Organisation, School and course policy and strategy

Activity Ten 

How do your ideas and strategies for flexible learning fit with your organisation?

The Otago Polytechnic institutional vision (in red).

To inspire capability: 

Nursing is a vocation.  Staff teach collaboratively in papers and across years of the BN programme.  Modules (topics) if clinical papers are designed so that students have appropriate theoretical knowledge and instruction before entering a clinical skill practice area.  While they are on a clinical placement, their work is supervised by a RN preceptor who has been trained to oversee the work of a student nurse.  The student’s knowledge development is facilitated by School of Nursing staff meeting weekly regularly with the student and preceptor.

My course:

·         The majority of the learning outcomes of my course relate to the development of oral, and to a lesser extent written communication skills.  We have a course textbook which describes the basics of therapeutic communication skills for health professionals.  It contains a number of classroom activities and case studies that can be used to explore the kind of communication skills that a nurse might use in situations, such as working with a young child who is afraid of being left alone in hospital. 

·         Much of the face-to-face tutorial time and activities are designed to practice communication skills in a safe learning environment.  I use case studies and scenarios from the textbook that have been designed to develop critical thinking and communication skills.  I organise student into small groups (3 or 4) so that they can read the case study and answer the associated questions.  Answers are pooled and reported back to the class.  Different approaches are presented and we discuss different aspects of communication in the feedback.  Positive feedback is given for participating. 

·         Sometimes I use role plays.  Students are paired up and given a communication activity to perform. This might involve interviewing one another about their own health status.  The emphasis is on essential skills such as giving consent when providing personal information, and about keeping the information confidential.    

To build capability:

Nurses are definitely ‘work ready’.  By the end of the degree programme each student will have completed a minimum of 1160 supervised clinical hour’s work in a variety of healthcare settings.  A new graduate has a large portfolio of evidence of competency to do the job!

·         My course is part of the first year nursing programme.  It is a theory paper with an applied communication focus.  The communication skills learned and developed over this and subsequent years are an integral part of the degree programme.  Communication skill and the ability to apply theory to a wide range of nursing situations in part of the life long learning of a nurse.

To be a learner centered organisation:  

Flexible pathways to entry are provided. A formal selection process for the three year Bachelor of Nursing (BN) degree programme is held at the end of each year.  This year 110 students were selected from 300 applicants. (The number is restricted to 110 due to the limited number of clinical placements in the Otago region). The majority of students enter the BN programme at the end of their secondary schooling

The BN entry requirements are a minimum of 14 NCEA level 3 credits in science.  Entry can also be gained by the successful completion of the Certificate in Health Sciences programme run by Otago Polytechnic.  Graduates from other disciplines may receive a cross credit for equivalent papers in the BN degree programme.

There is also a pre-entry numeracy and literacy test.  Students must declare their health and immunization status.  Criminal convictions must also be reported.

During the degree programme, some students may opt to study part-time and take longer to complete their degree.  Blended delivery offers a variety of learner centered options (e.g., access to written resources, video, quizzes, etc. by way of Moodle).

·         My course uses a blended learning approach.  Technology is used as the repository of reading material and learning activities.  Students have the opportunity to practice skills face to face in tutorials.  Other work can be completed in the student’s own time and place via Moodle.  I am always available by email to answer student queries.

To act with integrity and be guided by respect for people, environment, Kai Tahu:

The degree programme begins with a week-long Treaty of Waitangi course.  During this week students become familiar with the cultural safety requirements of nursing and learn about the history of and colonization of Aotearoa.  Through this discussion and learner engagement, we are able to gain a deeper understanding of the structural determinants of contemporary Maori health issues.

·         In my course we use the Treaty of Waitangi principles of participation, protection and partnership to guide our learning.  We talk about different cultural beliefs and how we can honour and respect others in our nursing practice.  I have students from different cultural backgrounds and we discuss their experiences and include it in our learning.  For example, a student explained how she massaged her baby with mustard seed oil to soothe him when he was unsettled.  She described the importance of therapeutic effect of massage and touch in India.  A Maori student explained the importance of her pounamu stone necklace (and why it should never be removed) to the class.   

WHAT EDUCATION MUST BE FOR

..... a quick review of David Orr’s ideas about the six new principles of education from
http://www.context.org/ICLIB/IC27/Orr.htm

First, all education is environmental education

If found this interesting as I came across an article by Goodman (2011) highlighting the need for a 'sustainability curriculum' in nurse education.  The focus of this paper was not about sustainable education, but about addressing the topics of sustainability and climate change in nurse education curricula.  Goodman pointed out that sustainable living is about not endangering the physical environment for future generations.  Over lunch I discussed with a colleague the fact that sustainable working is about having balance in work and living (and how we were both working over a lunch break...).  Sustainable health practices are vitally important in nursing as health care costs increase.  Sustainable practice and differentail fuinding can also been seen in the move away from hospital level care to increased support in the community and the provision of Primary Health Organizations. 

A second principle comes from the Greek concept of paideia. The goal of education is not mastery of subject matter, but of one's person.

This is not just about teaching “the curriculums” it is about learning about oneself and how one fits in the world.  This is an essential part of being a nurse.  You cannot care for others, unless you first care for yourself!

Third,  knowledge carries with it the responsibility to see that it is well used in the world.

We should use our knowledge responsibly.  Registered Nurses must act within their scope ofpractice and use their nursing knowledge appropriately. 

Fourth, we cannot say that we know something until we understand the effects of this knowledge on real people and their communities

This is very pertinent to the nursing curriculum.  Over the degree programme students spend time working with real people and in different communities.  They gain a wide range of experience from this and write about the health needs of different groups.

The fifth principle follows and is drawn from William Blake. It has to do with the importance of "minute particulars" and the power of examples over words.

Nursing uses case scenarios and real-life examples in all teaching and learning contexts.   This places learning in a meaningful context.

Finally, the way learning occurs is as important as the content of particular courses.

Learning occurs and develops over the three years of the BN degree programme and for nurses, continues in every nursing context.  Providing blended learning fits in with the Polytechnic’s institutional vision of life-long learning. 

Reference:  Goodman, B. (2011).  The need for a ‘sustainability curriculum’ in nurse education.  Nurse Education Today, doi: 10.10.1016/j.nedt2010.12.010.

Sustainability

·         How can you become a more sustainable practitioner?

By recycling teaching material.. I just did it!  I used previous years’ lecture presentations with full acknowledgment of the original author.  Up to now, I would have felt uncomfortable doing this as I would have felt an obligation to write my own version of the lecture material.

I also had a discussion with some students who apologized for using text book material to explain moral development theory.  The students thought that they should have used a wider range of resources to complete their assignment.  However, what they did was the best option because they were able to use material that was relevant and appropriate for their topic. 

·         What sort of learning and teaching strategies meet your philosophy of sustainability?

Using existing textbook resources – in my course I have an online learning tool comprising quizzes which I could set up.  I already use the classroom activities provided by the book. 

Cut down on photocopying and paper waste.  Maybe use electronic submission although I hate reading on screen! 

Making the student workload more manageable for them by closer coordination with other theory and clinical papers. 

Adult learning theories for Flexible Learning.

Activity 9

Adult learning theories for Flexible Learning.

Explore adult learning theories relevant to your context. Start with looking at Four Orientations to Learning

The behaviorist orientation: purpose is to produce behavioural change in desired direction.  The educator arranges the environment to elicit desired behavioural response.  Learning is expressed as observable behaviour. (Good for learning skills, facts, anatomy and physiology, drug calculations, etc.)

The cognitive orientation   Also known as the information processing learning theory.  Key factors are insight, perception and meaning.  Control lies with the individual learner and how they process information.  Purpose: to develop capacity and skills to learn better.  The educator structures the content of the learning activity. (Good for clinical scenarios, teaching evidence based practice, assignments that involve research and application of ideas and problem solving activities)

The humanist orientation.  This views earning from the perspective of the unlimited potential for human growth.  These beliefs are the foundation of many adult learning theories that focus on the self-directed learner and the value of the learning process.  The purpose in education is to become self-actualised and autonomous (self-driven or self-directed) in learning.  The educator facilitates the development of the whole person.  (Good for exploring ethical dilemmas, developing critical thinking, project and portfolio work where there are general guidelines but no fixed or set limits on content.

The social and situational orientation.  This is based on the belief that people learn from others and interacting with other.  The context is important and the interaction of many factors help learning.  The purpose in education is full participation in communities of practice and utlisation of resources.  The educator works to establish communities of practice in which conversation and participation can occur.  (Good for class projects/activities, sharing experiences while on clinical placements).

·         Choose a learning theory for your Flexible learning Plan. (Explain the theory and why it is appropriate)

For this activity, I am going to focus on outcome 1. Demonstrate an ability to appropriately apply communication micro skills;

This outcome requires the student to appropriately apply communication micro skills.  As communication skills are an observable behaviour that can be changed I am going to use behavioural theory. 

First, I would select a case study where a number of communication skills could be assessed.  a mother takes her child to a clinic and the nurse has to take an oral health assessment of the child. 

I would organise students into groups of three: One as young adult/one as mother and one as observer.  The observer would have checklist that I had made to assess the desired communication skills.  It would include a tick list of required oral and non-verbal communication skills.  Measures would include ‘yes/no’, and a 7 point Likert scale to assess the extent the person demonstrated the observable behaviour of ………………………………

Students would read the case study and role descriptions before starting the exercise.  The first run through would be without any briefing concerning the required communication behaviours. .  Observers would report back to the other group members.

Then I would show a previously made DVD of the scenario showing all of the required professional communication skills. 

Students would then repeat the role play exercise.  Communication behaviours would be assessed again to see if the demonstrated communication behaviour had been achieved.  Roles could be swapped around so that everyone’s behaviour is assessed.

This communication role play activity could be used in a variety of other situations to teach ‘appropriate’ skills.  Through affirmation that students were performing the skills correctly evident in a higher score on the marking criteria, the desired communication skills would be reinforced (and hopefully the negative aspects extinguished). 

I have found an article (Brown et al., 2011) about assessing the communication styles of undergrdaute health students.   It mentions a Communication Style Measure which I might be able to track down and use.  it would be intersting to do a pre and posrt course measure.  This would be another indicator that behaviour had changed.

Reference. 

Brown, T., Williams, B., Boyle, M., Molloy, A., McKenna, L. Palermo, C., Molly, L, and Lewis, B. (2011).  Communication stlyes of undegraduate health students. Nurse Education Today (31), 317-322. 

Open Education….opening up to the global world….

A definition….

Open educations practices are publically available, usually free educational resources that are typically available on the internet.  Wikis are the most commonly used media for disseminating information. The idea is to connect individuals globally and to contribute to enhancing social capital.  Open Education Resources provide a helpful media for educators looking for teaching resources and for students participating in courses or doing research on a topic. 

The Otago Polytechnic has been using WikiEducator – “one of the world's fastest growing and most productive open education wiki communities in the formal education sector”..  It has also set up Learning4Content – “the world's largest free training project to develop wiki skills for education”.

Some strategies/resources I could use….

In regard to the Applied Psychology for Nurses course I am teaching, in addition to Wikipedia and You tube, I could use some of the free resources on these websites:

http://www.psychexchange.co.uk/.  I have just logged in to this teacher exchange and will keep you posted on how useful I find it!

There is also a huge website of resources (some are free) on this website http://www.all-about-psychology.com/psychology-research-methods.html.  Wow, I could get lost for hours here!!

There is another website which might be handy.  It has games and videos that look really interesting. http://freenursetutor.com/menuparent-growth-and-development/flash-a-match-ericksons-theory.html

Open education resources and philosophies are important for teaching and learning…because….

It allows teachers and learners to keep in touch with the latest trends and practices in their fields.  It enables communities to share ideas and contribute to knowledge in their discipline.  Resources allow educators to keep up with the changing world….lunch break becomes computer play time!

Adding to the toolbox! Blended learning appears to be preferred by students.

I have just read an article on problem-based learning of teaching nurses and will use this as one of my teaching strategies. 

Problem-based learning provides an excellent bridge between theory and practice.  So what is it?

According to Chunta and Katrancha (2010), it is a method of teaching using a case scenario that challenges critical thinking and provides a framework for directed learning, self evaluation, interpersonal communication and access and retrieval of information.  It helps the leaner link facts, concepts and principles to make decisions related to clinical situations.  Problem based learning will help me to deliver the outcomes of my course which has an inter-personal component and a theory component (see last blog posting).  

