Success story: Sharing the Ps Model for virtual teaching during COVID Pandemic
Shanaz Cassum, Amina Aijaz, Khairunissa Mansoor, Amina Hirji, & Amber David, AKU- SONAM Karachi, Pakistan
July 15th, 2020
With the COVID-19 pandemic hitting Pakistan in March 2020, the routine university activities of classroom teaching, meetings, research work were severely hindered. Everyone had to think of ways of working from home via zoom meetings for online teaching or offering telehealth services to enable the business to continue during this social distancing era. Faculty at the School of Nursing and Midwifery (SONAM) in Karachi also started thinking of how to initiate online teaching. Every year, a face to face module for Palliative Care and End of Life is offered to Trainee Nurse Interns (TNIs), but due to the COVID – 19 pandemic lockdown leading to a temporary closure of schools, this module was offered on an online mode. Biggs 3Ps model of teaching and learning was our guide during this transformation. However, we creatively expanded the Ps in the model based on our contextual experience of planning and programming an online module. The Ps Model created (Figure 1) became our framework, as it outlined the additional P variables that must be kept in mind for innovating a teaching-learning endeavour.
The adapted model has three phases. The first phase Presage refers to the characteristics of the learner and the learning environment (Ingrid, 2014). Our Presage indicator began in March 2020, when the COVID - 19 pandemics reached Pakistan, and the government announced the closure of schools and offices and advised that people should work from home, and teachers to start online teaching. What were our perspectives? As part of the internship curriculum, trainee nurse interns (TNIs) who are recent graduates of a four-year degree program, had to be offered a Palliative and End of life care module, via face to face classes and simulation-based activities at the Centre for Innovation in Medical Education (CIME) laboratory with high fidelity simulators. However, this was not possible due to the lockdown phenomenon during the pandemic. The participants, both teachers and learners, were observing social distancing and working/studying from home. The presage was favoured by the fact that learners had the experience of using VLE as a blended modality, and the teachers were expert in developing hybrid modules on HTML 5 Package, on MOODLE (VLE) which ignited our desire to transit to online teaching.
The second phase Process refers to the creation and execution of various study processes to make learning meaningful (Ingrid 2014). Our processes started with virtual planning meetings, whereby we discussed objectives and ways of transforming the conventional module into a blended online module. We met with the e-learning coordinator and sought help with preparing the digital resources required such as voice-over PowerPoint and creating lecture videos. We decided to use a blend of teaching pedagogies; online quizzes, reflective writing, virtual seminar, discussion board, virtual simulation and live online classes using Microsoft Teams software. As the university had a license for using the Microsoft Teams (MT) software, we got a short informal training on using MT for conducting synchronous live classes. Our goal was to create a learning package that would allow the participants to engage with peers, the content and the faculty, synchronously and asynchronously and promote deeper learning.
The last phase Product refers to the performance outcomes and the productivity of learning of the students (Ingrid, 2014). Our last phase, Product, began, when our program was uploaded on MOODLE and the TNIs were sent an official email, with the URL link, and a password, so they could enrol, access and review the H5P module on the course site, prior to the starting date. The performance began, when on day one, 141 TNIs came online, as scheduled, and joined the live synchronous class. We gave them a virtual tour of the course site and reviewed the module objectives, expectations, and the activities to complete during the week-long module. This helped the learners not only to be organized but also allowed them to manage their overall learning activities and monitor their own performance. We met them on Microsoft Teams, in a large class (LCF) where all TNIs attended the faculty lecture, as well as in seven small teams for group discussions and simulation activity, with a teacher-student ratio of 1:20. The pitfalls we faced, were unique and challenging. Three TNIs could not join, as they were on earned leave, and had gone home to the Northern Areas of Pakistan during the lockdown, and could not connect virtually due to poor internet connectivity. About 10% of Karachi based TNIs also experienced electricity shutdown and therefore had internet connectivity issues. However, they were able to access the VLE course materials and attend online classes via smartphones 3G mobile data package, which they claimed to find expensive. These TNIs were also intermittently present in the online classes and were sent live class recordings to supplement their learning. The prize for this online endeavour was achieved when the TNIs achieved the learning outcomes and completed the expected learning activities. They attempted an online test from their own homes or hostels via the VLE system, and the scores ranged between 61%-95%. In the test, the questions and responses were shuffled to negate discussions with peers via phone calls since the test was time-bound. The multiple-choice questions were marked automatically and the faculty graded the short answers manually from the online site and after reviewing the item analysis, the results were shared with the TNIs, at the click of a few buttons. The written feedback from interns was very encouraging. Many shared that they felt more responsible for doing required readings, and completing activities on time, as faculty were not taking classes in the usual manner. Some even mentioned that they studied for more than eight hours a day, watching videos and reviewing articles and PowerPoint as they found it quite interesting and useful; some found it exhausting to sit in front of their computers for long hours. Some shared that the reflection and virtual simulation were reality-oriented and helpful, whereas others felt that online guided imagery did not trigger them as much as in face to face class. Some TNI shared that their motivation to study online was less due to COVID stress, whereas few felt it was a good diversion during the lockdown. TNIs appreciated the faculty's efforts of putting together the online module for them despite social distancing, as they were missed interacting with their friends and peers. Many TNIs commented that the module was very intensive and suggested that we increase its duration and spread it over two-three weeks, as it was difficult for them to study from home while participating in household chores during the lockdown.
Overall it was a victorious endeavour for the teaching team involved despite the challenging hitches encountered. Similar models of innovative eLearning must be developed to provide insight on student engagement, supporting student learning post lockdown, and assisting faculty and students to use flexible and innovative pedagogy and transit to virtual online learning successfully.
Ingrid del Valle García Carreño, (2014). Theory of Connectivity as an Emergent Solution to Innovative Learning Strategies. American Journal of Educational Research, 2(2): 107-116. doi: 10.12691/education-2-2-7. http://pubs.sciepub.com/education/2/2/7
Flipped Classroom Pedagogy: A contemporary step towards impactful learning
Laila Akber Cassum Senior Instructor AKUSONAM
July 14th, 2020
“It is the supreme art of the teacher to awaken joy in creative expression and knowledge." – Albert Einstein
As a professional, nursing educator working at the Aga Khan University School of Nursing and Midwifery Karachi, my teaching philosophy aims to empower and facilitate students' academic journeys, through self-directed learning approaches. I strongly believe in developing the art of critical thinking, problem-solving, and decision-making skills among my students. In order to breed a competent, compassionate, and critical-thinking, nursing task force, it is imperative to accept and adapt to shifts in teaching and learning and its associated methodology.
Our students live in an era of rapid technological advancement and are quick to adapt to using technology. Hence, as demands change with time, it has become essential to upgrade and integrate various teaching strategies from traditional in-classroom learning to learning online.
As a nursing educator, I firmly believe in the concept of change and understand that students require a learning environment that is interactive and fun. To do so, I adopted the Flipped Classroom Pedagogy which transformed traditional in-person lectures for two courses in the Post-RN BScN program. Although the modification of my teaching strategies was time-consuming, the impact yielded productive outcomes such as active learning and enhanced material retention.
