Saturday 25 May 2013

Reflection 4 @ CHECET 2013



Following online discussions and feedback on my and colleagues’  Google Docs reflective pieces, I note below the changes that have happened and are planned for future student groups entering their practical Obstetrics block then later after their 8 week exposure and workplace experience in the Cape Town clinics.

What I have learnt to change my practice:

  • My objectives and process need to be clearer to the students to get their buy-in. Students value recognition for their input. Evaluating the student participation will indicate if there is greater uptake from the students.
  • There needs to be some kind of accountability in the task e.g. students get a bonus mark on their block if they hand in their reflection online.
  • Although the Faculty Learning Management System, Vula has been effective in the task, Google Docs offers more affordances that can enhance the learning for students, offer greater insights to the educators and enable others to gain insight from the co-constructed knowledge. In essence, this classroom initiative will be expanded to become more meaningful and productive.

What I have learnt for myself as the educator:

  • I recognize the value of working together in an online Community of Practice as opposed to individuals all developing their own processes.
  • By using Google docs myself and freely commenting on the work of others and on the facilitators’ comments, I have appreciated the affordances of this tool beyond just talking about it. Learning by doing is extremely valuable for us all.  
  • I recognize that we need to be flexible as educators to continually adjust to the students’ needs and advances in technology that can improve our teaching.

Planned intervention


1.    Planning phase

Insights gained from other course participants, facilitators and relevant readings indicate that I need to improve the scaffolding of my task. For instance in planning the exercise I can now use a raw document as a baseline example for the students to then experiment with the tools of technology. A student in the previous block posted his reflective commentary anonymously on the Question&Answer section of Vula. He has offered me permission to use it with other groups.

From our conversation on Adobe Connect I have recognized the value of setting up Google subgroups which will comprise 4 students in each of the 10 groups. This will mean that the sharing is limited to a few students therefore lessening the vulnerability of each student as they expose themselves to others with their comments. I will need to organize these groupings beforehand using students’ email addresses. The Departmental Head has given me the go-ahead to ask for assistance from one of the consultants.

2.    Introduction

In the face-to-face introductory session we will move beyond writing comments that indicate insights gained from others. This icebreaker will then lead to students reviewing their colleagues experience by indicating their thoughts and feelings related to his experience.
Further changes include:
  • Demonstrate Google docs in the unthreatening environment
  • Persuade and motivate: Explain that Google Docs is easy to use anywhere, anytime, and is a free, useful tool for professional practice and collaborative work in general, not just a classroom exercise for assessment
  • Practice with consumer comments
  • Suggest to students that they can download the Google Drive app on their Smartphones or other mobile devices.

3.    Time span between student rotations at the Maternal Obstetric Units

Students have varied experiences as they rotate through the different facilities.
As pointed out by Ian, our facilitator, by posting their reflective commentaries into a collaborative space and commenting on their colleagues’ experiences, students shift from the role of consumers of the curriculum to become producers of knowledge and insights – an evolving role.

4.    Workshop

During the face-to-face workshops students present their narratives to their peers followed by discussion. These interactive sessions are enriched by the sharing of experiences between the students and the discussions both on and offline that have happened in preparing for the peer-to-peer learning event.

My post-workshop evaluation will now have a feedback question related to the Google docs usage.

End of course presentation


http://www.slideshare.net/VeronicaMitchell/checet-may-2013

Saturday 11 May 2013

Reflection 3 @ CHECET 2013



After exploring the literature and narrowing down my intended outcomes for this case study, I now consider what has been the established practice for students’ reflective commentaries in  fourth year Obstetrics teaching, and I follow on with an examination of the possibilities that technology provides for shifting practices. 

Established practice in terms of students’ reflective curricular tasks

[T]eaching at universities is changing towards student-centred learning-by-doing with high student activity, where teachers as tutors have different roles, and formal skills have to be supplemented with reflection-in-action (Walkington, Christensen, & Kock 2001).

