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.

Australian Learning and Teaching Council, Learning and Teaching Academic Standards Statement for Architecture

The development of the Learning and Teaching Academic Standards Statement for Architecture (the Statement) centred on requirements for the Master of Architecture and proceeded alongside similar developments in the building and construction discipline under the guidance and support of the Australian Deans of Built Environment and Design (ADBED). Through their representation of Australian architecture programs, ADBED have provided high-level leadership for the Learning and Teaching Academic Standards Project in Architecture (LTAS Architecture). The threshold learning outcomes (TLOs), the description of the nature and extent of the discipline, and accompanying notes were developed through wide consultation with the discipline and profession nationally. They have been considered and debated by ADBED on a number of occasions and have, in their fi nal form, been strongly endorsed by the Deans. ADBED formed the core of the Architecture Reference Group (chaired by an ADBED member) that drew together representatives of every peak organisation for the profession and discipline in Australia. The views of the architectural education community and profession have been provided both through individual submissions and the voices of a number of peak bodies. Over two hundred individuals from the practising profession, the academic workforce and the student cohort have worked together to build consensus about the capabilities expected of a graduate of an Australian Master of Architecture degree. It was critical from the outset that the Statement should embrace the wisdom of the greater ‘tribe’, should ensure that graduates of the Australian Master of Architecture were eligible for professional registration and, at the same time, should allow for scope and diversity in the shape of Australian architectural education. A consultation strategy adopted by the Discipline Scholar involved meetings and workshops in Perth, Melbourne, Sydney, Canberra and Brisbane. Stakeholders from all jurisdictions and most universities participated in the early phases of consultation through a series of workshops that concluded late in October 2010. The Draft Architecture Standards Statement was formed from these early meetings and consultation in respect of that document continued through early 2011. This publication represents the outcomes of work to establish an agreed standards statement for the Master of Architecture. Significant further work remains to ensure the alignment of professional accreditation and recognition procedures with emerging regulatory frameworks cascading from the establishment of the Tertiary Education Quality and Standards Agency (TEQSA). The Australian architecture community hopes that mechanisms can be found to integrate TEQSA’s quality assurance purpose with well-established and understood systems of professional accreditation to ensure the good standing of Australian architectural education into the future. The work to build renewed and integrated quality assurance processes and to foster the interests of this project will continue, for at least the next eighteen months, under the auspices of Australian Learning and Teaching Council (ALTC)-funded Architecture Discipline Network (ADN), led by ADBED and Queensland University of Technology. The Discipline Scholar gratefully acknowledges the generous contributions given by those in stakeholder communities to the formulation of the Statement. Professional and academic colleagues have travelled and gathered to shape the Standards Statement. Debate has been vigorous and spirited and the Statement is rich with the purpose, critical thinking and good judgement of the Australian architectural education community. The commitments made to the processes that have produced this Statement reflect a deep and abiding interest by the constituency in architectural education. This commitment bodes well for the vibrancy and productivity of the emergent Architecture Discipline Network (ADN). Endorsement, in writing, was received from the Australian Institute of Architects National Education Committee (AIA NEC): The National Education Committee (NEC) of the Australian Institute of Architects thank you for your work thus far in developing the Learning and Teaching Academic Standards for Architecture In particular, we acknowledge your close consultation with the NEC on the project along with a comprehensive cross-section of the professional and academic communities in architecture. The TLOs with the nuanced levels of capacities – to identify, develop, explain, demonstrate etc – are described at an appropriate level to be understood as minimum expectations for a Master of Architecture graduate. The Architects Accreditation Council of Australia (AACA) has noted: There is a clear correlation between the current processes for accreditation and what may be the procedures in the future following the current review. The requirement of the outcomes as outlined in the draft paper to demonstrate capability is an appropriate way of expressing the measure of whether the learning outcomes have been achieved. The measure of capability as described in the outcome statements is enhanced with explanatory descriptions in the accompanying notes.

