Susan Toohey

The purpose, value and structure of the practicum in higher education: a literature review

The practicum constitutes an integral part of many professional courses in higher education; and is manifest in several different forms depending on the discipline: field experience, cooperative education, sandwich programs, internships, clerkships, clinical practicum, and the like. This paper provides an overview of different ways in which the practicum has been conceptualised, implemented and evaluated in higher education. It focuses attention on the purpose and value of the practicum; the relationship between the practicum and the learning outcomes of a course as a whole; and the structure and placement of the practicum within a course. Findings indicate that whilst the practicum is widely accepted as a valuable and successful component of professional education, it has a number of shortcomings; and the lack of good quality research into the practicum makes it difficult to draw unequivocal conclusions. A number of questions are posed to guide further research into the role of supervision during practicum placements; the kinds of learning goals and outcomes that are best achieved through the practicum; and the impact on student learning of the length and structure of the practicum.

An innovative outcomes-based medical education program built on adult learning principles

An innovative medical curriculum at the University of New South Wales (UNSW) has been developed through a highly collaborative process aimed at building faculty ownership and ongoing sustainability. The result is a novel capability-based program that features early clinical experience and small-group teaching, which offers students considerable flexibility and achieves a high degree of alignment between graduate outcomes, learning activities and assessments. Graduate capabilities that focus student learning on generic outcomes are described (critical evaluation, reflection, communication and teamwork) along with traditional outcomes in biomedical science, social aspects, clinical performance and ethics. Each two-year phase promotes a distinctive learning process to support and develop autonomous learning across six years. The approaches emphasize important adult education themes: student autonomy; learning from experience; collaborative learning; and adult teacher–learner relationships. Teaching in each phase draws on stages of the human life cycle to provide an explicit organization for the vertical integration of knowledge and skills. A learning environment that values the social nature of learning is fostered through the programs design and assessment system, which supports interdisciplinary integration and rewards students who exhibit self-direction. Assessment incorporates criterion referencing, interdisciplinary examinations, a balance between continuous and barrier assessments, peer feedback and performance assessments of clinical competence. A portfolio examination in each phase, in which students submit evidence of reflection and achievement for each capability, ensures overall alignment.

Assessment of professionalism in undergraduate medical students

Background: Professionalism is comprised of a set of values and behaviours that underpin the social contract between the public and the medical profession. Medical errors are reported to result in significant morbidity and mortality and are in-part related to underdeveloped professionalism. Aims: The aim was to determine whether specific aspects of professionalism were underdeveloped in medical students. Method: A questionnaire with 24 vignettes was taken by Year 2, 4, and 6 medical students and their responses were compared to responses from practicing Medical Academics. Results: Second, fourth and sixth Year medical students’ responses differed from Academics in two aspects of professionalism, firstly, high ethical and moral standards and secondly, humanistic values such as integrity and honesty. Only Year 2 medical students’ responses were different from Academics when it came to responsibility and accountability. Conclusions: Certain aspects of professionalism seem to be underdeveloped in medical students. These aspects of professionalism may need to be targeted for teaching and assessment in order that students develop as professionally responsible practitioners. In turn, students with well-developed professionalism may be less involved in medical error, and if involved they may have the personal values which can help them deal with error more honestly and effectively.

Assessing the Practicum

Abstract The practicum appears in many different forms in professional education — as field placement, cooperative education, sandwich programs, internship and clinical placement. This review of current literature reveals many different conceptions of the kinds of learning outcomes that can be achieved through learning in the workplace and the contribution that the practicum can make to professional education. In consequence, assessment philosophies and methods are equally varied. Five distinct approaches to assessment of the practicum are identified and the strengths and weaknesses of each are evaluated. While assessment of the practicum in some programs has been very limited, in the best examples cited, integration of the practicum with the educational program has provided opportunities for students to bring together a range of knowledge and skills in a complex natural environment. Well‐designed assessment requirements can make a significant contribution to learning in the practicum by putting pressure ...

Impact of a new integrated medicine program on students’ approaches to learning

This paper presents the results of a study on the impact of a new integrated medical educational design on students’ approaches to learning. Although the new program was based on curriculum features identified in the research literature as likely to promote deeper approaches to learning, the results revealed a more complex response from students. While a proportion of students reacted as expected and changed to deeper approaches, a significant subgroup moved in the opposite direction and adopted more surface approaches. Further analysis revealed that specific features of the new curriculum – integration of content, requirement for both independent and collaborative learning – were likely to polarise students. The findings suggest that shifting students towards deeper approaches to learning may be a more complex task than previously understood. The authors suggest some ways in which such major curriculum change may be moderated so that all learners are more likely to benefit.

