Wednesday, June 13, 2007

Reflections on CDD & Instructional design

CDD and Instructional Design- Reflective Commentary
Reflect on your instructional design process and conceptions by providing responses (approx. 200 words each, excluding references) to the following statements. Even though you are now reflecting on the course as a whole and final completion of your CDD, we encourage you to continue to express any doubts or questions about your design, the role of learning theory, etc; maintaining self- critique of actions and understanding are a healthy sign of reflective thinking and commitment to excellence. Wherever possible, cite a source (from the course readings, others' discussion forum postings, or elsewhere, using APA format) to support your response:
1. There were strategies, resources, and processes that I found really helpful as I constructed my Course Development Document, and others that did not work for me.
Some of the resources that I found useful:
Practically based papers which are reviews of information about successful e-learning eg (Leeder, 2000) or reminders about what works well in quality courses(Herrington, 2001).
Modelling on courses already set up (such as ours)
Discussion with my peers both in the course – thank you especially, Robyn- and other teachers that I interact with.
The Nunes paper which clarified that constructivism and objectivism are not dichotomous but are part of a continuum(Nunes, 2003): it is not one or the other but what works.
Readings about what makes a successful course (eg (Chickering & Ehrmann, 1996)

The strategies and processes that didn’t work for me:
First is a big complaint: I think that there is over-use of unnecessarily opaque, new, silly language in the whole field of e-learning. New language makes us feel that we are doing something that is different, better and more special than the old ways…but are we? For example, why on earth is “repurposing learning objects(Gunn, 2007)” not just “adapting useful media?” The difference in language styles between those who actually seem to personally have to make a course work (in a topic other than learning theory) (Leeder, 2000) and those who write about it is striking.
But, more importantly, language can involve us, intrigue us- or repel us. If the issue is the communication of ideas, for better teaching of health professionals and therefore better outcomes for patients, then some of this language won’t do. I have definitely been repelled.
It was surprisingly difficult to find real learning objects as opposed to those that people wrote about, even in the creative commons/e-ward areas. In the end I used an existing resource for my learning object: a CD of interviews of children & adolescents which can be watched to gain an understanding of the issues faced by the person. I think it might be the case that if I want a learning object, I will have to make it.

I also found the Cecil processes quite difficult for communication, although I am using Cecil for my own courses. For example, the different areas which you have to click on separately (questions, discussions etc) – I didn’t even realise there was some info in questions about the CDDs and because I had to click on another button in Slow Cecil I didn’t realise Sanya had posted quite a lot of stuff in her blog.

2. Considering my project and the various elements of e-learning that I explored in this course, the depiction or metaphor for instructional design that I created in Module 9 provides a useful model of instructional design and the role it plays in teaching, learning, and professional development.
Instructional design is the yeast that allows a loaf to rise. If the yeast is allowed to dominate the process the bread is high & beautiful but empty and lacking substance. If there is too little yeast the loaf may be full of good things but it is flat, unappealing and no-one wants to eat it.

Bread may be made by a cookbook – or even in a bread machine - but the best loaves are developed from yeasts made up of natural organisms from the air around us. These “wild yeasts” may be more difficult to handle but the result is one of a better structured, better tasting loaf more adapted to local tastes

The loaf of a successful learning experience is made of simple materials: only flour, water and yeast. It takes time, energy (kneading) and practice and tastes differently depending on where it comes from and who has put it together.


I was very resistant to completing this task. I haven’t found the drawing programmes useful and I don’t want to spend time learning how to use them. For my own learning, the module diagrams in our course about where we were complete with flashing arrows didn’t help orient me: I don’t think I learn with pictures.

I hate “theories that cover everything” and I think that this is what is being requested here. And I also hate empty words. Therefore, I think my bread metaphor is extremely apt and useful for me, although I am very aware some will find it irrelevant for them. Above all it is a practical metaphor – the theory is secondary to the practise of making bread. I also like the fact that anyone can make bread, but only people who pay close attention to the mix and adapt it to the circumstances (the learners, the environment) will make bread that everyone wants to eat and that sustains them for long journeys. And there is still the element of quality – striving for the perfect loaf, the perfect combination. (By the way, I don’t actually make bread.)

3. The strategy underlying my learning design reflects the view of teaching and learning evidenced by my Teaching Perspectives Inventory results, but also reflects new insights I have gained into clinical education, e-learning, and instructional design.
I still don’t approve of the TPI, and I don’t want to keep reviewing my results on something I don’t regard as a validated tool for the assessment of instruction styles. I think that my learning design reflects a balance of a style of transmission, apprenticeship learning and a developmental approach. Feedback on my CDD from Robyn made me consider whether I am as nurturing as I think I am – the answer is clearly “no” and some of the strategies for introductions and supports are adapted with this in mind. I have been communicating more with my current students this year via Cecil (they are distance students who come for block courses) .
I have tried to emphasise the learning that happens between learners, since that has been an interesting and very helpful part of this course and I think that this is an area I have under-used previously. I have enjoyed using some of the web-based methods which have been new to me and think that these might have appeal for communication strategies for some of my students, along with Cecil discussion.
I liked Oliver’s 2006 statement that has been included in Module 10: (Can’t find the reference) regarding e-learning: nothing has changed, but everything is different.


References
Chickering, A., & Ehrmann, S. (1996, September 6, 2006). Implementing the Seven Principles: Technology as Lever. TLT Group, from http://www.tltgroup.org/programs/seven.html
Gunn, C., Woodgate, S, O'Grady, W. (2007). Repurposing learning objects: a sustainable alternative? [Electronic Version]. ALT-J research in Learning Technology, 13, 189-200.
Herrington, A., Herrington, J, Oliver, R, Stoney, S, Willis, J. . (2001). Quality guidelines for online courses: The development of an instrument to audit online units [Electronic Version]. Meeting at the crossroads: Proceedings of ASCILITE 2001, 263-270.
Leeder, D. (2000). From Linear Lecture To Interactive Multimedia Module: A Developer's Perspective. Educational Media International, 37(4), 219-224.
Nunes, M., McPherson, M. (2003). Constructivism vs objectivism:Where is difference for Designers of e-learning environments. Paper presented at the The 3rd IEEE International COnference on ADvanced Learning Technologies (ICALT'03).

Sunday, May 20, 2007

COurse development doc

Kia Ora ... well, I must say that it doesnt look nearly as nice without the formatting....Adam is there a place we can drop these documents or shall we just email them to each other?

L
Course Development Document

E-Learning & Clinical Education (ClinEd 711)


department:
Psychological Medicine
course:
Psychiat 768 Clinical skills in child, adolescent and family mental health
course coordinator:
Leah Andrews
project sponsor:

date:
20/05/07
doc version:
4

[To complete this document, use the MS Word version; left click in the grey boxes and type.]


Scoping Questionnaire
Project Title:
Clinical formulation and the development of management plans in child & adolescent mental health

Client:


Project Goal:
Clinical work in child and adolescent mental health requires more than simple recognition of diagnostic categories. Developing structured plans in collaboration with children, young people and whanau is at the core of good mental health practice, yet service-user and service audit data suggests that it is often poorly done. The project aims to extend practising clinicians’ skills in the area of clinical formulation and the development of management plans in child and adolescent mental health.


Development Team:

Project Objectives:


Structure of Learning Objectives and Content for Course/Module:
Unit/Module/Topic
Learning objectives
(consistent with Needs Analysis Document)
Learning hours
Who is responsible for content?
Formulation and Management Plans in Child & Adol Mental Health
1. 1 Demonstrates understanding of structure and process of formulation

1
LA

1.2. Demonstrates understanding and process of structured management plans

1
LA

1.3. Demonstrates evidence-based approach to management plans
1
LA

2.1 Demonstrates understanding of formulation structures used by Maori
1
LA






What is the intended audience, and any characteristics that are relevant to your learning design and its implementation?
20-25 learners who are currently clinicians working in child and adolescent mental health. They generally have access to computers with fast connections through their workplaces but may be underconfident in the use of technology.
All clinicians have current experience and some basic knowledge of diagnosis and psychopathology. Many students have worked in adult mental health and take this course to extend their knowledge of child and adolescent mental health. However, they are a mixed group and some students have little mental health background.

If this is an existing course/module, how has it been delivered in the past?
Current delivery is by a lecture on formulation, some small group teaching (held during four two-day blocks over two semesters) in which learners pair together to practise formulation and management plans, reading and using set texts and by writing a case study which forms a large part of the summative assdessment.

In 1-2 paragraphs, what is your intended teaching/learning strategy for the course/module in an e-learning environment?
The project aims to extend practising clinicians’ skills in the area of clinical formulation and the development of management plans in child and adolescent mental health.
It aims to use students’ knowledge, background and current clinical work to develop and extend their knowledge of these areas, while exposing them to a range of models.


Your strategy should be:
consistent with your Project Goal and Project Rationale from your Needs Analysis Document;
enacted by, and consistently evident throughout, your learning design in this document.



Learning Design (note the colour-coding in relation to the e-learning framework)
Detail the proposed e-learning tasks, resources, supports, technologies and assessment for your project that will enable your students to achieve the learning objectives you have specified earlier in this document.
Use Herrington et al’s (2001) ‘Quality Guidelines for Online Courses’* to guide your design decisions; these guidelines will be used for both peer and instructor assessment of the quality of your learning design.
Module/Topic and
Learning task



Student role/activities (what will students do?)
Technologies
(how will you enable access,
communication,
collaboration?)
Resources (what materials or information will students draw on to complete the task?)
Teacher role (how will you support the students as they undertake the task?)
Assessment/Feedback (how will you assess and/or provide feedback on the students’ work?)
Built into course
Contributed during course
Understanding structure and process of formulation processes in child & adolescent mental health

Students working in twos or threes: post introductions, (self generated descriptions of learners and services they work in,) statement re their current models of formulation, asked to comment briefly on one other model & post to group for assessment
Use learning object to develop a formulation in pairs, critique each others & post
Use formulation structure for two different clinical cases: submit to peer for critique and development: post to instructor and whole class


Cecil management system
On-line discussion forum (Cecil)
Possible use of WIki if not document development/sharing not available in Cecil.
Powerpoint files of suggested structures
Relevant linked article regarding models of formulation (McConville, 2006)
Whare Tapawha available from
http://www.maorihealth.govt.nz/moh
“Anonymised” clinical cases from workplaces

http://shscal.swan.ac.uk/eward/sshots.html
NB I think we can do a better on eof these in my department, on reflection.
Introduction and self- description Create files based on commonly used structures
“Pair” students & outline their tasks

Reminders
Structure discussion on formulation models
Development of resource of multiple examples of formulations contributed by students
Teacher proposed questions on formulation to start
Teacher provides structure for comments and feedback from students on others’ formulations
Development of structure for assessment

Student self-assess by marking guide
Feedback on two formulations from peer pair/trio depending on numbers
Completion of two structured formulations posted by student 10%
Assessment structure to be developed, circulated to students
Discussion in response to questions: participation assessed by a structure



Developing structured management plans using evidence-based treatments

Students work in pairs to share & critique at least 2 anonymous management plans and post 1 online, using evidence-based approaches
Cecil management system
On-line discussion forum (Cecil)
Possible use of WIki if not document development/sharing not available in Cecil.
Powerpoint files of suggested structures
“Anonymised” clinical cases from workplaces
http://shscal.swan.ac.uk/eward/sshots.html
Relevant linked article regarding models of management plans
Course texts (electronic) regarding treatments
As above

As above
-
Same process for management plans as above for formulatio
5%
Understanding structured formulation and management plans used by Maori

Discussion about formulation and management plans as used in Kaupapa Maori services

Cecil
Online discussion

Powerpoint files
Recorded lecture

As above

As above with special emphasis on student-student engagement

One of the cases or management plans to use a Taha Maori structure
Assessment structure for this 5%





















Does your learning design depart from Herrington et al’s (2001) ‘Quality Guidelines for Online Courses’. If so, how, and why?
1. Pedagogies:
Authentic tasks, opportunities for collaboration, relatively learner-centred and meaningful assessments.
But: not sure if environments/tasks will be engaging enough or how to improve on this.
2. Resources:
Accessibility may be an issue, currency is ok, richness of perspective ok I think, and the materials will demonstrate social, cultural and gender inclusivity since students will be provide many of the examples.
3. Delivery strategies:
Reliability and band-width - who knows??
I still have some work to do on clarifying goals and directions and learning plans. Communication will be encouraged between learners and all materials should be accessible as long as students have access to on-line. I don’t think I want to know about corporate style!! Perhaps it just means having the University logo on everything?I

Are there any technical or other constraints on the development?
Yes, I think some of the more complex electronic organisation is beyond me.

Current Budget Available:
$0

When will the project begin?
?

When will the project end?


What are the project deliverables & milestones, and who is responsible?
Deliverables
Responsibility
Milestones



















Signed off by Project Sponsor:




Name: Date:


* Herrington, A., Herrington, J., Oliver, R., Stoney, S. & Willis, J. (2001). Quality guidelines for online courses: The development of an instrument to audit online units. In G. Kennedy, M. Keppell, C. McNaught & T. Petrovic (Eds.) Meeting at the crossroads: Proceedings of ASCILITE 2001, (pp 263-270). Melbourne: The University of Melbourne. Available from: http://elrond.scam.ecu.edu.au/oliver/2001/qowg.pdf.
McConville, B., Delgado, S. (2006). How to Plan and Tailor Treatment: An Overview of Diagnosis and Treatment Planning (p ) In W. Klykylo & J. Kay (Eds.), Clinical Child Psychiatry (pp. 91-108). Baltimore: John Wiley & Sons, Ltd

Tuesday, May 15, 2007

Discussion for Learning Objects Module 7

This is the learning object I have chosen:http://shscal.swan.ac.uk/eward/sshots.html

Learning Objects
1. Which repositories did you visit, and what process/strategy did you use to locate an appropriate learning object? What tips would you offer to somebody else undertaking their own search?

Learning Object Repositories
I visited the following repositories and websites which stated that they gathered learning materials and searched by “Mental Health” and Psychiatry” and “Paediatrics/Pediatrics.”
CAREO (Campus Alberta Repository of Educational Objects)
Intute (Intute)
MedEdPORTAL (Association of American Medical Colleges) Here I found a suitable-sounding resource (simulated teenage patient with depression and obesity) and emailed the contact but have not heard back.
JISC (Joint Information Systems Committee (JISC))
The following search strategies were used:Via Google:
Child psychiatry learning objects/child psychiatry online teaching/Psychiatry learning objects/teaching/ Mental Health learning objects/Mental Health learning online.
Since this didn’t produce much, I also looked at:Paediatrics learning objects/online teaching and Interview learning objects/online teaching
Via Medline & ERIC
Psychiatry AND online, teaching AND online, learning AND online
Much information from these sources is about learning/training eg (Kobak, Opler, & Engelhardt, 2007)rather than examples of resources.

Like Robyn I would suggest specific searches, going to the places where learning objects are collected and being sure to specify “free” if this is required. I think that searching for learning objects in my field is extremely time-consuming and not very satisfactory. Many resources sound good but don’t deliver formed Learning Objects, eg Massey University’s PBL site (Massey University) and others seem great for psychiatry but require substantial fees.

2. What learning objective(s) will the learning object help your students achieve? How?
AND
4. How will you integrate the learning object into your course design? Can it be used exactly as is, or does it (or your course) require changes? Are changes permissible/realistic?


Chosen Learning ObjectSearches for learning objects supporting the learning aims did not reveal anything entirely suitable, but there was one which was close and could be adapted.(I am declaring war on the verb “repurpose.” This word is culturally insulting to me: as the daughter of an English teacher! I just can’t use a noun as a verb!!)

This is as follows:http://shscal.swan.ac.uk/eward/sshots.html

This learning object is an unfolding scenario of a 17 year old with psychotic symptoms (it says 19 on the website but 17 on the screenshots) and I think that it could be adapted to use with local content and a structure for case formulation and planning for management.
(We have a number of digital interviews with actors which we currently use in our courses for helping students learn about diagnosis: they are at present on DVD and CD but could be uploaded to Cecil (I think – I have not used Cecil for this) for students to view by segment.)

Learning Objectives
The learning aims which this would support:
Understanding structure and process of formulation processes in child & adolescent mental health
Developing structured management plans using evidence-based treatments
Students would use this learning object to practise their skills at formulation by observing a standardised interview and making a formulation and management plan. They would share these and critique each others’ work.

3. What are the terms and conditions for accessing and re-using the learning object in your course? If you did not locate an appropriate learning object, what were the access/re-use terms and conditions for one of the repositories you visited that you found notable?
There are no listed terms or conditions, There is a contact email. It is not entirely clear whether this is a resource which will be shared, although it is listed in a site which says it exists for that purpose.
From viewing other sites it seems that it depends on the purpose of the site: commercial sites clearly have very strict limits on altering learning objects, whereas the repositories allow alteration as long as the original source is acknowledged. For some sites you have to contact a specific person: one wonders how viable this is long-term as people change jobs or take leave, and as noted I haven’t had a response to a request to view a learning object.

5. What knowledge, experience and attitudes of your particular student group do you anticipate might help or hinder the integration of your learning object? How can you best harness or overcome these factors?
My learners are likely to need IT access, support and practise, (McKimm, Jollie, & Cantillon, 2003)possibly with some of the learning objects I have found which address readiness for e-learning.
They are also likely to require the usual strategies for successful e-learning, including student-student contact or teacher-student contact.
They are experienced clinicians therefore engaging them in tasks they see as meaningful is likely to result in authentic learning.