Designing Assessment for Quality Learning

- Considers broad-scale assessment approaches and how they impact on educational opportunity and outcomes. - Brings together internationally recognised scholars providing new insights into assessment for learning improvement and accountability. - Presents different theoretical and methodological perspectives influential in the field of assessment, learning and social change. - Contributes to the theorising of assessment in contexts characterised by heightened accountability requirements and constant change. This book brings together internationally recognised scholars with an interest in how to use the power of assessment to improve student learning and to engage with accountability priorities at both national and global levels. It includes distinguished writers who have worked together for some two decades to shift the assessment paradigm from a dominant focus on assessment as measurement towards assessment as central to efforts to improve learning. These writers have worked with the teaching profession and, in so doing, have researched and generated key insights into different ways of understanding assessment and its relationship to learning. The volume contributes to the theorising of assessment in contexts characterised by heightened accountability requirements and constant change. The book’s structure and content reflect already significant and growing international interest in assessment as contextualised practice, as well as theories of learning and teaching that underpin and drive particular assessment approaches. Learning theories and practices, assessment literacies, teachers’ responsibilities in assessment, the role of leadership, and assessment futures are the organisers within the book’s structure and content. The contributors to this book have in common the view that quality assessment, and quality learning and teaching are integrally related. Another shared view is that the alignment of assessment with curriculum, teaching and learning is linchpin to efforts to improve both learning opportunities and outcomes for all. Essentially, the book presents new perspectives on the enabling power of assessment. In so doing, the writers recognise that validity and reliability - the traditional canons of assessment – remain foundational and therefore necessary. However, they are not of themselves sufficient for quality education. The book argues that assessment needs to be radically reconsidered in the context of unprecedented societal change. Increasingly, communities are segregating more by wealth, with clear signs of social, political, economic and environmental instability. These changes raise important issues relating to ethics and equity, taken to be core dimensions in enabling the power of assessment to contribute to quality learning for all. This book offers readers new knowledge about how assessment can be used to re/engage learners across all phases of education.

Emotional climate and high quality learning experiences in science teacher education

The role of emotion during learning encounters in science teacher education is under-researched and under-theorized. In this case study we explore the emotional climates, that is, the collective states of emotional arousal, of a preservice secondary science education class to illuminate practice for producing and reproducing high quality learning experiences for preservice science teachers. Theories related to the sociology of emotions informed our analyses from data sources such as preservice teachers’ perceptions of the emotional climate of their class, emotional facial expressions, classroom conversations, and cogenerative dialogue. The major outcome from our analyses was that even though preservice teachers reported high positive emotional climate during the professor’s science demonstrations, they also valued the professor’s in the moment reflections on her teaching that were associated with low emotional climate ratings. We co-relate emotional climate data and preservice teachers’ comments during cogenerative dialogue to expand our understanding of high quality experiences and emotional climate in science teacher education. Our study also contributes refinements to research perspectives on emotional climate.

Teaching for Learning, Living and Serving

I offer four eclectic maxims for schooling. They do not represent a cohesive philosophy of schooling or education, but they are a sampling of my views which I hope reflect and honour the great life’s work of Phil Hughes.

Preservice EFL teachers’ beliefs about teaching writing and learning to teach writing before their practicum : a case study in Vietnam

The standard of English as a Foreign Language (EFL) education has prompted calls for reform to preservice EFL teacher education. Field experiences are central to their professional development and for implementing reform measures. This study aims to examine preservice EFL teachers’ attitudes, needs, and experiences about learning to teach writing in English before their practicum in Vietnamese high schools. An open-ended questionnaire collected data from 97 preservice EFL teachers at the beginning of their final practicum. The data suggested that these preservice EFL teachers were motivated to learn to teach English in general and teaching writing in particular but required mentors to model effective teaching practices and share their teaching experiences. They also needed their mentors to be enthusiastic and supportive, and provide constructive feedback. These findings may assist teacher educators and school mentors for motivating and developing preservice EFL teachers’ practices.

