team-based teaching
UNE is a
regional Australian university with a long and distinguished history in the
provision of distance education. However as best practices in pedagogy have shifted,
becoming decreasingly instructivist and increasingly contructivist in focus, the
need to provide students with different
kinds of learning experiences (other than traditional print-based
‘learn-everything-you-need-to-know-to-pass-this-unit' booklets) has become more
imperative, not only in order to retain pedagogical credibility , but to retain
student engagement, and thus to remain a competitive provider in the education
marketplace.
Prior to
2006, two undergraduate nursing courses were offered at UNE: the three-year Bachelor
of Nursing for students seeking to study
full-time to become Registered Nurses, and the Bachelor of Nursing Studies,
designed for Enrolled Nurses wishing to upgrade their qualification to
Registered Nurse status. These courses were both offered via traditional
methods: face-to-face classroom teaching for on-campus students, with separate
print-based teaching materials mailed to the off-campus cohort.
In 2006, in
response to clearly perceived needs to modernize the undergraduate nursing
course, make it more attractive to a broader range of students, meet industry
requirements for a more diverse workforce, and rationalize the number of
undergraduate nursing units taught by a small nursing team, a completely new
curriculum was devised and implemented at UNE. Its streamlined entry and exit
points and multiple study pathways were designed to deliver more flexible learning
to diverse student cohorts, and to maximize effectiveness and efficiency of
staff teaching. Part of this project was to replace previous on-campus lectures
and print-based distance education with a blended learning model in which all
students would both participate in face-to-face learning and teaching and
interact within an online learning environment hosted by the Sakai LMS.
The
perceived benefits of the blended learning model included the integration of
on-campus and distance education nursing students into a common curriculum, where
they could share the same learning materials, and more easily communicate with
each other during semester and while on clinical placements, through participation
in online learning activities such as discussion forums or wiki-based learning
groups analyzing clinical case studies or preparing group projects.
Sakai was
already being used at UNE by the School of Education in a pilot project, and
although the institution's primary LMS was WebCT, the use of Sakai was extended
at the commencement of the 2008 teaching year to host the online component of
the revised nursing curriculum, because of Sakai's superior capacity to support
students in learning experiences characterized by connectivity, collaboration
and a seamless online environment.
Challenges
faced by staff and students were twofold: becoming familiar with the new
technologies, and devising and using new teaching strategies to optimize
student engagement online. To this end, staff were encouraged to participate in
a short professional development course offered within the Sakai LMS, which
gave them opportunity to experience Sakai from a student perspective and to
learn how to use various tools to develop effective student-centred learning
activities. Understandings thus gained enabled staff to better support each
other and students in adopting the new curriculum.
Students in
the Bachelor of Nursing course complete 22 core units and 2 elective units over 6 semesters of full-time study.
Each unit
includes an online component providing students with the core learning for that
subject, with online activities (including formative and summative assessment)
to consolidate and extend that learning, and with a communication framework
enabling students to interact with each other and with teaching staff whilst
engaged in off-campus practicum placements.
All units
incorporate many common design characteristics and structural elements. All
units include a Syllabus tab (renamed START HERE), a customized ASSESSMENT tab,
and a Content Modules tab (rebadged as STUDY GUIDE to link with terminology
familiar to students prior to the introduction of online learning).
The START
HERE tab provides students with core information about teaching staff, texts,
time expectations for study, and general direction about how to engage with their
learning in the unit.
ASSESSMENT
communicates information about assessable tasks, marking criteria and due dates
(to conform with institutional assessment policy requirements). The STUDY GUIDE
contains all core learning for the unit as well as orientation to aspects of
the online site including tutorials for various tools.
Deliberate standardization
provides a consistent and intuitive interface for students. Kirschner, Sweller
& Clark (2006) highlight the benefits of clear guidance to maximize student
engagement in constructivist learning environments.
Delivery is
structured around progressive release of learning materials and activities, and
information about this is communicated to the students using the Schedule and
Announcement tools. Regular ‘Keeping on track' notices are posted in the
Schedule to remind students of where they should be up to and what they need to
focus on. Instructors also use ‘Keeping on track' to encourage students with
positive messages during times of anticipated stress, e.g. during challenging practicum
placements. Site emails (also forwarded to students' UNE email) communicate
release of new resources and other special messages.
Instructors
have made innovative use of the Tasks, Tests and Surveys tool to administer
online assessment quizzes, previously formulated as written exams for which
students had to travel either to UNE or to their closest examination centre.
The tool's flexibility, coupled with thoughtful question design, has enabled
testing of students' understanding at deeper levels, rather than the surface
questioning often associated with online quiz content.
Forums and
Chats are used for various types of communication, both social and
course-related. Students are encouraged to use designated ‘informal' spaces to
‘connect' with each other. Groups are also encouraged to use Chat spaces to
work on group-based projects and both Forums and Blogs are used in many units
as tools for assessment.
The wiki
tool is the most sophisticated and most diverse in its application across the
spectrum of units within the course: it is used for whole-class collaboration
in some units, to create individual work spaces in others, for small groups/pairs
in yet other settings, and sometimes for all three purposes within the same
unit! Instructors continue to explore the powerful potentials of wikis for
collaborative outputs in diverse areas.
Communication
tools within Sakai have been utilized in a planned and staged progression
throughout the units in the BNurs course,
to introduce, establish and foster learner engagement and to lead learners
through the necessary steps to ultimately facilitate their confident
participation in achieving sophisticated collaborative learning outcomes.
The
acculturation process begins in earlier units with invitations to students to
experiment with the communication tools to socialize and connect with fellow
students in the online learning environment. These activities reflect the first
of Gilly Salmon's (2002) five-stage e-moderating framework, and allow learners to
begin to interact with each other and explore the technologies in a secure, well-supported,
predominantly social, context.
Blogs are
also introduced in these units as tools for personal reflection to support and
extend learning.
From these
first steps, learners escalate levels of participation quite rapidly, blogging
clinical goals for assessment prior to their first practicum. However, this
process is well-supported both via a writing template framework and through
active face-to-face tutorial support in a computer lab setting.
Forum
participation is the next target - again, introduced in an optional social
context before being used for assessable course-related activities.
Overall
across the course, the progress of learners from ignorance and fear of the
technology to becoming confident users competently and flexibly interacting
within all spheres of online communication and collaboration is supported and reinforced
through thoughtful assessment design and judicious allocation of marks. Beginning
nursing students are rewarded simply for participating and engaging in online
activities. As the course progresses, this extrinsic motivation is withdrawn,
as students are expected to understand the rewards and appropriate the benefits
of engagement for themselves.
By the
second and third years of the course,
communication tools are used for many different learning and assessment purposes.
For example, in Aged Care Nursing students work in pairs on case study materials,
assessing patient scenarios and developing appropriate care strategies. Achieving this necessitates close
communication which occurs most frequently via the online communication tools, and
also via external tools such as Google docs, to enable sharing and collaborative
production of documentation. During this process students can be located at
great distances from each other, including internationally (e.g., on exchange
in Canada). Students' final submission for this task is an individual portfolio.
In Professional Clinical Practice, individual students
blog responses to critical incidents on prac, but the blogs are shared to
enable all students to access and reflect on each other's learning. Providing a
peer reflection then becomes part of students' assessable output. Students also
work together in groups to develop a Pharmacological wiki, which then becomes a
study resource for their pharmacology exam.
Excellent
print-based learning materials, primarily textbooks, characterized teaching in
nursing units prior to the redevelopment of the course. However, the transition
to blended learning has required evaluation of the kinds of materials used, in
order to support instruction that is relevant, up-to-date, student-centred, and
industry-compliant. This evaluation process has resulted in the development of
new sets of learning materials, incorporating the best of the ‘old' together
with refreshing new possibilities offered through access to online
technologies. These new learning materials have received both industry and
student acclaim.
All units in
the Bachelor of Nursing course are appraised by an external nursing
accreditation body, the Nurses and Midwives Board (NSW). Learning materials are
rigorously scrutinized and evaluated to assess whether they conform to industry
training standards and requirements. The curriculum content of the BNurs has
been held to be of such high quality that members of the teaching team responsible
for its development have been invited to take positions on both the Nursing
Practice Committee of the NMB (NSW), the committee responsible for assessing
and accrediting all NSW nursing education courses, and also the National Health
Workforce Taskforce, responsible to develop practical solutions in health
workforce innovation and reform, including areas of education and training.
Course
learning materials also importantly have the student seal of approval. Using
the online learning environment has enabled incorporation of many innovative
elements to assist students' learning, including web-based video materials,
support materials and activities from other nursing and health-related training
bodies, and links to and RSS feeds from latest research in relevant topic
areas. Students are encouraged to interact with the materials and with each
other about the content, and the diversity of learning materials and
experiences enables capture of learners across a broad spectrum of aptitudes, interests and learning styles. The
positives of this have been noted in student responses to and evaluations of
units within the BNurs course.
Innovation
in assessment within this course is demonstrated by the shift that has taken
place towards more clearly defined and measurable learning outcomes, the development of scaffolded and embedded assessment
within the framework of authentic discourse-related tasks, and the inclusion of
interactive and collaborative group-based assessments.
Ragan (Good Teaching Is Good Teaching, 1999)
makes the point that ‘specific instructional activities should be directed
toward providing learners with the necessary skills, knowledge, or experiences
to meet the goals and objectives of the course. The course content should be
sequenced and structured to enable learners to achieve the goals articulated in
the learning outcomes.'
All units in
the BNurs course explicitly adhere to this fundamental instructional design
principle. Learning outcomes for each unit were closely examined as part of the
course redesign and redevelopment and reframed where necessary to make them
more student-centred, specific, achievable and measurable. The design of each
unit begins with the learning outcomes. Activities
and assessment tasks are then planned that clearly and specifically align with
these outcomes and which scaffold student learning towards achieving them.
Students
have opportunity to engage in formative assessment (blogs, discussions self-tests,
reflective exercises) prior to engagement with summative tasks. Often,
summative tasks are built on a framework of smaller formative tasks, to engage
students more thoroughly in the learning sequence and to provide opportunity
for them to examine, evaluate and reframe their own responses prior to
submitting work for final assessment.
Marking
criteria and evaluation rubrics are also provided to give students clear
indicators of the structures and expectations for each assessable piece of
work.
Problem-based
learning structures and case study scenarios have been utilized to construct
assessments meaningful to the learning topics; for example, presenting Critical
Care Nursing students with patient information recorded in actual hospital
observation charts for their analysis and response. Students have also been
required to ‘think backwards': in other words, to construct complete case details
and appropriate nursing responses themselves from an initial brief set of
patient data (e.g., in the Mental Health Nursing unit).
The biggest
shift evidenced in assessment in this course has undoubtedly been the
development of group-based assessment tasks, enabled by the collaborative tools
available in the Sakai LMS, particularly the forum and wiki tools. Instructors
have worked very hard to establish both a culture of collaboration amongst
students (as distinct from the traditional competition-focused ‘independent
individual' mindset), together with clear expectations for group participation
and response, contained within an assessment agenda that underpins a perception
of the value of group work. Group participation is not an option; it is a
requirement. It is not only a requirement; it is an assessable requirement. It
is not only assessable; marks are awarded to individual students solely on the
basis of their group's performance. This unmistakably communicates to students
the expectation that they will work together responsibly and productively within
their groups, which clearly aligns with the expectations they will encounter in
their future professional careers.
UNE has
traditionally served its distance education student cohort very effectively in
orientating them to the requirements of their study. The innovation has been in
successfully translating these well-established ‘best practice' principles from
the former print base into the online learning environment.
The online course
look and feel has been developed to optimize user experience by providing a
standardized interface, using templates and images to ‘signpost' particular locations
and activities.
The learning
design within the course is centred around two recognized instructional
frameworks: ICARE (Introduce: Connect: Apply: Review: Evaluate) for first-year
students and the RICJ (Review: Interpret Construct: Justify) framework for
subsequent years. Specific images have
been employed for each stage/activity type throughout all units in the course,
to act as visual prompts and advance organizers orientating students to what
they should expect to find and to do within each section.
Similarly,
templates have been developed to standardize presentation of text-based
content, so students are clear about what is being communicated and how they
are expected to respond.
Course
instructors have chosen also to adhere to an agreed set of tools, a common
order and standard naming conventions for items shown in the LH navigation menu
to enhance usability for students.
A suite of
instructional materials, examples and tutorials about the online learning
environment and the use of the Sakai tools is common to all units and located
in a designated Orientation module in the Content Modules (STUDY GUIDE) section
of each unit.
The Home
Page is each instructor's personalized space, and very effectively reflects the
different personalities of each instructor. This departure from the
‘standardized' interface is actually a very important aspect of user
navigation: Sakai's ‘seamless' environment, which allows students to access any
unit in which they are enrolled via a single navigation bar, can be quite
confusing for new users. Messages from and images of different instructors provide
important markers to help new undergraduates find their way in the online
environment.
Providing
high-quality learner support has been one of the challenges of the shift to the
online learning environment for the BNurs. Instructors accustomed to solving
problems in face-to-face interaction with their students have had to find
innovative ways to ‘bridge the gap'.
One learner
support frequently used throughout units in the course is the ‘orientation
quiz', which may or may not have marks attached, and which requires students to
search through the information on the unit site to answer questions about such
matters as due dates for assignments, appropriate locations for different sorts
of assistance, unit coordinator contact details, text information, etc.
Another
pivotal point of learner support has actually been to use the opportunity
offered by the mandatory intensives to build learners' online skills through practical
means (e.g., conducting guided online learning workshops) as well as to
instruct and reassure students about the types of support available to them,
both within the university itself and via the online learning environment, so
that they develop familiarity with and confidence in the learning framework.
These
processes have been particularly relevant to the Endorsed Enrolled Nurse
cohort, who, because of advanced standing gained for prior learning, commence
their studies at the beginning of Year 2 of the BNurs course. Though these
students have mature skills and industry experience, they are generally daunted
by both the academic and technological demands of the studies they have
undertaken. Supervised hands-on experience in guided learning activities,
together with assurance of personal help available through the online
environment, largely alleviates their anxieties, therefore enabling more confident,
and consequently more effective, engagement with online learning tasks and
requirements.
Within each
unit of the course there is also a dedicated forum space for learner support
issues, moderated by both the unit coordinator and the flexible learning
advisor supporting the BNurs team. However, learners are also deliberately encouraged
within this environment to support one another and answer each other's queries,
partly to promote collaborative functionality, but also to foster
problem-solving proficiency and resilience in preparation for the demands of
professional life.
Research
indicates that learners retain 10% of what they read, 30% of what they see, 50%
of what they see and hear, and 90% of what they act on (Sims 2006). High levels
of interactivity require learners to actively participate, greatly enhancing
the retention and transfer of learning.
With this in
mind, I would like to highlight a number of ways in which different instructors
have used Sakai as a platform for innovation to transform students' educational
experiences within the Bachelor of Nursing course.
Medical terminology wiki
Traditional
instructional methods required nursing students to purchase a medical
dictionary and rote-learn medical terminology in preparation for rigorous
testing via exams. However one of the tasks students undertake in their first
core unit in this BNurs course is to begin working together in groups in a wiki
environment to develop and refine their own collaborative list of medical terms
and definitions. This list then follows them throughout all units in their
continuing studies, expanding and being upgraded with each new area of learning
and set of competencies, accessible to them for reference at any time. The
change in mental processing from information retrieval to information
acquisition, sharing and review activates more effective learning pathways and hence
improves student understanding and retention.
Clinical handover blog task
Traditionally
nursing students listened to a lecture about clinical handover protocols,
memorized the mnemonics for each and restated them in exams, with little
understanding of practice implications. In this course, students first view a
simulated handover on video, then actively research handover protocols, then
use this research as a basis to critique the observed handover, using the Blog
Wow tool to communicate their ideas. The task is further extended by asking
students to then blog their observations of a handover during their practicum.
Thus they must apply the information from their research to evaluate practice
in a more immediate and relevant setting. The links between theory and practice
constructed through this cycle of activity are much stronger and more relevant to
developing future professional practice skills than the rote learning of the
elements of handover for an exam.
Mental health nursing wikis
In the
Mental Health Nursing unit, students were given four case outlines to choose
from, with a view to working in pairs, assuming roles in two different cases,
one as a nurse and one as a mental health consumer. The scenario in each
different situation was then extended and constructed from the given outline via
an interview process taking place over a period of time between nurse and
consumer. The interview transcripts were logged in separate wikis, and from
these interviews, each ‘nurse' was asked to develop and submit an assessment of
the consumer together with a treatment plan to accompany this assessment. Using
the wiki tool in this way facilitated far deeper student engagement with and
learning about types of mental illness, stigma, marginalization, and the
realities of mental health consumer experience, than ‘surface' text-based
learning.