Flipped Classroom Pedagogy
The Flipped Classroom Approach inverts traditional ideas of in-classroom learning and focuses on how course material is delivered outside the classroom, in the form of pre-reading materials, podcasts/vodcasts, voice-over power points (VOPP), and videos. Within this approach, class time is utilized to engage students in collaborative learning such as group-based discussion, reflections, mini-group presentations, and case studies.
I utilized this strategy in two courses: Culture, Health and Society and Advance Concepts in Adult Health Nursing.
I implemented this approach in the Culture, Health and Society Course, which is purely a theoretical course offered through a blended modality. There were seven modules in this course, four of which were transformed into the flipped classroom approach.
In Advance Concepts in Adult Health Nursing, the flipped classroom approach was applied to teach concepts like the Nursing Process, Clinical Concept Mapping, and Clinical Incident Analysis.
The process was implemented in two phases:
Class modules were converted into an online learning experience, where Vodcasts, Podcasts and VOPPs were developed. Additionally, pre-reading materials consisting of peer-reviewed articles were sent to students 7 – 10 days prior to class. Announcements for the Flipped class were sent via email and through the Virtual Learning Environment (VLE), which is an online learning management system. The students were encouraged to post questions onto VLE with regard to the concepts they were to learn, to deepen their collective understanding of the content.
In this phase, sessions were designed to utilize collaborative and interactive classroom activities which enabled the students to explore case studies and critically think about questions emerging from the content. This exploration was followed by group discussions, presentations, reflections, and a gallery walk.
The class used the in-person time to provide feedback to each other and ask questions. The activity used to structure the feedback process was called Start, Stop, and Continue, where the students were given three, coloured sticky notes and they in turn pasted feedback onto the correlating columns on the whiteboard. This strategy was inspired by the Teaching and Learning Enhancement Workshops and the Rethinking Teaching Workshop, facilitated by AKU's Networks of Quality, Teaching and Learning.
The session was concluded with a quiz using Kahoot and with reflections on Padlet.
The greatest obstacle to implement the Flipped Classroom Approach involved the use of technology. Unfortunately, the Vodcast and VOPP files which I had created were corrupted and reported an error when the students tried to access them. In response, I spent time developing a new Vodcast which I uploaded without any issues. The process can be demotivating, however, the feedback received after class was rejuvenating and reaffirmed my aim to explore this new pedagogy.
The Flipped Classroom Pedagogy was highly valued by the learners, with many wanting to continue to learn through this approach. One student mentioned, “The class was interactive and interesting. Group discussions and the activities helped clarify the concepts."
Another student shared, “I learned a lot of new things in these two sessions. I better understood the nursing process and Clinical Concept Mapping which is a new and very effective tool for me."
Lastly, the students appreciated the brainstorming activities, gallery tour, and its critique on their developed Clinical Concept Mapping. In addition, the concluding activity on Kahoot and Padlet was thoroughly enjoyed, as they created a space for reflection.
Teaching Students How to Learn Through Mentorship
Festus Mulakoli- Instructor-SONAM Kenya
July 14th, 2020
I am a Basic Science Instructor at the School of Nursing and Midwifery, Nairobi. Apart from teaching microbiology and parasitology to Year One students at the school, I am also the 'in-charge' of the science laboratory.
Concept of an Instructor As a Mentor
My teaching philosophy as a medical instructor is to model creative and bold scientific thinking strategies. Therefore, to me, students are future colleagues more than just being there as students. I share my enthusiasm for their career development, which I do through formal teaching, using dynamic examples of what is currently happening in the medical field, mentorship, providing my students with ample opportunities to comprehend and institute changes at their workplace. I espouse a mentorship approach that is democratic and where ideas, reflections and knowledge are made deeper (Hultman and Sobel, 2013; Lauvas and Handal, 2015). Further, as a mentor teacher, I get my inspiration from a quote by Benjamin Franklin who said: “Tell me and I forget, teach me and I may remember, involve me and I learn."
My approach to mentoring students to learn is meant to help them get actively involved in every step of the learning process. During the entire course, students have an opportunity to discuss issues using various platforms. This enables them to have a deep understanding of the subject matter. One example of such a platform is the discussion forums on the Virtual Learning Environment (VLE). Here the students get an opportunity to share their reflections on what they are learning and how the learning is impacting them at their workplace. This helps students get empowered and take charge of their learning. These opportunities and reflection on experiences help my students to become critical thinkers, an important component in their daily activities. and at the same time uplift their academic performance. This facilitates their learning better instead of only listening to me or reading textbooks. Mentorship is an example of a cooperative learning pedagogy and as I had indicated early my students are my future colleagues. The course delivery in itself is a collaboration between my students and I allow them to do reviews on a topic through group work which we later discuss during class tutorials and this makes learning fruitful, enjoyable and a continuous process. Of course. A mentoring approach to teaching comes with some challenges. For example, when the students join the university, they are used to being spoon-fed and so it comes as a cultural shock to them to take responsibility for their own learning.
I feel fortunate to teach medical microbiology and parasitology to nurses because my teaching through mentorship helps them immediately recognize the importance of this learning approach greatly impacts on their academic performance in nursing education. Medical microbiology and parasitology as a course have difficult and complex concepts that sound abstract at the beginning. As an instructor, am expected to play an important role in mentoring professional nurses to be critical thinkers and helping them learn new concepts as well. Students learn a lot through being mentored by their instructor and this gives them the ability to realize their potential of being self-directed learners. Therefore, much of what students learn from observation is not detailed in the curricula. In a way, my mentorship help my students grow as people and set achievable goals, improves our relationship and makes them passionate about their studies.
Learning The “Length Tension Relationship" Through A Flipped Laboratory Session
Sadia Fatima, Assistant Professor, Department of Biological and Biomedical Sciences, Medical College, Karachi
April 29th, 2020
In a bid to keep students engaged as well as maintain their interest in the topic on the length of the muscle fibre and more particularly on the 'length-tension relationship', I conducted an interactive laboratory session for undergraduate students. This was an opportunity to do away with the routinely conducted session using isolated animal tissue.
Students often found it challenging to understand the concept of length-tension relationship with regard to the varied force produced by muscle fibres which is dependent on the bone-ligament attachment. I had come to realise that using one piece of animal tissue to explain this concept was not the optimum approach to developing my students' understanding as well as maintaining their interest in class as they learnt this topic. For diagnostic purposes, I administered the 'one-minute paper' so as to obtain students' feedback with a view for improving the lab session for future classes. I noted that most of the students suggested the use of a simulator and/or human subject as a means for better understanding. This triggered me to seek ways to make the concept more explicit to my students as well as make my teaching more engaging.
I had previously conducted flipped class sessions and had come to appreciate how learning became active, how students became engaged in what they were learning and were, therefore, able to understand the subject matter taught to them. Hence, to teach about the length-tension relationship of the muscle fibre, I chose to try a flipped laboratory model.
Students applying different scenarios and recording muscle force response during the face-to-face lab session
To do this, I developed a simple experiment that involved the use of different weight dumbbells. The experiment was designed using the Lab Station software (AD instruments) that could measure real-time force and generate plots which would enable the students to understand the whole concept of length-tension. I prepared a video, showcasing the experimental setup, relevant terminologies and brief concept of muscle contraction along with examples from daily life situations like holding a book or lifting a heavy bucket. I shared the video with my students via the department's YouTube channel prior to the lesson in class for them to review out of class and as part of their independent learning.
Prior to the in-class session, I conducted two pilot runs of the experiment with my technologists in order to check if there were any issues with the software or the design of the laboratory set up. During one of these pilot runs, I realized that students need to know how the learned knowledge can be applied in daily life such as while lifting a chair or grocery bag or why doing physical therapy helps patients with muscle disorders. In addition, I developed relevant applied anatomy questions and used the Mentimetre and Kahoot as testing tools. I also built student feedback into the tools later.
On the day of the actual in-class session, I observed a positive impact of all these changes on my learners. Not only were they able to understand the concept but their performance in response to questions on the topic also improved in the subsequent examinations.
In conclusion, post laboratory session based on “Q&A sign off activity", where students had to perform a scenario [such as perform a wall sit or stand on tip toe] and explain the length-tension relationship curve; revealed that the changes not only substantiated student learning but helped me to identify and clarify students' misconceptions on the spot, thus increasing my students' interaction and engagement. I was able to identify the mightiest aspect of my lesson, which was the student interaction and feedback; and the muddiest moment was the slow internet speed we experienced during the online quiz. This latter experience taught me to always have a contingency plan, such as keeping at least 3-5 hard copies of the quiz ready should the internet fail or be extremely slow.
Acknowledgement: Special thanks to Sabah Farhat, Mussarat Ashraf, Masnoon Akhter, Fizza Nazim, Mahwish Fatima who all conducted the laboratory session with me
Developing Discipline-Specific Vocabulary using Word Clouds, in Oncology Nursing
Diana Kassaman, Senior Instructor, SONAM
Tayreez Mushani, Senior Instructor, Faculty, Joint Appointment, SONAM - Kenya and the Princess Margaret Cancer Center, Toronto
April 9th, 2020
Word clouds are a visual depiction of words that may appear in written materials, books, websites or lectures. By utilizing different font sizes, you can display frequency of words. Word clouds award students the agency to take ownership of their learning process, in a way that fits their style, leading to a more effective approach to understanding concepts (Miley and Read, 2011, p.93). This creative exploration of concepts enhances their motivation, which then increases success in the course (Miley and Read, 2011, p.96).
Use of Word Clouds
In the oncology program, each of the courses that students take build upon each other. In our class, we gave students little pieces of paper and asked them to write the words that stood out to them. We then took the papers and inputted them into an online tool, which organized results into a cloud. We would then display the clouds on our classroom bulletin boards. Keeping it student-driven and as uninstructed as possible, we could curate the concepts that came out as important in our teachings, keeping them displayed for students to have a constant reminder throughout their learning journey. This is important because the students could connect what they had learned from semester one, to semester two, to semester three, and so on.
One of the most prominent impact of the above was that the students were clearly developing discipline-specific vocabulary, with words such as compassion, professionalism and confidentiality, as soft skills, consistently coming up in the word cloud. Even with courses that were almost pure science, dealing with lessons that mention terms such as intracranial pressure or malignant tumours, the soft skills still came out consistently. In Using a Bloom’s Taxonomy lens, one could see them advance from recalling information to application, analysis, evaluating and finally creating by curating all these important soft skills into word clouds. Students connected everything that they learned throughout each semester, weaving in concepts, and internalizing them. See the word cloud examples below for two semesters, one in 2017 and the other in 2018.
The oncology diploma is a speciality program. It was important to us that students were able to grasp concepts and feel confident about the course. We did not want to just teach them the oncology course; we wanted them to become oncology nurses. The use of word clouds gave us the forum to understand key attributes such as compassion among others that students grasped in their learning which is important in oncology nursing. To see soft skills identified, as resonant terms was a pleasant surprise, but reinforced to us that, we were training a class of caring, intelligent and perceptive oncology nurses. One student remarked; “Word cloud-increased my engagement with the courses we learnt. The three words every month helped me to remember the key concepts we had learnt”.
Miley, F., & Read, A. (2011). Using word clouds to develop proactive learners. Journal of the Scholarship of Teaching and Learning,11(2), 91-110.
Field trips are where theory comes alive
Dr. Mweru Mwingi, Assistant Professor, Institute for Educational Development, East Africa
December 30, 2019
In East Africa, there is a long history of gender inequality - we find vulnerabilities on both sides, as boys and girls are susceptible to mistreatment due to gender discrimination. Last semester, when teaching my Gender in Education course, elective in the Masters in Education programme I employed the use of field trips to help my graduate student teachers understand the interplay between gender and education first-hand in a classroom. The experience they got became fundamental in their own learning processes. My rationale was that using field trips would give the students exposure to something beyond the university and allow them to build on their knowledge in a practical way. Gender in education course must be experienced as theoretical underpinning alone may not be comprehended.
Thus, I wanted to take my students into the field and let them face the challenges that a real-world environment brings. The resulting lesson -my students found - was invaluable.
The Field Trip
In the final week of the course, my students and I visited a girl’s school that enrolls students from all over Tanzania. Many of the girls had been rescued from child marriage, female genital mutilation, and other gender-related vulnerabilities. The students thus come into the school with their particular histories which made me realize it would be the perfect setting and opportunity for my students to teach, but more importantly to learn from the students as well. In discussion with the school, we decided to cover topics of student leadership, healthy relationships and sexual education, self-esteem and identity, and provided information on STEM (science, technology, engineering, and mathematics) subjects and future career options in STEM.
My students were divided into 4 classrooms as per the topics and conducted workshops. The girls - Form 1 to Form 4 - were rotated through different classrooms so that the four teams of students had the opportunity to teach each form for two hours. Each team taught a different topic, but were tasked with tailoring a lesson plan to the specific needs of each form. The girls ranged in age and backgrounds, and thus the task given to the team of student teachers put them in an environment where they had to think on their feet and personalize teaching to the girls in the most effective way possible. Teaching each group was a different learning experience even for these graduate students who are experienced classroom teachers.
I found as the lessons went on that there were preconceived assumptions from my students about what the girls knew or did not know. The girls asked remarkable questions which the students did not anticipate, and some of their questions would take the lesson in a direction they had not prepared for. For instance, when educating the students on albinism, they used an image of a girl with albinism for their lesson. With one group of girls, the lesson went well and as expected. However, with another group the lesson took an unexpected turn when the girls disagreed with the image, saying that the girl in the photograph did not have albinism but had actually bleached her face. This opened up another discussion of the negative effects of skin bleaching, the science behind it, and the importance of cultivating self-esteem and self-image, which the students had to facilitate on the spot. The real-life experience of being in the classroom taught my graduate students about the unpredictability of student experiences, the influence of pre conceptions coming from prior experiences, and the importance of being flexible in the classroom - a lesson that cannot be learned theoretically within the walls of a university lecture hall.
