Different learning theories can contribute to the development of online programs. Behaviourist approaches can support teaching of facts (what), cognitivist strategies the attitudes and procedures (how), and constructivist strategies the real-life and individual applications and contextual learning. Connectivism addresses the learning skills and tasks needed for learners to do well in a digital era. It recognizes that learning is no longer an internal, individualistic activity.
Registrars are adult, postgraduate students aspiring to become medical specialists.
Registrars are adult, postgraduate students aspiring to become medical specialists.
When developing an e-learning course to equip them as teachers, the available technologies should be used to develop a program based on adult learning principles. Some may reason that this includes registrar involvement in the planning and development of the module, but I would argue against that at this point. Data obtained from student interns’ questionnaires indicate inexperience, uncertainty and possibly an unwillingness to teach amongst registrars. However, based on Knowles’s original work, the educator should not have complete control once the course is developed. The program should allow for student autonomy and should recognize registrar’s life experiences, including professional knowledge, on which they can build new knowledge. Goal-orientation may be somewhat of a problem, as not all registrars may see teaching as essential to qualifying as an obstetrician. However, this may be countered if some other characteristics of adult learning as defined by Knowles are taken into account. Adult learners need relevancy, but they are practical. The learning has to relate to their work, which include supervision of students. Registrars are actually currently assessed on their teaching of undergraduates every three months, but it is not specified what the consequences are of persistently performing unsatisfactorily in this evaluation. All consultants should assist in improving the status of teaching by directly attending to the registrar’s teaching skills on combined ward rounds and other clinical areas. If registrars see that learning something about teaching applies to their work or other responsibilities, they will value it more. It is important for them to understand the usefulness of a lesson.
However, I do not really want to write about the application of adult learning principles to e-learning. That could be a topic for another day. I am specifically thinking about the place of student-student interaction in adult learning. This is a central consideration in modern constructivist theory which assists students in developing multiple perspectives. There are several (evidence-based) advantages associated with collaborative learning. Without exhausting the literature, I came across improved development of important social and interpersonal skills, gains in knowledge and increased completion rates of courses as well as improved investigation of implicit knowledge (shared by group members) in addition to the formal curriculum.
So I have decided that interactive discussion is an essential component. However, I am uncertain as to which format of discussion is best. I am only familiar with the WebStudies discussion board, as well as the “blog system”. Both will fit the purpose, as I only foresee asynchronous discussions. I tried a mobisite approach to set up a discussion group for student interns, but several of the students did not have cell phones with which they could access the site. Will a blog work? I specifically like the advantage of being informed of new postings by the use of RSS, which prevents "unnecessary log-ons". I also think that the organisation of comments under the posting makes following the discussions easy. Or is the advantage that messages can be threaded in traditional discussion boards enough to rather use them?
Perhaps I can summarise my (current) thinking on my first theme, which consist of two sessions.
THEME 1: THE UNDERGRADUATE STUDENT IN OBSTETRICS
SESSION 1: YOUR OWN DAYS AS UNDERGRADUATE STUDENT
GOALS OF SESSION: TO REFLECT ON YOUR DAYS AS FINAL YEAR UNDERGRADUATE STUDENT IN OBSTETRICS
ACTIVITIES: 1. COMPLETE THE QUESTIONNAIRE ON THE WEBPAGE. 2. WRITE SHORT NOTES ON HOW YOU REMEMBER YOUR OWN ROTATION AS UNDERGRADUATE STUDENT IN OBSTETRICS ACCORDING TO THE REQUIREMENTS AS STATED. PUBLISH THEM ON THE BLOGSITE AND COMMENT ON THOSE OF YOUR PEERS.
OUTCOMES: 1. LIST THREE POSITIVE MEMORIES OF YOUR OWN UNDERGRADUATE ROTATION THROUGH OBSTETRICS 2. LIST THREE NEGATIVE MEMORIES OF YOUR OWN UNDERGRADUATE ROTATION THROUGH OBSTETRICS. 3. DEFINE YOUR OPINION OF WHAT LEARNING DURING AN UNDERGRADUATE ROTATION THROUGH OBSTETRICS ENTAILS.
