Nurses driving change to improve access to education and quality in lcinical teaching : A partnership between Australia and Viet Nam

In Viet Nam, standards of nursing care fail to meet international competency standards. This increases risks to patient safety (eg. hospital acquired infection), consequently the Ministry of Health identified the need to strengthen nurse education in Viet Nam. This paper presents experiences of a piloted clinical teaching model developed in Ha Noi, to strengthen nurse led institutional capacity for in-service education and clinical teaching. Historically 90% of nursing education was conducted by physicians and professional development in hospitals for nurses was limited. There was minimal communication between hospitals and nursing schools about expectations of students and assessment and quality of the learning experience. As a result when students came to the clinical sites, no-one understood how to plan their learning objectives and utilise teaching and learning approaches appropriate to their level. Therefore student learning outcomes were variable. They focussed on procedures and techniques and “learning how to do” rather than learning how to plan, implement and evaluate patient care. This project is part of a multi-component capacity building program designed to improve nurse education in Viet Nam. The project was funded jointly by Queensland University of Technology (QUT) and the Australian Agency for International Development. Its aim was to develop a collaborative clinically-based model of teaching to create an environment that encourages evidence-based, student-centred clinical learning. Accordingly, strategies introduced promoted clinical teaching of competency based nursing practice utilising the regionally endorsed nurse core competency standards. Thirty nurse teachers from Viet Duc University Hospital and Hanoi Medical College participated in the program. These nurses and nurse teachers undertook face to face education in three workshops, and completed three assessment items. Assessment was applied, where participants integrated the concepts learned in each workshop and completed assessment tasks related to planning, implementing and evaluating teaching in the clinical area. Twenty of these participants were then selected to undertake a two week study tour in Brisbane, Australia where the clinical teaching model was refined and an action plan developed to integrate into both organisations with possible implementation across Viet Nam. Participants on this study tour also experienced clinical teaching and learning at QUT by attending classes held at the university, and were able to visit selected hospitals to experience clinical teaching in these settings as well. Effectiveness of the project was measured throughout the implementation phase and in follow up visits to the clinical site. To date changes have been noted on an individual and organisational level. There is also significant planning underway to incorporate the clinical teaching model developed across the organisation and how this may be implemented in other regions. Two participants have also been involved in disseminating aspects of this approach to clinical teaching in Ho Chi Minh, with further plans for more in-depth dissemination to occur throughout the country.

Using ‘think aloud’ as a strategy for learning clinical reasoning in high fidelity case-based simulation for undergraduate nursing students

