Vivienne Bozalek

The role of blended learning in the clinical education of healthcare students: a systematic review

Background: Developing practice knowledge in healthcare is a complex process that is difficult to teach. Clinical education exposes students to authentic learning situations, but students also need epistemological access to tacit knowledge and clinical reasoning skills in order to interpret clinical problems. Blended learning offers opportunities for the complexity of learning by integrating face-to-face and online interaction. However, little is known about its use in clinical education. Aim: To determine the impact of blended learning in the clinical education of healthcare students. Methods: Articles published between 2000 and 2010 were retrieved from online and print sources, and included multiple search methodologies. Search terms were derived following a preliminary review of relevant literature. Results: A total of 71 articles were retrieved and 57 were removed after two rounds of analysis. Further methodological appraisals excluded another seven, leaving seven for the review. All studies reviewed evaluated the use of a blended learning intervention in a clinical context, although each intervention was different. Three studies included a control group, and two were qualitative in nature. Blended learning was shown to help bridge the gap between theory and practice and to improve a range of selected clinical competencies among students. Conclusion: Few high-quality studies were found to evaluate the role of blended learning in clinical education, and those that were found provide only rudimentary evidence that integrating technology-enhanced teaching with traditional approaches have potential to improve clinical competencies among health students. Further well-designed research into the use of blended learning in clinical education is therefore needed before we rush to adopt it.

South African Social Welfare Policy: An Analysis Using the Ethic of Care

New policies have been developed in South Africa since the demise of apartheid. This article examines one of these policy documents - theWhite Paper for Social Welfare - using the lens of a feminist political ethic of care. The ethic of care is used to trace the normative framework of this policy document and to make judgements about how adequately issues of care, welfare and citizenship are dealt with. Policy texts display authoritative ways of talking about care and contain a range of gendered assumptions in the way that they represent social practices of care. The article proposes that the White Paper for Social Welfare inserts care principally into a familialist framework. This framework does not address current South African social problems in an adequate manner, nor does it correspond with social justice principles that are endorsed in the White Paper. The contribution that the ethic of care can make in solving the problems that are identified in the analysis of the White Paper for Social Welfare is elaborated on. It is proposed that care should be positioned in notions of citizenship rather than family or community. In this way, the responsibility for care would be deprivatized and made a common concern, centrally placed in human life.

‘Ah, but the whiteys love to talk about themselves’: discomfort as a pedagogy for change

This article reports on an interdisciplinary and collaborative educational module prepared for fourth‐year Psychology and Social Work students at two higher education institutions in the Western Cape, South Africa. The aim of the module was to provide students with the opportunity to experience learning across the boundaries of institution, discipline, language, race and class, and to provide the team with data to enhance understanding of how students grapple with issues of difference. The study was based on data obtained from student texts produced in response to the final reflective essay assignment. The texts provided valuable insights into how students, some of whom appeared to come into contact with peers from different socioeconomic backgrounds for the first time, grappled with themselves in relation to ‘the other’. A theoretical framework based on the notion of a ‘pedagogy of discomfort’ and the complementary relationship of recognition and distribution, was used to explicate the data. The data revealed that there are cognitive as well as affective dimensions in learning about difference. It suggested that a pedagogical intervention can enhance what students learn about difference, but that this depends on various factors: pedagogical factors, and factors pertaining to the students’ own prior experience and cultural capital. The analysis of the assignments suggested that power differentials and inequality in terms of material and cultural resources can limit the transformational character of such initiatives.

Using Google Drive to facilitate a blended approach to authentic learning

While technology has the potential to create opportunities for transformative learning in higher education, it is often used to merely reinforce didactic teaching that aims to control access to expert knowledge. Instead, educators should consider using technology to enhance communication and provide richer, more meaningful platforms for the social construction of knowledge. By using technology to engage in shared learning experiences that extend beyond the walls of the classroom, we can create opportunities to develop the patterns of thinking that students need to participate in complex, real world situations. We used authentic learning as a framework to guide the implementation of a JOUR-based, blended module in a South African physiotherapy department. Google Drive was used as a collaborative online authoring environment in which small groups of students used clinical JOURs to create their own content, guided by a team of facilitators. This paper describes an innovative approach to clinical education using authentic learning as a guiding framework, and Google Drive as an implementation platform. We believe that this approach led to the transformation of student learning practices, altered power relationships in the classroom and facilitated the development of critical attitudes towards knowledge and authority. [ABSTRACT FROM AUTHOR]

The use of emerging technologies for authentic learning: A South African study in higher education

