assignments education physiotherapy students

Giving students a voice in Physiotherapy Ethics

I’ve been going through some of the “Professional Ethics” assignments I received from our third year physiotherapy students, and wanted to share this one with you (with the students’ permission). It was written by Basil Buthelezi, and which I think really showcases the wonderful talents our students have, which we would never usually encounter because we focus so much energy on the clinical component of physiotherapy education.

The assignment was to explore the theme of Human rights in South African healthcare, using any media that the students wanted. So far, I’ve received a fictional newspaper front page (which I’m hoping to put up here as well), been directed to this blog, and now this poem by Basil. I wanted to share it because I think it illustrates the potential that students have to amaze us when we give them the opportunity to speak with their own voices. Here’s the poem by Basil Buthelezi…

Site of entertainment (voices personalising HIV / AIDS)

I’m all over,
From the person next to you,
In the neighbourhood and,
All four corners of the world.

They all bow for me,
From TB to Cancer,
From strokes to the paralysed,
Beautiful or ugly,
From infants to the elderly,
Rich or poor,
White or black, “colour with no discrimination”,
But all the negativities in me.

Fair enough,
I’m tired of tears and the angry faces of stranded orphans,
Their tears have given birth to an ocean.
Yes, my throat is dry, but I can’t drink in this ocean because it’s dirty,
All infected, the attack of vampires is in full swing,
Kill them, kill them all!!
Seize the duplication.

Dollars and dollars,
I have explored their pockets and robbed their monies,
Monies buying antiretrovirals
To keep me low, yet
The dead sentence is coming.

Graves and graves,
If they were coloured red
This world will be red, red
Red for danger
Red bloody red.

The equation is shifting,
Outplaying the moments of pleasure,
Abstain to restore the equilibrium
“Be faithful” is a song of goodwill.

If not!
Pause, before you explore the site of entertainment,
Have you worn a jacket to protect you,
To protect you from hot and juicy stuff?
I know you want to be happy down there…,
But you need a license to enjoy,
Cause I’m like a vampire waiting to attack
And destroy the essence of your life.

Basil Buthelezi (2009)

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Twitter Weekly Updates for 2009-09-28

  • Cultivating Communities of Practice: A Guide to Managing Knowledge – 7 Principles #
  • Can’t wait for my netbook to arrive so that I can play with Moblin 2.0… #
  • BMJ Case Reports blog: Finding your doctor through their published case reports #
  • Trends and issues in open and distance learning in Africa IRRODL, Vol 10, No 4 (2009) #
  • Seeking health information online: does Wikipedia matter? J Am Med Inform Assoc. (2009 Jul-Aug] – PubMed Result #
  • Ethics assign. for 3rd yr South African physio student. Please visit & comment to show support for innovative approach #
  • “What’s New in the Sixth Edition of the APA Publication Manual?” from #
  • “The International Review of Research in Open and Distance Learning” from #
  • “New Edition of the APA Manual | Virtual Canuck” from #

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assignments physiotherapy students

Third year ethics assignment

I just wanted to send out a quick post to highlight the great work that one of my third year students has done as part of her ethics assignment.  The idea was to discuss the topic of human rights in South African healthcare using any method that the students wanted to.  I’m getting some great feedback from them, which is pretty exciting considering that students almost never want to discuss their assignments.

Here’s the link:

If you like the idea, please consider posting a comment or two on her blog, as she is trying to generate a conversation around the topic.

education students

Assessment in an outcomes based curriculum

I attended a seminar / short course on campus yesterday, presented by Prof. Chrissie Boughey from Rhodes University. She spoke about the role of assessment in curriculum development and the link between teaching and assessing. Here are the notes I took.

Assessment is the most important factor in improving learning because we get back what we test. Therefore assessment is acknowledged as a driver of the quality of learning.

Currently, most assessment tasks encourage the reproduction of content, whereas we should rather be looking for the production of new knowledge (the analyse, evaluate and create parts of Bloom’s top level cognitive processes).

Practical exercise: Pick a course / module / subject you currently teach (Professional Ethics for Physiotherapists), think about how you assess it (Assignment, Test, Self-study, Guided reflection, Written exam) and finally, what you think you’re assessing (Critical thinking / Analysis around ethical dilemmas in healthcare, Application of theory to clinical practice). I went on to identify the following problems with assessment in the current module:

  • I have difficulty assigning a quantitative grade to what is generally a qualitative concept
  • There is little scope in the current assessment structure for a creative approach

This led to a discussion about formal university structures that determine things like, how subjects will be assessed, as well as the regimes of teaching and learning (“we do it this way because this is the way it’s always been done”). Do they remove your autonomy? It made me wonder what our university official assessment policy is.

