning behaviour

List of digital tools and blending them with f2f spaces

Issues in obtaining evidence of effective CPD:

  • Differing content in med ed → differing ways of delivering / teaching
  • Traditional curriculum vs no curriculum
  • Rare comparison between e-learning intervention and traditional intervention
  • Difficulty with educational RCTs (very “medical” to think that RCTs are an important evaluative tool in education)

Kirkpatricks model to categorise the level of evaluative outcomes

Majority of research looks at participant satisfaction, but limited research demonstrating performance change in practice, no studies demonstrated that web-based CME had any effect on clinical practice

Internet learning associated with large positive effects compared with no intervention, but the effects were heterogeneous and small (internet learning interventions were broad in terms of content)

Comparison of different virtual patient desings suggest repetition, advance organisers, enhanced feedback and explicitly contrasting cases can improve learning outcomes (Cook at al, Academic Medicine, 2010)

Which “e-learning” techniques enhanced learning experiences?

  • Peer communication
  • Flexibility
  • Support of a tutor who was also a moderator
  • Knowledge validation
  • Course presentation
  • Course design

Effectiveness of the online course is mediated by the learning experience

Cost effectiveness of online CPD is mainly based on self-report, so data not robust (Walsh et al, Education for primary care, 2010)

Most to least effective approaches (Bloom, International Journal of Technology Assessment in Health Care, 2005):

  • Interactive techniques (audit / feedback, academic detailing / outreach, reminders)
  • Clinical practice guidelines and opinion leaders less effective
  • Didactic presentations and distributed print material have little to no effect

Therefore, not much evidence for the use of online learning, and the effects that do exist, are small (smaller than traditional), course design is important, and interactivity appears to be key

Improving knowledge and skills without an associated change in behaviour, is useless


  • Isolated, invidualised online CME is focused on delivering content more efficiently but that misses the point
  • We need to integrate social components into the learning experience
  • We evaluate episodic events and expect to find behavioural change
  • It’s not about one approach or the other, we need to blend different teaching methods
  • We need to stop talking about e-learning, we don’t talk about overhead projector learning

Problems with CME (currently)

  • Exisiting models do not improve patient care
  • Current models are incomplete, and are used for different reasons
  • Use is unco-ordinated
  • Participation is low
  • Much research names existing models as “largely irrelevant”

Moving from knowledge and skills to changing behaviour. What is the / a new model?

The outcome must be: improving patient care. This comes about through supporting information exchange, opinion and advice to make sense of the complexity of practice

Technology used must be useful and relevant

Technology + pedagogy = outcome (is it this simple?)

Should move psychological learning theory to sociological theory

Professionals learns as they go about doing things, sharing tacit knowledge, discussing and interacting with others in social networks. As people interact they share ways of thinking, feeling and acting in daly life, which influences their behaviours and habits. We are living, learning and changing in practice. They are reflexive. Learning, behaviour and change are all dynamically connected in networks and make practice complex.

Learning practive should be embodied and emergent

Reflexive networks used in teaching and learning

We should be more strategic in collaboration, rather than having collaboration forced.

How do you evaluate outcomes?

  • CME credits
  • Self-report: was it relevant and useful?
  • Patient care audit: do patients have improved outcomes?

Tacit knowledge = useful knowledge

Practice and learning are inseparable

If individual practice is only part of the team approach, is it reasonable to expect that changing an invidual’s approach will actually impact on patient outcomes?

Interprofessional workplace-based learning using social networks
JM Wagter

Difference between in/formal learning

80% of learning is outside the formal context. How do we make the informal learning explicit?

Between whom is learning taking place i.e. identifying actors within the network by mapping relationships between teams, professions, etc.

Look at density and information and communication flows

Everybody is involved in informal learning within networks, but the relationships are assymetrical and not collaborative or reciprocal

Network analysis is a useful method to identify relationships between professionals, but what do you do with the information i.e. how do you change the relationships?

Patient attitude to medical students experience in General Practice
H Cheshire

Patients lack confidence to ask students to leave when receiving a personal physical examination by a GP

Female patients are less likely to have positive attitudes with regards a medical student conducting an assessment, although the numbers are quite high nonetheless

The context of the examination changes whether or not patients are happy to have students present e.g. sexual health, etc.

Learning at a clinical education ward: first and final year nursing students’ perceptions
K Manninen

Final year students have an emphasis on supervisor relationships and are more dependant on feedback and affirmation but don’t experience internal authenticity, which is what drives the understanding of the nursing role.