References

CAREO Campus Alberta Repository of Educational Objects. from http://careo.netera.ca Intute. from http://www.intute.ac.uk/Association of American Medical Colleges. MedEdPORTAL
from http://services.aamc.org/jsp/mededportal
Campus Alberta Repository of Educational Objects, C.
Joint Information Systems Committee (JISC). from http://www.jisc-collections.ac.uk/
Kobak, K. A., Opler, M. G. A., & Engelhardt, N. (2007). PANSS rater training using Internet and videoconference: Results from a pilot study: Schizophrenia Research. Vol 92(1-3) May 2007, 63-67. Elsevier Science.
Massey University. Tools for Delivering Scenario-Based E-Learning both Locally and Across the Internet, from http://pbl.massey.ac.nz/pbl-interactive.htm
McKimm, J., Jollie, C., & Cantillon, P. (2003). ABC of learning and teaching: Web based learning
10.1136/bmj.326.7394.870. BMJ, 326(7394), 870-873.

Friday, May 11, 2007

Discussion for Module 6


Discussion for Module 6 Assessment

Assessment for Formulations/Management plans in mental health
Feedback on two formulations from peer pair/trio depending on numbers
Completion of two structured formulations posted by student
Assessment structure to be developed, circulated to students
Discussion in response to questions: participation assessed by a structure

Same process for management plans


1. The form of assessment I have chosen for each learning activity is consistent with its learning objectives, and is integrated into the learning activity.
The form of the assessment that I have decided on (Producing formulations as for clinical work) will exactly mirror the task in an everyday setting: it is therefore authentic and consistent with the learning objectives that I have specified. I am interested to see that Race (Race, 2003)concentrates on authenticity in terms of plagiarism rather than a broader view: how well does this task assess what the students want and need to know?
The discussion assessment will follow a structure yet to be decided, although I have seen that some of the sites dedicated to sharing resources have standard rubrics which may be adapted according to the circumstances(Anon).This should increase the validity of the assessment as well as the transparency. I also hope that, as Race suggests(Race, 2003) the quantity will be at a level which allows meaningful and prompt feedback rather than a flurry of writing.
In addition, there will be some accumulation of assessment into a whole (a process which we are going through in this course) although I am not really very clear about how to do this for this particular section.
This year the students are completing a portfolio which will become a resource for their learning as well as something which can be assessed bit-by-bit and I can probably use this for the electronic delivery: ie a structure for their formulations, which can be completed by the students for their particular patients, thereby providing examples. I notice that electronic portfolios are increasingly used in clinical education(Dornan T, Lee C, & Stopford A, 2001), (Duque G, Finkelstein A, Roberts A, Tabatai D, & Winer L, 2006) in the move away from traditional health professional apprenticeship/transmission models. I think forming a whole document contributes very much to the reality/authenticity of the learning.

2. Students will have opportunities to undertake self-assessment and peer critique as well as receiving instructor feedback
As the tasks include peer critique this part is covered. How to pair people up? In classes people sit with friends and colleagues so they don’t always get exposed to a range of views/experiences, and I have learned to be a bit bossy about arranging groups for small group discussions. But we feel more comfortable with people who are known to us! I guess if the class is small learner-learner contact occurs and maybe people don’t feel so exposed in online anyway.
I am not sure how to ensure that the assessment process includes self-assessment: formal strategies seem too mechanistic eg checklist (have I covered X? Y?Z?) or methods such as unfolding linked statements. Perhaps I am taking self-assessment too formally: self assessment also includes noting what others do and comparing one’s own work with others’.

3. The strategy underlying the assessment approaches I have chosen reflects the view of teaching and learning evidenced by my Teaching Perspectives Inventory results, but also reflects new insights I have gained into assessment and e-learning.
There are elements of the range of teaching perspectives in these strategies: transmission in the provision of structures and the organisation of the materials, nurturing in hassling people nicely to get on with their tasks, but also a strong developmental approach. I have noticed that I have been far more active in interacting with students via Cecil than I have previously based on some of the principles about student-teacher interaction and the need for feedback and contact.

