Categories
mobile

Update on the Clinical Teacher mobile app

I’ve just finished a full draft of the first article I’ve written for the Clinical Teacher in more than a year. It’s been a busy 12 months and I’ve been involved in a host of other projects but now I’m ready to get back into writing for the mobile app. This next article is on the Objective Structured Clinical Exam and I’m really proud of how it’s turned out. I’ll publish the first draft here tomorrow and am hoping to have a final release by the end of the month.

In the meantime, I thought I’d mention that while I’ve been busy with other things, Snapplify has continued updating the app (iOS, Android and web versions) and I’m really excited with where it’s going. The web interface is especially elegant (see below).

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I’m also working on another article on Informed Consent, which will hopefully be ready before the end of the year. It’s already about 80% done but we’re also trying to figure out the new design for the articles, so that’s taking up quite a bit of time as well. I’m really looking forward to putting out some new content for the Clinical Teacher app in the next few months, and hope to make up for lost time.

Categories
personal

Starting new projects and catching up with old ones

It’s been a long time since I’ve updated my blog, for a few very good reasons. The first and most important is that in the middle of last year my daughter was born. I took time out from as many non-essential work-related activities as possible so that I could spend time with her whenever I could.

During this same period of time I also developed and ran an open online course on Professional Ethics in collaboration with Physiopedia as part of a sabbatical project I was working on. While I blogged extensively as part of the course, it meant that I had no time to write about other things I found interesting.

At about the same time, I agreed to chair the organising committee of the 2014 SAAHE conference, which was recently held in Cape Town. The conference organisation and sabbatical research project, together with my normal workload and commitment to family time meant that I had to take a step back from blogging.

However, now that the conference and research project is over and our family have settled into a more structured routine, I’m finding that I have a little more time to start blogging again. I thought that I’d get back into the swing of things by saying a little bit about the main projects that I anticipate working on during the next few months.

The first is my Clinical Teacher mobile app. It’s been ages since I’ve added any new content and I’m feeling really guilty about that, especially since interest in the project seems to be growing. I’ve slowly been adding bits and pieces to a few articles that I wanted to write but never had the time to finalise any of them. Over the next few months I’m hoping to finish 2 or 3 articles and get them published into the app. I’m also going to work on a visual refresh for the app. I’ve been really impressed with the material design principles highlighted in the the developer preview of Android “L”. The flat design and use of colour and depth, together with new ideas about fonts and how they display on many different screen sizes, has got me thinking differently about the app.

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The change won’t be anything drastic but I do want to give the app a more modern look and feel, and remove the faux leather covers and gradients. I also want to come up with a consistent image theme for article headers. The more recent articles have had an “animal” theme, where I try to find an image of an animal that somehow speaks to the topic (even if the link is only in my mind). However, there have been times when I’ve ignored that trend and just used something clearly related. I haven’t yet decided what to do but am clear that it will be a design decision that will be consistently applied moving forward. Finally, I want to experiment with the new features that Snapplify have been building into the platform, including publishing video and audio, annotations, and text highlighting.

I mentioned earlier in the post that in 2013 I ran an open online course on ethics, and would now like to build on that work. I’ve submitted a funding proposal to support the next phase of the project, which is to offer the course in a variety of countries and educational contexts, and across a range of professional disciplines. We learned an enormous amount during the 2013 experience and we want to build on those lessons by doing something that really challenges how we think about physiotherapy education in an international context. I’m definitely going to work with Physiopedia again, since we had a really great experience during the first course and their input was invaluable. I’ll post more about that project once I’ve found out about the funding outcome and ethics approval.

Finally, and on a somewhat related note, we’re going to be developing a few courses within our department, which we will offer to our clinical supervisors and clinicians at the placements where our students work. They will most likely be a blend of online and physical components, and be relatively short in duration (ranging from a few hours to 2-4 weeks). Our supervisors have identified several areas where they would like additional input that they feel will help them to better support our students. For example, assessment and feedback are two areas that could be improved. So, we’ll be exploring different ways to support our clinicians and supervisors over the next few months.

