assessment curriculum learning physiotherapy students teaching workshop

SAFRI 2011 (session 2) – day 3

Began today with a session on workplace-based learning, spent some time “developing a model” for learning a new skill after actually trying to learn (what was for many) a new skill…spinning a top. My group came up with the following model which, truth be told was obviously based on Kolb’s learning cycle.

Reviewed educational model of Teunissen et al (2007)

Models are fluid frameworks that help to develop understanding, not algorithms that need to be followed


  • Teunissen et al, (2007). Attending doctors’ perspectives on how residents learn. Medical Education, 41: 1050-1058
  • Teunissen et al (2007). How residents learn: qualitative evidence for the pivotal role of clinical activities. Medical Education, 41: 763-770


One minute preceptor / 5-step micro-skills

Has led to modest improvements in teaching skills (Furney et al, 2001), has been found to be equal to or better than traditional methods of clinical teaching in time-constrained environments e.g. bedside, ward rounds (Aagaard et al, 2004).

The one-minute preceptor is a framework (Neher et al, 1992):

  1. Get a commitment: statement of understanding / intent, should be verbal (“What do you think?”)
  2. Probe for supporting evidence: question student for further depth / detail i.e. probe the statement (“Why do you say that?”)
  3. Reinforce what was done well: provide feedback on appropriate behaviour / performance
  4. Give guidance about errors or omissions: error correction
  5. Teach a general principle: extrapolate the situation / event to more general terms
  6. Conclusion: end with clear steps for moving forward


  • Furney et al, 2001. Teaching the one-minute preceptor: a randomised controlled trial. Journal of General Internal Medicine, 16: 620-624
  • Aagaard et al, 2004. Effectiveness of the one-minute preceptor model for diagnosing the patient and the learner: proof of concept. Academic Medicine, 79: 42-49
  • Neher et al, 1992. A five-step “microskills” model of clinical teaching. Journal of the American Board of Family Practice, 5: 419-242



What is a portfolio? A collection of learning objects / experiences, aggregated over time, directing at documenting the achievement of developmental objectives. Demonstrates progress. Must be measurable although this is hard to do.

Short session on designing portfolio tasks, asked to design a task for something we currently teach. This is a useful framework for an assignment. I chose a task for Movement Science:

  • What – To understand the relationships between concepts in movement science and apply those concepts to clinical practice (challenging for students)
  • Activity – Develop a concept map of an activity (e.g. observed movement of a patient with a movement disorder), using concepts from module to explore / explain the activity
  • Where – Clinical setting / patient encounter
  • How – Short patient history, with an associated concept map
  • Reflection – Each link on the concept map must have a note explaining the observed movement / activity, it’s relation to the module concept, and be linked to the patient history
  • Measure – concept maps can demonstrate understanding of relationships between concepts (theory) and their application to practice (patient presentation)

Type of learning taking place in above example:

  • Clinical reasoning
  • Professionalism (i.e. note taking and patient presentation)
  • Reflective practice
  • Interpreting data

Assessment is a snapshot of learning

Students worry that they didn’t learn something that you might ask them in an assessment

Be strategic in what you’re going to measure

Portfolios are about “doing”, there should be consideration of patient management involved

Portfolio assessment is often not feasible in a resource-constrained environment as it can be labour intensive. The document should serve as an indicator to guide assessment of the student. It must assess something different to what is already being assessed.

Assess reasoning. Knowledge is better assessed with other methods e.g. MCQ

Portfolios are not just another thing to do



Reflection raises awareness → exploration of alternative methods

Asked to do a short reflection on personal / professional development since beginning with SAFRI programme:

“My SAFRI project began as a study that would look (in retrospect) quite superficially at the use of a social network to development clinical / ethical reasoning skills.

Over time it became clear that the method involved little more than describing “what students did”, which I found deeply unsatisfying. “Is there more to this?”

I began looking into theoretical frameworks that could help to structure the research. I’m now analysing the data with a structure (i.e. theoretical framework) that is helping me develop a deeper understanding of the process.

This has played a role I changing how I think about research. I find myself questioning a lot more in other parts of my life…”Why is it like that?”

We discussed the challenges of evaluating personal (and often deeply personal) reflections. Giving marks clouds the issue, as students then write what they think you want to hear in order to get a better mark, in contrast to sharing honest, open, authentic experiences.

It’s important to link their reflections with expected outcomes

In the community block that I supervise, students share and discuss their reflections in a group. I do this because I think it’s important to hear what others are going through (i.e. to “normalise” the experiences and emotional responses). I understand that this can change the reflections that students produce i.e. will they be honest and open if they know the reflection will be shared? I’ve found that students give still give honest reflections when they realise that the feedback is non-judgemental and that it can help them to move to deeper understanding

Does reflecting actually change practice? Is there a difference between what they say and what they do?

assessment curriculum learning physiotherapy students teaching

Workshop on Intended Learning Outcomes

I’ve already mentioned that my institution has increased the emphasis on the scholarship of teaching and learning over the past few years, by placing it on an equal footing with research. This has forced all academics to reconsider their roles within the university, which many have resisted. Luckily (for me) I work in a department where we see these changes as opportunities for growth, rather than obstacles to be baulked at. As part of our response to this challenge, we’ve been working at integrating a scholarship of teaching and learning into our everyday teaching practices, including (among many other things), regular workshops to aid with both staff development and curricular alignment.