Changing relationships: activating student and staff engagement in a design studio

In the design studio learning environment, traditional student and staff expectations are of close contact teaching and learning. In recent years at QUT students have experienced reduced personal staff attention, and have increasingly felt “anonymous” and correspondingly disengaged, to the detriment of quality learning (Carbone 1998: 8; Biggs 2003). Concurrently, there has been a necessary increase in teaching by sessional staff at QUT with varied levels of experience and assurance. This paper outlines the first iteration of an action research project exploring whether changing the current QUT design studio student and staff relationships may lead to more engaged, dynamic learning environments. “Engagement” is understood as a primarily emotional, rather than operational student concern (Solomonides and Martin 2008; Austerlitz and Aravot 2007). The project inverted the standard QUT design studio teaching structure, and evaluated the new structure and activation of student engagement across four identified markers: attendance, participation, learning and performance (ACER 2009; NSSE 2005; Chapman 2003). Student and staff surveys and focus groups, corporate data, and informal feedback informed these evaluations. Overall, the results support the premise that when students and staff feel part of a reasonably-sized studio class with a dedicated lecturer and self-selected project, the majority are inclined to value these relationships, to feel actively engaged, and to experience some improvement in their learning and teaching performances.

Design education online : learning delivery and evaluation

Online learning has been recognised as an effective pedagogical method and tool, and is broadly integrated into various types of teaching and learning strategies in higher education. In practice, the use of Virtual Learning Environment (VLE) in higher education has become an integral strategy for quality education. The field of design education however has not been researched extensively in regard to online learning, delivery and evaluation. This paper discusses design education from an online learning perspective. It proposes an integrated framework with three key components for online learning via VLE including an interactive delivery structure, communication channels, and learning evaluation. Additionally, the paper describes and evaluates how VLE sites for two design units were built based on an integrated framework and student learning experiences. The results indicate that online design education should be integrated with various educational values and functional features in a systematic manner, and requires designing learning evaluation protocols as part of learning activities and communicative forms within online-based learning sites.

Blackboard as an online learning environment : what do teacher education students and staff think?

Abstract: As online learning environments now have an established presence in higher education we need to ask the question: How effective are these environments for student learning? Online environments can provide a different type of learning experience than traditional face-to-face contexts (for on-campus students) or print-based materials (for distance learners). This article identifies teacher education student and staff perceptions of teaching and learning using the online learning management system, Blackboard. Perceptions of staff and students are compared and implications for teacher education staff interested in providing high quality learning environments within an online space are discussed.

Evaluation of financial incentives as a quality improvement strategy in the public hospital context : clinician attitudes, design variables, and economic costs

