A connectionist perspective of the transition from Face-to-Face to online teaching in Higher Education

Existing research shows a slow transition to online education by many university teaching staff. A mixed methods approach is used to survey teacher educators in three jurisdictions in the UK who have made the transition to online teaching, followed by focus group and individual interviews to triangulate the data. The eight tenets of connectivism are used as a lens for analysis. Findings reveal sound pedagogical reasons for the limited choice of online tools and tutors highlight two elements, namely, self-fulfilment and their desire to continually develop as an educator, as the rationale for adopting informal professional development in the 21st century.

Public health education for midwives and midwifery students: a mixed methods study

Background: Current national and international maternity policy supports the importance of addressing public health goals and investing in early years. Health care providers for women during the reproductive and early postnatal period have the opportunity to encourage women to make choices that will impact positively on maternal and fetal health. Midwives are in a unique position, given the emphasis of the philosophy of midwifery care on building relationships and incorporating a holistic approach, to support women to make healthy choices with the aim of promoting health and preventing ill health. However, exploration of the educational preparation of midwives to facilitate public health interventions has been relatively limited. The aim of the study was to identify the scope of current midwifery pre registration educational provision in relation to public health and to explore the perspectives of midwives and midwifery students about the public health role of the midwife.

Methods: This was a mixed methods study incorporating a survey of Higher Educational Institutions providing pre registration midwifery education across the UK and focus groups with midwifery students and registered midwives.

Results: Twenty nine institutions (53% response) participated in the survey and nine focus groups were conducted (59 participants). Public health education was generally integrated into pre registration midwifery curricula as opposed to taught as a discrete subject. There was considerable variation in the provision of public health topics within midwifery curricula and the hours of teaching allocated to them. Focus group data indicated that it was consistently difficult for both midwifery students and midwives to articulate clearly their understanding and definition of public health in relation to midwifery.

Conclusions: There is a unique opportunity to impact on maternal and infant health throughout the reproductive period; however the current approach to public health within midwifery education should be reviewed to capitalise on the role of the midwife in delivering public health interventions. It is clear that better understanding of midwifery public health roles and the visibility of public health within midwifery is required in order to maximise the potential contribution of midwives to achieving short and long term public health population goals.

A systematic review protocol on the use of online learning and blended learning for teaching clinical skills to undergraduate health professional students

Aim: This paper is a review protocol that will be used to identify, critically appraise and synthesize the best current evidence relating to the use of online learning and blended learning approaches in teaching clinical skills in undergraduate nursing.

Background: Although previous systematic reviews on online learning versus face to face learning have been undertaken (Cavanaugh et al. 2010, Cook et al. 2010), a systematic review on the impact of online learning and blended learning for teaching clinical skills has yet to be considered in undergraduate nursing. By reviewing nursing students’ online learning experiences, systems can potentially be designed to ensure all students’ are supported appropriately to meet their learning needs.

Methods/Design: The key objectives of the review are to evaluate how online-learning teaching strategies assist nursing students learn; to evaluate the students satisfaction with this form of teaching; to explore the variety of online-learning strategies used; to determine what online-learning strategies are more effective and to determine if supplementary face to face instruction enhances learning. A search of the following databases will be made MEDLINE, CINAHL, BREI, ERIC and AUEI. This review will follow the Joanna Briggs Institute guidance for systematic reviews of quantitative and qualitative research.

Conclusion: This review intends to report on a combination of student experience and learning outcomes therefore increasing its utility for educators and curriculum developers involved in healthcare education.

Evaluation of the contribution of theatre attendance to medical undergraduate neuroscience teaching - a pilot study.

Introduction: Medical students often attend the neurosurgical theatre during their clinical neurosciences attachment. However, few studies have been performed to objectively assess the value of this theatre-based learning experience. The main aim of this study was to explore student perceptions on the contribution of neurosurgical theatre attendance to clinical neuroscience teaching.

Materials and Methods: Third-year medical students undergoing their 2-week clinical neurosciences rotation at the Royal Hospitals Belfast were invited to participate in this study. A multi-method strategy was employed using a survey questionnaire comprising of closed and open-ended questions followed by semi-structured interviews to gain a greater 'in-depth' analysis of the potential contribution of neurosurgical theatre attendance to neuroscience teaching.