Overall, the students gained invaluable experience from teaching at the girl’s school. My students felt challenged, but in a great way; they understood what it takes to think through and prepare teaching and learning materials for a workshop. They immensely appreciated the rewards of teamwork. From a gender in education perspective, the student-teachers were able to understand how hard it is for girls to even attend a day-school given the many challenges they face such as not having access to feminine hygiene, having other chores and work to do as part of their role in their households, dealing with early marriage putting a halt to their education, and much more. With this new understanding and appreciation, my students can go forward and apply their knowledge and newly acquired skills to the next classroom they teach in. As for me, I’ve learned just how effective this teaching method was, and will simply say: field trips are where theory comes alive.
How Attending a Teaching and Learning Workshop
Transformed my Approach in the Classroom
Ms Shireen Shehzad, Assistant Professor – School of Nursing and Midwifery (SONAM), Pakistan
October 20, 2019
This summer, I attended the Teaching and Learning Enhancement Workshop (TLEW), hosted by the Networks of Quality, Teaching and Learning (QTL_net). The purpose of TLEW is to enhance faculty members' teaching skills by introducing new instructional strategies. TLEW allows educators to develop and refine their teaching skills for more productive learning in their classrooms.
An important organizational skill that I learned in TLEW was the BOPPPS model for lesson planning. The acronym BOPPPS stands for: Bridge-in, Outcomes (or Objectives), Pre-assessment, Participatory learning, Post-assessment, and Summary. This method provides a structured framework for teaching and allows faculty members to implement their content in the most effective way.
In my experience in the classroom, the BOPPPS model did not change the content of my teaching; as I have been teaching the same course since the last few years and have also been applying various teaching and learning strategies. BOPPPS provided a framework for my teaching so that the content was well absorbed and understood by the students in an organized way. It has transformed the way I teach and my students' interaction with the content in the most positive way.
Putting BOPPPS into Practice
My first session after attending TLEW was on community assessment of Community Health Nursing (CHN) course. It is a clinical based course and students are expected to integrate this session's learning into their clinical practice. I was very excited and a little nervous about applying my TLEW learnings because of the large class size but yet again it was a trial and error process. I began my lesson of the day by bridging-in with a video of a local community assessment that I wanted my students to take part in. I was very clear in my outcome/objective that I wanted to simulate the students' first day in the community before they had even set foot there and they would learn how to assess a community that may be far different from their own. For pre-assessment and participatory learning, I distributed sticky notes among students. Each row of the venue got different domains of the community core system or the sub system. I asked each student to think about an assessment strategy to assess the assigned domain when entering into the new community. This actively engaged students as they wrote down what they already knew about community assessment through the video and then formulated a question or an observation for community assessment. Afterwards, the students placed their sticky note on the blackboard below their assigned domains of community assessment such as environment, health, society, politics, history, etc. I then asked students to go through each and every domain and read the notes and learn from each other's knowledge and they were allowed to deliberate on these questions, if needed. For post-assessment, I asked their understanding through some reflective scenarios. This way, even after the lesson was over, students would keep reflecting on the discussions and develop their own thought processes. After summarization, I utilized another activity that I learned in TLEW: the 'ah-ha moment' and the 'muddiest moment' to conclude my session. Students reflected on the session: when they had a spur-of-the-moment brilliant insight, and what moment they found most challenging.
I got a lot of positive feedback from students who enjoyed the activities and learned the required concepts. Using the BOPPPS model in my lesson, students were well prepared with the precise analytical tools for their first day of clinical in the new communities.
Classrooms of Care: Connecting with Students in an Oncology Nursing Diploma Programme
Diana Kassaman, Senior Instructor, SONAM and Tayreez Mushani, Adjunct Faculty SONAM - Kenya
October 10, 2019
Classrooms of Care establish the foundation of caring and collaborative culture among students and practitioners. Our teaching philosophy is deeply rooted in the nexus of caring and collaboration which we wanted to set as a classroom norm from the beginning of our course in the Oncology Nursing Diploma Program. We were greatly inspired by the University Chancellor's speech at the inauguration of the School of Nursing and Midwifery (SONAM) in Karachi, Pakistan where he stated,
"If you fail, I have failed, if you succeed, Pakistan will be rewarded."
We used this as a preamble in the course; and on the first day, we told our students,
"If you fail, we will have failed and if you succeed, Kenya will be rewarded because our patients will receive better care."
Classroom of care is an important milieu for an Oncology Nursing Diploma Programme where students learn to empathize with patients and families they would be working with in the hospitals. Generally, students in the program come from many different and diverse backgrounds. In our class, there was only one student who had an experience of working in an Oncology Centre and the rest of the students had little knowledge about Oncology nursing due to which some concepts were entirely new to them. Therefore, it was important for us to establish a safe class environment from the very beginning with clear instructions so that students felt comfortable in asking questions and expressing themselves whenever concepts were unclear. Moreover, during the course we fostered the elements of care and collaboration through three distinct ways:
- Creating Culture of Caring Classrooms: In the diploma programme, our course classes were scheduled for two days a week. On day one of each week, we encouraged students to share their stories, songs, poems, etc. and then we reflected on them together as a whole class. To appreciate students' efforts and engagement, we also displayed some of the printable stories and poems on the bulletin board. For day two of each week, we initiated prayers in the classroom, following the guidelines of being respectful to all faiths. Both of these initiatives (i.e. reflection on students' work and prayers) established the culture, comfort and exemplified the practice that we saw all our students as equals and we cared about their learning experiences. In our class, holistic care has always been central to the learning process; therefore, we extended the concept of care beyond classroom boundaries by celebrating students' birthdays, baby showers, and reaching out to individuals who were struggling. Through this approach, we wanted to show our students that, as human beings, there will be many different moments and emotions they will experience in their nursing careers and they must adjust how they care for patients depending on these circumstances.
- Valuing Students' Feedback: It is widely acknowledged that effective teaching requires one to make an effort to know one's students because in the class, there are students with diverse personalities, needs and learning styles. We believe that knowing students' strengths and weaknesses, and then planning our lessons and activities accordingly, made us more effective teachers. Therefore, on a regular basis, we would request our students to share their feedback on the course content and facilitation, and indicate areas they thought required improvement. Through this process, we learned that whilst teaching, it's important to look around and recognize when students are not following the concepts. For example, when we experienced this situation, we stepped back and asked ourselves, "How do students want us to approach this concept? Which strategy would help them to understand the concepts in an easier way"? Reflection on these questions along with students' feedback through evaluation forms helped us improve our skills as facilitators. This improvement in our teaching strategies helped students recognize that their feedback and thinking was valuable to the class and to us.
- Preaching what we practice: Role modelling and awareness of your actions as a facilitator are also crucial, as students do not only learn from 'what you say' but they critically observe and learn from 'what you do'. For instance, when we go to the clinical site in the hospital, how we interacted with the staff, doctors, and patients was a key learning aspect.
Through some of these approaches, we created a caring community of learners—a community whose members feel valued, personally connected to one another, and committed to everyone's growth and learning. Towards the end of the course, it was fulfiling for us to see our students progressing through the course. They excelled in their licensing exam: out of the 16 students who sat the Nursing Council Examination, 13 students passed with distinction, and 3 with credit, placing all students within the top two levels of the examination. Furthermore, we were happy to see that prior to taking the exam, students were very confident in their abilities to succeed. We were very pleased with these results, and truly proud of their hard work.
