Klara Bolander Laksov

Developing a Community of Practice around Teaching : a Case Study.

It is neither easy to change teacher thinking, nor is it easy to influence teaching practice by handing teachers the tools to do this in a course. It is suggested in this paper that it is not enough to let teachers who teach take a course on teaching in higher education. The process of influencing teachers’ thinking should include working with the communities within which they practise. One way of doing this is to apply the theory of communities of practice to the academic department. Drawing from quantitative, as well as qualitative, data during one year, this case study describes the process of a collaborative project aimed at increasing the educational quality at a research‐intensive department, and how what happened in the project seemed to contribute to the development of a community of practice to include teaching and learning.

What students really learn: contrasting medical and nursing students’ experiences of the clinical learning environment

This paper explores and contrasts undergraduate medical and nursing students’ experiences of the clinical learning environment. Using a sociocultural perspective of learning and an interpretative approach, 15 in-depth interviews with medical and nursing students were analysed with content analysis. Students’ experiences are described using a framework of ‘before’, ‘during’ and ‘after’ clinical placements. Three major themes emerged from the analysis, contrasting the medical and nursing students’ experiences of the clinical learning environment: (1) expectations of the placement; (2) relationship with the supervisor; and (3) focus of learning. The findings offer an increased understanding of how medical and nursing students learn in the clinical setting; they also show that the clinical learning environment contributes to the socialisation process of students not only into their future profession, but also into their role as learners. Differences between the two professions should be taken into consideration when designing interprofessional learning activities. Also, the findings can be used as a tool for clinical supervisors in the reflection on how student learning in the clinical learning environment can be improved.

Does teacher thinking match teaching practice? A study of basic science teachers

Objective  To obtain an understanding of basic science medical teachers’ conceptions of learning and their ideas for facilitation of learning.

Let’s talk about integration: a study of students’ understandings of integration

Today, the knowledge concerning clinical reasoning is advanced enough to translate into curriculum interventions such as an integrated curriculum, in which science theory and clinical practice can be interwoven effectively. However, the interpretations of what integration means differ and the purpose of this study was to elicit how students understand integration. This study was carried out using an interpretative perspective. Medical students, in their 2nd year of study, were asked to apply basic science knowledge from all previous courses to clinical cases in an examination. Subsequent to the examination, focus group interviews were conducted. The interviews were audio recorded, transcribed and analysed by the use of qualitative content analysis. The analysis revealed how students comprehended integration: as the creation of wholeness, as relating new knowledge to core concepts, as reasoning, as application and as collaboration between teachers. The five categories were linked to three dimensions: intra-personal, inter-personal and organizational, each of which resonates with different theories of how expertise is developed. The outcome of this study adds to our understanding of how students conceptualize integration. The categories of ‘integration’ drawn out by the study are helpful in promoting further discussion of how eliciting students’ own reports of cognition and may help the ongoing design of curricula by putting students at the center of the curriculum design process.

Exploring perceptions of the educational environment among undergraduate physiotherapy students

Objectives The aim of this study was to explore areas of strength and weakness in the educational environment as perceived by undergraduate physiotherapy students and to investigate these areas in relation to the respondents’ demographic characteristics. Methods This study utilized a cross-sectional study design and employed the Dundee Ready Education Environment Measure, a 50-item, self-administered inventory relating to a variety of topics directly pertinent to educational environments. Convenience sampling was used, and the scores were compared across demographic variables. All undergraduate physiotherapy students in their first five terms of the programme in a major Swedish university were invited to participate in the study. Results A total of 222 students (80%) completed the inventory. With an overall score of 150/200 (75%), the students rated the educational environment in this institution as “more positive than negative”. Two items consistently received deprived scores - authoritarian teachers and teaching with an overemphasis on factual learning. Students in term 4 differed significantly from others, and students with earlier university education experience perceived the atmosphere more negatively than their counterparts. There were no significant differences with regards to other demographic variables. Conclusions This study provides valuable insight into how undergraduate physiotherapy students perceive their educational environment. In general, students perceived that their educational programme fostered a sound educational environment. However, some areas require remedial measures in order to enhance the educational experience.

Laying bare educational crosstalk: a study of discursive repertoires in the wake of educational reform

In the wake of the Bologna process, many European universities are undergoing comprehensive educational reform. Our attention in this paper is focused on how a medical university came to terms with the challenges presented therein. We wished to explore how educators identify, understand and deal with opportunities for change at a medical university. To accomplish this, we devised meetings between the respondents and colleagues at the university and examined the reported results of these meetings. Our results suggest that there may be substantial educational crosstalk taking place, whereby people are experiencing a communicative mismatch in terms of negotiating the meaning of change initiatives. This can act as a hindrance for implementation of educational reforms. We acknowledge that educational developers and people in leadership need to consider different ways of creating opportunities for peer review and dialogue around educational issues in order to fully embrace opportunities for change.