In addition to these projects, I’m also going back to Brazil in November to attend The Network: Towards Unity for Health conference. The main reason for attending is to try and establish partnerships with colleagues from other institutions, who might like to be involved in the international ethics project that I mentioned earlier. There are many parallels and similarities between Brazil and South Africa, and I’d like to develop stronger links between my own institution and others over there because there’s a lot we can learn from each other.

So that’s it. My tentative plans for the rest of 2014.

Categories
curriculum learning students teaching

Small group teaching

This is the first draft of an articles that published in my Clinical Teacher mobile app.

Introduction

Small group learning is one of several educational strategies used to promote student learning, as it promotes a student-centred approach in the educational context (as opposed to a teacher-centred approach, in which the teacher determines the objectives, content to be covered and assessment tasks). There are a variety of benefits associated with learning in small groups, which is why they are often integrated into different learning approaches. For example, working in small group is usually an integral component of problem-based learning (Dent & Harden, 2005).

The learning objectives are what should determine the teaching strategy and as such, small group learning should not be seen as universally appropriate for all educational contexts. In addition, the success of small group learning will be influenced by the availability of resources, including physical space, facilitators and materials. In addition, the relative experience of the facilitators can play a major role in the outcomes of the learning experience.

There are four important group characteristics for small group learning to be effective:

  • There should be active participation and interaction among all group members
  • There should be a clearly defined, specific task or objective/s, that the group is working towards
  • The group should reflect on learning experiences and modify their behaviour accordingly
  • There is no defined number of students that should be in a small group, and in fact, the size is often dictated by the availability of facilitators and other resources

Advantages of small group teaching

Students have opportunities to develop important skills for working in multidisciplinary teams. They learn how to communicate effectively, as they are encouraged to discuss new concepts that arise. They learn how to prioritise tasks, which is usually a component of the PBL process (Kitchen, 2012; Dent & Harden, 2005; Crosby, 1997; Entwhistle, Thompson & Tait, 1992; Walton, 1997).

  1. Promotes ‘deep’ learning: Encourages deep learning and higher order cognitive activities, such as analysis, evaluation and synthesis. Engage by being active participants in the learning process, as opposed to passively “absorbing” information.
  2. Develops critical thinking skills: Allows students to develop critical thinking by exploring issues together and testing hypotheses that are difficult to do well in a lecture. This practice develops problem-solving skills.
  3. Promotes discussion and communication skills: Environment is conducive to discussion. Students do not feel exposed or hidden, but are comfortable. Each student is encouraged to actively participate.
  4. Active and adult learning: Help identify what a student does not understand, and discussion aids understanding by activating previously acquired knowledge. Students are encouraged to reflect on their experiences and develop self-regulatory skills.
  5. Self motivation: Encourages involvement in the learning process, increasing motivation and learning. By taking responsibility for their learning they become self-motivated rather than being motivated by external factors e.g. the lecturer (teacher-centred approaches usually do not facilitate self-directed learning).
  6. Develops transferable skills: Helps develop skills necessary for clinical practice, e.g. leadership, teamwork, organisation, prioritisation, providing support and encouragement for colleagues, problem solving and time management.
  7. Application and development of ideas: Yields opportunities to apply ideas and consider potential outcomes. Making connections during group discussion enhances student understanding.
  8. Tutor as a role model: A logical and systematic tutor approach demonstrating ‘transferable’ skills motivates student learning and development.
  9. Recognises prior learning: Students are encouraged to surface their own prior knowledge, including their own perceptions (and misconceptions) of material previously covered.
  10. Social aspects of learning: Participation and social aspects of small group learning means that learning is more enjoyable than solitary approaches.
  11. Encourages alternative viewpoints: Encourages an awareness of different perspectives on various topics and can therefore help develop an attitude of tolerance.

