Results of my Delphi first round

I’ve recently finished the analysis of the first round of the Delphi study that I’m conducting as part of my PhD. The aim of the study is to determine the personal and professional attributes that determine patient outcomes, as well as the challenges faced in clinical education. These results will serve to inform the development of the next round, in which clinical educators will suggest teaching strategies that could be used to develop these attributes, and overcome the challenges.

Participants from the first round had a wide range of clinical, supervision and teaching experience, as well as varied domain expertise. Several themes were identified, which are summarised below.

In terms of the knowledge and skills required of competent and capable therapists, respondents highlighted the following:

  • They must have a wide range of technical and interpersonal skills, as well as a good knowledge base, and be prepared to continually develop in this area.
  • Professionalism, clinical reasoning, critical analysis and understanding were all identified as being important, but responses contained little else to further explain what these concepts mean to them.

In terms of the personal and professional attributes and attitudes that impact on patient care and outcomes, respondents reported:

  • A diverse range of personal values that they believe have relevance in terms of patient care
  • These values were often expressed in terms of a relationship, either between teachers and students, or between students and patients
  • Emotional awareness (of self and others) was highlighted

In terms of the challenges that students face throughout their training:

  • Fear and anxiety, possibly as a result of poor confidence and a lack of knowledge and skills, leading to insecurity, confusion and uncertainty
  • Lack of self-awareness as it relates to their capacity to make effective clinical decisions and reason their way through problems
  • A disconnect between merely “providing a service” and “serving”
  • They lack positive and supportive clinical learning environments, have poor role models and often aren’t given the time necessary to reflect on their experiences
  • The clinical setting is complex and dynamic, a fact that students struggle with, especially when it comes to dealing with complexity and uncertainty inherent in clinical practice
  • Students often “silo” knowledge and skills, and struggle to transfer between different contexts
  • Students struggle with the “hidden culture” of the professional i.e. the language, values and norms that clinicians take for granted

These results are not significantly different from the literature in terms of the professional and personal attributes that healthcare professionals deem to be important for patient outcomes.

The second round of the Delphi is currently underway and will focus on the teaching  strategies that could potentially be used to develop the attitudes and attributes highlighted in the first round.

Twitter Weekly Updates for 2011-04-11

  • Twitter, Teaching, & Impersonality – http://bit.ly/eWDgur. Sharing some “personal” information with students creates a trusting environment #
  • eLearn: Opinions – Academic Honesty in the Online Environment http://bit.ly/gYQfHk #
  • The Daily Papert http://bit.ly/i2Shy7. Video games can be “…fast-paced, immensely compelling, and rewarding” forms of learning #
  • Professors With Personal Tweets Get High Credibility Marks http://ow.ly/1snR57 #
  • E-portfolios – taking learning out of the shoebox: a reply to Donald Clark http://ow.ly/1snR1D #
  • Don’t Wait for Permission to Innovate http://ow.ly/1snOel. If you don’t ask, they can’t say “no” #
  • IRRODL call for papers on Emergent Learning, Connections, and Design for Learning http://bit.ly/hQJawp #
  • @sarah_blc I think it’s hard to acknowledge non-institutional learning, mainly because our curricula / assessments don’t value it #
  • How To Use An Apostrophe – The Oatmeal http://bit.ly/fCUE8g. Should be required reading for everyone #
  • The Politics of Queering Anything http://ow.ly/1smRO2 #

Personal attachment to research

Yesterday I had a meeting with my supervisor to discuss the assignments I’m going to run as part of the first objective of my PhD. Together with a systematic review and a survey, I was interested in using student and staff participation in a social network to derive additional data that would help me form a baseline understanding of their attitudes and skills around teaching and learning practice, as well as establish the level of digital and information literacy within the department.

After joining the SAFRI programme, I incorporated the social network idea into my SAFRI project, but unconsciously ended up with a different agenda. Instead of using the network to highlight potential problem areas and the challenges of teaching with technology, it morphed into me trying to demonstrate the effectiveness of using a social network to facilitate reflective practice. In hindsight, it’s clear that the 2 projects were at odds with one another, and the objectives were definitely not aligned.

When my supervisor pointed out that there was inconsistency in the 2 projects I really struggled to accept it. I was adamant that my methods were fine and she suggested that I hand over facilitation of the assignments within the network to other staff who didn’t have such a high personal stake in the success of the project, and I strongly disagreed. I found several reasons to explain why I had to be the person to run it, the strongest of which was that “…no-one else will try as hard as I will to make sure it works”. Which kind of made her point.

When I went away and thought about our conversation I reviewed my objectives for the 2 projects, and then it was clear that they really were 2 different projects. One was suggesting that this would be a useful tool to describe the current state of affairs, which I know will be less than ideal. The other was intent on proving that the network would be a positive tool, rather than describing what would happen if we just incorporated one into the department.

After the painful realisation that I’d let my personal desire for this project to succeed override my objectivity as a researcher, I agreed to let others lead the social network assignments, with guidance from me. This will greatly reduce the impact of researcher bias, as well as synchronise the objectives of the 2 projects. As it stands now, it will more accurately describe the state of the department in terms of attitudes and skills around teaching and learning, and the levels of digital and information literacy, which will give me valuable data that will inform the next objectives of my study.

This was a great learning experience for me, and a warning of the dangers of getting too close to one’s project. There are some situations where the researcher can be an integral part of the project, but this experience has shown me when it would be detrimental to the process.