While reflective tasks are strongly recognized as an important curricular component in medical education, the process is changing. Reflective journals were first introduced into the fourth year MBChB Primary Health Care community-based block in 1996. In email correspondence (2012) Melanie Alpenstein in her role as Faculty curriculum developer explained that “reflective practice was encouraged to assist students understand issues affecting communities and themselves personally, as they were sometimes in very unfamiliar environments”. She added “traumatic issues related to their Obstetrics block were raised in these journals. Consequently Dr George Draper, an Obstetrician with a particular interest in student learning, then introduced a student reflective commentary as a tool for improving Obstetrics care.  His Masters thesis researched students’ developing roles, identities and relationships that emerge as they are introduced into a Community of Practice (CoP) through their debut experience of their first delivery (Wenger 2006). He noted the shift “from involvement to detachment and from care to cure” (Draper 2006:75).

From 2006 till 2013 students were asked to hand in a hard copy of their reflective commentary following instructions in their course booklet (2010:23) that clarified the task as one not for assessment but rather intended to “make [students] stop and think about [their] experience in the knowledge that this facilitates learning”. The objective was to facilitate students’ insights as they entered the Obstetric community of practice. Students were requested to keep their commentary simple and brief – to about one page. Informality was suggested in the genre of the instruction – “More is OK if you feel what you have to say is important”. Instruction in the booklet indicated that students needed to draw on their practical experience, reflect on it, and discuss how their early delivery experiences “had:
  • Affected [each student] as a person
  • Shaped [each student’s] understanding of the role of the midwives and medical colleagues as teachers and models, and
  • Given [each student] insight into the needs of mothers in labour”.
 In 2012 an extra commentary was requested from the students in which they had to post online their reflections and interpretations of a particular event that occurred in their learning block of 8 weeks in which they rotate between several Maternal Obstetric Units (MOUs). This task was facilitated by referring students to an online visual a six step framework, called the Six Step Spiral for Critical Reflection (SSS4CR) which guided students thinking through probing questions.

Because the uptake was below half the class, the course convenors and facilitator decided to drop the original reflective task in favour of the latest one in which a structured approach to critical inquiry was required. Initially very few students responded online however with encouragement and acknowledgement of the difficulty in sharing reflections online, more students have engaged in the task. Scaffolding the task was noted as a key factor to improve participation. At the initial introductory session, students were introduced to the Probing Professionalism towards Positive Practice website on the Learning Management System (LMS). They were also encouraged to post a comment on the Chatroom relating to their prior knowledge about the Obstetrics block. This has developed a cluster of insights, adding energy to the group towards cultivating an electronic CoP (Wenger 2006). Further participation in the online space then happens asynchronously. 

Self-organized activity following the introductory session encouraged students to use the six separate threads on the LMS Forum space for their future posts. However alternative suggestions were offered as an acknowledgment of the difficulty in sharing personal experiences. These were mailing the facilitator directly or using the anonymous Question&Answer option, as described in my previous reflective blog post.

Affordances of technology

[C]ontemporary educational design needs to focus on the selection of technologies which are complex combinations of media that do not fall into simple categories (Bower 2008:3)

Recent advances in technology offer many more opportunities to enhance reflective practice in medical education. Beyond the single text Word document written by each individual student and signed off in a register as the task completed, are flexible and collaborative tools that can enhance the individual and collective inquiry process as well as offering a product available for sharing with others.

While looking back on an experience is important, Donald Schon (1983) reminds us of the value of considering reflection in three phases described as reflection to action in preparation for a process, reflection in action which is more difficult for a novice practitioner than an expert, and  the more commonly used simpler process of reflection on an experience. (Butler 1996). As an educator interested in developing democratic teaching practices I also identify the opportunities available to shift the classroom power and control towards more student ownership for developing knowledge and valuing the collective contributions of their peers. A collaborative approach to learning is another of the key features for Authentic Learning as described by Herrrington, Reeves & Oliver (2010), and demonstrated by recent research with Physiotherapy students (Rowe, Bozalek & Frantz 2013).