SESSION 2: UNDERGRADUATE TEACHING AT THE FACULTY OF HEALTH SCIENCES
GOALS OF SESSION: TO FAMILIARIZE YOURSELF WITH THE CONTENT AND PHILOSOPHY OF UNDERGRADUATE TEACHING AT STELLENBOSCH UNIVERSITY.
ACTIVITIES: 1. PARTICIPATE IN THE DISCUSSION ON THE BLOGSITE ON THE ORGANIZATION OF THE MBCHB COURSE AT SU. 2. PARTICIPATE IN THE DISCUSSION ON THE BLOGSITE ON THE ORGANIZATION OF THE OBSTETRICS AND GYNAECOLOGY COURSE AT SU. 3. PARTICIPATE IN THE DISCUSSION ON THE BLOGSITE ON THE “PROFILE OF THE STELLENBOSCH DOCTOR” ACCORDING TO THE REQUIREMENTS AS STATED. 4. PARTICIPATE IN THE DISCUSSION ON THE BLOGSITE ON THE OF STUDENT INTERNS’ EXPECTATIONS OF THIS ROTATION.
OUTCOMES: 1. EXPLAIN THE STRUCTURE OF THE MBCHB COURSE AT SU. 2. EXPLAIN THE COMPONENTS OF THE OBSTETRICS AND GYNAECOLOGY TEACHING AT SU. 3. SUMMARISE THE CORE CHARACTERISTICS (AS IDENTIFIED BY YOU AND YOUR COLLEAGUES) OF THE PHILOSOPHY TOWARDS UNDERGRADUATE TEACHING AT SU. 4. EXPLAIN HOW STUDENT INTERNS ARE ASSESSED DURING THEIR ROTATION THROUGH OBSTETRICS AND GYNAECOLOGY. 5.EXPLAIN THE FIVE MOST COMMON EXPECTATIONS OF STUDENT INTERNS FROM THIS ROTATION.
SOURCES: 1. SHORT INTERVIEWS WITH AT LEAST TWO CONSULTANTS, TWO STUDENT INTERNS AND ONE COLLEAGUE WHO TRAINED AT SU AS UNDERGRADUATE STUDENT.2. YEARBOOK OF SU. 3. PROFILE OF THE STELLENBOSCH DOCTOR. 4. GUIDELINES FOR UNDERGRADUATE STUDENTS (URO-GENITAL SYSTEM, REPRODUCTIVE SYSTEM AND LATE CLINICAL ROTATION (OBSTETRICS AND GYNAECOLOGY.)
I thought a blog could work well and can also serve as a way to encourage students' reflective learning and communication. Will it work? Please help.
Regards
Wilhelm
Hallo Wilhelm
ReplyDeleteI might have missed out onwho your target group for the teaching is. Am I right in saying that the focus is on the consultants and the example they set, as educators, for the registrars. Your strategy for involving registrars to teach is preceded by the example the consultant will set. The consultant would hereby model the behaviour of a good medical educator to the registrar, thereby coaching and encouraging peer teaching amongst themselves and younger students?
I know that Elize is looking into designing a facilitators course. I am sure she will value your input and experience with the O&G students.
Estelle
Hi Estelle
ReplyDeleteNo, the focus is really on the registrars, with whom undergraduate students spend most of their time during their clinical rotation. The students are complaining that the quality and amount of teaching they receive from different registrars vary a lot. My aim is to enable registrars to improve their teaching skills.
The aim of the first two sessions is to get the registrars to reflect on their own undergraduate training and, secondly, for them to get a feeling of the undergraduate training at Stellenbosch. The latter is necessary to ensure that the level of their teaching is appropriate and that the teaching is better aligned with the outcomes and the assessment. I am working to a point at the end of the course where the registrars will be asked to compile a list of their "duties" regarding teaching. Once that is established, it can serve as blueprint for the assessment of the registrars themselves.