AIMS This paper reports on the implementation of a research project that trials an educational strategy implemented over six months of an undergraduate third year nursing curriculum. This project aims to explore the effectiveness of ‘think aloud’ as a strategy for learning clinical reasoning for students in simulated clinical settings. BACKGROUND Nurses are required to apply and utilise critical thinking skills to enable clinical reasoning and problem solving in the clinical setting [1]. Nursing students are expected to develop and display clinical reasoning skills in practice, but may struggle articulating reasons behind decisions about patient care. For students learning to manage complex clinical situations, teaching approaches are required that make these instinctive cognitive processes explicit and clear [2-5]. In line with professional expectations, nursing students in third year at Queensland University of Technology (QUT) are expected to display clinical reasoning skills in practice. This can be a complex proposition for students in practice situations, particularly as the degree of uncertainty or decision complexity increases [6-7]. The ‘think aloud’ approach is an innovative learning/teaching method which can create an environment suitable for developing clinical reasoning skills in students [4, 8]. This project aims to use the ‘think aloud’ strategy within a simulation context to provide a safe learning environment in which third year students are assisted to uncover cognitive approaches that best assist them to make effective patient care decisions, and improve their confidence, clinical reasoning and active critical reflection on their practice. MEHODS In semester 2 2011 at QUT, third year nursing students will undertake high fidelity simulation, some for the first time commencing in September of 2011. There will be two cohorts for strategy implementation (group 1= use think aloud as a strategy within the simulation, group 2= not given a specific strategy outside of nursing assessment frameworks) in relation to problem solving patient needs. Students will be briefed about the scenario, given a nursing handover, placed into a simulation group and an observer group, and the facilitator/teacher will run the simulation from a control room, and not have contact (as a ‘teacher’) with students during the simulation. Then debriefing will occur as a whole group outside of the simulation room where the session can be reviewed on screen. The think aloud strategy will be described to students in their pre-simulation briefing and allow for clarification of this strategy at this time. All other aspects of the simulations remain the same, (resources, suggested nursing assessment frameworks, simulation session duration, size of simulation teams, preparatory materials). RESULTS Methodology of the project and the challenges of implementation will be the focus of this presentation. This will include ethical considerations in designing the project, recruitment of students and implementation of a voluntary research project within a busy educational curriculum which in third year targets 669 students over two campuses. CONCLUSIONS In an environment of increasingly constrained clinical placement opportunities, exploration of alternate strategies to improve critical thinking skills and develop clinical reasoning and problem solving for nursing students is imperative in preparing nurses to respond to changing patient needs. References 1. Lasater, K., High-fidelity simulation and the development of clinical judgement: students' experiences. Journal of Nursing Education, 2007. 46(6): p. 269-276. 2. Lapkin, S., et al., Effectiveness of patient simulation manikins in teaching clinical reasoning skills to undergraduate nursing students: a systematic review. Clinical Simulation in Nursing, 2010. 6(6): p. e207-22. 3. Kaddoura, M.P.C.M.S.N.R.N., New Graduate Nurses' Perceptions of the Effects of Clinical Simulation on Their Critical Thinking, Learning, and Confidence. The Journal of Continuing Education in Nursing, 2010. 41(11): p. 506. 4. Banning, M., The think aloud approach as an educational tool to develop and assess clinical reasoning in undergraduate students. Nurse Education Today, 2008. 28: p. 8-14. 5. Porter-O'Grady, T., Profound change:21st century nursing. Nursing Outlook, 2001. 49(4): p. 182-186. 6. Andersson, A.K., M. Omberg, and M. Svedlund, Triage in the emergency department-a qualitative study of the factors which nurses consider when making decisions. Nursing in Critical Care, 2006. 11(3): p. 136-145. 7. O'Neill, E.S., N.M. Dluhy, and C. Chin, Modelling novice clinical reasoning for a computerized decision support system. Journal of Advanced Nursing, 2005. 49(1): p. 68-77. 8. Lee, J.E. and N. Ryan-Wenger, The "Think Aloud" seminar for teaching clinical reasoning: a case study of a child with pharyngitis. J Pediatr Health Care, 1997. 11(3): p. 101-10.

Some reflections on winning an ALTC Teaching Excellence Award

Since 1996, quality teaching has been recognised in the Australian Awards for University Teaching (AAUT), administered first by the Australian government Department of Education, and then from 2000, by the Australian Universities Teaching Committee (AUTC). In 2005, the awards were overseen by the government funded Carrick Institute for Learning and Teaching in Higher Education and known as the Carrick Awards for Australian University Teaching. The newly elected Rudd government reconfigured the process and established the Australian Learning and Teaching Council (ALTC) in 2008 to administer the awards under the AAUT nomenclature. In this edition of Re-Union, Deborah Henderson reflects on receiving an a 2010 ALTC Teaching Excellence Award in the category of Social Sciences (including Education).

A design approach to teaching new product development

The educational unit new product development, taught within the industrial design program at the Queensland University of Technology (QUT) introduces the relationship between product design and commercialisation to third year industrial design undergraduate students. In which, they are exposed for the first time to product strategy development aimed at meeting consumer expectations, whilst at the same time achieving corporate objectives. Delivered content such as intellectual property, market opportunities, competitor analysis and investor requirements are taught within the thirteen week semester timeframe. New product development theory is not a new field. However, the design approach to teaching this theory and more importantly how designers can use it in the design process is novel. This paper provides an overview of the curriculum design of this unit as well as its incremental development over the past four year duration period. Student project outcomes and more importantly the process and tools from this unit are also discussed and presented.