Today we had a workshop on using learning outcomes to structure a module, with the intention that we would each take one of our modules and refine the outcomes before working on aligning teaching strategies, assessment and content. I didn’t take too many notes, as we were provided with handouts but here are the notes I did take. Nothing ground breaking if you’ve read anything about learning outcomes before but bear in mind that the emphasis of the workshop was on the application of concepts to our actual modules, as opposed to a purely learning activity.

  • It is important to expose learners’ current and prior knowledge / understanding before beginning a learning activity, and then try to build on that
  • We don’t “teach”, so much as we create an environment conducive to students’ learning
  • Learning outcomes can be useful guides / “maps” for both new and experienced staff members
  • Objectives (related to teacher) are different to outcomes (related to student)
  • Programme outcomes (might be found in a mission statement) must be linked to module outcomes
  • Outcomes must be specific
  • Use concept mapping to link outcomes, lectures and assessment
  • Students just out of high school may need to be taught how to learn
  • Get students to agree to take responsibility for their own learning, possibly in the first lecture, by making explicit what the roles / expectations are of everyone involved
  • Make a list of the things that bug you about students, and get students to agree to not do those things. Then ask them what you do that bugs them, and agree to try and avoid those too. Ask regularly, “what is working / not working for you right now?”

Benefits of learning outcomes:

  • Helps to structure the module content
  • Helps to guide assessment practices
  • Helps to direct teaching strategies
  • Provides a measure of accountability
  • Helps students to focus on what to study / learning outcomes are the “scope of the exam”


  • Learning activities are “supported” by assessment / assessment drives learning
  • Many students come into higher education thinking “Give me the stuff, and I’ll give it back to you”. How can we change that mindset?
  • Look at how SAQA’s level descriptors link to learning outcomes, and make them specific to module descriptors (1st year = level 5, 2nd year = level 6, 3rd year = level 7, 4th year = level 8)
  • Try to get students to see why the outcomes are important i.e. do they have personal meaning for the students, or are they just words
  • Review the lecture outcomes at the beginning and end of the lecture. Ask students if they felt that the outcomes were achieved

Structure of a curriculum

We had the first of our curriculum review meetings earlier this week, with the intention of evaluating the alignment of our module outcomes (using our module descriptors) and the course content (using the course outline). The plan is that we will spend time in small groups reviewing components of the curriculum, and at each meeting, look at one part in the context of the whole thing. Here’s the structure of the curriculum as we understand it:

We’ve already started to identify inconsistencies between the 2 documents within modules. Here are a few issues that were raised:

  • The module descriptor is sometimes too vague to be of any use in determining whether the content is aligned to it
  • The course outlines often lack structure and would be difficult to use in evaluating the module content
  • We’re not sure if the module objectives are aligned with the HEQF level outcomes
  • There’s no evidence of graduate attribute integration in most of the module descriptors

Once we’ve finished looking at the module outcomes and course outlines to highlight the gaps, we’ll address those issues before moving onto another component, probably the link between what we teach and how we teach it.

I was struck at how complex the process is. It’s easy to draw diagrams outlining a method but when you actually get down to it, these are hard problems to solve.


Curriculum development and PhD

Earlier this week we had our second curriculum development meeting in our department. It’s something we’ve recently implemented after realising that we need to pay more attention to teaching and learning, especially now that the university’s released it’s implementation plan for the next 5 years.

After going through one of the modules, we quickly realised that in order to really understand the relationships between modules, we’d need to look at them in 2 different ways:

  • Horizontally – how do concepts in different “groups” relate to each other in the same year of study? E.g. what are students learning in anatomy and how does that relate to their applied subjects?
  • Vertically – how do concepts in the same “groups” relate to each other over time? E.g. how does what students learn in PHT203 relate to what they learn in PHT303?
  • It’s hard to visualise how these different “tracks” relate to each other. I’m thinking that a concept mapping tool (e.g. Cmap, Xmind) would be the best way to do it.

We’ve split the curriculum into “groups” of related modules e.g. Movement Science (human movement and movement disorders), Applied physiotherapy (clinical theory), Clinical practice (application of theory). Staff members were then assigned to groups to look at the following over the next few weeks:

  • Curriculum alignment. We’ll need to make sure that our learning outcomes are aligned with content, and assessment
  • Practical assessment. We’re looking at moving to our practical assessments to an OSCE-type format
  • Integration of teaching and learning practices in alignment with university policy
  • Determine how we’re going to integrate the institutional graduate attributes (scholarship, lifelong learning, etc.) into our modules and teaching practice

During the meeting we noted other issues that arose. We realised that we have no naming convention for our digital files, which means they all have different names. I’d like to see a convention adopted during this process e.g. module code-description-version-increment. I also think we should consider having a Notes section at the end of each module descriptor, where we can document minor editorial corrections that happen during the year, as opposed to creating a new version for major changes and archiving the old one.

I’ll be sitting in on each group to document the process we’re going through. Part of my PhD will be how I track the changes that are happening in the department, both as a result of my own work, but also as we fall in line with institutional changes in teaching and learning. I don’t see this becoming part of my publications, but will rather form bridging documents that establish relationships between research objectives. I’ll need to evaluate the process of the project, and these meetings will form an important part of the process. I’m starting to realise that the curriculum we had when this project began will be quite different from the one that exists when it ends.

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