Jonas Nordquist

The disconnections between space, place and learning in interprofessional education: an overview of key issues

Abstract This article explores and discusses current conceptual and empirical dimensions of the study of space, place, education and interprofessional education (IPE) within a health professions context. This article addresses defining elements of the concepts, their use in nursing and medical literature and their positioning within educational theories. It outlines a series of ideas and approaches for future research aimed at investigating the intersections and relationships amongst these concepts. Importantly, this article argues that the conceptualization of space and place in IPE can potentially impact how educational space, places and curricular are (re)conducted and utilized.

Focusing on future learning environments: exploring the role of space and place for interprofessional education.

While space and place have been important units of analysis in studying learning across a number of social science domains (e.g. environmental studies), there has been little research exploring these elements in either the health professions education or the interprofessional education literature (Leander, Phillips & Taylor, 2010). This editorial highlights the importance of acknowledging and beginning to understand the role of space and place in interprofessional education. Specifically, our aim is to initiate a dialogue about how space, place and learning can affect the design and implementation of this type of education. We suggest that understanding the conceptual and practical relationship between space, place and learning is necessary to the construction and reconstruction of learning spaces that aspire to follow interprofessional education principles (e.g. student-centredness, flexibility, interactivity, collaboration and communication).

Designing spaces for the networked learning landscape.

Abstract The concept of the learning landscape is used to explore the range of learning environments needed at multiple scales to better align with changes in the medical education curriculum. Four key scales that correspond to important types of learning spaces are identified: the classroom, the building, the campus and the city. “In-between” spaces are identified as growing in importance given changing patterns of learning and the use of information technology. Technology is altering how learning takes place in a wider variety of types of spaces as it is interwoven into every aspect of learning. An approach to planning learning environments which recognizes the need to think of networks of learning spaces connected across multiple scales is proposed. The focus is shifted from singular spaces to networks of inter-connected virtual and digital environments. A schematic model comprising the networked learning landscape, intended as a guide to planning that emphasizes relationships between the changing curriculum and its alignment with learning environments at multiple scales is proposed in this work. The need for higher levels of engagement of faculty, administrators and students in defining the briefs for the design of new kinds of medical education environments is highlighted.

An educational leadership responsibility in primary care: ensuring the physical space for learning aligns with the educational mission.

WHAT IS ALREADY KNOWN IN THIS AREA ⦁ Physical learning spaces (the hardware) are seldom aligned with the curricula (the software) – this is true both for health professions’ education in general as well as for education in primary care specifically. ⦁ Without an alignment between the hardware and software the quality of learning in primary care education will be jeopardised with implications for patient safety. This situation poses a true challenge for educational leaders.

Spaces for learning - A neglected area in curriculum change and strategic educational leadership

Would anyone dream of trying to run the latest app on an IBM computer from 1980? Most probably not. The reason is quite simple: software development is so much more advanced today than 35 years ago. Contemporary software requires a new hardware. For most of us it is obvious that software has to be compatible with hardware. However, our 21st century curricula with its ideas about learning centeredness, teambased and/or inter-professional education are not compatible with the physical learning environments of our universities. Physical learning spaces reflect and express underlying assumptions about teaching and learning (Kennedy et al. 2005; Oblinger 2006; Nordquist et al. 2011, 2013). Just by walking through our campuses, classrooms or other learning spaces, many stories about how we view teaching and learning are told (Kennedy et al. 2005). Values are expressed through the design, organization and layout of physical learning environments. The physical environment is our ‘‘hardware’’ and should better support our ‘‘software’’ – the underlying ideas of our curriculum which are expressed through a medical school’s vision to achieve inter-professional, learning-centered and student-activated learning. What is now called the learning landscape is changing rapidly. Technology enables us to learn and study across time and space in new ways, impacting the purpose of space. First, lectures can be accessed virtually by students any time of the day, seven days a week. This forces us to reevaluate the value of spaces such as lecture theatres, as well as the format of the lecture itself. Many lecture theatres (based on didactic design ideas from the early 1800’s) still exist; designed for the one-way transfer of information from the expert to the learners. Now the ‘flipped’ classroom turns that model inside out: classrooms become sites of intense collaboration, the lecture can be viewed virtually at another time. Classrooms have to be re-designed for these patterns of use. Libraries used to be where books and journals could be accessed by researchers and students. Today, journals and other information sources can be accessed through the internet 24-7. The physical spaces of the library are re-purposed as centers for collaborative learning. These are just some rather obvious examples. We need to revisit our learning spaces and ask two simple questions: (1) What curricula do we aspire to achieve, and (2) are our physical spaces compatible with these curricula? We claim that a positive answer to question number two is necessary to turn our aspirations for the curricula into successful practice. Indeed, for our future curricula to be really successful, physical spaces have to be more than merely compatible, they have to be purposefully designed for transformational learning experiences. There has been very limited research on how physical space impacts on learning in higher education and in the health professions (Oblinger 2006; Boddington & Boys 2011; Harrison & Hutton 2013; Kitto et al. 2013). However, one area that has been highlighted is social learning spaces (Boddington & Boys 2011; Harrison & Hutton. 2013). The Centre for Excellence in Teaching and Learning Through Design (CETLD) opened in 2005 to research this field. In other sectors, notably corporate workspaces, there has been much greater re-thinking of the alignment between technology, space, and new ways of working (Duffy 2008). Both of these examples provide health profession educators with knowledge, evidence, inspiration and guidance about aligning physical space with contemporary curricula. In early 2014 we (Nordquist and Laing) conducted a short survey of members on the AMEE email list about developments in learning spaces to map the current state of awareness and best practices. We found pockets of excellence and innovation globally. We are analyzing the responses at three scales: – The classroom – The building – The campus The responses show that many schools and faculty members around the world are aware of the misalignment between physical space and curricula. This is most clearly evidenced at the classroom scale where we received many excellent examples of redevelopments of spaces to respond to new educational approaches such as team-based learning.