In 2008, a three-year pilot ‘pay for performance’ (P4P) program, known as ‘Clinical Practice Improvement Payment’ (CPIP) was introduced into Queensland Health (QHealth). QHealth is a large public health sector provider of acute, community, and public health services in Queensland, Australia. The organisation has recently embarked on a significant reform agenda including a review of existing funding arrangements (Duckett et al., 2008). Partly in response to this reform agenda, a casemix funding model has been implemented to reconnect health care funding with outcomes. CPIP was conceptualised as a performance-based scheme that rewarded quality with financial incentives. This is the first time such a scheme has been implemented into the public health sector in Australia with a focus on rewarding quality, and it is unique in that it has a large state-wide focus and includes 15 Districts. CPIP initially targeted five acute and community clinical areas including Mental Health, Discharge Medication, Emergency Department, Chronic Obstructive Pulmonary Disease, and Stroke. The CPIP scheme was designed around key concepts including the identification of clinical indicators that met the set criteria of: high disease burden, a well defined single diagnostic group or intervention, significant variations in clinical outcomes and/or practices, a good evidence, and clinician control and support (Ward, Daniels, Walker & Duckett, 2007). This evaluative research targeted Phase One of implementation of the CPIP scheme from January 2008 to March 2009. A formative evaluation utilising a mixed methodology and complementarity analysis was undertaken. The research involved three research questions and aimed to determine the knowledge, understanding, and attitudes of clinicians; identify improvements to the design, administration, and monitoring of CPIP; and determine the financial and economic costs of the scheme. Three key studies were undertaken to ascertain responses to the key research questions. Firstly, a survey of clinicians was undertaken to examine levels of knowledge and understanding and their attitudes to the scheme. Secondly, the study sought to apply Statistical Process Control (SPC) to the process indicators to assess if this enhanced the scheme and a third study examined a simple economic cost analysis. The CPIP Survey of clinicians elicited 192 clinician respondents. Over 70% of these respondents were supportive of the continuation of the CPIP scheme. This finding was also supported by the results of a quantitative altitude survey that identified positive attitudes in 6 of the 7 domains-including impact, awareness and understanding and clinical relevance, all being scored positive across the combined respondent group. SPC as a trending tool may play an important role in the early identification of indicator weakness for the CPIP scheme. This evaluative research study supports a previously identified need in the literature for a phased introduction of Pay for Performance (P4P) type programs. It further highlights the value of undertaking a formal risk assessment of clinician, management, and systemic levels of literacy and competency with measurement and monitoring of quality prior to a phased implementation. This phasing can then be guided by a P4P Design Variable Matrix which provides a selection of program design options such as indicator target and payment mechanisms. It became evident that a clear process is required to standardise how clinical indicators evolve over time and direct movement towards more rigorous ‘pay for performance’ targets and the development of an optimal funding model. Use of this matrix will enable the scheme to mature and build the literacy and competency of clinicians and the organisation as implementation progresses. Furthermore, the research identified that CPIP created a spotlight on clinical indicators and incentive payments of over five million from a potential ten million was secured across the five clinical areas in the first 15 months of the scheme. This indicates that quality was rewarded in the new QHealth funding model, and despite issues being identified with the payment mechanism, funding was distributed. The economic model used identified a relative low cost of reporting (under $8,000) as opposed to funds secured of over $300,000 for mental health as an example. Movement to a full cost effectiveness study of CPIP is supported. Overall the introduction of the CPIP scheme into QHealth has been a positive and effective strategy for engaging clinicians in quality and has been the catalyst for the identification and monitoring of valuable clinical process indicators. This research has highlighted that clinicians are supportive of the scheme in general; however, there are some significant risks that include the functioning of the CPIP payment mechanism. Given clinician support for the use of a pay–for-performance methodology in QHealth, the CPIP scheme has the potential to be a powerful addition to a multi-faceted suite of quality improvement initiatives within QHealth.

Development and evaluation of an integrated clinical learning model to inform continuing education for acute care nurses

Background Significant ongoing learning needs for nurses have occurred as a direct result of the continuous introduction of technological innovations and research developments in the healthcare environment. Despite an increased worldwide emphasis on the importance of continuing education, there continues to be an absence of empirical evidence of program and session effectiveness. Few studies determine whether continuing education enhances or develops practice and the relative cost benefits of health professionals’ participation in professional development. The implications for future clinical practice and associated educational approaches to meet the needs of an increasingly diverse multigenerational and multicultural workforce are also not well documented. There is minimal research confirming that continuing education programs contribute to improved patient outcomes, nurses’ earlier detection of patient deterioration or that standards of continuing competence are maintained. Crucially, evidence-based practice is demonstrated and international quality and safety benchmarks are adhered to. An integrated clinical learning model was developed to inform ongoing education for acute care nurses. Educational strategies included the use of integrated learning approaches, interactive teaching concepts and learner-centred pedagogies. A Respiratory Skills Update education (ReSKU) program was used as the content for the educational intervention to inform surgical nurses’ clinical practice in the area of respiratory assessment. The aim of the research was to evaluate the effectiveness of implementing the ReSKU program using teaching and learning strategies, in the context of organisational utility, on improving surgical nurses’ practice in the area of respiratory assessment. The education program aimed to facilitate better awareness, knowledge and understanding of respiratory dysfunction in the postoperative clinical environment. This research was guided by the work of Forneris (2004), who developed a theoretical framework to operationalise a critical thinking process incorporating the complexities of the clinical context. The framework used educational strategies that are learner-centred and participatory. These strategies aimed to engage the clinician in dynamic thinking processes in clinical practice situations guided by coaches and educators. Methods A quasi experimental pre test, post test non–equivalent control group design was used to evaluate the impact of the ReSKU program on the clinical practice of surgical nurses. The research tested the hypothesis that participation in the ReSKU program improves the reported beliefs and attitudes of surgical nurses, increases their knowledge and reported use of respiratory assessment skills. The study was conducted in a 400 bed regional referral public hospital, the central hub of three smaller hospitals, in a health district servicing the coastal and hinterland areas north of Brisbane. The sample included 90 nurses working in the three surgical wards eligible for inclusion in the study. The experimental group consisted of 36 surgical nurses who had chosen to attend the ReSKU program and consented to be part of the study intervention group. The comparison group included the 39 surgical nurses who elected not to attend the ReSKU program, but agreed to participate in the study. Findings One of the most notable findings was that nurses choosing not to participate were older, more experienced and less well educated. The data demonstrated that there was a barrier for training which impacted on educational strategies as this mature aged cohort was less likely to take up educational opportunities. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group’s reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales following attendance at the ReSKU program. These subscales included influence on nursing care, educational preparation and clinical development. Findings suggest that the use of an integrated educational model underpinned by a robust theoretical framework is a strong factor in some perceptions of the ReSKU program relating to attitudes and behaviour. There were minimal differences in knowledge between groups across time. Conclusions This study was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies and a robust overarching theoretical framework to support study concepts. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful and collective reflection, was a powerful educational strategy to enhance competency and capability in clinicians.