The application of Item Response Theory on a teaching strategy profile questionnaire

BackgroundIn medical education research, various questionnaires are often used to study possible relationships between strategies and approaches to teaching and learning and the outcome of these. However, judging the applicability of such questionnaires or the interpretation of the results is not trivial.MethodsAs a way to develop teacher thinking, teaching strategy profiles were calculated for teachers in a research intensive department at Karolinska Institutet. This study compares the sum score, that was inherent in the questionnaire used, with an Item Response Theory (IRT) approach. Three teaching dimensions were investigated and the intended sum scores were investigated by IRT analysis.ResultsAgreements as well as important differences were found. The use of the sum score seemed to agree reasonably with an IRT approach for two of the dimensions, while the third dimension could not be identified neither by a the sum score, nor by an IRT approach, as the items included showed conflicting messages.ConclusionsThis study emphasizes the possibilities to gain better insight and more relevant interpretation of a questionnaire by use of IRT. A sum score approach should not be taken for granted. Its use has to be thoroughly evaluated.

Becoming an educational leader – exploring leadership in medical education

Abstract Research on educational leadership emphasizes the importance of having institutional leaders heavily involved with advanced instructional programming. Best practices for developing educational leadership in higher education health care and medical faculties have to be better understood. Within the framework of a seminar series, researchers and practitioners were involved in a dialogical process of inquiry, coupled with an explicit activity-oriented approach emphasizing empowerment among educational leaders. In a reflective paper, 10 participants of the seminar series elaborated on what it meant to develop and to ‘take’ leadership in your professional role and which factors that were identified as adding value to the development of professional leadership expertise. Qualitative content analysis was conducted resulting in thirteen categories reported in relation to Wenger’s theory of communities of practice. The findings show that educational leadership involves processes on the levels of students, teachers as community and at the organizational level. The individuals created a place for backstage conversations at which they got opportunity to develop their thinking and inspiration to break new ideas into their own educational communities. In addition, a systemic approach is essential for the effective implementation of educational leadership to reach all levels via interaction and communication across an organization.

To belong or not to belong: nursing students’ interactions with clinical learning environments – an observational study

BackgroundBelongingness has been argued to be a prerequisite for students’ learning in the clinical setting but making students feel like they belong to the workplace is a challenge. From a sociocultural perspective, workplace participatory practices is a framework that views clinical learning environments to be created in interaction between students and the workplace and hence, are dependent on them both. The aim of this study was to explore the interdependence between affordances and engagement in clinical learning environments. The research question was: How are nursing students influenced in their interactions with clinical learning environments?MethodsAn observational study with field observations and follow-up interviews was performed. The study setting comprised three academic teaching hospitals. Field observations included shadowing undergraduate nursing students during entire shifts. Fifty-five hours of field observations and ten follow-up interviews with students, supervisors and clinical managers formed the study data. A thematic approach to the analysis was taken and performed iteratively with the data collection.ResultsThe results revealed that students strived to fill out the role they were offered in an aspirational way but that they became overwhelmed when given the responsibility of care. When students’ basic values did not align with those enacted by the workplace, they were not willing to compromise their own values. Workplaces succeeded in inviting students into the community of nurses and the practice of care. Students demonstrated hesitance regarding their desire to belong to the workplace community.ConclusionThe results imply that the challenge for clinical education is not to increase the experience of belongingness but to maintain students’ critical and reflective approach to health care practice. Additionally, results suggest students to be included as an important stakeholder in creating clinical learning environments rather than being viewed as consumer of clinical education.

Identifying keys to success in clinical learning: a study of two interprofessional learning environments.

Abstract The aim of this study was to study the intrinsic system behind interprofessional clinical learning environments. Two health care units were selected on the basis of having received a reward for best clinical learning organization. Interviews were carried out with health care staff/clinical supervisors from different professions. The interviews were transcribed and analysed according to qualitative content analysis, and categories and themes were identified. Analysis revealed two different systems of clinical learning environments. In one, the interplay between the structural aspects dominated, and in the other, the interplay between the cultural aspects dominated. An important similarity between the environments was that a defined role for students in the organization and interprofessional teamwork around supervision across professional borders was emphasized.