Small group processes

“Appropriate ground rules make students feel ‘safer’ in sharing and expressing their views” – Kitchen (2010)

Students often find that working in small groups is a greater challenge than expected, probably because they are used to situations in which they work as individuals within a group. However, when individual success is dependent on the group cohesion and collaboration, and the group struggles to perform effectively, students may resist the process. It is therefore important to make them aware of the normal progression of group development (Tuckman & Jensen, 1977).

  1. Forming – a collection of individuals attempting to establish their identity within the group
  2. Storming – characterised by conflict and dissatisfaction that may lead to the development of trust
  3. Norming – attempts to function effectively by developing a sense of group identity and norms
  4. Performing – group performs at an optimal level by being focused on the task, and manages disagreement appropriately

The role of the facilitator

“Small group productivity depends on good facilitation, rather than on topic knowledge” BUT “Less than one third (of clinicians) have received formal training in small group teaching” – Kitchen (2010)

The facilitator plays an essential role in small group, and traditionally would design the module. This would include the development or preparation of stimulus material, which can be in the form of questions, scenarios, images, video, research papers or case studies (Kitchen, 2012). In addition, the facilitator would present the objectives of the session, initiate the process, encourage participation, promote discussion and close the session. In these cases, the facilitator is very clearly leading the process and is in control. This approach is probably the one that most clinical educators are familiar with, and derives from a combination of ability, expertise, experience and enthusiasm. However, when the facilitator clearly dominates the process, self-directed learning and interaction between learners can be limited. Increasingly, small group learning is looking to students to provide more initiative, explore learning options, test hypotheses, develop solutions and review outcomes. In these situations the role of the tutor is less clear and will vary depending on the type of learners making up the groups.

The facilitator/s (often, small groups have multiple facilitators) must all be informed of the objectives of the session. If not, there is the possibility of different groups moving in different directions. This is not as much of a problem if exploration of a concept is the goal. However, if all groups are meant to achieve the same objective, consistency among facilitators is important. For this reason, staff training is vital whenever small groups are being considered as a teaching strategy. It is important to understand that, while content-specific expertise is useful, facilitation skills are essential.

“A fundamental feature of effective facilitation is to make participants feel that they are valued as separate, unique individuals deserving of respect” – Brookfield (1986)

One of the most important roles of the facilitator is to ensure that an atmosphere of trust and collaborative enquiry is created in the small group. This can be achieved by the group setting their own norms and objectives for the session, or if they are inexperienced in groupwork, for the facilitator to guide them through this process. It would also be useful to have the students express their own expectations for the session, especially of their role and responsibilities in the group. As the group members grow in experience, they should take over more and more of the facilitators role, until it may be difficult to tell them apart. As the learners take more control of the group session, more traditional teachers and facilitators may have a challenge adjusting to the new dynamic.

Finally, it is the responsibility of the facilitator to arrive early in order to check that the venue is appropriately prepared for the session. Arriving early is not only useful in order to ensure that the session runs smoothly, but also to set an example for students.

Assessment of small groups

“With undergraduate medical education currently carrying a health warning because of the stress and anxiety exhibited by students and young graduates, any educational process that promotes enjoyment of learning without loss of basic knowledge must be a good thing” – Bligh (1995)

As with all assessment, it is important for students to be aware of the assessment process and outcomes. Teachers and facilitators must decide beforehand on the nature of the assessment task, as well as whether it will be formative or summative, and who will be responsible for conducting it. If the person responsible for assessing the students is also involved with facilitating the groups, it is especially important for students to feel that the environment is a safe space. If not, they may be reluctant to fully participate in the process, as in doing so, they may reveal their ignorance and therefore be vulnerable. This may be addressed by the facilitator being open and discussing their role in assessment as part of the process. If students will be evaluating the facilitators, there may also be a sense of shared responsibility for assessment, thereby “equalising” the balance of power in the relationship.

Assessing the group outcomes is reasonably straightforward and can relate to either the achievement of objectives, or the process of working in a group. Determining the achievement of objectives can be be through student self-report, facilitator observations, or observation by an external assessor. While the assessment of individuals within the group is more challenging it is nonetheless possible, especially when students are able to assist in the process by evaluating their peers. Individual performance can be measured through attendance, contribution or participation, conducting research for the group, and by supporting or encouraging others.