Building organizational capability through a quality assurance program within a business school and encouraging organizational culture change

This study explores organizational capability and culture change through a project developing an assurance of learning program in a business school. In order to compete internationally for high quality faculty, students, strategic partnerships and research collaborations it is essential for Universities to develop and maintain an international focus and a quality produce that predicts excellence in the student experience and graduate outcomes that meet industry needs. Developing, marketing and delivering that quality product requires an organizational strategy to which all members of the organization contribute and adhere. Now, the ability to acquire, share and utilize knowledge has become a critical organizational capability in academia as well as other industries. Traditionally the functional approach to business school structures and disparate nature of the social networks and work contact limit the sharing of knowledge between academics working in different disciplines. In this project a community of practice program was established to include academics in the development of an embedded assurance of learning program affecting more than 5000 undergraduate students and 250 academics from nine different disciplines across four schools. The primary outcome from the fully developed and implemented assurance of learning program was the five year accreditation of the business schools programs by two international accrediting bodies, EQUIS and AACSB. However this study explores a different outcome, namely the change in organizational culture and individual capabilities as academics worked together in teaching and learning teams. This study uses a survey and interviews with academics involved, through a retrospective panel design which contained an experimental group and a control group. Results offer insights into communities of practice as a means of addressing organizational capability and changes in organizational culture. Knowledge management and shared learning can achieve strategic and operational benefits equally within academia as within other industrial enterprises but it comes at a cost. Traditional structures, academics that act like individual contractors and deep divides across research, teaching and service interest served a different master and required fewer resources. Collaborative structures; fewer master categories of discrete knowledge areas; specific strategic goals; greater links between academics and industry; and the means to share learned insights will require a different approach to resourcing both the individual and the team.

Learning and teaching from the edge to centre stage : Critical factors in embedding sustainable university-wide engagement in external awards and grants funding initiatives.

Teaching awards, grants and fellowships are strategies used to recognise outstanding contributions to learning and teaching, encourage innovation, and to shift learning and teaching from the edge to centre stage. Examples range from school, faculty and institutional award and grant schemes to national schemes such as those offered by the Australian Learning and Teaching Council (ALTC), the Carnegie Foundation for the Advancement of Teaching in the United States, and the Fund for the Development of Teaching and Learning in higher education in the United Kingdom. The Queensland University of Technology (QUT) has experienced outstanding success in all areas of the ALTC funding since the inception of the Carrick Institute for Learning and Teaching in 2004. This paper reports on a study of the critical factors that have enabled sustainable and resilient institutional engagement with ALTC programs. As a lens for examining the QUT environment and practices, the study draws upon the five conditions of the framework for effective dissemination of innovation developed by Southwell, Gannaway, Orrell, Chalmers and Abraham (2005, 2010): 1. Effective, multi-level leadership and management 2. Climate of readiness for change 3. Availability of resources 4. Comprehensive systems in institutions and funding bodies 5. Funding design The discussion on the critical factors and practical and strategic lessons learnt for successful university-wide engagement offer insights for university leaders and staff who are responsible for learning and teaching award, grant and associated internal and external funding schemes.