References
Anon. Applying Assessment Strategies in Psychology. Critique of Assessment Strategies Applied to Goals and Outcomes.
. Retrieved 11/05/07, from http://www.apa.org/ed/critique_goals.html
Dornan T, Lee C, & Stopford A. (2001). SkillsBase: a web based electronic learning portfolio for clinical skills. Academic Medicine, 76, 542–543.
Duque G, Finkelstein A, Roberts A, Tabatai D, & Winer L. (2006). Learning while evaluating: the use of an electronic evaluation portfolio in a geriatric medicine clerkship, BMC Medical Education (Vol. 6).
Race, P. (2003). Why fix Assessment? [Electronic Version]. . Retrieved 02/05/07, from http://www.scu.edu.au/services/tl/why_fix_assess.pdf

Tuesday, May 8, 2007

Reflections on Module 6 Assessment in course development doc

Reflections on Course Development: Assessment Module 6


Assessment clearly has a vital role in driving e-learning course design, but I think it is also quite problematic. Although van der Vleuten and Schuwirth (2005) are often quoted as saying assessment drives learning in fact assessment may simply drive learning for assessment, (MacLachlan 2006) This makes the issue of ensuring that assessment is authentic as defined by Wiggins in 1999 about teacher education even more vital. He says that all assessment should be about completing tasks that learners are actually training to do, and never about parts of tasks.
If assessment is checking that learners “know” subject matter that is only loosely relevant to their context, then knowledge without context may be what we get.


Positives and Negatives
Two issues that I think are problematic in e-learning (and why it can never fully replace F2F learning for clinical education) are the areas of interactions with others and attitudes. How does skill with electronic methods of communication correlate with abilities to interact with staff and patients? I don’t know, and haven’t found much which helps me know.

While there are some methods of assessment which attempt to assess complex clinical reasoning, eg (Sibert, Darmoni et al. 2005)it is clear that complex human-to-human activities can be difficult to assess online. This is not to say that they cannot be assessed: for example the fact that there are many on-line therapists offering support to people with mental health problems and developing guidelines to decide whether patients can benefit from these methods (eg http://www.ismho.org) suggests that feasibility of at least some aspects of assessment.

This is an are which is far from resolved, however and I like Robyn’s analogy of the Emperor’s new clothes: so much written, so little well-validated.

I am involved in psychiatry exams which attempt to assess clinical skills with patients, and know first hand how difficult it can be. Even in a face-to-face setting. There is a bit of literature:a review of peer assessment models showed that there was lots of promise but little validation (that sounds familiar!!) (Evans, Elwyn et al. 2004). I guess the answer still lies in regarding on-line learning as a part but not as the whole: drawing out the things that can be assessed online and not attempting to do the things that can’t. I would once have said that clinical reasoning could not be taught on-line but now I can see that it can, so perhaps we will find ways which allow us to extend what we can do.


References
Evans, R., G. Elwyn, et al. (2004). "Review of instruments for peer assessment of physicians." BMJ 328(7450): 1240-.
Sibert, L., S. Darmoni, et al. (2005). "Online clinical reasoning assessment with the Script Concordance test: a feasibility study." BMC Medical Informatics and Decision Making 5(1): 18.
Wiggins, Grant (1990). The case for authentic assessment. Practical Assessment, Research & Evaluation, 2(2). Retrieved May 7, 2007 from http://PAREonline.net/getvn.asp?v=2&n=2

Saturday, April 28, 2007

Reflections on the role of the teacher in course development doc

Course development: the role of the teacher: Reflective Commentary


1.The teaching presence I intend to enact to enable my students to achieve the learning outcomes specified in my Needs Analysis Document will acknowledge the importance of my students’ prior knowledge, and encourage them to take ownership of their own learning.
The teaching presence does include some basic structure which doesn’t rely on learners having prior knowledge (provision of digitised talk etc.)
However, the structure will require learners to use their own clinical experience which will encourage authentic learning and motivation. The Experiential Learning Theory suggested by Kolb,(Kolb 1984), in (Reese 1998) seems relevant here: students use their concrete experience, followed by reflection/observation, development of theory and testing of that theory.
The teacher’s role here is to support that process, especially to encourage the reflection and observation which allows movement into the development of theory.
Students often seem to discount the relevance of their experience: my task will be to ensure that their experience is harnessed for their learning.(Harden and Crosby 2000)
Description of student’s own experience and issues that students have found relevant is one way that I will use in my course. It does seem important to have a structure to hang reflections around (as for this document) or else the reflection easily becomes irrelevant to learning goals for the course: but this is the same for face-to-face teaching.