Results: Based on the completed survey responses of 22 students, the overall experience of neurosurgical theatre-based learning was a positive one. 'In-depth' analysis from semi-structured interviews indicated that students felt that some aspects of their neurosurgical theatre attendance could be improved. Better preparation such as reading up on the case in hand and an introduction to simple theatre etiquette to put the student at ease (in particular, for students who had never attended theatre previously), would improve the learning experience. In addition, having an expectation of what students are expected to learn in theatre making it more learning outcomes-based would probably make it feel a more positive experience by the student.

Conclusions: The vast majority of students acknowledged the positive learning outcomes of neurosurgical theatre attendance and felt that it should be made a mandatory component of the curriculum.

What Are the Effects of Teaching Evidence-Based Health Care (EBHC)? Overview of Systematic Reviews

Background

An evidence-based approach to health care is recognized internationally as a key competency for healthcare practitioners. This overview systematically evaluated and organized evidence from systematic reviews on teaching evidence-based health care (EBHC).

Methods/Findings

We searched for systematic reviews evaluating interventions for teaching EBHC to health professionals compared to no intervention or different strategies. Outcomes covered EBHC knowledge, skills, attitudes, practices and health outcomes. Comprehensive searches were conducted in April 2013. Two reviewers independently selected eligible reviews, extracted data and evaluated methodological quality. We included 16 systematic reviews, published between 1993 and 2013. There was considerable overlap across reviews. We found that 171 source studies included in the reviews related to 81 separate studies, of which 37 are in more than one review. Studies used various methodologies to evaluate educational interventions of varying content, format and duration in undergraduates, interns, residents and practicing health professionals. The evidence in the reviews showed that multifaceted, clinically integrated interventions, with assessment, led to improvements in knowledge, skills and attitudes. Interventions improved critical appraisal skills and integration of results into decisions, and improved knowledge, skills, attitudes and behaviour amongst practicing health professionals. Considering single interventions, EBHC knowledge and attitude were similar for lecture-based versus online teaching. Journal clubs appeared to increase clinical epidemiology and biostatistics knowledge and reading behavior, but not appraisal skills. EBHC courses improved appraisal skills and knowledge. Amongst practicing health professionals, interactive online courses with guided critical appraisal showed significant increase in knowledge and appraisal skills. A short workshop using problem-based approaches, compared to no intervention, increased knowledge but not appraisal skills.

Conclusions

EBHC teaching and learning strategies should focus on implementing multifaceted, clinically integrated approaches with assessment. Future rigorous research should evaluate minimum components for multifaceted interventions, assessment of medium to long-term outcomes, and implementation of these interventions.

Evaluation of Multidisciplinary Delivery of Surgical Anatomy Teaching

Title Evaluation of Multidisciplinary Delivery of Surgical Anatomy Teaching

Authors Walsh I.K., Taylor S.J., Dorman A, Boohan M.

Objectives To evaluate the efficacy of newly introduced multidisciplinary methods to deliver Surgical Anatomy teaching to undergraduate medical students.

Design and Setting Qualitative and quantitative study using questionnaires and focus groups, employing students of the perioperative and emergency medicine (POEM) module of the phase 4 undergraduate medical curriculum at Queen’s University Belfast.