Reflections from a "master" teacher: It's never too late to learn
Dr. Nancy Booker, Assistant Professor and Director - Academic
Affairs, Graduate School of Media and Communications (GSMC)
April 3, 2019
I thought I should share my reflections regarding a course that I am teaching for the second time. The first time I taught this course was in January 2018. I hadn't enrolled for any of the workshops offered by the Network of Quality Teaching and Learning so I was relying on my prior experience and anything I could find online regarding the flipped classroom approach. I now have the advantage of having attended two workshops namely the Teaching and Learning Enhancement Workshop (TLEW) in April 2018 and Re-thinking Teaching (RTT) Workshop in November 2018. During the Re-thinking teaching workshop, I redesigned a different course but applied the ideas to the course I am currently teaching.
The result: My first class this semester was great. I went home elated by the three-hour class session we had. I was even able to get on a Skype call after class and work for another hour! Ordinarily, I would be so exhausted after class that driving myself home would be a nightmare – partly because as a teacher I would do most of the talking – you all know how we sometimes like the sound of our own voices. Well, not yesterday. This is how my three-hour class ran.
5:30 – 6:00pm: We started at 5:30pm with some housekeeping and a re-cap of the assessments the students will be undertaking in the Digital Journalism course this semester. I also checked with them whether they had completed their prior readings and made short notes as indicated on VLE. They were also to watch a short video that had been shared on VLE. During the orientation week Edward, insisted that I walk them through my course on VLE. Initially I was timid. I didn't think I had done much but with his encouragement, I walked the students through my course on VLE and Edward was very impressed with how I had infused different ways of teaching and how I had flipped the classroom.
6:00 – 6:30pm: I put the students in groups of 5, to discuss the readings. I had developed a set ofquestions based on the readings and the video they watched. I also had questions that would allow them to reflect on their own organizations and their everyday work experience in the current media ecosystem.These discussions were animated. They couldn't stop talking among themselves. As I walked from group to group, I saw the class come alive and the passion to share with each other was evident.
6:30 – 7:00pm: I selected a few questions that I wanted us to reflect on jointly as a class. Since they had discussed these in their groups, the feedback session was very rich. Please note this is a skill I learnt from RTT workshop in Karachi. I saw how Jacque would run the sessions and I said to myself, "I mustto do that when I get back to Nairobi." I also got a chance to share bits of my lecture notes with the class and they could see how my presentation related to what they were experiencing in their workplaces.Boom! They were able to relate theory and practice.We then took a quick tea break before settling down for a panel discussion with invited guests from the media industry.
7:15 – 8:30pm: Each of the guests had a brief regarding what areas they would focus on during their presentation – they would speak to various issues regarding the media ecosystem from a local, regional and global perspective and the import of this to journalism practice and more importantly to story- telling – which is what my course is all about. Each spoke for 5-6 minutes then we opened it up for Q and A. Let me state that I had this same panel last year and it was exhausting to run because I did all the work and ran the show. This time the students engagedthe panelists much more. They had questions ready. Remember they had read, discussed in groups and then discussed as a class and I had pushed them to think about some of the issues that were emerging and challenged them to engage the panelists because they are the practitioners.
This session went very well. At some point, there were so many questions that I had to seek their indulgence to extend the class by about 10 minutes so that we could have a few more questions addressed. When it was finally over at 8:40pm no one wanted to go home. They stayed on, debated further in small groups and engaged the panellists further - in small groups or as individuals. The panellists said they also learnt a lot from the students.
What I have learnt from this.
One, my teaching experience has improved greatly since I took the courses you offer and for that I am eternally grateful. Having taught for so long (never mind that I am not a trained teacher. I am an expert in my field) I kept wondering what there was to learn about teaching. I had been there, done that! Well, I have learnt a lot in the past year from TLEW and RTT workshops and will continue to learn so that I can improve the experience for my students.
Two, flipping the classroom is the best way to get students – particularly in the graduate programmes, to learn. They share so much with each other and they learn better from each other. I am working with students who come to class with so much knowledge and practice as they are practitioners. I sometimes wonder what more there is to learn for them, but it is amazing just how many walk out saying, "that was a good class, I learnt so much." But, for this to happen, one needs to do lots of preparation before class. It is what the teacher does prior to the 3-hour lecture that will determine how well the class runs and how much learning takes place. Hence proper planning and structuring of the lesson, the activities and other teaching resources is key.
I continue to improve my teaching and the learning experience for my students' every day. It is a journey but with your help I am well on course! Thank you and looking forward to more engagements with the team. I will update you as we go along.
Teaching through Case Study Method using Toulmin's Model of Argumentation
Dr. Sadia Muzaffar Bhutta, Assistant Professor, Institute for Educational Development (IED), Pakistan
February 20, 2019
Being the eldest in the family, I started teaching my younger siblings at a very young age. After completing my Masters, I joined a local school and started teaching the way I was taught by my teachers. As an early career teacher, I was a strong believer of 'teacher-led' classrooms with 'slight touch' of student-talk. I started questioning this notion of pedagogical practice after being exposed to 'alternative' strategies of teaching which brought a paradigm shift in my notions and theories of teaching and learning. My espoused teaching philosophy is deeply rooted in constructivism, which relies on the nexus of 'active teaching' (teacher presents the content through interactive teaching) and 'active learning' (students take initiative to deconstruct and reconstruct knowledge and develop skills).
I view active teaching and learning as a 'balanced approach' in which both, the facilitator and the learners, actively participate to construct knowledge. Within this balanced approach, I find case studies to be an effective method, because it enables the facilitators and learners to critically apply disciplinary concepts in an authentic, real life, context.
An example from a Master of Education course called the Pedagogical Content Knowledge in Science clearly manifests the effectiveness of the case study method in improving students' learning. For one of the course themes, I generally use the case of the 'Designer's Baby' to engage students in argumentation while teaching socio-scientific issues. Students begin their learning cycle by exploring the case and sorting out the relevant facts and figures. Afterwards, they are involved in analyzing the information presented in the case, posing relevant questions, and developing logical conclusions through peer discussions. Based on their analysis, they take positions that require them to argue for or against the permissibility of a choice for parents to design their babies by selecting specific traits using the Toulmin's Model to frame their arguments and back/support their claims. Toulmin's model is the tool used for analyzing the components of arguments. Subsequently, they provide scientiﬁcally grounded arguments, expressing opinions, making decisions, and applying their learned theoretical concept in the given scenario. An example of the arguments developed by students using the Toulmin's Model is shown in the image below:
Evidently, the image shows that the learners argued for and against the Designer Baby case following the line of reasoning, whereby ethical and social considerations were demystified and discussed during the argumentation session in the class.
Many such experiences using the case study method for teaching and learning have led me to believe that it enhances students' cognition from merely recalling the information present in the scenario to a step ahead, where they are actively engaged in analyzing and evaluating the concepts and finally generating arguments to support their decision. Some of the students shared their views regarding this process as:
Argumentation [using case studies] generated a discussion in the classroom where we did not only begin to articulate reasons for supporting a particular claim and justify our views but we also started to listen to our peers' ideas, challenging them and then respond accordingly
Argumentation helps us to go beyond the memorization and superficial learning to a stage where we can actively integrate and apply concepts under an array of situations and circumstances
Having applied this strategy for over 5 years, I find case-based discussions effective in helping apply theoretical knowledge in daily life situations. This approach seems to have contributed to stretching the boundaries of the science classroom by applying the theory in real-life situations and connecting it to social, political, economic, religious and ethical issues.
