There’s a lot of anxiety among health professions educators right now as they try to move classes and entire courses online. They weren’t trained to do this, have little experience doing this, and many may not even want to do this. Hardly an inspiring thought. And I found myself agreeing with them. They didn’t sign up for this and most of them really do believe that a lot will be lost with the move online.
Thinking about this predicament (i.e. people who don’t think that “online” is the best way to teach health professionals, but who nonetheless must do it) made me wonder if reframing the question would change how they approach the problem. Instead of asking, “How do I move my course online?” what if we asked, “How can I help my less-experienced colleagues in their professional development?” Instead of focusing on building online classrooms, how about providing additional opportunities for CPD? Rather than focusing on moving content online, ask your less-experienced colleagues what the gaps are in their own learning. Don’t spend a lot of time trying to figure out how to control the assessment process but rather try to help our less-experienced colleagues to evaluate their own performance.
You may already have noticed that each of the above shifts the emphasis from you as a teacher having to control the process of students’ learning (environment, content, assessment, etc.), towards something that probably looks more like a dialogue. A conversation. You know, probably more like how you learn. No-one tells you what you need to focus on, or how far “behind” you are, or what you have to read. Maybe over the next few weeks and months we could reflect on how each of us learns best and provide our less-experienced colleagues (previously known as “our students”) with more authentic opportunities to develop as healthcare professionals.
Note: Thank you to Joost van Wijchen who first introduced me to the concept of “working with our less-experienced colleagues”, rather than “teaching to our students”, and who recently reminded me of this wonderful mental model.
I’m in the process of putting together a workshop for the facilitators of one of our modules that we’re restructuring in order to use a blended learning approach. Here are the notes that I’ve been putting together on the Community of Inquiry (CoI) for the workshop. Bear in mind that these notes are my attempt to get a better understanding of the CoI, and so lack academic rigor (i.e. there are no references). Finally, I apologise in advance for any errors or misinterpretation of the model, especially where I’ve given my own examples for our participants. Feedback, as always, is welcome.
The Community of Inquiry is a framework developed by Garrison and Archer (2001) as a way of describing favourable conditions to stimulate learning in online environments. Since a lot of the Applied Physiotherapy module will be conducted online, the CoI is a useful framework to guide our understanding of interactions in the social network we’ll be using. The CoI suggests that in order for meaningful learning to take place in online spaces, there needs to be evidence of 3 types of “presence”:
Social presence is about encouraging purposeful communication in a trusted setting, and developing interpersonal relationships by projecting personality. There are 3 categories of social presence;
Open communication: recognition, interaction, reflection
Group cohesion: use names, greet students, use inclusive pronouns (e.g. “Hi Sue. This is a good question that we can all learn from”)
Social presence is an essential component in online learning, in that students who perceive that it is lacking (i.e. they don’t feel welcome and safe) demonstrate low levels of cognitive presence. Some of the ways in which social presence can be enhanced is by communicating in ways that are perceived by students to be “warm” (think; a caring attitude). Participate regularly, respond quickly, use chat when possible. In other words, create a sense of “being there”.
Cognitive presence refers to an ability to construct meaning through sustained communication. There are 4 practical components to developing a sense of cognitive presence, which are similar to Kolb’s cycle of experiential learning:
Provide a triggering event or problem that is indicated by a sense of puzzlement. The idea is to create a conflict between a students perceived understanding of reality (“This is how I believe the world to be”) and a realisation that the evidence doesn’t support their perception (“The world is not how I believed it to be”).
Opportunities for exploration of the problem. This is achieved by creating an opportunity for students to understand the nature of the problem (“How or why isn’t the world the same as my mental construct of it?”), find relevant information (“What evidence can I find that will help me to understand this problem better?”), propose explanations (“If this is true, then it means that…”), and exchange information (“Hey guys, here’s some information that will help us understand this better”). You can see from these examples that this is similar to the process we want to stimulate in our cases.
Students must try to integrate the new information through a focused construction of new meaning based on the new evidence. They do this by connecting new ideas and concepts to old knowledge that they already have. An understanding of the Zone of Proximal Development would be useful here.
There must be a final resolution of the problem i.e. it must be solved.