Construct validity: Are we using assessment to asses something other than what we say we’re assessing? If so, what are we actually assessing?

There was also a question about whether or not we could / should asses only what’s been formally covered in class. How do you / should you asses knowledge that is self-taught? We could for example, measure the process of learning, rather than the product. I made a point that in certain areas of what I teach, I no longer assign a grade to an individual peice of work and rather give a mark for the progress that the student has made, based on feedback and group discussion in that area.

Outcomes based assessment / criterion referenced assessment

  1. Uses the principle of ALIGNMENT (aligning learning outcomes, passing criteria, assessment)
  2. Is assessing what students should be able to do
  3. “Design down” is possible when you have standardised exit level outcomes (we do, prescribed by the HPCSA)
  4. The actual criteria are able to be observed and are not a guess at a mental process, “this is what I need to see in order to know that the student can do it”
  5. Choosing the assessment tasks answers the question “How will I provide opportunities for students to demonstrate what I need to see?” When this is the starting point, it knocks everything else out of alignment
  6. You need space for students / teachers to engage with the course content and to negotiate meaning or understanding of the course requirements, “Where can they demonstrate competence?”

Criteria are negotiable and form the basis of assessment. They should be public, which makes educators accountable.

When designing outcomes, the process should be fluid and dynamic.

Had an interesting conversation about the priviliged place of writing in assessment. What about other expressions of competence? Since speech is the primary form of communication (we learn to speak before we learn to write), we find it easier to convey ideas through conversation, as it includes other cues that we use to construct meaning. Writing is a more difficult form because we lack visual (and other) cues. Drafting is one way that constructing meaning through writing could be made easier. The other point I thought was interesting was that academic writing is communal (drafting, editors, reviewers all provide a feedback mechanism that isn’t as fluid as speech, but is helpful nonetheless), but we often don’t allow students to write communally.

Outcomes based assessment focusses on providing students with multiple opportunities to practice what they need to do, and the provision of feedback on that practice (formative). Eventually, students must demonstrate achievement (summative).

We should only assign marks when we evaluate performace against the course outcomes.

Finally, in thinking about the written exam as a form of assessment, we identified these characteristics:

  • It is isolated and individual
  • There is a time constraint
  • There is pressure to pass or fail

None of these characteristics are present in general physiotherapy practice. We can always ask a colleage / go to the literature for assistance. There is no constraint to have the patient fully rehabilitated by any set time, and there are no pass or fail criteria.

If assessment is a method we use to determine competence to perform a given task, and the way we asses isn’t related to the task physio students will one day perform, are we assessing them appropriately?

Note: the practical outcomes of this session will include the following:

  • Changing the final assessment of the Ethics module from a written exam to a portfolio presentation
  • Rewriting the learning outcomes of the module descriptors at this year’s planning meeting
  • Evaluating the criteria I use to mark my assignments to better reflect the module outcomes
physiotherapy research social media

Results of a reflective blogging assignment in physiotherapy ethics

Earlier this year I gave my 4th year Ethics class an assignment in which they were required engage in a reflective exercise that not only encouraged interaction with others, but allowed them to see that their own perceptions of the world were different to others’.

Reflection has been shown to be a significant factor in developing clinical and ethical reasoning skills, so the initial requirement was to read two articles and then post a short reflection on each. Other students would then comment on your reflections and you would have to respond to that comment, hopefully having considered your colleagues comment. The learning objectives of the assignment were to:

  • Understand some of the ethical problems inherent in the South African healthcare system
  • Be able to discuss some types of ethical dilemmas in healthcare, even if they are not directly related to physiotherapy
  • Understand the role of reflection in your professional development, especially in the clinical and ethical reasoning process
  • Have participated in an online, networked conversation with your peers
  • Acknowledge the differing perspectives of others who may experience the world in different ways
  • Understand some of the advantages and disadvantages of using new technologies in healthcare education

I set up a WordPress blog on my own server because I wanted the students to have full control over their data (and it was surprisingly difficult to get access to a university server), created an author account for each student and then gave a tutorial on blogging and the blogging environment. The 47 students then had about a month to complete the assignment before the blog was closed to everyone.

Here are some quick stats:

  • 94 posts (2 each)
  • 222 comments (some students made more than the 3 that were required)
  • 109 tags (the main ones being MDR-TB, Apartheid and Torture)
  • 3983 pageviews (pretty impressive for 47 students)

While the initial results seem to be favorable, I have to say that anyone who assumes that all students in higher education are tech-savvy, needs to rethink that idea. One of the biggest challenges I had was trying to get students to understand what a blog is. And I don’t mean the deeper meaning of what blogging is, I mean the concept of a website that they could edit. Forget about RSS feeds and blogging software clients. The notion of digital natives does not apply here, and if the use of technology in education is going to move forward (in this country, at least), this is one major challenge that’ll have to be overcome.