2. The supports (eg strategies, templates, announcements) that I intend to build into the course materials and contribute during the course will model critical thinking and reflection appropriate to clinical practice.
Harden and Crosby (Harden and Crosby 2000) suggest that an important role for clinical teachers is that of role model. Therefore it will be important to demonstrate critical thinking: to provide some reflective comments, and to combine case discussion with reference to relevant literature in the initial postings which get students oriented and start the process.
Students will need some structures to develop their formulations. Although it would be possible to let students develop these themselves as part of their learning this seems rather inefficient as there are some already well-accepted structures. But it may be helpful to encourage some discussion of these.
Reflection seems key: perhaps I also need to ensure that reflection forms part of the assessment since assessment supposedly drives learning (Newble and Entwhistle 1986) although there has been recent critique (MacLachlan 2006) of the statement “assessment drives learning” as being over-simplified.
Encouraging reflection is not easy even in face-to-face settings and strategies which can be used for these purposes vary depending on the stage of the student group(Salmon 2004).

3. The strategy underlying the teaching presence I intend to enact reflects the view of teaching and learning evidenced by my Teaching Perspectives Inventory results, but also reflects new insights that I have gained into the role of the teacher and e-learning.
Given the broad range of my TPI, I think there is limited opportunity for comment. Clearly some of my role will be developmental, some apprenticeship and some nurturing. There is not likely to be much scope for a transmission perspective, although I am intending to provide some materials for students to read.
As suggested in the 5-Stage model of moderation (Salmon 2004), the role of the teacher must change depending on where they are in the course and their interactivity with each other. For example, teachers are likely to need to provide a lot of encouragement initially, while this can be replaced by other roles such as encouraging discussion in certain learning areas.

The role of the teacher as a moderator (even the term suggests a rejection of the transmission approach) is vital to good e-learning, even more than in face to face learning. E-learning requires considerable support and encouragement, regular checks on progress etc and even though many writers emphasise the relative importance of interaction with other students for motivation and deeper learning, without a clear structure (which a teacher puts together initially) none of this can happen. The trick is, just as with face-to-face teaching, to ensure that the teacher’s responsibility for structure doesn’t overwhelm the students’ interactions as they develop their knowledge and theory.


Harden, R. and J. Crosby (2000). "The good teacher is more than a lecturer-the twelve roles of the teacher." Medical Teacher 22: 334-347.
Kolb, D. (1984). Experimental Learning. Englewood Cliffs, NJ, Prentice Hall.
MacLachlan, J. (2006). "The relationship between assessment and learning." Medical Education 40: 716–7.
Newble, D. and N. Entwhistle (1986). "Learning styles and approaches: implications for medical education." Medical Education 29: 162–75.
Reese, A. (1998) "Implications of results from cognitive science research for medical education." Medical Education Online Volume, DOI: http://www.med-ed-online.org/f0000010.htm
Salmon, G. (2004). "The 5 stage model of E-moderation." Retrieved 27/04/07, from http://www.atimod.com/e-moderating/5stage.shtml.

Wednesday, April 11, 2007

Reflections on Course design

Reflect on your design decisions by providing responses (approx. 150- 200 words each, excluding references) to the following statements. If you have doubts or questions about your decisions to date or the role of learning theory, express them as part of your response so that you are aware of gaps in your understanding and/or design. Wherever possible, cite a source (from the course readings, others' discussion forum postings, or elsewhere, using APA format) to support your response:

1. The learning activities I intend to use to enable my students to achieve the learning outcomes specified in the Needs Analysis Document will actively engage them in problem-solving, and reflect the way that the learning outcomes will be applied in real world settings.

The activities are based on student clinical activity, therefore are based on actual, real-life student work. Students are engaged in active problem-solving: attempting to understand the reasons behind a child or adolescent’s presentation to a mental health service and working with that child/whanau to develop a plan for management. This follows one of the basic tenets of clinical education: that active involvement in realistic tasks promotes student engagement and therefore deeper learning (Newble and Cannon 2001), p9.

2. The learning activities I intend to use will require my students to articulate and justify their understandings, and to collaborate to create meaningful products..Students will be required to record their management plans and formulations and share these with other students, thereby articulating their understandings of the processes involved. Since they are using their own clinical work, which is constantly changing, they are required to develop new formulations and management plans, rather than using a pre-selected case example. Since students are required to collaborate and give each other feedback on their structures, this will encourage justification and articulation. (It will be important to include some assessment for this process to emphasise its importance.)
Furthermore, students who work in Kaupapa Maori services will provide their view on processes of formulation and management as they apply to their clients(Anon 2003), thereby providing a broader perspective on the student tasks than can be provided by one teacher and helping address one of the learning objectives.
Students are more likely to develop deeper understanding of their topics when there are ample opportunities for collaboration with other students(Newble and Cannon 2001)p 9, and when learning tasks are active (ie require students to engage in a meaningful process) and also when there is “ample time on task” (Chickering and Ehrmann 1996).