Perspectives of teaching in Papua New Guinea : a case study of elementary teacher trainers and their mentors

Global and national agenda for quality education led to reform in Papua New Guinea (PNG) based on the provision of quality basic education. “Education for All” (EFA) is a worldwide emphasis on the review and restructure of existing curriculum and teacher training programs to provide quality education and quality life. The provision of quality education is seen as an investment in developing countries including PNG. Quality education is facilitated through structural and curriculum reform, and teacher education programs. One such influence on quality education in teacher education relates to perspectives of teaching. Existing research shows teachers’ beliefs and perceptions of teaching influence their practice (Kember & Kwan, 2000; Prosser & Trigwell, 2004). However, there is no research focusing on perspectives of teaching for elementary education in PNG. This single exploratory case study (Yin, 2009) investigated the perspectives of teaching of eighteen elementary teacher trainers and their five mentors in the context of an Australian university Bachelor of Early Childhood (in teacher education) degree programme. The study drew on an interpretivist paradigm to analyse journals, semi-structured interviews and course planning documents using a thematic approach to data analysis (Braun & Clark, 2006). The findings revealed that participants held perspectives of teaching related to teaching children and teaching adults. The perspective of teaching children described by the trainers and mentors was learning-centred (the focus is on what the teacher does); while the perspective of teaching adults was both learning-centred and learner-centred (the focus is on what the learner does). The learning-centred perspective is at odds with the learner-centred perspective espoused in the PNG reform. The perspectives of teaching adults reflected a culturally nuanced view; providing insights about how teaching and learning are understood in different sociocultural contexts. Based on these findings, the study proposes a perspective of teaching for elementary education in PNG known as culturally connected teaching. This perspective enables the co-existence of both the learning-centred and learner-centred perspectives of teaching in the PNG cultural context. This perspective has implications for teacher training and the communities involved in elementary education.

O'Neill Building Nudgee College

This project involved the complete refurbishment and extension of a 1980’s two-storey domestic brick building, previously used as a Boarding House (Class 3), into Middle School facilities (Class 9b) on a heritage listed site at Nudgee College secondary school, Brisbane. The building now accommodates 12 technologically advanced classrooms, computer lab and learning support rooms, tuckshop, art room, mini library/reading/stage area, dedicated work areas for science and large projects with access to water on both floors, staff facilities and an undercover play area suitable for assemblies and presentations. The project was based on a Reggio Emilia approach, in which the organisation of the physical environment is referred to as the child’s third teacher, creating opportunities for complex, varied, sustained and changing relationships between people and ideas. Classrooms open to a communal centre piazza and are integrated with the rest of the school and the school with the surrounding community. In order to achieve this linkage of the building with the overall masterplan of the site, a key strategy of the internal planning was to orientate teaching areas around a well defined active circulation space that breaks out of the building form to legibly define the new access points to the building and connect up to the pathway network of the campus. The width of the building allowed for classrooms and a generous corridor that has become ‘breakout’ teaching areas for art, IT, and small group activities. Large sliding glass walls allow teachers to maintain supervision of students across all areas and allow maximum light penetration through small domestic window openings into the deep and low-height spaces. The building was also designed with an effort to uphold cultural characteristics from the Edmund Rice Education Charter (2004). Coherent planning is accompanied by a quality fit-out, creating a vibrant and memorable environment in which to deliver the upper primary curriculum. Consistent with the Reggio Emilia approach, materials, expressive of the school’s colours, are used in a contemporary, adventurous manner to create panels of colour useful for massing and defining the ‘breakout’ teaching areas and paths of travel, and storage elements are detailed and arranged to draw attention to their aesthetic features. Modifications were difficult due to the random placement of load bearing walls, minimum ceiling heights, the general standard of finishes and new fire and energy requirements, however the reuse of this building was assessed to be up to 30% cheaper than an equivalent new building, The fit out integrates information technology and services at a level not usually found in primary school facilities. This has been achieved within the existing building fabric through thoughtful detailing and co-ordination with allied disciplines.

