Reflection on the development of an e-learning course for registrars

This module was special in various ways, not the least because of the wrong impression I had of e-learning. Thinking back, I probably thought of e-learning as Webstudies making your life easier and perhaps of nice little video programs which someone else developed to facilitate learning (but never exactly what you are looking for).
There were many stimulating new experiences. Participating in the blog discussions was exciting and often thought provoking. The continuous input of the lecturers throughout the course was of great value. But, apart from the content, one also became aware of the potential of these discussions in an organisation such as an Obstetrics and Gynaecology department where some members are always on call or post-call and therefore often cannot attend academic discussions. I followed all references to webpages, became adventurous and found a couple “of my own” on Powerpoint and becoming an e-learner site developer, joined several blogsites and exhausted my Vodacom internet account.
The emphasis on the learning (and not the “e”) in e-learning was important. This module tied the different modules in the MPhil course together, forcing me back to my notes on learning, curriculum development, leadership, facilitating learning and also assessment. I was surprised about the few references to the ADDIE approach in the medical literature – has no obstetrician ever used it before? I was sometimes uncertain how to interpret different articles on ADDIE, as it sometimes seemed as if there were too much overlap between phases and also repetition of work done in a previous phase. Till I saw that there were more than 100 variations on the theme and realised that one has to adjust the approach to your own needs to some extent.
There is a real need for registrars to be better teachers. It took some thinking to decide where in the current MMed course this could be fitted in and how much content should included. It was a nice challenge to build this course around the principles of adult learning – registrars differ from undergraduates in many ways and I once again wondered if (all) undergraduates are really adult learners. I was convinced, after reading a couple of publications especially from the field of nursing, that the constructivist approach was ideally suited for the development of e-learning courses for adults. Till I heard about connectivism. I found Siemens’s original (and subsequent) work and have little doubt that this is the one publication which I encountered during the module which I have to highlight. Normally I would have probably chosen a scientific article with clearly described methods, but Siemens’s persuasive arguments for a learning theory addressing the challenges of the 21st century convinced me. (Siemens G. Connectivism: A learning theory for the Digital Age. International Journal of Instructional Technology and Distance Learning 2005; 2: 3 – 9). He emphasises several points. One is the change in knowledge, which is expanding at a rate unknown previously – available knowledge is doubling every 18 months. Informal learning has developed in importance to such an extent that formal education is no longer the most important way of learning. The importance of technology is highlighted throughout the article and the limitations of behaviourism, cognitivism and constructivism are discussed in detail. These learning theories deal mainly with the belief that learning occurs within a person. In the digital age learning can reside outside a person. The questions posed by technology to existing learning theories require revision to such an extent that an entirely new approach is required. The result is a new theory combining components of existing learning theories, social structures and technology. The principles of connectivism are as follows:

* Learning and knowledge rests in diversity of opinions.
* Learning is a process of connecting specialized nodes or information sources.
* Learning may reside in non-human appliances.
* Capacity to know more is more critical than what is currently known
* Nurturing and maintaining connections is needed to facilitate continual learning.
* Ability to see connections between fields, ideas, and concepts is a core skill.
* Currency (accurate, up-to-date knowledge) is the intent of all connectivist learning activities.
* Decision-making is itself a learning process.

One cannot fault any of these principles. However, the readiness of the individual will determine the success of its implementation. I still cannot knit, but that is due to lack of trying. Perhaps our approach to teaching of registrars is to blame. We cannot deny that, even at the postgraduate level, there is still a degree of “spoon feeding” necessitate by students’ lack of readiness to use the technology, the often present inability to distinguish between what is really important, and of course, the implications of selecting wrong information in a discipline where an estimated 9000 babies died between 2005 and 2006 because of wrong decisions taken by health care workers. We clearly have much to do.
A bit of good news to end off. Our head of department is very enthusiastic about e-learning and has arranged that I will have one week per month set aside to work exclusively on the development of e-learning within our department. How’s that?

Regards

Wilhelm