Challenges when working in small groups

“The size of a small group is less important than the characteristics of the group” – Dent & Harden (2005)

When considering implementing small group learning in your course, bear in mind that a change in teaching approach should complement the overall programme strategy and objectives, as well as actually enhance the learning experience. Small group learning should be seen as an integrated component of the curriculum and should be related to other components. In other words, small group learning should be seen as a simple addition.

Often, busy clinical teachers struggle to find the time to implement small group learning strategies, especially when you take continuity of the teaching experience into account. However, this has an impact on scheduling of other teaching activities, which can be challenging to arrange. Careful planning is therefore an important aspect of integrating small groups into the curriculum.

There is a perception that students do not enjoy working in small groups. However, this is possibly based on situations in which students either were not able achieve the objectives, or their learning experience was poor. Careful planning and design are essential in order for the group to successfully achieve the outcomes that are set. Too often, teachers think that group work is about a group of individuals working in a team. It is essential for the groups’ success to be based on cooperative behaviour. In other words, the individuals must work together in order to achieve shared goals that are difficult to achieve as individuals.

Practice points

  • Working in small groups is characterised by student participation and interaction, in order to promote student learning.
  • The size of the group is dependent on the learning activity, although 3-6 students is usually recommended. The size of the group is less important than the group characteristics.
  • Facilitator training is an essential factor for small group success, although most small group facilitators have received no formal training.
  • Integrating small group learning into a curriculum should be carefully considered as part of an overall teaching and learning strategy, rather than as an addition.

Conclusion

Small group work can be an exciting and engaging approach to teaching and learning practice, especially if it is implemented with careful thought and consideration as part of an integrated curricular strategy. The reasons for making the choice should be pedagogical and as such, have educational advantages as the primary motivating factor for the move. Small group teaching has been shown to be beneficial in terms of developing self-directed approaches to learning, critical thinking and reasoning, tolerance of the views and perspectives of others, and the development of interpersonal skills. While there are challenges in its implementation, they can be addressed with thoughtful design and regular feedback from all stakeholders.

References and other sources

Categories
mobile technology

Clinical Teacher app upgrade

The Clinical Teacher mobile app has just been upgraded. The most noticeable features include:

  • Push Notifications so that you’ll always find out immediately when new content is available
  • A new default white theme that looks fresh and clean
  • Compatible with iOS7

Thanks to Snapplify for getting this done so quickly.

Note: also trying Google+ embeds, which seem to work quite nicely.

Categories
mobile technology

Clinical Teacher development progress

It’s been a long time since I’ve written about my Clinical Teacher mobile app, so I thought I’d write a short post to highlight the progress that has been made over the past few months. Thanks a ton to the amazing team at Snapplify, who are making this project possible.

First up, after a long time of being iOS-only, the app is now available on any Android device through Google’s Play store, as well as through the browser. This effectively means that you can now access the Clinical Teacher content on any internet-enabled device. Once the content has been downloaded to the mobile app, it will be available offline.

The Clinical Teacher available through Google's Play Store.
The Clinical Teacher available through Google’s Play Store.

The app has also recently been updated to include bug fixes and minor UI improvements. However, we are due for another update in the next few weeks that will mean that content bought on any platform will be available on any other platform. So, if you’ve bought content in the iOS app, then it’ll be available online in the browser, or on Android. Right now, if you purchase content in the browser you won’t be able to sync it to the app until after the upcoming update.

An index of the content available through the browser-based version of the app.
An index of the content available through the browser-based version of the app.

There’s also some new content, including Effective lectures, Case-based learning and How to write Systematic Reviews. I’m going to begin working on a few more articles, which I hope to have finished in the next few months.

So, as you can see, development on the app is moving along nicely, the content is being developed and published and . If you’d like to write something for the Clinical Teacher, let me know about your idea so that we can get you started.