Outcome Measures To determine:
(1) if multidisciplinary teaching is effective in delivering surgical anatomy teaching,
(2) student’s learning preferences regarding this teaching method.
Results The questionnaire response rate was 89% (216 of 244 students; female: male ratio 1.25) and 42 students participated in 6 focus groups. Mean questionnaire responses indicated a favourable opinion on quality assurance items and multidisciplinary teaching. 81% of students agreed that multidisciplinary teaching enhanced learning and 86% felt that this did not adversely affect interaction. A positive contribution towards POEM learning was reported for Radiology (95% of students), Anatomy (93%) and Surgery (78%). The benefits of multidisciplinary teaching were congruent for Anatomy, Radiology and Surgery with 78% of students indicating a perceived favourable association with learning. Multidisciplinary teaching was not associated with diluted interaction, with 62% of students describing interaction as sufficient. 88% of students positively ranked tutor characteristics of enthusiasm and encouragement as being strongly associated with teacher quality. Positive perception of overall quality was strongly associated with learning preferences as well as more generic quality assurance issues (80% students; alpha coefficient 0.83).
The results were supported by triangulation of the above quantitative data with qualitative data generated by the focus groups. Whilst students frequently misunderstood the meaning of “multidisciplinary teaching”, there was an appreciation of the method’s worth; students recognised and valued the relevance of Anatomy, Radiology and Surgery teaching to POEM learning. The importance of vertically integrating Anatomy into all stages of the undergraduate curriculum was especially recognised.

Reference Aarnio M, Nieminen J, Pyorala E, Lindbolm-Ylanne S. Motivating medical students to learn. 2010 Med Teach;32(4):199-204.

Precision Teaching in IV Fluid Prescribing and Patient Safety

OBJECTIVES: Precision Teaching (PT) has been shown to be an effective intervention to assess teaching method effectiveness and evaluate learning outcomes. SAFMEDS (Say All Fast Minute Every Day Shuffled) are a practice/assessment procedure within the PT framework to assist learning and fluency. We explored the effects of a brief intervention with PT, to impart high frequency performance in safe intravenous fluid prescription in a group of final year undergraduate medical students.
METHODS: 133 final year undergraduate medical students completed a multiple choice question (MCQ) test on safe IV fluid prescription at the beginning and end of the study. The control group (n= 76) of students were taught using a current standardized teaching method. Students allocated to the intervention arm of the study were additionally instructed on PT and the use of SAFMEDS. The study group (n = 57) received 50 SAFMEDS cards containing information on the principles of IV fluid prescription scenarios. These students were trained/tested twice per day for 1 minute.
RESULTS: Interim analysis showed that the study group displayed an improvement in fluency and accuracy as the study progressed. There was a statistically significant improvement in MCQ performance for the PT group compared with the control group between the beginning and end of the study (35% vs 15%).
CONCLUSION: These results suggest PT employing SAFMEDS is an effective method for improving fluency, accuracy and patient safety in intravenous fluid prescribing amongst undergraduate medical students.

How should teaching on whole person medicine, including spiritual issues, be delivered in the undergraduate medical curriculum in the United Kingdom?

Background

Although the General Medical Council recommends that United Kingdom medical students are taught ‘whole person medicine’, spiritual care is variably recognised within the curriculum. Data on teaching delivery and attainment of learning outcomes is lacking. This study ascertained views of Faculty and students about spiritual care and how to teach and assess competence in delivering such care.

A questionnaire comprising 28 questions exploring attitudes to whole person medicine, spirituality and illness, and training of healthcare staff in providing spiritual care was designed using a five-point Likert scale. Free text comments were studied by thematic analysis. The questionnaire was distributed to 1300 students and 106 Faculty at Queen’s University Belfast Medical School.

351 responses (54 staff, 287 students; 25 %) were obtained. >90 % agreed that whole person medicine included physical, psychological and social components; 60 % supported inclusion of a spiritual component within the definition. Most supported availability of spiritual interventions for patients, including access to chaplains (71 %), counsellors (62 %), or members of the patient’s faith community (59 %). 90 % felt that personal faith/spirituality was important to some patients and 60 % agreed that this influenced health. However 80 % felt that doctors should never/rarely share their own spiritual beliefs with patients and 67 % felt they should only do so when specifically invited. Most supported including training on provision of spiritual care within the curriculum; 40-50 % felt this should be optional and 40 % mandatory. Small group teaching was the favoured delivery method. 64 % felt that teaching should not be assessed, but among assessment methods, reflective portfolios were most favoured (30 %). Students tended to hold more polarised viewpoints but generally were more favourably disposed towards spiritual care than Faculty. Respecting patients’ values and beliefs and the need for guidance in provision of spiritual care were identified in the free-text comments.