The problem –based learning method has four basic stages problem analysis, brainstorming, self-directed leaning and solution testing.  The student group works together to gain knowledge about the problem by using a range of resources and tools such as text books and internet information.  This simulates the kind of problem solving activity that a nurse would engage in to solve a problem in a clinical nursing situation. 

Problem–based scenarios are usually case studies that have been written with a clear purpose and learning objectives.  They are considered as a living document as they need revision and updating over the process of learning.  The educators’ role in learning is that of group facilitator, to model, guide and coach the learning process.  The educator should also encourage decision making and collaboration among the students.  The group evaluates the decision at every step of the process and feedback is provided by the facilitators. 

Sounds very helpful and a process that embraces learner centred-flexibility.  The challenge will be to write the case scenarios! 

Reference

Chunta, K. and Katrancha, E. D. (2010).  Using problem-based learning in staff development. Strategies for teaching registered nurses and new graduate nurses.  The Journal of Continuing Education in Nursing, 41(12), pp 557-564.

Horray, I've managed to blog on!!!!

Activity Five – Design and describe flexible learning strategies for your context.

The course I teach is an “applied theory” paper.  This means that there is a mix of theory (content that should be learned) and doing (talking about and applying theory to nursing situations. 

Teaching strategies are designed to meet the course learning outcomes which I have organised into the relevant content areas.

Communication:

1. To demonstrate an ability to appropriately apply communication micro skills;
2. Increase their self awareness and effectiveness as communicators with individuals and within groups;
3. Demonstrate effective use of assertive communication and problem solving skills
4. Discuss use of the diverse technologies for effective communication.

The methods that I currently use are classroom based, face-to-face activities including role plays, case studies, small group activities and debates. 

This part of the course is formally assessed by a small group oral presentation worth 20%.  Groups have to self-mange the process of doing the presentation.  Students have to justify their choice of communication method and technology when presenting their assigned topic.

They then complete an individual written review of the group process that they were involved in that includes a reflection on their involvement in the communication activity.  This is also assessed at 20% of the course grade.

In order to foster a group dynamic, students are kept in the same tutorial group for the year so they can get to better know each other. 

Theory

1. Discuss key psychological concepts and begin to relate these to nursing practice;
2. Demonstrate understanding of physical, social, emotional and cognitive development and spirituality and culture and how each may relate to the health of people across the lifespan.

This is done by reading the course text book, answering questions related to case studies in the text and from other sources, group discussion that brings in examples from current clinical placements.  Short answer questions are provided at the end of each class so students can practice answering them.  A selection of these questions is used to make up the final examination. This helps students to learn the concepts during the year and gives them a chance to work together and practice writing their answers before the time of the examination.

Talk to colleagues about the strategies they use for teaching and learning.

They use similar strategies in the theory courses.

Investigate the Gallery of Strategies on the Australian Flexible framework site. This is about eLearning but many strategies are applicable in all areas of learning.

There is an amazing variety of strategies here.  I use case studies, debates, problem-based learning, role plays, student presentations and web based content – audio and graphic. 

There are a lot more that I could be using …food for thought!!! 

Design and describe strategies for your context, and post them to your blog.

Nursing uses a blended learning approach (Ireland et al., 2009).  This is a method of educating at a distance that’s uses technology (internet) combined with traditional (stand up) education and training.  The theoretical elements of undergraduate nursing education have traditionally been delivered on-site with face-to-face methods being the traditional core.  This is the model that I am currently using. 

To be more specific, the methods I am currently using include directed study, proximate study, lectures/group activities, enquiry based learning and assessment of oral and written communication skills. 

When I look at Figure 2 in Heinz and Proctor (2004), the course content delivery mode is on-line via Moodle.  Apart from the printed course outline, Moodle becomes the electronic instructor providing information, instruction and resources for the course.  It is however, one-way unless students engage in the discussion forum in the course set up.  I will think of how to make this course m more interactive as part of my design plan.

References:

Heinze, A. & C. Procter (2004). Reflections on the use of blended learning. Education in a Changing Environment. University of Salford: Salford, Education Development Unit.

Ireland, J., Martindale, S., Johnson, N., Adams, D., Eboh, W., and Mowatt, E (2009).  Blended learning in education: effects on knowledge and attitude.  British Journal of Nursing, Vol. 18(2), pp 124-130.