“Living museums”: is it time to reconsider the learning landscape for professional and interprofessional education?

At many university campuses, globally, there is a tendency to find buildings inhabited by individual health professions. Similarly, at clinical learning sites many of these professions still retain their own dedicated learning spaces, libraries, seminar rooms or even lecture theaters. In at least two ways, this reflects traditional siloed thinking about health professions education, manifested and expressed through, campus design and architecture of learning spaces. First, there was a strong focus on individual professions and how this was solidly established through the distribution of individual physical spaces. Second, there was also a tendency for didactic and teacher-centered spaces within the buildings that focused on knowledge transfer from experts to learners – space was essentially designed for teacher monologues to predominate. In this sense, health professions institutions could be considered ‘‘living museums’’ – reflecting an outdated notion of the separation of medicine, nursing and other health professions’ education, through their campus design and the interior/ exterior architecture of buildings. Given the historically isolated approach to delivering health professions education, the design and construction of these buildings is not surprising. However, many new buildings continue to have a strong emphasis on teacher-centric monologue and single profession-orientation. In this editorial, we briefly explore the significance of space and how it affects the nature of professional and interprofessional learning. Building upon our initial discussion of these issues (Nordquist, Kitto, Peller, Ygge, & Reeves, 2011), we argue that more attention needs to be focused on the design and redesign of learning spaces in order to meet the new challenges for health professions in the 21st century. We also provide an overview of the ‘‘Future Learning Environment Project’’ at Karolinska Instituet (for more information on this project see: www.ki.se/ learningspaces), Sweden and a related conference where architects, facility management, curriculum developers and academics came together to present, discuss and debate these issues. The role of the health professions

Building for change: university hospital design for future clinical learning

Abstract Recent developments in the way health care is organized and delivered have rendered many old hospital structures obsolete. The creation of an entire new university hospital for tertiary health care, clinical research and education has made it necessary to discuss and define what pedagogical strategies should be used in this new setting and how physical structures can support learning. Contemporary health care is per se interprofessionally team-based, but most health care education is still performed in silos, separated for each profession. When building a new hospital new possibilities arise to create an interprofessional and learner-centered environment with an adjusted physical infrastructure and spaces for learning. The old hospital conserved highly discipline-based (and professionally isolated) curriculas and didactically oriented; all manifested in the physical environments. However, the New Karolinska University Hospital presents a shift towards a pedagogy characterized by learning centeredness, interprofessionalism clearly expressed in the architecture, design and allocation of spaces within the new buildings. The aim of this article is to highlight the considerations that have been made during the process to design and plan for the new university hospital.

Medical schools viewed from a political perspective: how political skills can improve education leadership

Medical Education 2011: 45: 1174–1180

Aligning physical learning spaces with the curriculum: AMEE Guide No. 107.

Abstract This Guide explores emerging issues on the alignment of learning spaces with the changing curriculum in medical education. As technology and new teaching methods have altered the nature of learning in medical education, it is necessary to re-think how physical learning spaces are aligned with the curriculum. The better alignment of learning spaces with the curriculum depends on more directly engaged leadership from faculty and the community of medical education for briefing the requirements for the design of all kinds of learning spaces. However, there is a lack of precedent and well-established processes as to how new kinds of learning spaces should be programmed. Such programmes are essential aspects of optimizing the intended experience of the curriculum. Faculty and the learning community need better tools and instruments to support their leadership role in briefing and programming. A Guide to critical concepts for exploring the alignment of curriculum and learning spaces is provided. The idea of a networked learning landscape is introduced as a way of assessing and evaluating the alignment of physical spaces to the emerging curriculum. The concept is used to explore how technology has widened the range of spaces and places in which learning happens as well as enabling new styles of learning. The networked learning landscaped is explored through four different scales within which learning is accommodated: the classroom, the building, the campus, and the city. High-level guidance on the process of briefing for the networked learning landscape is provided, to take into account the wider scale of learning spaces and the impact of technology. Key to a successful measurement process is argued to be the involvement of relevant academic stakeholders who can identify the strategic direction and purpose for the design of the learning environments in relation to the emerging demands of the curriculum.

Alignment achieved? The learning landscape and curricula in health profession education.

The overall aim of this review is to map the area around the topic of the relationship between physical space and learning and to then draw further potential implications from this for the specific area of health profession education.