It is now widely accepted that the transmission of disciplinary knowledge is insufficient to prepare students leaving higher education for the workplace. Authentic learning has been suggested as a way to bring the necessary complexity into learning to deal with challenges in professional practice after graduation. This study investigates how South African higher educators have used emerging technologies to achieve the characteristics of authentic learning. A survey was administered to a population of 265 higher educators in South Africa who self-identified as engaging with emerging technologies. From this survey, a sample of 21 respondents were selected to further investigate their practice through in-depth interviewing using Herrington, Reeves and Olivers nine characteristics of authentic learning as a framework. Interrater analysis undertaken by five members of the research team revealed both consistencies and differences among the twenty one cases across the nine elements of authentic learning. The highest levels of authenticity were found for the elements authentic context and task, and the lowest for articulation. Furthermore, there was a moderate correlation identified between levels of authenticity and the role played by emerging technologies in achieving the authenticity, showing a potentially symbiotic relationship between them.

Bringing the social into pedagogy: unsafe learning in an uncertain world

The paper describes a collaborative curriculum development project implemented over 3 years at 2 universities in the Western Cape Province of South Africa. The project involved a short module in which students in their fourth year of study interacted and learnt collaboratively across the boundaries of institution, discipline, race and social class, about the concepts of community, self and identity. The pedagogic approach adopted is described, as well as the responses of the students, and a brief reflection on some of the learning outcomes attained. The paper considers the learning processes which the curriculum development team experienced, and suggests that in order to facilitate learning for an ‘uncertain world’, the curriculum designers, too, need to engage in learning processes in which they make themselves vulnerable, mirroring some of the learning processes they expect the students to undergo.

'It doesn't matter who or what we are, we are still just people': Strategies used by university students to negotiate difference

South Africa, after decades of apartheid, continues to be a highly segregated society. Higher education institutions need to prepare students for work in such a divided society. Recent work on inter-group contact has stressed the importance of taking into account peoples interpretation and meanings about contact in particular contexts, and the need for contact to involve dialogue about socio-historical situations. This article reports on a collaborative project involving fourth-year psychology and social work students from two universities. The project facilitated the interaction of students from diverse racialised and classed backgrounds. A combination of a thematic and discourse analysis of their online interaction identified strategies students used when negotiating and interacting with one another on issues of difference. The analysis identified ways of referring to difference, strategies for negotiating difference, and ways of managing the conversations about difference. These indicate differing levels of engagement. Dialogue designed to educate students about difference requires interventions that make students aware of these strategies and their implications.

Beyond knowledge and skills: the use of a Delphi study to develop a technology-mediated teaching strategy

BackgroundWhile there is evidence to suggest that teaching practices in clinical education should include activities that more accurately reflect the real world, many educators base their teaching on transmission models that encourage the rote learning of knowledge and technical skills. Technology-mediated instruction may facilitate the development of professional attributes that go beyond “having” knowledge and skills, but there is limited evidence for how to integrate technology into these innovative teaching approaches.MethodsThis study used a modified Delphi method to help identify the professional attributes of capable practitioners, the approaches to teaching that may facilitate the development of these attributes, and finally, how technology could be integrated with those teaching strategies in order to develop capable practitioners. Open-ended questions were used to gather data from three different expert panels, and results were thematically analysed.ResultsClinical educators should not view knowledge, skills and attitudes as a set of products of learning, but rather as a set of attributes that are developed during a learning process. Participants highlighted the importance of continuing personal and professional development that emphasised the role of values and emotional response to the clinical context. To develop these attributes, clinical educators should use teaching activities that are learner-centred, interactive, integrated, reflective and that promote engagement. When technology-mediated teaching activities are considered, they should promote the discussion of clinical encounters, facilitate the sharing of resources and experiences, encourage reflection on the learning process and be used to access content outside the classroom. In addition, educational outcomes must drive the integration of technology into teaching practice, rather than the features of the technology.ConclusionsThere is a need for a cultural change in clinical education, in which those involved with the professional training of healthcare professionals perceive teaching as more than the transmission of knowledge and technical skills. Process-oriented teaching practices that integrate technology as part of a carefully designed curriculum may have the potential to facilitate the development of capable healthcare graduates who are able to navigate the complexity of health systems and patient management in ways that go beyond the application of knowledge and skills.

Editorial: Massive open online courses (MOOCs): Disrupting teaching and learning practices in higher education

An introduction is presented in which the editor discusses the special issue, which is on the topic of massive open online courses (MOOCs) in higher education and the ways in which these online courses qualify as a disruptive technology in higher education teaching.

Re)searching difference

Jacky Sunde and Vivienne Bozalek explore further the debate on whether women in differing positions of power can teach and write about the experiences of other women