My role as an educational designer (as well as the student facilitator) is important to acknowledge. By choosing a new tool for reflective practices I recognize the need to continually assess and adapt it in a creative manner to reach my desired educational outcomes.

Tools of technology considered

The success of educational technology implementations is dependent on the educational developer’s ability to appreciate the requirements within the learning context and subsequently select and utilize technologies in a way that meets those needs.” (Bower 2008:14).

From my understanding, a flexible approach that can provide scaffolding through the process is an important factor that will determine my choice of technology tools. Over this past year I have offered students the vehicles of Forum posts, Question&Answer or emails to me.

Exploring alternatives has led me to consider several options based on the affordances of technology which is understood as the possibilities available through the tools of technology. Bower (2008) suggests a form of classification to assist educators to design e-learning tasks with available technology indicating the social and educational affordances. He separates affordances into the degree of interaction naming those that are static and instructive as compared to those that are collaborative and productive (2008:7). Because the latter is more appropriate for my case study, I identify particularly relevant affordances in the table below with suggested reasons.


Functional affordance
Reason
Usefulness for my context
Ability that is enhanced
Access-control
Choice of access with one or many others.
Choice about the level of participation offered to others.

Students are sharing personal experiences where safety in sharing is important. The sharing can be scaffolded by first encouraging them to share just with a partner and myself, then with others.
Permission-ability
Share-ability
Media affordances
Providing a vehicle to expose products of individuals by sharing experiences.
Students value the opportunity to write about their experiences, recognizing that they have something to contribute to the furthering of maternal health. They appreciate their colleagues experiences too.
View-ability
Speak-ability (through text or multimodal pedagogies
Temporal affordances
The written narrative offers a window into the students’ experiences, thoughts and perspectives – a valuable feedback tool for Faculty and peers.
Students narratives provide a text to act as evidence for good and poor practices in the clinics. This has led to further actions from the Department.
Record-ability
Resource affordances
Linking to related resources can be valuable.
Experts in the field could be offered access to add relevant comments to deepen the learning.
Adding readings and images can foster a broader learning experience.
Bringing experts into the online space develops the learning beyond the classroom and single facilitator
Link-ability
Expert-ability
Timing affordance
Asynchronous sharing is possible
Synchronous editing offers the ability to write on the same document together

Students can choose when they work on the documents.
This can create a new shared experience for students.
For the educator it offers a view into the written dialogue
Synch-ability
Motivational affordance
Student buy-in to this curricular task is important.
If students can recognize the wider benefit to themselves it will be beneficial
Use-ability
Mobile affordance
To promote engagement anytime anywhere it is valuable to include the use of mobile devices
Students can access the documents through the free Google Drive app on their Smartphones or similar devices by downloading it for future use. It can be used to edit text (not to create)
App-ability
Collective affordance
To accumulate all students’ experiences to view their practical learning as a collective departmental experience, thereby becoming a user-friendly type of wiki.
Isolated experiences can be useful however a pattern of systemic behaviours can indicate where intervention is needed. It can also act as a normalizing feature for students.
Group-ability
Clouding affordance
Available 24/7 where internet is accessible.
Cloud computing beyond the Faculty LMS is welcomed by the student group.
Avail-ability
Organizing affordance
The ability to set up folders in Google Drive offers an organized platform for working.
Medical students tend to be logical and structured as they cope with high quantities of information and heavy workloads.
Structure-ability
Reviewing affordance
By using the insert function added benefits can be gained such as the dictionary and thesaurus. Footnotes are possible.
A revision history enables readers to refer to previous contributions
Small groups with peer editting
Students’ writing ability can benefit by using the extra options available on Google docs. For instance in their partners they may choose to explore the meaning of certain terms.
A record of the document history can encourage students to take risks as they make changes because an older version can always be brought back.
Research-ability
Long-lasting affordance
By Google docs staying in coud without limitations on folder size (as is the case with other applications such as Dropbox), the text can remain accessible for a long time
The lasting nature of the document enables students to relook at their writing and their peers at a later stage
Last-ability

Further considerations are the timing affordance and the ease of access. Using an asynchronous medium will be most useful to our students who work and learn at different hours in this block which weaves practical shifts with theoretical input. Furthermore cloud computing offers students easier access to information wherever and whenever they wish particularly as our students access the internet through their Smartphones and laptop computers. Anecdotal reports indicate that many students avoid using the Faculty LMS as they find it cumbersome and boring. Perhaps it doesn’t offer them the ownership and freedom that they value through the internet.