Students and Faculty generally recognise a spiritual dimension to health and support provision of spiritual care to appropriate patients. There is lack of consensus whether this should be delivered by doctors or left to others. Spiritual issues impacting patient management should be included in the curriculum; agreement is lacking about how to deliver and assess.

Time Efficient Assessment and Feedback Methods for Large Computer-Aided-Design Cohorts

Timely and individualized feedback on coursework is desirable from a student perspective as it facilitates formative development and encourages reflective learning practice. Faculty however are faced with a significant and potentially time consuming challenge when teaching larger cohorts if they are to provide feedback which is timely, individualized and detailed. Additionally, for subjects which assess non-traditional submissions, such as Computer-Aided-Design (CAD), the methods for assessment and feedback tend not to be so well developed or optimized. Issues can also arise over the consistency of the feedback provided. Evaluations of Computer-Assisted feedback in other disciplines (Denton et al, 2008), (Croft et al, 2001) have shown students prefer this method of feedback to traditional “red pen” marking and also that such methods can be more time efficient for faculty.
Herein, approaches are described which make use of technology and additional software tools to speed up, simplify and automate assessment and the provision of feedback for large cohorts of first and second year engineering students studying modules where CAD files are submitted electronically. A range of automated methods are described and compared with more “manual” approaches. Specifically one method uses an application programming interface (API) to interrogate SolidWorks models and extract information into an Excel spreadsheet, which is then used to automatically send feedback emails. Another method describes the use of audio recordings made during model interrogation which reduces the amount of time while increasing the level of detail provided as feedback.
Limitations found with these methods and problems encountered are discussed along with a quantified assessment of time saving efficiencies made.

Patience, Persistence and Pragmatism: Experiences and Lessons Learnt from the Implementation of Clinically Integrated Teaching and Learning of Evidence-Based Health Care - A Qualitative Study

Background

Clinically integrated teaching and learning are regarded as the best options for improving evidence-based healthcare (EBHC) knowledge, skills and attitudes. To inform implementation of such strategies, we assessed experiences and opinions on lessons learnt of those involved in such programmes.

Methods and Findings

We conducted semi-structured interviews with 24 EBHC programme coordinators from around the world, selected through purposive sampling. Following data transcription, a multidisciplinary group of investigators carried out analysis and data interpretation, using thematic content analysis. Successful implementation of clinically integrated teaching and learning of EBHC takes much time. Student learning needs to start in pre-clinical years with consolidation, application and assessment following in clinical years. Learning is supported through partnerships between various types of staff including the core EBHC team, clinical lecturers and clinicians working in the clinical setting. While full integration of EBHC learning into all clinical rotations is considered necessary, this was not always achieved. Critical success factors were pragmatism and readiness to use opportunities for engagement and including EBHC learning in the curriculum; patience; and a critical mass of the right teachers who have EBHC knowledge and skills and are confident in facilitating learning. Role modelling of EBHC within the clinical setting emerged as an important facilitator. The institutional context exerts an important influence; with faculty buy-in, endorsement by institutional leaders, and an EBHC-friendly culture, together with a supportive community of practice, all acting as key enablers. The most common challenges identified were lack of teaching time within the clinical curriculum, misconceptions about EBHC, resistance of staff, lack of confidence of tutors, lack of time, and negative role modelling.

Conclusions

Implementing clinically integrated EBHC curricula requires institutional support, a critical mass of the right teachers and role models in the clinical setting combined with patience, persistence and pragmatism on the part of teachers.

Autism in the air: using Point of View Video Priming and Natural Environment Teaching to help children with autism travel by plane

This paper describes a study that used video materials and visits to an airport to prepare children on the autism spectrum for travel by plane. Twenty parents and carers took part in the study with children aged from 3 to 16 years. The authors explain that the methods they used were based on Applied Behaviour Analysis (ABA) research; a video modeling technique called Point-Of-View Video-priming and during visits to an airport they used procedures known as Natural Environment Teaching. The findings suggest that using video and preparing children by taking them through what is likely to happen in the real environment when they travel by plane is effective and the authors suggest these strategies could be used to support children with autism with other experiences they need or would like to engage in such as visits to the dentist or hairdressers and access to leisure centres and other public spaces.