Teaching and Learning in Maritime Security: A Literature Review

With the rise in attacks and attempted attacks on marine‐based critical infrastructure, maritime security is an issue of increasing importance worldwide. However, there are three significant shortfalls in the efforts to overcome potential threats to maritime security: the need for greater understanding of whether current standards of best practice are truly successful in combating and reducing the risks of terrorism and other security issues, the absence of a collective maritime security best practice framework and the need for improved access to maritime security specific graduate and postgraduate (long) courses. This paper presents an overview of existing international, regional national standards of best practice and shows that literature concerning the measurement and/ or success of standards is virtually non‐existent. In addition, despite the importance of maritime workers to ensuring the safety of marine based critical infrastructure, a similar review of available Australian education courses shows a considerable lack of availability of maritime security‐specific courses other than short courses that cover only basic security matters. We argue that the absence of an Australian best practice framework informed by evaluation of current policy responses – particularly in the post 9/11 environment – leaves Australia vulnerable to maritime security threats. As this paper shows, the reality is that despite the security measures put in place post 9/11, there is still considerable work to be done to ensure Australia is equipped to overcome the threats posed to maritime security.

Facilitating growth in prospective teachers’ knowledge : teaching geometry in primary schools

This paper reports on a study that focused on growth of understanding about teaching geometry by a group of prospective teachers engaged in lesson plan study within a computer-supported collaborative learning (CSCL) environment. Participation in the activity was found to facilitate considerable growth in the participants’ pedagogical-content knowledge (PCK). Factors that influenced growth in PCK included the nature of the lesson planning task, the cognitive scaffolds inserted into the CSCL virtual space, the meta-language scaffolds provided to the participants, and the provision of both private and public discourse spaces. The paper concludes with recommendations for enhancing effective knowledge-building discourse about mathematics PCK within prospective teacher education CSCL environments.

Teaching English : some remarks on the emergence of the sympathetic teacher in the English classroom

The chapter explores the concept of the teacher-student relationship within the English classroom and proposes that this relationship has a specific purpose in building a civil society by inculcating practices of self-reflection, empathy and ethics. The topic is explored through the example of teaching Australian literature, specifically, Tim Winton’s Lockie Leonard, Human Torpedo to secondary school students. Ian Hunter’s work on literature education and the construction of socio-ethical practices provides a conceptual framework for the chapter.

Reflections around artefacts - using a deliberative approach to teaching reflective practices in fashion

The importance of reflection in higher education, and across disciplinary fields is widely recognised; it is generally included in university graduate attributes, professional standards and program objectives. Furthermore, reflection is commonly embedded into assessment requirements in higher education subjects, often without necessary scaffolding or clear expectations for students. Despite the rhetoric around the importance of reflection for ongoing learning, there is scant literature on any systematic, developmental approach to teaching reflective learning across higher education programs/courses. Given that professional or academic reflection is not intuitive, and requires specific pedagogic intervention to do well, a program/course-wide approach is essential. Over the last 18 months, teaching staff from five QUT faculties: Business, Creative Industries, Education, Health and Law, have been involved in an ALTC-funded project to develop a systematic, cross-faculty approach to teaching and assessing reflection in higher education. This forum will present a reflective model that staff have used in their teaching and they will also share their ideas and approaches to reflective teaching and assessment with colleagues from QUT and other universities. A poster format will enable forum participants to talk informally with the presenters about how the approaches and resources they have developed for units have contributed to the development of the reflective model which can be applied across faculties. Participants will also be able to explore the web resources which have been developed as part of the project.