Social media could be a possibility in which for instance a closed Facebook group is set up. However the sensitive nature of the student reflections and the higher order thinking required for this task seems to indicate that the conversational nature of Facebook is not the appropriate online space for posting deeply meaningful and sensitive insights. Once posts are made on Facebook there is no option available for editing as a result of deeper understanding of the concepts or responding to feedback received from others. Furthermore the shifting nature of this medium that acts primarily as a social virtual interactive space, makes it challenging to actually follow through on a meaningful dialogue when many posting intervene. Privacy laws by Facebook may also interfere with the dissemination of information.


Common collaborative tools mentioned by Brodahl. Hadjrrrouit & Hansen (2011) include blogs and wikis. 

Blogs: Each student could create a blog offering them a sequential space for their comments. This is unlikely to be welcomed by our student group as time is an extremely limiting factor in their programme.  This affordance enables removing documents and adding new ones through the editing option however it does not provide for changing documents or openly responding to feedback on the original text.
Wikis: Although used in some places in the undergraduate curriculum, this option appears to not necessarily encourage the deep personal introspection that I am hoping to achieve from each student. The feature of editing to produce a polished finished product is tangential to my desired outcomes. The process of reflecting critically to offer an opportunity for transformative learning is more important for me as the teacher than the product.

Google docs:
Engaging in Google Drive may facilitate more interaction and collaboration with the students. By using a sharing platform through Google docs, students can collectively co-construct their knowledge while unpacking their experiences towards mutual learning and interpretation of their personal events in their practical block.

Students can choose with whom they wish to share their documents. For instance the concept of critical friends has been welcomed by the students. They may choose to only share their document with their friend and the facilitator rather than all their colleagues in the small group of 40 students. In our online discussion it was suggested that I create subgroups of students to enable them to share just with a few colleagues thus providing a less threatening environment and developing the scaffolding further.  

Google docs may provide an avenue to enable students to comment and assess each other’s reflections leading to a deeper peer-to-peer engagement beyond the articulation and conversation that has occurred to this stage. It may even offer the opportunity for outside experts to review the students’ work and perhaps assess it too.

Rowe, Bozalek & Frantz (2013) used Google docs as “a collaborative authoring platform to implement authentic learning tasks”. Advantages cited by the authors included the facility to modify content at any stage of the process, and that text and images can be added and edited by multiple group members. The automatic saving is a helpful time saver. It offers reassurance to students that their work will not be lost through not saving it in time thus possibly reducing their anxiety. The products can be shared with others chosen by the group adding to the sense of ownership of the students. It could also be downloadable. Therefore if permissionis granted, it can be mailed to other people. Collaboration becomes possible and visible. Further advantages that may be useful for the future are that Google Drive can enable feedback comments, instant messaging and notifications via email when changes are made. As students move to satellite compuses such as Vredenberg, this can mean that physical distance becomes irrelevant in their group work.

Task feedback from students

Since initiating the online reflective dialogue by students on their personal experiences at the MOUs, there have been mixed responses. Just when I felt that there was buy-in on the Forum of the LMS with half the student group posting their comments, the next group mostly chose to mail me their commentaries with 10% posting on Vula. After querying this with a few students at our face-to-face session, reasons offered were that:
  • It is quicker to just mail to Word document to the facilitator rather than posting each of the six stages into the relevant Forum thread. As mentioned in my earlier reflection, time is a big issue with these students
  • It is uncomfortable sharing experiences with others
  • There is a sense of vulnerability; it would seem that students feel more supported by sending their document straight to me their facilitator
However there is a strong consensus that hearing about one another’s experiences is hugely beneficial which leads me to recognize the value of developing a collaborative approach. Although one student has now chosen the anonymous option of Q/A on Vula, the coded format seems bulky and not particularly user friendly. He has given me permission to use his post as a example to other student groups thereby providing me with a form of scaffolding.