Groete
Wilhelm
Hi Wilhelm
ReplyDeleteThis is effectively a survey questionairre using open ended questions, albeit more interactive and casual.
Are you planning on using this information as part of research?
I am interested in knowing if the Ethics committee would approve a "blog" forum as a research information gathering platform. What are your thoughts on that?
With regard to your questions, my concern remains in the way we expect and coerce persons who are not interested in teaching into doing so. Surely in a student centered learning environment which we supposedly adhere to, we should ensure that all teachers are enthusiatic and knowledgable about their teaching. How does this forced teaching influence the undergraduate programme?
Regards
Bronwen
Hi Bronwen
ReplyDeleteI have reservations about most of your statements. If you read this posting together with my previous postings, the outcomes should clearly indicate that this is not a survey questionnaire of any kind. The questionnaire in the first session serves a purpose in terms of intended sessions later where I attempt to encourage registrars to invent their own solutions. My understanding of the constructivist theory is that emphasis is placed on the learner who interacts with objects and gains an understanding of these objects by constructing his or her own concepts of and solutions to problems. I attempt to assist the registrars to fit new information to prior knowledge and previous experience. As I read it, constructivist thoughts are that learning is influenced by context as well as the beliefs and attitudes of the learner. I hope to assist registrars in formulating this for themselves.
What I am uncertain about, is whether a blog is the most appropriate form for this discussion.
Regards
Wilhelm
Hi Bronwen
ReplyDeleteI do not know on what evidence you base your statement that registrars are coerced into teaching. Obstetric registrars in South Africa are assessed on their ability to teach (every three months at Tygerberg Hospital) and they have to include in their logbooks evidence that they had lectured, which has to be verified by the head of department. They have the status of “junior lecturers”. Faculty has identified that this is an area which should be further developed.
Educating others is a vital role of the clinician. Hippocrates placed a doctor’s role as a teacher before that of clinician in his oath. The registrars have therefore already given this undertaking when they themselves qualified as doctors. The American College of Obstetrics and Gynecology stated that it is an ethical obligation to teach. The Royal College of Obstetrics and Gynaecology states on its website that “Good Medical Practice sets out the principles and values on which good practice is founded and includes, as one of duties of all doctors, a willingness to contribute to teaching of other doctors and students. It also makes clear that doctors involved in teaching must develop the skills, attitudes and practices of a competent teacher”. I further quote the following directly from the General Medical Council’s website: “
All doctors have a professional obligation to contribute to the education and training of other doctors, medical students and non-medical healthcare professionals on the team
Every doctor should be prepared to oversee the work of less experienced colleagues and students
Teaching skills are not necessarily innate, but can be learned. Those who accept special responsibilities for teaching should take steps to ensure that they develop and maintain the skills
This course is no more of a coercion of people into doing something they do not want to do than stating that we are coercing want-to-be-obstetricians into doing caesarean sections or hysterectomies. I am merely attempting to facilitate the development of their skills in this regard.
Bronwen, I have now been a member of different faculty ethics committees for almost ten years but must confess that I was not involved in the assessment or discussion of a request to use a blog to gather information. I would be hesitant to attempt such a study myself. I suggest that you contact dr. Lynn Horn at research development for advice if you are planning to do something of that kind.
ReplyDeleteI was on quite a busy labour ward call last night (two eclamptics, one pulmonary edema, three HELLP syndromes) and spent today at a strategic planning meeting of the Colleges of Medicine. There were numerous discussions on aspects related to teaching and assessment. Two of those were the concern that the HPCSA might dictate the curriculum (content) in future, since the development of a single exit examination where HPCSA will appoint an agent to do the examination is a given. Secondly, the effect of NHI on private and public hospitals which is totally uncertain at present, also as far as the type of training which will have to take place is concerned.
Interessante tye!
Regards