Maths anxiety in psychology undergraduates: A mixed-methods approach to formulating and implementing interventions

A key challenge to educators in disciplines that, while not maths based, nevertheless
contain some maths component, is mathematics anxiety. Over the years, a number of
intervention strategies have been tested, seeking reduce maths anxiety in undergraduates.
Many of these studies, however, contain methodological issues that challenge their validity. It
is also unclear how many of these studies decide which type of interventions to use. This
research sought to correct both of these issues. In Study 1, focus groups were carried out to
explore which interventions students believed would most likely reduce their maths anxiety.
Study 2 implemented those interventions that Study 1 showed to be practical and potentially
effective, utilising a large sample of Year 1 and Year 2 psychology undergraduates,
controlling for potential methodological confounds. Results showed that only one
intervention (teaching quantitative research methods using real-life examples) had any
significant effect on maths anxiety, and this was slight. These results, while not impressive by
themselves, do suggest ways in which larger-scale interventions could seek to proceed in
terms of reducing maths anxiety.

Effective Teaching and Learning of Science in the Outdoors: A Blended Model

This paper reports on an innovative Continuing Professional Development (CPD) programme which addressed transition issues and issues with conducting outdoor work and attitudes towards science through ‘Shared Learning' days between elementary and middle school transition classes. Teachers supported each other to overcome issues with conducting outdoor work and contributed their expertise from their educational stage. The project utilised a blended CPD approach of workshops, coteaching and in-class support and was based upon a wealth earlier successful CPD programmes to result in a sound theoretical framework.
The outcomes were measured using a thorough mixed-methods approach. This paper will report on the achieved outcomes with effective outdoor learning as the vehicle to overcome identified issues and key challenges for policy development.

Current status of Gerodontology teaching in Europe: preliminary findings

Aim(s): The aim of this study was to explore the findings of a survey on the prevalence, contents and status of Gerodontology teaching amongst the European Dental Schools.
Materials and Methods: A first wave of emails, including an electronic questionnaire in English, and two weeks later a first reminder, were sent to the Deans or other contact persons in 185 dental schools in 40 European countries. The electronic questionnaire recorded the prevalence, contents and status of Gerodontology education at the undergraduate, postgraduate and continuing education levels.
Results: The first wave of responses included 70 dental schools from 28 countries. Gerodontology was included in the undergraduate curricula of 77% of the respondents and was compulsory in 61% of them. It was taught as an independent course in 39% of the respondents. When embedded in other courses, these were mainly the Prosthodontics lectures. Clinical training in Gerodontology was on the curriculum of 56% of the respondents. Sixteen percent of the schools had a Gerodontology Division, and 43% an assigned Programme Director. Gerodontology was taught in the postgraduate programmes of 33% of the schools, again mostly embedded in Prosthodontic programmes. Continuing education courses in Gerodontology were offered by 34% of the responding schools.
Discussion and Conclusions: When interpreting the results of this still ongoing study, a "worst case scenario" has to be born in mind, where dental schools, who failed to participate in the survey, may not be teaching in Gerodontology. Under this perspective, a moderate prevalence of Gerodontology is recorded in the undergraduate curricula of European dental schools. At a postgraduate level, it is less frequently offered, and mainly embedded in the Prosthodontic programmes. European guidelines on the dental curriculum might help to increase awareness and introduce Gerodontology to undergraduate, postgraduate and continuing education.

How using Technology Enhanced Learning could help modernise traditional large group teaching or Lecturing.

The efficiency of lecturing or large group teaching has been called into question for many years. An abundance of literature details the components of effective teaching which are not provided in the traditional lecture setting, with many alternative methods of teaching recommended. However, with continued constraints on resources large group teaching is here to stay and student’s expect and are familiar with this method.

Technology Enhanced Learning may be the way forward, to prevent educators from “throwing out the baby with the bath water”. TEL could help Educator’s especially in the area of life sciences which is often taught by lectures to engage and involve students in their learning, provide feedback and incorporate the “quality” of small group teaching, case studies and Enquiry Based Learning into the large group setting thus promoting effective and deep learning.