Challenges

Students’ digital competence and comfort is an important consideration and may be a limiting factor. I recognize the value in beginning the collaborative process in class to enable some students to draw on the expertise of others and the educator so that they become more comfortable to then progress in their different places and spaces.
When students are motivated to develop a collaborative skills on line, they are more inclined to engage in the process (Brodahl, Hadjrrrouit & Hansen 2011). Some students may not own a Gmail address, This could exclude them from the process unless they are willing to initiate a new email identity. However I note from a Facebook posting in our group area that access is now possible through Google Accounts offering a different type of functionality.
Initial resistance to a collaborative online approach is reported by Rowe, Bozalek & Frantz’s research (2013). Yet the acquisition of new relevant skills and a shared process that contributes towards “empowering students to take control of their learning …[and a] move towards thinking about learning” appeared to be later welcomed when students recognized their personal and professional growth.
As suggested by Brodahl, Hadjrrrouit & Hansen (2011) there are arguments towards keeping to traditional teaching practices with students who prefer working on their own, and that the affordances of technology may not be a gain for the students themselves.

Conclusion

To successfully implement innovative tools into our teaching, more is needed than merely setting up a structure. Veletsianos (2011) points out that the educator may provide the opportunities for deep learning and transformation through the affordances of technology, however it is up to the learners to fully engage with the process. I find the infographic below useful as it encompasses the complexity of online teaching indicating how teachers and students need “personal tools to orchestrate the inquiry process” (http://www.teachthought.com/learning/what-are-the-habits-of-mind/).
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References

Alpenstein, M. 2012. Personal e-mail communication 15 May 2012.
Bower, M. 2008. Affordance analysis – matching learning tasks with learning technologies. Educational Media International. 45:1:3–15.
Brodahl, C. Hadjrrrouit, S. and Hansen, N.K. 2011. Collaborative writing with Web 2.0 Technologies: Education Students’ perceptions. Journal of Information Technology Education: Innovations in Practice. 10:73–103. Available http://www.jite.org/documents/Vol10/JITEv10IIPp073-103Brodahl948.pdf Accessed 7 May, 2013.
Butler, J. 1996. Professional development: Practice as text, reflection as process, and self as locus. Australian Journal of Education. 40:3:265-283.
Draper, G. 2006. A classroom of life. A qualitative analysis of the reflections of medical students on their entry into an obstetric community of practice.  Masters of Philosophy thesis.  (Unpublished).
Educational Technology and Mobile Learning website. Available http://www.educatorstechnology.com/2013/04/8-mental-habits-you-should-know-about.html Accessed 7 May 2013.
Herrington, J., Reeves, T. & Oliver, R. 2010. A guide to authentic e-learning. Routledge. London.
Kelly, x. 2013. What Are The Habits Of Mind? TeachThought Website. Available  http://www.teachthought.com/learning/what-are-the-habits-of-mind/ Accessed 7 May 2013.
Rowe, M., Bozalek, V. & Frantz, J. 2013. Using Google Drive to facilitate a blended approach to authentic learning. British Journal of Educational Technology.
Schön, D. 1983. The reflective practitioner: How professionals think in action. New York. Basic Books.
Veletsianos, G. 2011. Designing Opportunities for Transformation with Emerging Technologies.  Educational Technology. 51:2:41-46.
Walkington, J., Christensen, H., Kock, H. 2001. Developing critical reflection as a part of teaching training and teaching practice. European Journal of Engineering Education. 26:4:343–350.
Wenger, E. 2006. Community of Practice. http://www.ewenger.com/theory/