The Cross-Over Phenomenon: Unexpected Patterns of Change in Students' Approaches to Learning.

A key aim of educational course design is to encourage students to adopt deeper approaches to learning. This article reports the findings of three studies that explored how medical students responded to three carefully designed educational course units. The findings suggest that, while a subgroup of the students responded by adopting deeper approaches (as intended by the designers of the course units), another subgroup responded by adopting more surface approaches. Two further subgroups displayed minimal changes in their approaches despite significant changes in their learning contexts. The finding (in all three studies) of a notable proportion of students adopting more surface approaches is of particular concern, as this could adversely affect the impact of even the most carefully designed educational program. These findings suggest that the context‐dependent nature of approaches to learning merits further investigation, as it may be more complex than previously described in the literature.

The ‘Power Test’: its impact on student learning in a materials science course for engineering students

Abstract This paper explores the impact on students’ learning of a change in assessment in a materials science course for engineers. The theory behind the move is discussed with reference to previous work on developing deeper approaches to learning in students at university. The new concept adopted was a ‘power test‘ — an open book format final exam, with extended time and opportunities for colleague interaction. Student response was evaluated by interviews and structured group discussions using a nominal group technique and outcomes were assessed by classification of student exam answers using the SOLO taxonomy of Biggs & Collis (1982). Results were compared with those of students taking the same course in the previous year but who were assessed by standard closed book exam. Problems associated with the introduction of such a novel course assessment to an otherwise traditional degree are discussed.

Assessment of Students' Personal Development as Part of Preparation for Professional Work--Is It Desirable and Is It Feasible?.

Personal attributes such as self-appraisal, willingness to take responsibility for continued learning, self-management and ability to work with others are significant factors in effective professional practice. This article explores the issues that arise when development of such personal attributes is identified as one of the goals of a new undergraduate medical programme. The issue of whether such personal learning should be assessed is examined, as well as the question of what assessment methods might be appropriate for evaluating this form of learning. The conclusion reached by this medical faculty is that such personal learning should be assessed, but that the purpose of such assessment should not be to certify competence but rather to harness and direct the powerful effects of assessment onto an important aspect of practice and to provide opportunities for students to reflect, self-evaluate and receive feedback.

eMed Teamwork: a self-moderating system to gather peer feedback for developing and assessing teamwork skills

Students in the six-year undergraduate medicine program at UNSW must submit a portfolio which demonstrates inter alia their development in teamwork skills. Much of the feedback they need to develop these skills, as well as the evidence they require to document their achievements, can only come from their peers. The eMed Teamwork system, developed for this purpose, is a computer-based system which gathers feedback from peers in project groups. The feedback submitted to the system is available to the recipient for formative purposes, and becomes part of both the authors and the recipients portfolios for later summative assessment. This dual use ensures that the feedback is thoughtful and constructive and the system operates without significant moderation by teachers.

Twelve tips on choosing web teaching software

Experimentation with the new technology of web-based teaching has meant that many medical schools are using more than one software system for delivery. In the medical faculty at the University of New South Wales at the end of 1999, three different software packages (WebTeach, Top Class and Learning Space) were used for mediating teaching and learning on the web. The type of applications for which web-based teaching is used also varied widely. They ranged from a distance-education coursework masters programme delivered via the web, to the provision of additional resource materials and case discussions to supplement undergraduate classes on campus. Once web-based teaching moves out of the experimental phase and into the mainstream there is usually pressure to standardize on one software system. This has the advantage of limiting costs for training and support but it may require some compromise on functionality. Faced with the need to limit the number of software packages in use at UNSW the published comparisons of web software (Landon, 2001; University of California at Berkeley; 2001; Marshall University, 2001; Murdoch University, 2001) were first investigated. These show in broad terms what each package will do but often lack sufficient detail to determine whether the package will meet specific requirements. To get a better idea of how different software packages operate under the pressure of day-to-day teaching, 15 academic course coordinators, instructional designers and educational developers from six Australian universities who are involved in designing and delivering web courses were interviewed. The authors also joined online user groups and asked questions of international users. The aim was to find out what strengths and weaknesses they had found in the packages they used and whether they would make the same choice again. The authors were particularly interested to find out what questions they would ask when considering a new package. The twelve tips that follow summarize their advice to those considering the choice of a web teaching package.