There are 6 practical suggestions for how cognitive presence can be facilitated in online spaces. I’ve tried to explain each of these suggestions in terms of how we might implement them because it turns out the when facilitators model the behaviour we want to see in students e.g. critical discourse with each other and constructive critique, students tend to do similar things. The idea is that if we succeed in doing things like what is outlined below, we create the favourable conditions for cognitive presence in the online space:
Discourse. We should aim to be active guides by posing questions that are relevant to emerging topics of discussion. Be aware of entering a discussion and “breaking it” by being an authority figure and / or using “academic” language that students may not be familiar with. There’s little point in students’ continuing a discussion when one of us comes in and provides a definitive resolution (i.e. an “answer”) to whatever problem they’re discussing, or when we say things that they don’t understand. Remember that we want to stimulate a conversation for them, not end one they’re already having.
Collaboration. Groupwork should aim to involve generating, sharing, critiquing and prioritising solutions. There are 2 key elements; availability of the facilitator and the intellectual engagement of the student with the content.
Management. Students begin to take increasing control of the learning activities e.g. suggesting and developing their own projects, with feedback from the larger group guiding their implementation.
Reflection. Students tend to spend more time deliberating on their reflections when they know that what they write will be read and commented on by others. This is why we will use “public” reflections online and students will be expected to read and comment on each others’ reflections. Reflection, simply, is forming relationships between your abstract view of the world (i.e. how you believe the world to be) and how the world actually is (i.e. the congruence between your belief and what actually happens in the world). Try to use language to help students make connections between the cases and personal experiences.
Monitoring (self-assessment). Rubrics can be used to help students grade their own progress and understanding. They take responsibility for making judgements about their work, which is what self-directed learning is. In the professional world, it is rare that we have someone else telling us what we don’t know. It’s up to us as professionals to evaluate our skillset and make decisions about where we’re lacking and what we need to do to fill gaps in our knowledge and skills. We need to enable students to make judgements about what they know and don’t know. Peer- and self-assessment is one way of doing this.
Knowledge construction. Students must make personal meaning (i.e. “sense”) of the information they gather. They must identify the problem (“The patient can’t weightbear on the ankle”), collect data related to the problem (ROM, history of the incident, functional ability, etc.), create an hypothesis (“I believe that the lateral ankle ligament has a grade 2 sprain”), test the hypothesis (send patient for stress test under X-ray), confirm hypothesis or collect more data if necessary, make a conclusion. This process is more effective in terms of “deep learning” than memorising the signs and symptoms of a sprained ankle.
Teaching presence is about directing the social and cognitive processes (see above) to develop personally meaningful and worthwhile outcomes. There are 3 categories of teaching presence:
Design and organisation i.e. developing and structuring the learning experience and activities
Facilitating discourse by maintaining student and facilitator interest, motivation and engagement
Direct instruction through “injecting knowledge”, dealing with issues around content and summarising discussions
There is a significant relationship between teaching presence and perceived learning / satisfaction with online courses. In the absence of synchronous, moment by moment negotiation of meaning available in the classroom, high levels of teaching presence in the online space is even more important, as it has a greater relative impact on cognitive presence when compared to students in a physical interaction.
Social, cognitive and teaching presence all interact / are dependent on each other. Studies have found that “teaching and social presence play a major role in predicting online students’ ratings of cognitive presence, and that teaching presence is strongly correlated with students’ satisfaction with the online learning experience and their sense of community. Furthermore, comfort in online discussion was the most significant factor in students’ perceptions of cognitive presence i.e. in order to develop higher order critical thinking, students need to feel comfortable with online discussion. It may be useful to ask students to reflect on their levels of comfort with online discussion. If they report low levels of comfort, further reflection on their part might identify why they feel this way and what might be done to improve their comfort levels, allowing facilitators to modify their approaches and / or the environment.
A few weeks ago I spent 3 days at Mont Fleur near Stellenbosch, on a teaching and learning retreat. Next year we’re going to be restructuring 2 of our modules as part of a curriculum review, and I’ll be studying the process as part of my PhD. That part of the project will also form a case study for an NRF-funded, inter-institutional study on the use of emerging technologies in South African higher education.
I used the workshop as an opportunity to develop some of the ideas for how the module will change (more on that in another post), and these are the notes I took during the workshop. Most of what I was writing was specific to the module I was working with, so these notes are the more generic ones that might be useful for others.