You can download the content of the blogging tutorial here (2.4 MB ppt). I’ll be opening up the blog to the public once I’ve graded them, and will be presenting the results of an evaluation at the SAAHE conference in July.

education technology

Blogging downturn

This term has been a bit mental so far, which is why I’ve cut back considerably on the blog. Between clinical supervision, preparing for exams, extra courses and research, I’m finding it hard to keep up. It’s not permanent and once things have slowed down, I’ll get back into it.  Here’s a brief update on what’s going on with me:

  • My abstract for “Blogging as a reflective tool in physiotherapy ethics” (or something like that) has been accepted for presentation at the SAAHE conference.
  • A quick review of the Ethics blogging assignment has been very positive and I’ve received some great feedback from students, who really enjoyed it.  This is the project that the presentation mentioned above will be based on.
  • The Mozilla Open Education course continues with minor technical problems. It’s difficult to stay on track with everything else that’s happening but the course participants are fantastic with documenting what’s happening, so I can always follow the main themes.

That’s it for now.  I’m hoping to get back on track with the blog soon and in the meantime I’ll try to keep up with short posts like this that don’t need much research.

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Twitter Weekly Updates for 2009-04-12

  • UK students study blogging, wikis, podcasts as part of curriculum Wish that was included at university level in SA #
  • The lead up to elections in South Africa have started having an effect at our universities…and it’s not good #
  • UK university offers Masters degree in social media. Course too simplistic. £4500 to learn what students already know? #
  • Flutter: a nanoblogging tool using only 26 characters. Brilliant parody of Twitter #
  • Political satire and cultural stereotyping does more harm than is funny #
  • Introduction to lung auscultation with audio #
  • Ethics podcast from the Open University. Series of interviews on the role of ethics in everyday life #
  • Trying to log in to #mozopenedcourse, getting internal server errors, anyone else experiencing the suckiness? #
  • @epanto I’m still not getting any love 🙁 Will keep trying though in reply to epanto #
  • @kfasimpaur Thanks, I’m still unable to log in. Have sent message to Phillip but uncertain he can do anything about server problems. Enjoy in reply to kfasimpaur #
  • @epanto Thanks a ton, Phillip sent email, nothing anyone can do now anyway. Will download video later. Cheers in reply to epanto #
  • @sdkaaa Same for me, almost exact same system 🙂 Problems logging in and now audio is stuffed…frustrating as… in reply to sdkaaa #
  • #mozopenedcourse audio issues too frustrating, going to bail, enjoy the rest of it everyone #
  • @sdkaaa Sorry for late response, had Internet issues probably unrelated to the platform, hope you come right for the next session in reply to sdkaaa #
  • Microlectures, condensing only most relevant info into 1-20 min. mini-lectures, promising results & #

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conference education physiotherapy social media

SAAHE ’09: abstract for oral presentation

Here’s the abstract I submitted for SAAHE ’09.  It was submitted for consideration in the Innovations and work in progress category.

The use of blogging as a reflective tool in physiotherapy ethics.

The use of social software in higher education facilitates collaborative learning practices and mirrors the social constructivist principles of education by encouraging deeper engagement with both content and individuals. Reflection promotes higher order cognitive skills that promote critical thinking, and together with ethical reasoning has been shown to contribute to professional development and clinical practice. A blog is a service that allows a user to post ideas online, as well as solicit feedback from others that serve to contribute to an ongoing discussion. This allows for a rich, diverse stream of ideas that provide further inputs into the reflective process.

The main aim of this study is to evaluate the use of blogging as a tool for enhancing physiotherapy students’ reflective practice during an ethics module. By participating in an online, networked conversation on human rights in healthcare, students will discuss some of the problems inherent in the South African healthcare system, as well as recognise and acknowledge the different viewpoints of others.

What was done
A blogging environment was created to allow only students and the lecturer access to post, read and comment on reflections. Articles relevant to the ethics module were provided for students to read and to inform their reflections. They are required to read and comment on the reflections of their peers, facilitating an ongoing conversation around the topic. On completion of the assignment, students will be asked to evaluate the process.

With the move towards a more networked society and the increasing use of online tools in education and practice, educators must take cognizance of new approaches to teaching and learning. The use of blogging as a tool for reflective practice has shown positive results in other disciplines but has not been evaluated in physiotherapy education.

Take home message
The use of blogging as a tool for reflection brings significant advantages to the process that are not easily leveraged with any other medium. The characteristics of the platform allow for collaborative discussion, immediate feedback and encourages deeper engagement with the content, all of which facilitate more meaningful interactions and stimulate professional development.