First year students focus on patient relationships with concomittant feedback

Creating a student ER
A O’Neill

Highly integrated, student-centred, emphasis on PBL → creation of a student ER

Organisation based on teams, rather than a hierarchy. Team sees the patient concurrently, rather than consecutively

Approach allows the student to manage the patient with a focus on structured feedback. Tried to avoid students managing those with obvious serious pathology, cognitive dysfunction, etc.

Supervisor behind the student, not the other way around

Received positive feedback from students, in addition to significant improvement in student note-taking ability, among other clinical skills

Evaluating medical grand rounds – 10 years later
Mary J Bell

High numbers of repeated evaluations in order to determine reliability

We tend to give colleagues higher evaluator ratings

Highest scores had less to do with knowledge and presentation of objectives, and more to do with presenter style, level of presentation and enthusiasm → edutainment

When grand rounds were done using digital video, overal presenter ratings went down, seeming to concur with social learning theories i.e. we want to be in the same room as those we’re learning from (but is social just about physical presence?)

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Did you know?

I recently came across an updated version of the Did you know 2.0 video that was doing the rounds in 2006/2007.  Did you know 3.0 has new statistics (although they’re probably already outdated) and a different visual appeal.

If you haven’t seen it and are interested in the role the internet is playing in fundamentally changing society and education, it’s definitely worth a look.


Laptops in class

A few days ago I wrote about employing technology in classrooms and how we need to make sure that it’s appropriate technology and not being used just because we can.  I felt at the time that it probably wasn’t a good idea for students to have their own machines in front of them because of the many distractions present online.

Today I came across an article that discusses the scenario (i.e. laptops in classrooms) from both perspectives, and offers some insight into the issue.  I’m intrigued at the possibility that laptops and internet connectivity may bring some advantage to the classroom.

The one point mentioned in the article that resonates strongly with me is the use of the word “engagement”.  I’ve often felt that students in my classes aren’t actively engaged with the content and recently I’ve started to think about options in terms of encouraging that process.  The idea that managing the expectations of both staff and students is also a powerful factor that’s often left to chance.

I guess it comes back to the point I made in the first article.  It’s not enough to throw technology at learning / teaching and expect it to solve the problem (if there’s even a problem to solve?).  The use of appropriate technology needs to be integrated into the curriculum if it’s to make any positive impact.

Here’s the link to the article:

And to a site related to discussions about the use of laptops in classrooms:


Technology in the classroom: can we make it work?

I’ve been trying to think how to use technology to enhance both my teaching and my students’ learning and it’s proving more difficult than I’d initially thought.  I like to think that laptops and internet access in every classroom give students real-time access to related content while they engage in meaningful discussion, but this will never happen.  Their Facebook profile and IM conversations are far more interesting than the “Pathology of stroke” or “Justice in access to healthcare”.  And that makes sense in a bizarre kind of way.  Even while they (or their parents) pay vast sums in tuition fees to have the privilege of attending university, most students (in my very limited experience) see studying as inherently boring.

Some studies in American classrooms have all but proven that the distraction of the Internet in class is too strong for students to ignore and that most of the lesson is spent checking email, catching up with friends and even shopping.  Now, after that initial foray into “embracing” technology”, it seems as if there’s a move towards banning laptops altogether.

This is the kind of about-turn I’d like to avoid.  E-learning, while I have no doubt will be a revolution in education, is not the idea that technology for it’s own sake is the way forward.  Just because it’s possible to have Internet access in class, does it mean that we should?  Rather, teachers must take an approach whereby technology is used in a way that enhances it’s advantages, while minimising the disadvantages.  Just because I put the course reader online doesn’t make it “e-learning”, and neither does having a student blog.  The technology in itself doesn’t enhance learning in any way, but how you use it can have powerful implications.

I’ve been toying with the idea of using a wiki to manage a course, whereby any change to either the course content, test schedule or mark availability can by syndicated through RSS to all the students in the class.  Students will have to, as a course requirement, both add to and edit course content (obviously moderated), which can also then be tracked.  I think that this may be one way to encourage them to actively engage with the content, as well as introduce concepts like peer review, referencing and drafting, which may also improve their reading and writing skills (another huge problem).  The point though, will be to make the learning outcomes apparent from the beginning, so that students know what’s expected of them.  Merely creating a wiki and telling students to “Go forth and create content” isn’t enough.

I think that technology will fundamentally change the way we teach and how students learn, but not just by throwing technology at the problem.  The trick is to figure out how to use technology to facilitate deep learning by getting students to actively engage with the content.  A bad teacher will continue to teach badly, no matter how much “technology” they use.

Link to the article that inspired this post: