Claudia Kiessling

Crossing boundaries in interprofessional education: A call for instructional integration of two script concepts

ABSTRACT Clinical work occurs in a context which is heavily influenced by social interactions. The absence of theoretical frameworks underpinning the design of collaborative learning has become a roadblock for interprofessional education (IPE). This article proposes a script-based framework for the design of IPE. This framework provides suggestions for designing learning environments intended to foster competences we feel are fundamental to successful interprofessional care. The current literature describes two script concepts: “illness scripts” and “internal/external collaboration scripts”. Illness scripts are specific knowledge structures that link general disease categories and specific examples of diseases. “Internal collaboration scripts” refer to an individual’s knowledge about how to interact with others in a social situation. “External collaboration scripts” are instructional scaffolds designed to help groups collaborate. Instructional research relating to illness scripts and internal collaboration scripts supports (a) putting learners in authentic situations in which they need to engage in clinical reasoning, and (b) scaffolding their interaction with others with “external collaboration scripts”. Thus, well-established experiential instructional approaches should be combined with more fine-grained script-based scaffolding approaches. The resulting script-based framework offers instructional designers insights into how students can be supported to develop the necessary skills to master complex interprofessional clinical situations.

Feedforward interview: enhancing reflection for successful teachers

What problem was addressed? Summative feedback provided by students at the end of a course did not offer lecturers the opportunity to improve their teaching methods during the course. There was a lack of instant and formative feedback to help individual lecturers identify strengths and weaknesses in their teaching methods. We sought to advocate timely self-reflection among lecturers in a continuous process within an academic year. What was tried? In alignment with the implementation of a revamped curriculum, 12 groups of students (n = 179) took turns to evaluate various types of daily teaching activity (e.g. lectures, seminars, laboratories, problem-solving activities and clinical teaching sessions). Each group was assigned a 2week period to provide feedback and the process was repeated throughout the academic year. An example of a question asked (for a 1-hour lecture) is: ‘Was there alignment between the content delivered and the learning objectives?’. Other questions were related to delivery of the content, intellectual level and overall rating. Students also wrote about their positive and negative experiences, and recommended possible areas for improvement through online feedback. Next, respective lecturers received the feedback reports via e-mail. Lecturers then informed the medical education management of their response to students’ feedback (e.g. Lecturer: ‘I will take note of the recommendations and try to improve further. This method of feedback is very useful.’) At the end of each learning block (system), we met students to present a summary of their feedback and the actions taken by faculty members. What lessons were learned? We believe that students’ feedback could reinforce lecturers’ commitment to maintaining effective teaching methods (e.g. Student: ‘He encouraged two-way interactions by asking us questions’). Lecturers realised that students valued their efforts (e.g. Lecturer: ‘Happy to be of service to the students and nice to feel appreciated’). By contrast, lecturers were made aware of areas for improvement (e.g. Student: ‘I hope the lecturer can speak slower’). The aforementioned lecturer accepted the recommendation and changed his delivery methods (e.g. Student: ‘The lecturer spoke slower and continued repeating the facts that he wanted to tell us. . . he had improved his ways of giving lectures’). The increasing amount of written feedback indicated that students began to buy in to the initiative when their feedback was taken seriously. Meanwhile, the implementation was accompanied by reasonable deliberations. Firstly, we invited all students to evaluate three lectures on a randomly selected Monday in order to resolve lecturers’ concerns about the reliability of small-group evaluation. A Mann–Whitney test reported that, for all nine questions asked in each lecture evaluation, the responses of a randomly selected group (n 15) did not differ significantly from those of others in the class (n 130). The response rate was approximately 85%. Secondly, some students’ feedback contained comments that described negative emotions and used inappropriate wording. Subsequently, we met with students regularly to facilitate their learning of how to provide constructive feedback. This also served to cultivate their personal and professional development. Thirdly, we found that lecturers became more open to accepting criticism from students and demonstrated a commitment to change.

When predicting item difficulty, is it better to ask authors or reviewers?

questions do we need to ask now in order to move the OES towards the collective vision? What relevant and credible information is needed to answer these questions? Step 5 pulled together the relevant information and a ‘learning huddle’ was held with members of the core team. The learning huddle had three objectives: (i) to make meaning of the information collected, (ii) to discuss what the core team is noticing or sensing in the system as a result of the work of the OES (emergent outcomes) and (iii) to identify any new or relevant questions that the core team thought important to ask in order to move the OES towards the collective vision. Step 6 involved ‘refreshing’ the evaluation based on the learning huddle discussion and Step 7 was the sharing of the evaluation findings to date with relevant stakeholder groups. What lessons were learned? The advantages to using this process include gaining a comprehensive understanding of the true value of the OES, making informed strategic decisions with confidence, and growing capacity within the department for learning and inquiry. That said, this evaluation approach should only be used in situations where the following is true: the primary focus of the work is programme growth and improvement (rather than solely accountability), there is flexibility to change or adapt the programme, there is a core team of people who can commit to the process as it requires dedication over a long period of time, and the culture of the organisation is one that is open to making mistakes and learning from them.