Reflections around artefacts : using a deliberative approach to teaching reflective practices in fashion

While asking students to think reflectively is a desirable teaching goal, it is often fraught with complexity and sometimes poorly implemented in higher education. Here we describe an approach to academic reflective practice that fitted well within an existing design subject in fashion education and was perceived as effective in enhancing student learning outcomes. In many design based disciplines it is essential to evaluate, through a reflective lens, the quality of tangible design outcomes - referred to as artefacts in this case. Fashion studio based practice (unlike many other theory based disciplines) requires an artefact to be viewed, in order to initiate the reflective process. This reflection is not solely limited to reflective writing - the reflection happens through sight, touch and other non traditional approaches. Fashion students were asked to reflect before, during and after the development of an artefact and through a variety of media a review of the first garment prototype, called 'Sample Review', occurred. This teaching approach has been formalised as a "pedagogic pattern" in order to abstract successful experience for re use by other university teachers in different contexts. This case study fits within the broader project outlined in Paper 1. In this presentation we explore some of the complexities associated with teaching academic reflection along with the value in representing successful practices as pedagogical patterns. The teaching practice and student outcomes associated with the case study will be described. Finally, we shall argue that the pedagogical pattern, called 'Reflection Around Artefacts', can be applied in diverse discipline areas, and especially where students are engaged and reflecting on the design of an artefact(such as an assignment that includes the making of a professionally-relevant product).

Analysing mentoring practices to understand how a preservice teacher reflects on practice to advance teaching

Mentors (cooperating classroom teachers) have a shared responsibility with universities for developing preservice teachers’ pedagogical practices, particularly towards becoming reflective practitioners. Preservice teachers need to participate actively in their own learning, by reflecting and acting on the mentor’s constructive feedback provided during planning and feedback dialogue sessions. This case study uses feedback practices outlined within a five-factor mentoring model to analyse dialogue between a mentor and her respective mentee during different stages in their school-based programs (first practicum). This investigation uses multiple data sources such as video and audio-recorded interviews, archival documents from participants such as lesson plans, reflections and reports to examine preservice teacher’s reflections and implementations of practice as a result of her mentor’s feedback (e.g., establish expectations, review lesson plans, observe teaching then provide oral and written feedback, and evaluate progress). Findings indicated that reflective thinking was more apparent when the mentor did not dominate conversations but instead asked astute pedagogical knowledge questions to facilitate the mentee’s reflections on practice.

Re-thinking context and reflexive mediation in the teaching of writing

This paper calls for a renewed focus on the teaching of writing. It proposes a conceptual model, based on a social realist perspective, which takes account of the ways in which teachers reflexively mediate personal, professional and political considerations in enacting their writing pedagogies. This model extends understanding of the factors contextualising the teaching of writing. It also provides a useful guide for research into the teaching of writing and a prompt for reflexivity in professional development.

Moral and social development: teachers’ knowledge of children’s learning and teaching strategies in the early years

The intention of the analysis in this paper was to determine, from interviews with 11 early years’ teachers, what informed their knowledge of children’s learning and teaching strategies regarding moral development. Overall, the analysis revealed four main categories: definitions of moral behaviour, understanding of children’s learning, pedagogy for moral learning, and the source of knowledge for moral pedagogy. Children’s learning was attributed by five of the teachers to incidental/contextual issues. Nine of the teachers reported using pedagogies that involved discussion of issues, in various contexts, as a way of teaching about social and moral issues. The majority of the teachers (n = 7) described the source of their knowledge of pedagogy as practical/observed as opposed to being theoretically informed. There was no clear relationship between teachers’ definitions, understanding of children’s learning, pedagogy or source of knowledge. These results suggests a strong need for the teaching of moral development to be given more prominence and addressed directly in in-service courses so that teachers are clear about their intentions and the most effective ways of achieving them.