Mock Drill: Simulator Mediated Activity for Resuscitation Training (SMART)
Azmat Khan, Assistant Professor, School of Nursing and Midwifery (SONAM), Pakistan
October 5, 2018
I am a graduate of AKU-SONAM-Pakistan, and I have been teaching in an undergraduate nursing program (BScN) for several years. I teach Bachelor of Science in Nursing (BScN) fourth year program's clinical course where students are expected to work in the emergency department (ED) and provide care to patients in vulnerable situations. Over the years, I have observed that the students usually avoid performing Cardio-Pulmonary Resuscitation (CPR) in emergency situations. They feel anxious and fearful even while observing CPR and tend to stay far from the resuscitation team. I decided to use a
Simulator-Mediated Activity for Resuscitation Training (SMART) in the simulation lab at CIME, to reduce their anxiety and enhance their clinical skills. I purposely use mannequin (Resusci Anne Simulator) as the simulator has high quality airway management with endotracheal tubes, spontaneous breathing, live defibrillation and synchronized ECG, IV insertion, blood pressure and pulse monitoring, Quality Chest compression feedback on the SimPad, voice, lung and heart sounds for basic simulation training. I teach the session in four phases namely: pre-session briefing, orientation, implementation, and modeling and debriefing.
This is conducted, a day prior to actual mock drill a pre-session briefing. I engage students in discussions around life threatening arrhythmias, algorithms and resuscitation team roles.
In this phase, I divide students into two groups (Group A and B), and orient them on simulated ED room, mannequin, simulator and equipment (Crash Cart, Defibrillator, Ambo bag, Oxygen flow-meter).
I provide a scenario to students in Group A and they share roles as a resuscitation team. I regulate SimPad to provide them with specific situation and they run a Mega Code on simulated mannequin according to the given scenario (used American Heart Association testing mega code scenarios). During resuscitation activity, I provide different arrhythmias through SimPad and according to these arrhythmias students select an appropriate algorithm and run the code.
Also, I assign a student from Group B to video-record the whole activity while the rest of Group B members observe critically from the adjacent observation room and make notes on Group A's activity. After the performance of one group, roles of both the groups are switched.
Modelling and Debriefing
After the performance of both the groups, we discuss the activity. Subsequently, I model CPR for the students on the mannequin having the pre-set arrhythmias. The students then demonstrate CPR and get feedback on their performance and I re-demonstrate where necessary. Thereafter, we debrief the session using the recorded videos where students reflect and discuss what and how they have learned and how can they perform better.
Students' feedback on the use of SMART was sought and 81% students indicated that the mock-drill enabled them to meet their objective of identifying cardiac dysrhythmias and performing algorithms in their resuscitation teams. 94% were satisfied with the learning methodology used in the mock-drill and 93% of the students found SMART useful in enhancing their knowledge and skills regarding CPR. Some students shared:
"The mock drill was fruitful and I suggest more of these kind of mock drills as practice make a person perfect".
"SMART mock-drill was a good initiative as it helped me reduce my anxiety towards CPR. It should be organized for all BScN students."
"The drill was a nice practice to give same exposure to what we might face in critical area".
In nursing education, simulation based technology and simulation environment plays a crucial role in providing students with hands-on practice where they can engage in recursive practice and learn through their mistakes which contribute towards becoming a competent and a safe nurse. Next time I teach the course again, I plan to go a step further and take the learners to the Emergency Room to enable them apply their learning in the real-life critical area. My students and I have benefitted greatly using SMART approach. I recommend SMART approach to all faculty who teach CPR to health care professionals.
Evoking a rhythm for learning in Health and Development
Kausar S. Khan, Senior Lecturer, Community Health Sciences, Medical College, Aga Khan University, Karachi.
July 31, 2018
I teach the program of Community Health Sciences to undergraduate and graduate medical students at AKU. I also teach short courses to people from non-governmental and government organizations. My teaching is inspired by Paolo Freire and Carl Rogers, whereby the learner is 'engaged' in the subject to be learnt. I strongly believe that 'people remember what they discover' and, therefore, while teaching I engage learners in making meaning of the subjects/ideas introduced. In short, I follow the maxim, that learners are not empty vessels that have to be filled by some expert.
The following is an example of a very specific teaching strategy that I developed and used with the first-year undergraduate medical students (80+ students), while teaching the topic of health and development. My aim was to help them comprehend the complex and evolving relationship between health, poverty and development; identify determinants of health in Pakistan; discuss factors affecting determinants and propose ways to eradicate elements that negatively affect health. The students sit in rows after rows in a large hall; average age is 17 years. I used PowerPoint presentation to flash the topic and introduce the content of the topic. I distributed what I call 'Students – Worksheets', which have seven sections that correspond with the questions raised during my presentation. In the worksheets, each student is requested to write his/her responses to questions raised. A short (5 min) video clip on health issues in Karachi is shown, and students write down the salient health issues raised by the film. After every section filled in the Worksheet, students share what they have written. Students at one point are asked: "For better health outcomes of the most vulnerable and marginalized, who should define development?" (Question displayed on a slide of the power-point presentation). This is the rhythm of the class room session – questions raised, students write their response on the Worksheet, share their response, and power presentation moves on. For example, section 6 on the worksheet required students to write what they learnt from the session and in section 7 they write their reflexive note (reflexivity is introduced to the students in an earlier session). Worksheets are collected at the end of the session.
It is quite striking that the majority of students successfully write the reflexive notes and, barring a few, are able to separate their thoughts and feelings. In my experience, the process of separating feelings and thoughts is often not easy for learners. An example from students' reflexive notes, reads: "Empathy leads to a will to change things. I thought about how to help the poor after I graduate. I understood the importance of community health, I felt empathy for my community." It was also very striking that the learning (section 6) went beyond the stated objectives of the session.
Having experienced the efficacy of Student-worksheets in my classroom, I believe that the worksheet provides the students the opportunity to first access their own understanding/opinions before listening to other views while remaining focused on the learning task. When the students shared what they wrote, they were open to hear and appreciated diverse point of views and were not disrespectful towards each other. For me, worksheets have always worked – they stimulate students to think and share their thoughts with others. My role in teaching is simply appreciating students' thoughts and validating them. The student-worksheets are taylor made for every session, however, the section 6 and 7 i.e. what have you learnt; and reflexive note remains same all across.
Game based learning: using technology to enhance active learning in a health assessment course
Ms. Beth Waweru, Instructor, School of Nursing and Midwifery, Kenya.
August 17, 2017
My teaching philosophy evolves around active learning and understanding of concepts by the students and that learning has to be interesting. My approach of teaching hence reflects this philosophy and that is why I chose Kahoot as part of my instructional methods in the Health Assessment Course.