Content determines what we teach, but not how we teach. But it should be the outcomes that determine the content?
“Planning” for learning
Teaching is intended to make learning possible / there is an intended relationship between teaching and learning
Learning = a recombination of old and new material in order to create personal meaning. Students bring their own experience from the world that we can use to create a scaffold upon which to add new knowledge
We teach what we usually believe is important for them to know
What (and how) we teach is often constrained by external factors:
Amount of content
Time in which to cover the content (this is not the same as “creating personal meaning”)
We think of content as a series of discrete chunks of an unspecified whole, without much thought given to the relative importance of each topic as it relates to other topics, or about the nature of the relationships between topics
How do we make choices between what to include and exclude?
Focus on knowledge structuring
What are the key concepts that are at the heart of the module?
What are the relationships between the concepts?
This marks a shift from dis-embedded facts to inter-related concepts
This is how we organise knowledge in the discipline
Task: map the knowledge structure of your module
“Organising knowledge” in the classroom is problematic because knowledge isn’t organised in our brains in the same way that we organise it for students / on a piece of paper. We assign content to discrete categories to make it easier for students to understand / add it to their pre-existing scaffolds, but that’s not how it exists in minds.
Scientific method (our students do a basic physics course in which this method is emphasised, yet they don’t transfer this knowledge to patient assessment):
Construct an hypothesis
Test the hypothesis
Is the outcome new knowledge / expected?
Task: create a teaching activity (try to do something different) that is aligned with a major concept in the module, and also includes graduate attributes and learning outcomes. Can I do the poetry concept? What about gaming? Learners are in control of the environment, mastering the task is a symbol of valued status within the group, a game is a demarcated learning activity with set tasks that the learner has to master in order to proceed, feedback is built in, games can be time and resource constrained
The activity should include the following points:
Align assessment with outcomes and teaching and learning activities (SOLO taxonomy – Structured Observation of Learning Outcomes)
Select a range of assessment tools
Justify the choice of these tools
Explain and defend marks and weightings
Meet the criteria for reliability and validity
Create appropriate rubrics
Assessment must be aligned with learning outcomes and modular content. It provides students with opportunities to show that they can do what is expected of them. Assessment currently highlights what students don’t know, rather than emphasising what they can do, and looking for ways to build on that strength to fill in the gaps.
Learning is about what the student does, not what the teacher does.
Assessment defines what students regard as important, how they spend their time and how they come to see themselves as individuals (Brown, 2001; in Irons, 2008: 11)
Self-assessment is potentially useful, although it should be low-stakes
Use a range of well-designed assessment tasks to address all of the Intended Learning Outcomes (ILOs) for your module. This will help to provide evidence to teachers of the students competence / understanding
In general quantitative assessment uses marks while qualitative assessment uses rubrics
Checklist for a rubric:
Do the categories reflect the major learning objectives?
Are there distinct levels which are assigned names and mark values?
Are the descriptions clear? Are they on a continuum and allow for student growth?
Is the language clear and easy for students to understand?
Is it easy for the teacher to use?
Can the rubric be used to evaluate the work? Can it be used for assessing needs? Can students easily identify growth areas needed?
What were you evaluating and why?
When was the evaluation conducted?
What was positive / negative about the evaluation?
What changes did you make as a result of the feedback you received?
Evaluation is an objective process in which data is collected, collated and analysed to produce information or judgements on which decisions for practice change can be based
Course evaluation can be:
Teacher focused – for improvement of teaching practice
Learner focused – determine whether the course outcomes were achieved
Evaluation be conducted at any time, depending on the purpose:
At the beginning to establish prior knowledge (diagnostic)
In the middle to check understanding (formative) e.g. think-pair-share, clickers, minute paper, blogs, reflective writing
At the end to determine the effectiveness of the course / to determine whether outcomes have been achieved (summative) e.g. questionnaires, interviews, debriefing sessions, tests
Feedback from students
Peer review of teaching
Knight (n.d.). A briefing on key concepts: Formative and summative, criterion and norm-referenced assessment
Morgan (2008). The Course Improvement Flowchart: A description of a tool and process for the evaluation of university teaching