[Show abstract][Hide abstract] ABSTRACT: Workplace learning happens in work processes in the context of work, is multi episodic, often informal, problem based and takes place on a just in time basis. While this is a very effective means of delivery, it also does not scale very well beyond the immediate context. We review three types of technologies that have been suggested to scale learning and three connected theoretical discourses around learning and its support. Based on an in-depth analysis of the challenges of two workplace learning domains, Healthcare and Building and Construction, four design-based research projects were conducted that have given rise to designs for scaling informal learning with technology. These projects also contributed to a model that provides an integrative view on three informal learning processes at work and how they can be supported with technology.
British Journal of Educational Technology 12/2014; · 1.54 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Making an accurate clinical diagnosis is an essential skill for all medical students and doctors, with important implications for patient safety. Current approaches for teaching how to make a clinical diagnosis tend to lack the complexity that faces clinicians in real-life contexts. In this Guide, we propose a new trans-theoretical model for teaching how to make an appropriate clinical diagnosis that can be used by teachers as an additional technique to their current approach. This educational model integrates situativity theory, dual-information processing theory and socio-cognitive theory. Mapping and microanalysis help the teacher to identify the main processes involved in making an accurate clinical diagnosis, so that feedback can be provided that is focused on improving key aspects of the skill. An essential aspect of using the new educational model is the role of the experienced clinical teacher in making judgments about the appropriateness of the learner's attempts to make a clinical diagnosis.
[Show abstract][Hide abstract] ABSTRACT: Objectives: The aim of the study was to develop and consider the usefulness of a new mixed-methods approach to evaluate the student-centredness of teaching and learning on undergraduate medical courses. An essential paradigm for the evaluation was the coherence between how teachers conceptualise their practice (espoused theories) and their actual practice (theories-in-use).
Methods: The context was a module within an integrated basic sciences course in an undergraduate medical degree programme. The programme had an explicit intention of providing a student-centred curriculum. A content analysis framework based on Weimer’s dimensions of student-centred teaching was used to analyze data collected from individual interviews with seven teachers to identify espoused theories and 34h of classroom observations and one student focus group to identify theories-in-use. The interviewees were identified by purposeful sampling. The findings from the three methods were triangulated to evaluate the student-centredness of teaching and learning on the course.
Results: Different, but complementary, perspectives of the student-centredness of teaching and learning were identified by each method. The triangulation of the findings revealed coherence between the teachers’ espoused theories and theories-in-use.
Conclusions: A mixed-methods approach that combined classroom observations with interviews from a purposeful sample of teachers and students offered a useful evaluation of the extent of student-centredness of teaching and learning of this basic science course. Our case study suggests that this new approach is applicable to other courses in medical education.
International Journal of Medical Education (IJME). 09/2014; 5:157-164.
[Show abstract][Hide abstract] ABSTRACT: Developmental student support has a focus on developing the whole person, not only academic and clinical competence. The positive and proactive developmental approach is in marked contrast to the deficit and reactive approach to student support which only targets identified students who are considered to be “at risk”. The medical school is a nexus for personal development, combining the personal identity formation journey of early adulthood with the variety of new experiences in medical school. Important aspects of developmental student support are the development of resilience and ensuring reasonable adjustments for students with learning difficulties and disabilities. Careers guidance is an essential aspect of developmental student support, including students with doubts about a career in medicine and who are leaving because of poor performance. Developmental student support requires an organizational culture in which student support is considered as the responsibility of everyone, with further support from named personal tutors.
[Show abstract][Hide abstract] ABSTRACT: While several technological advances have been suggested to scale learning at the workplace, none has been successful to scale informal learning. We review three theoretical discourses and suggest an integrated systems model of scaffolding informal workplace learning that has been created to tackle this challenge. We derive research questions that emerge from this model and illus-trate these with an in-depth analysis of two workplace learning domains.
EC-TEL'13 Proceedings of the 8th European conference on Technology enhanced learning: towards ubiquitous learning, Paphos, Zypern; 09/2013
[Show abstract][Hide abstract] ABSTRACT: Reflection has become established as a key principle underpinning maintenance of standards within professional education and practice. A requirement to evidence reflection within performance review is intended to develop a transformative approach to practice, identify developmental goals, and ultimately, improve healthcare. However, some applications have taken an excessively instrumental approach to the evidencing of reflection, and while they have provided useful templates or framing devices for recording individualistic reflective practice, they potentially have distorted the original intentions. This article revisits the educational theory underpinning the importance of reflection for enhancing performance and considers how to enhance its value within current paediatric practice.
Archives of Disease in Childhood 08/2013; · 3.05 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives Remediation is usually offered to medical students and doctors in training who underperform on written or clinical examinations. However, there is uncertainty and conflicting evidence about the effectiveness of remediation. The aim of this systematic review was to synthesise the available evidence to clarify how and why remediation interventions may have worked in order to progress knowledge on this topic. Methods The MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ERIC (Educational Resources Information Centre), Web of Science and Scopus databases were searched for papers published from 1984 to April 2012, using the search terms 'remedial teaching', 'education', 'medical', 'undergraduate'/or 'clinical clerkship'/or 'internship and residency', 'at risk' and 'struggling'. Only studies that included an intervention, then provided retest data, and reported at least one outcome measure of satisfaction, knowledge, skills or effects on patients were eligible for inclusion. Studies of practising doctors were excluded. Data were abstracted independently in duplicate for all items. Coding differences were resolved through discussion. Results Thirty-one of 2113 studies met the review criteria. Most studies were published after 2000 (n = 24, of which 12 were published from 2009 onwards), targeted medical students (n = 22) and were designed to improve performance on an immediately subsequent examination (n = 22). Control or comparison groups, conceptual frameworks, adequate sample sizes and long-term follow-up measures were rare. In studies that included long-term follow-up, improvements were not sustained. Intervention designs tended to be highly complex, but their design or reporting did not enable the identification of the active components of the remedial process. Conclusions Most remediation interventions in medical education focus on improving performance to pass a re-sit of an examination or assessment and provide no insight into what types of extra support work, or how much extra teaching is critical, in terms of developing learning. More recent studies are generally of better quality. Rigorous approaches to developing and evaluating remediation interventions are required.
Medical Education 03/2013; 47(3):242-51. · 3.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background: Usability is the ease with which something can be used, but this essential concept appears to be rarely considered when using technology for teaching and learning in medical education. Context: There is an increasing use of technology in an attempt to enhance teaching and learning in medical education, from the use of websites and virtual learning environments (VLEs) to interactive online tutorials to blogs and podcasts. However, research suggests that the potential use of technology to enhance teaching and learning in medical education is often not fully realised. One aspect is the perceived usefulness of the technology, but another is the usability as perceived by the learner. Innovation: The purpose of this article is to introduce the concept of usability in relation to the use of technology to enhance teaching and learning in medical education, the essential factors that should be considered in the design and implementation of using technology, and to describe how the usability can be tested. Implications: Careful attention needs to be made to the main factors that determine usability: the learner and context; the technology being used; and the content.
[Show abstract][Hide abstract] ABSTRACT: The ultimate goal of ''student-centered'' education is to empower students to learn beyond educational pro-grams. This means nurturing students' autonomy and fostering the development of their own motivation and mechanisms to become self-directed learners. This idea has been embodied in the ''lifelong learning'' mantra that pervades contemporary views of 21st century society, economy and (biological) science. For example, the AAAS report ''Vision and change'' defined as an ''action item'' to ''Develop lifelong science-learning competen-cies'' , the ''Scientific foundations for future physi-cians'' states that ''It is essential not only to read the medical and scientific literature of one's discipline, but to examine it critically to achieve lifelong learning''  and the Association of American Colleges and Universities lists lifelong learning as one of the ''Essential Learning Outcomes'' to prepare students for the 21st century . The big question and the huge challenge is: how can educational programs catalyze the development of life-long learning? To answer, it is necessary to understand how learning experiences should be designed accord-ingly, which implies a need to clarify how mechanisms of learning work. Unfortunately, ''lifelong learning'' is defined quite loosely and not very helpful. The model of self-regulated learning (SRL) may shed a clarifying light on the previous issues and also help on the understanding how to help students overcome conceptual difficulties in Biochemistry and Molecular Biology (BMB). In SRL, the ability to learn autonomously is analyzed with the recognition that all learners are active partici-pants in their learning process . Whenever learners are faced with a learning task, they need to actively integrate the ''will'' and ''skill'' components that are required for effective learning. The will is the essential motivational component and includes attribution and self-efficacy beliefs. The main attribution beliefs about success and failure are related to the learner's perceived control over their performance. High performing learners tend to at-tribute success to factors that the learner can control (such as the study skills that were used), whereas low-performing learners may attribute their lack of success to factors over which they perceive they have no control (such as the problem was too hard). The main self-effi-cacy beliefs are associated with personal confidence regarding the success of a learner's approach to learn-ing. High performing learners take measures to ensure success, such as making the topic personally interesting and relevant. The skill component relates to the various strategies or techniques that are used to complete the learning task successfully, such as time management and/or note taking skills. High performing learners choose strategies that will help them to achieve their intended goals despite poor concentration or stress. These strategies include taking frequent notes and regu-lar checking of their own performance. The continuous and dynamic adjustment of both the will and the skill to ensure that the learning task is achieved requires metacognitive processes to be used by the learner. These processes are at the heart of SRL . Before learning, learners need to actively plan and set themselves goals for learning (including both the will and the skill). High performing learners set goals that are specific and related to the process of learning, such as deciding to use the study technique of reading each paragraph in turn, compared with low performing students who set vague outcome goals, such as ''to understand the article.'' During learning, learners need to self-monitor through increasing their awareness of whether they are on track to achieve their intended goal. High performing learners constantly check their under-standing of what they are learning. Checking allows con-stant adjustments to ensure that their use of will and skill is effective. After learning, learners need to reflect and consider whether their approach to learning, including the will and skill, needs to be modified for future attempts at learning tasks. High performing learners actively reflect on their approach to learning, thereby
[Show abstract][Hide abstract] ABSTRACT: There is increasing use of hypermedia online learning in continuing medical education (CME) that presents the learner with a wide range of different learning resources, requiring the learner to use self-regulated learning (SRL) skills. This study is the first to apply an SRL perspective to understand how learners engage with hypermedia online learning in CME. We found that the main SRL skills used by learners were use of strategies and monitoring. The increasing use of strategies was associated with increasing interest in the topic and with increasing satisfaction with the learning experience. Further research is recommended to understand SRL processes and its impact on learning in other aspects of hypermedia online learning across the different phases of medical education. Research is also recommended to implement and evaluate the learning impact of a variety of approaches to develop the SRL skills of hypermedia online learners in CME.
Education for Primary Care 03/2012; 23(2):90-4. · 1.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There is an increasing use of online continuing medical education (OCME), but the potential use of social and collaborative learning to change professional performance and improve patient care has yet to be fully realised.
The integration of the main themes from the presentations and comments from participants at a symposium at AMEE 2011.
Sociological perspectives on change in professional performance highlight the need for social and collaborative learning in OCME so that learners can share information (explicit knowledge) and opinion (tacit knowledge). The educational topic should be relevant to the complexity of professional practice and use iterative cycles of implementation and critical reflection in social networks so that proposed solutions can be tested in actual practice. The challenge of developing effective online discussions for collaborative learning is recognised.
The provision of OCME requires a shift in both policy and practice to emphasise the importance of social and collaborative learning. Further research is recommended, especially to evaluate the implementation and impact of social and collaborative learning for OCME on patient care and the use of newer Web 2.0 approaches.
Medical Teacher 01/2012; 34(8):649-52. · 1.82 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There is increasing availability of a wide range of technology that has the potential to support and enhance the curriculum of the future. Learners expect to use technology for their learning, but this requires the development of information and digital literacy skills to maximise the potential learning opportunities. Learning resources will be increasingly delivered by a variety of mobile devices and also through different immersive and virtual learning environments. Mobile devices and Web 2.0 technology provide opportunities for learners to create their own deep and personalised learning experiences that are relevant for future professional practice. Tutors have a crucial guidance and support role for the effective use of technology for learning. There is a little evidence base to support the impact on learning for many of the potential scenarios and further research is urgently required.
Medical Teacher 01/2012; 34(7):534-8. · 1.82 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There is increasing interest in developing student self-regulated learning skills, especially self-monitoring, to improve academic performance.
A pilot study to investigate the impact of self-monitoring exercises on calibration accuracy and academic performance in undergraduate medical students on a Biomedical Science (BMS) module.
A randomised trial of 51 second-year students comparing a structured workbook with and without self-monitoring exercises.
Participants significantly improved calibration accuracy after completing the intervention, as well as increased self-efficacy and greater satisfaction with performance. The intervention group significantly improved their BMS exam score compared with the control group.
A relatively simple intervention seems to have the potential to improve self-monitoring skills and academic performance. Further research is recommended to identify if the development of self-monitoring skills by a similar intervention leads to long-term improvement in academic performance, if low-performing students can significantly benefit from a similar intervention and if there is transfer of improved self-monitoring skills from one context to another.
Medical Teacher 01/2012; 34(9):751-3. · 1.82 Impact Factor