Concept of Digital Game Based Learning (DGBL) as used in Health Assessment Course
The theoretical foundation of games as a teaching and learning strategy was first described by Kolb in his experiential learning model. Game-based learning is considered to be risk free and it encourages exploration and trial-and-error actions with instant feedback and hence stimulates curiosity and learning(Hussein, 2015). Digital game-based connects educational content with computer or video games and can be used in almost all subjects and skill levels. With advancement in technology, students need to be prepared to participate in the globalized technological society of the 21st Century in the course of their learning. Learning also need to be interactive and interesting with instant feedback.
What is Kahoot?
“Kahoot! is a free online classroom response system designed to allow instructors to quickly and easily create question-based learning games that can be used to assess student learning, review concepts, teach new material, and/or facilitate classroom discussions”(Graham, 2015). The Kahoot platform is a simple and intuitive game development tool that allows instructors to skip the technical hurdle they might otherwise encounter in developing a digital game and focus instead on instructional outcomes (Graham, 2015).
I mainly use Kahoot to evaluate whether students have done their pre-lesson reading and how well they have understood the material. It assists me to utilize the limited lesson time to clarify concepts that were not well understood and build on what is already known. Occasionally, I use Kahoot, to evaluate post lesson.
Initially, some students resisted. In my first lesson, some students were reluctant to connect to Kahoot and opted to work with their desk mates. So I had just a few participants but I rewarded the winners. In subsequent lessons I had more participants all hoping to be cheered up as winners and as we progressed it became more interesting.
At the end of the course, I did a simple evaluation of Kahoot as a teaching strategy. I used a likert scale type of questions with 1-4 points. There were also two open-ended questions of what they liked most and what they did not like about Kahoot. Most of the responses on the likert scale questions ranged between 1-2. Twenty-four out of twenty-six students participated in the evaluation. Most students rated the use of Kahoot high. Below are some of the students’ responses on what the students liked most and what they did not like:
The use of Kahoot: “ made lessons interactive” “Very interesting and fun” “Encouraged me to read prior to lessons” “Enabled me improve thinking ability” “Fast way of learning concepts” “Nice way of keeping learners awake”.
Some students felt that the time for answering the questions was not enough as stated in this comment: “there was no time to think”. Use of technology was also a challenge.
DGBL engages students in their learning and makes learning interesting. The instructor is able to assess whether or not learning has taken place and can give prompt feedback to students.
Graham, K. (2015). TechMatters: Getting into Kahoot!(s): Exploring a game-based learning system to enhance student learning. LOEX Quarterly, 42(3), 4.
Hussein, B. (2015). A Blended Learning Approach to Teaching Project Management:
A Model for Active Participation and Involvement: Insights from Norway. Education Sciences, 5(2), 104.
February 11, 2017
Flipping the classroom-Use of Moodle in the Teaching and Learning of Reproductive Health Nursing: A Teaching Story by Ms. Jane Kabo, Senior Instructor, School of Nursing and Midwifery, Kenya.
"As an instructor for Reproductive Health Nursing, I believe that every student deserves quality teaching and learning processes. Quality teaching and learning experiences enhances students’ achievement. Students come with unique experiences and backgrounds, and therefore it is pertinent to adapt the classroom teaching according to the needs of the learners.
I intentionally choose strategies that maximize students’ learning rather than choosing those, that are easy-to-use. For example, group works are more difficult to organize and manage, as compared to lectures. However, group work is more effective than lectures because it engages students in learning and allow them to take control of their own learning.
The flipped classroom is a pedagogical model which reverses what typically occurs in class and out of class. Students are first exposed to the material outside of class, in the form of video-based lectures. Subsequently, class-time is used to engage in activities like problem solving, creating, critiquing, analysis and synthesizing of information. Students take ownership of their learning by using flipped approach as it keeps them engaged in and outside classroom. The pedagogy has enabled me to apply more of active learning strategies by placing the responsibility for learning upon the student, giving me a role of a facilitator rather than one way provider of information. I have moved from instructor-centered to student-centered learning environment while using flipped approach and my students are able to interact prolifically with each other, the content and the instructor.
Use of Moodle platform while flipping classroom, has allowed me to use variety of methods to engage the learners and to provide online support for my course. Providing a central space on the web where students can access a set of tools and resources anytime anywhere allows them to work flexibly in and out of class. Through the platform, learners ask questions (in and out of classroom) without feeling embarrassed as their anonymity is maintained. I’m able to access students’ questions, summarise, organise and analyse them, and address them during my face to face lesson. I’m also able to share resources beforehand and engage students in discussion forums. Linking the assignments with the lessons and posting quizzes on line has saved me time, postage and paper.
The use of moodle to flip my classroom has supported learning throughout; expanded course offerings and experiences; increased student engagement and motivation; and accelerated learning. From my experience, the technology has improved educational productivity in a number of ways; and students learn faster in and out of class. It reduces the cost of instructional materials and increases efficiency (instructor’s time).
However, there are a few challenges in using flipped classroom and technology. For example, teachers may find it difficult as it takes a lot of time to design higher order thinking tasks. Students may find it difficult to take charge of their learning especially out of the classroom, and some students are not tech-savvy and thus they may find it difficult to work online effectively. Some planned strategies may not work well while delivering the course, and thus, teacher needs to rethink and redesign course as per students’ needs.
In conclusion, applying the flipped philosophy has enabled me adopt a teaching approach that allows me to adapt, in the online environment, the strategies that I use in face-to-face classes. The benefits of the flipped classroom model outweigh the challenges. The implementation of the model becomes easier over time. Moreover, it equips students with skills required in a changing technology landscape and instructors need to integrate knowledge, instructional practices, and technologies."
Use of Active Illustration in Patient Education:
Ms. Nausheen Salim, Senior Instructor, School of Nursing And Midwifery, Karachi.
January 13, 2017
Ms. Nausheen Salim, Senior Instructor , SONAM Pakistan shares her teaching story and experience as a teacher and nurse:
"Although I am a nurse by profession, I value my identity as a teacher. Teaching nurses in a clinical setting provides them with important on-site hands-on experience of patient care. One important clinical skill that I teach nurses is patient education. This involves educating patients to help them understand “what has happened to them,” “what are the possible causes,” “how can it be treated,” and “what is the future plan for care.”
“Active Illustration Technique” is a useful tool to use with patients and their families to inform them about their disease process and to help them make decisions about their proposed plan of care. By using the scientific knowledge base, effective communication skills, and simple metaphorical exemplars, a nurse can help the patient understand the medical diagnosis. For example, the metaphor of blocked water pipes is used to generate discussion about the risk factors, pathophysiology, signs and symptoms, and complication of high blood pressure.
To use active illustration technique, one needs to think of various life processes and compare them with real-life phenomena existing in society. This also involves thinking about how the disease could adversely affect the life processes. After choosing the metaphor from daily life, one illustrates the process using stick-figure drawings while conversing with the patient. To use this strategy, one only needs to have an A4-sized paper and a pencil.
There are two pre-requisites for successful use of this strategy: knowing the language of the patient and complete knowledge of the disease process under discussion. However, this strategy may not work in certain circumstances, for instance, if a patient is not interested or ready to hear the details of his/her disease or he/she is not in a state of mind to comprehend the issue.