3. The resources I intend to offer my students to help them of the complete the learning activities represent a variety of perspectives and use a medium that is engaging and well-suited to their message.
The process of teaching clinical reasoning behind formulation and management plans is complex (Peile 2004), and requires that students find a structure which works for them but also encompasses safe practice.
Students will be offered access to course texts and an on-line lecture using Articulate Presenter as well as Powerpoints of relevant models. In these a range of perspectives will be offered. This is in keeping with learning theory which emphasises student choice as an important factor in promoting deeper learning(Newble and Cannon 2001).
However, I continue to wonder whether teaching these issues by e-learning is feasible, largely because the informal elements of discussion are not as accessible/immediate. It is also difficult to know whether the medium is likely to be well-suited to the task because I am not very familiar to the media under discussion as yet. Basically, I think that most learners would far rather learn this stuff in a face-to-face situation but they can’t because they live all around the country!!

4.The technologies I intend to use to facilitate my students' learning activities are appropriate when considered in light of the SECTIONS model (Bates and Poole 2003)and the technology principles I helped to formulate during Module 3.
Regarding the students: in my NAD I have alluded to the issue of less computer-experienced students and their need for support and contact with instructors to promote learning (Chickering and Ehrmann 1996). This is especially true if students are from Maori or Pacific backgrounds(Hawke, Cowley et al. 2002)
On the other hand, learners in these courses are often older and have a wide experience of life and clinical situations: it is therefore important to tap into their experiences so that these can deepen and extend learning.
These students come from all around NZ and are not able to attend frequently for face to face teaching: access to learning depends at present on some electronic strategies and this is likely to increase. There will have to be a firm focus on contact: with instructors and with each other for these strategies to be helpful.
The students will also need access to support and training for use of these technologies, which need to be as easy to use as possible. As noted, they are designed to promote interactivity.
I continue to have concerns about my ability to spend the time to develop these strategies (Costs) in the Sections model and about the speed with which they can be applied.

5. The strategy underlying the learning activities I have chosen reflects the view of teaching and learning evidenced by my Teaching Perspectives Inventory results, but also reflects new insights I have gained into learning theory and e-learning.
I continue to doubt the validity of the Teaching Perspectives Inventory, and don’t consider that it assists me in clarifying my strategies for teaching. I have been unable to find any research which demonstrates that responses on the TPI are related to how instructors teach rather than how they say that they teach. Self-report measures are not necessarily reliable measures of behaviour: it all depends on how they have been benchmarked. It is possible that the TPI is no more valid that a magazine survey.
The only advantage that I can see in completing it is that it made me consider my teaching style and think more deeply about teaching strategies that are most effective for learning.
I don’t think that I have developed new insights into learning theory as a result of this course: I have some training in neuropsychiatry which I think covers many of the issues involved in learning and skills acquisition.
The principles of e-learning seem to me to be extremely similar to basic learning principles. However engagement and support become much more relevant when there is no face to face contact with instructors. I think I am experiencing this first hand!!

Submit your reflection on completion of columns 1-4 of the Course Development Document to your blog for others to read by the end of week 6.

References
Anon. (2003). "Maori Tertiary Education Framework
A Report by the Maori Tertiary Reference Group." Retrieved 19/05/06, 2006, from http://www.minedu.govt.nz/web/downloadable/dl9565_v1/maori-tertiary-education-framework.doc.
Bates, A. W. and G. Poole (2003). Effective teaching with technology in higher education. San Francisco, Jossey-Bass. .
Chickering, A. and S. Ehrmann. (1996, September 6, 2006). "Implementing the Seven Principles: Technology as Lever." TLT Group, from http://www.tltgroup.org/programs/seven.html.
Hawke, K., E. Cowley, et al. (2002). "The importance of the teacher/student relationship for Maori and Pasifika students." SET Research Information for Teachers 3: 44-49.
Newble, D. and R. Cannon (2001). A Handbook for medical teachers. Adelaide, Kluwer Academic Publishers.
Peile, E. (2004). "Clinical reasoning
10.1136/bmj.326.7389.591." BMJ 328(7445): 946-8.