My students use a variety of exemplars and metaphors in educating their patients about the health problems they are experiencing. Students report that “this technique enhances patients’ understanding of their conditions.” Consequently, “it enhances their competence in implementing any proposed plan of care.” They also find it “useful in developing a rapport with the patients and their families.” In addition, it develops a “sense of trust and mutual respect between patients and student nurses.” This is beneficial for patient compliance with treatment and post-treatment care. Also, this technique could lead patients’ improved satisfaction for the care provided, a better understanding of the role of nurses, and enhancement of nurses’ self-worth.
In conclusion, I think this strategy is applicable to most disciplines in general and nursing education in particular. Using on-the-spot narration of the phenomenon at hand, using metaphors and visual illustrations, and engaging learners’ multiple senses can lead to a better understanding of how complicated medical knowledge can be effectively transferred."
Patients at the Heart of Teaching:
A Blended Learning Course Experience - Dr. Sameena Shah
December 05, 2016
Dr. Sameena Shah, Associate Professor Family Physician, Medical College, Karachi, Pakistan shares her teaching story on how Blended Learning Faculty Development Programme has equipped her with critical online pedagogical skills. This is her experience:
“I am a consultant Family Physician at the Aga Khan University. In addition to being a clinician, I am also a teacher, and I love what I do.
Since 2012, I have been working extensively to develop and establish palliative medicine services including ‘end of life care’ at the Aga Khan University Hospital. As an emerging area in Medical Education in Pakistan, in order to increase capacity at AKUH and AKHSP, I have designed and developed regular face-to-face courses and workshops on Palliative Care for postgraduates and physicians.
In 2013, I participated in the Faculty Development Programme for Blended Learning.
My participation in the programme equipped me to use online pedagogies to reach physicians remotely in areas such as Interior Sindh, Gilgit-Baltistan, Karachi and AKU residents both on and off-campus.
Providing awareness about the human dimension of patients to ensure their holistic wellbeing and care has always been at the core of my teaching. In addition to the scientific side of medicine, students need to be sensitive to their patients’ and patients families’ socio-cultural and emotional dimensions to be able to facilitate effective care and management in clinical settings and indeed the community.
Previously, I used role-play and presentations to teach core concepts. With the blended learning approach, I now create ‘online’ patient stories as a resource to organise a number of teaching and learning activities.
To ensure holistic and patient-centred learning I have created varied socio-economic and cultural settings for each patient that highlight key issues. Moreover, I have included lab reports, radiological investigations and hand-written prescriptions as part of the patients’ narratives.
Towards the end of the course, students participate in a practical component where they visit a hospice and observe clinical consultations in real-time. The course concludes with a workshop based on the patient stories to teach and practice counselling skills through evidence based role-play strategies.
Through fictionalising real-life accounts and encouraging students to review them not only as clinical scenarios but ‘stories’, routinely moderating discussions and reasoning on online discussion forums, presenting students with probing questions and clarifying concepts, the patient’s life is at the centre of teaching and learning activities.
Feedback highlighted the usefulness of “interdependence” in discussions where participants were able to learn from each other. They appreciated the way patient stories were presented with incorporation of sensitive issues, and how visuals such as reports and prescriptions were added.
However, a few of the participants felt that the interaction on online discussions could be improved by more faculty member and peer input and more frequent live summary sessions for clarification of queries. This did strike a chord, as a challenge with this methodology for me has been establishing an adequate view of students’ progress, due to the asynchronous nature of discussions. However, reviewing students’ responses is always helpful to understand what they have learned and where they need assistance.
It was a learning curve, but by the end of discussions, I was able to ascertain the level of understanding of my students. Another challenge is structuring the task with relevant questions, activities and visual details so as to make it as real as possible. Linking it to the objective of the course and at the same time giving enough freedom to students to think and work independently is yet another challenge. I overcome these challenges by detailed planning and provision of pre-reading material to help students to come prepared to the (online) and classroom lectures.
I also want to highlight the importance of professional development in designing a course in such an innovative format; I learned by doing! Faculty mentors and course designers at the Network of Blended and Digital Learning provided me with strong pedagogical knowledge about blended learning, provided feedback on course design and developed digital learning artefacts for this course. Another important aspect to my learning were reflective conversations where course designers would ask me difficult but interesting questions on why I would like to design and teach a concept in a certain manner, how learning materials should be presented or how it can enhance students’ engagement in learning. Moreover, we would critically reflect upon the challenges and collaboratively devise strategies to overcome them for next offerings of the course.
Based on my experiences, I recommend that we should the attempt to make our teaching more patient-centred in content and clinical practice and include more student-centred in teaching and learning activities. It is also important to make changes of the courses as per student feedback.”
The Pedagogy of Service Learning
Mary Oluga, Assistant Professor and Coordinator, MEd Part-Time Programmes
March 16, 2015
In the last 30 years, I have taught learners ranging from primary school children to adults undertaking a Master in Education. Needless to say, my teaching philosophy has experienced a metamorphosis during this period. Today, I understand that the ultimate aim of education should be to develop an inquisitive mind, which, at the same time, seeks answers to questions raised by such a mind. This enables an individual to seek real answers that aim to improve society. This philosophy is intricately embedded in my teaching presently. Subsequently, as an educator, I often seek improvement for myself and others by engaging in reasoned thought.
Working with practitioners I always endeavour to encourage reasoning. One of the ways in which I have taught in this manner is through engaging my students in service learning – “a teaching and learning strategy that integrates meaningful community service with instruction and reflection to enrich the learning experience, teach civic responsibility and strengthen communities” (Eyler et al., 2001). I have found it most appropriate because service learning combines learning goals and community service in ways that enhance both student growth and the common good.
Teachers are often confronted with sensitive and controversial issues in their classrooms but are required to display a neutral and objective position. This is difficult and unreal. Hence, I have used both community service learning (CSL) and community based learning (CBL) to deal with such issues. For example, with the former, my groups of MEd students went into a community to engage the latter in thinking of solutions to problems in the community. With CBL, groups of teachers and school administrators were brought into the institution and my group of master’s students facilitated a classroom-like workshop. Once, the students used interactive theatre to engage the community in discussing two social issues: abortion and female genital mutilation. In interactive theatre, the actors speak directly to the audience or engage them in actions, thus breaking the imaginary wall between the performers (students) and the audience (community). Both approaches often attract the attention of other staff and faculty. I attribute this to the spontaneous ways in which the strategies offer realistic solutions to realistic problems.
After every session of service learning, I get the students to reflect on their learning. The lessons learnt by both the students and me help me improve on the structure of subsequent sessions.
While I recommend that educators should employ engaged pedagogies, I also recognise the challenge in "allowing the time" for this to take place. Elements of the intended outcome should be introduced gradually in the course or discipline taught. The course overview and objectives should state very clearly the purpose and justification for using service learning, as this pedagogy has implications on time, money and other resource materials.
The outcomes of service learning are immediate and are reflected in the attitudinal changes the students and community often share after such learning moments. The gains for the students are best captured by this comment from one of the MEd students after carrying out service learning, “We do not have to wait until the end of school for our students to see the impact of our teaching.” Indeed, the comment applies to me, too. I live my teaching as my students live their learning.
If you are interested in sharing your teaching story, please contact Kiran Qasim Ali.