Authentic Learning Colloquium @University of the Western Cape

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This presentation aims to highlight the complexity of medical education. It describes the necessity to engage in a non-linear approach that appreciates the students' experiences and their voices. Student-led workshops in their Year 4 & 5 Obstetrics blocks have led to collaborative initiatives promoting change in maternal healthcare services.

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Authentic Learning Colloquium @University of the Western Cape

  1. 1. Creating a collaborative space for criticalityAuthentic Learning Colloquium@the University of the Western Cape March 22nd 2013 Veronica Mitchell M Phil (HES) B Sc (Physio)
  2. 2. Medical EducationA case study in Obstetrics CC:BY|:SA http://www.flickr.com/photos/29604926@N08/4033334428/sizes/z/in/photostream /
  3. 3. Curriculum Complexity Patients Students Clinicians Other team members
  4. 4. Overview • Problem • Initiative • Authentic elements Articulation & Reflection • Impact
  5. 5. South Africa Everyone has the right to have access to health care service Section 27 Theory vs Reality 1996
  6. 6. Legal norms & standardsThe South African A guide to the National Health Professions Constitution Health Act (from the AIDS Council of South Africa, Law Project) (CC BY-SA) General Ethical Guidelines For The Health Care Professions
  7. 7. the gap betweenthe teeth of legal instruments & the implementation challenges CC-BY-ND-NC http://www.flickr.com/photos/hikingartist/5726750811/sizes/l/in/photostream/
  8. 8. Everyone has the right to the enjoyment of ICESCR the highest attainable standard Article 12 of physical and mental health … The Right to Health “ The right to health cannot be realized without the intervention and insight of health workers”Health care Underlying determinants Backman G., Hunt P., Khosla R et al. The Lancet. 2008:2048
  9. 9. Our curriculum
  10. 10. Graduates’ oath @ UCT
  11. 11. The reality in our Maternal Obstetric Units MOUs Reflecting on good/not so goodStacey Stent Illustrations
  12. 12. DiscomfortM. 2012 CC-BY. http://www.flickr.com/photos/aloha75/4024092009/sizes/o/in/photostream
  13. 13. Kaleidoscope of experiences Kaleido App on iPad
  14. 14. What are we doing ? CC-BY. http://www.flickr.com/photos/aloha75/4024092009/sizes/o/in/photostream//
  15. 15. Response Department of Obstetrics Curricular spaces for engagement
  16. 16. Me & my Dilemmas Promoting a culture of conversation in exploring the boundary lines Year 5
  17. 17. Students – peer teachingYear 5 roleplay in 2012Video production
  18. 18. Me & my Dilemmas Probing professional practices Year 4
  19. 19. Theoretical frames Freire Popular education Roleplays Herrington Authentic learning Reflective Mazur Flipped classroom Peer teaching CC:BY:NC:ND :http://www.flickr.com/photos/hikingartist/3000884520/sizes/o/in/photostream/
  20. 20. Context • Obstetrics practical Task • Critical reflection Experts • CoachingPerspectives • Diversity encouragedKnowledge • Classroom chat & presentation • Critical friendsconstruction Authentic elements Herrington, Reeves & Oliver 2010
  21. 21. Reflection • Group, partners and individuals Articulation • Tacit knowledge becoming explicit • Expert guest Scaffolding • Facilitator Assessment • Not practiced here yetProfessional learning • Communities of Practice Authentic elements Herrington, Reeves & Oliver 2010
  22. 22. http://www.elearnopen.info/images/AuthenticityAcademicSettings.png
  23. 23. Peer scaffolding “ To tell the stories of a culture of practice is fundamental to learningLave and Wenger (1991) in Herrington, Reeves & Oliver 2010
  24. 24. Initiative in Year 4 Department of Obstetrics Shift from a culture of silence to dialogueArticulation of real-world problems
  25. 25. Taking a closer look CC:BY http://www.flickr.com/photos/aloha75/4024089915/sizes/o/in/photostream/
  26. 26. Articulation of real-world problems Personal ownership of learning Students in social context“Inherent – as opposed to constructed – opportunities Herrington, Reeves. & Oliver. 2010:32.
  27. 27. Articulation Personal meaning-making Hand-in reflection Critical friend Discussion, online posts Small group interactions Large group chat room“Inherent – as opposed to constructed – opportunities Herrington, Reeves. & Oliver. 2010:32.
  28. 28. Vula & UCT Open Content http://www.uct.ac.zahttp://opencontent.uct.ac.za/Health-Sciences/Probing-Professionalism-Towards-Positive-Practice
  29. 29. Vula & UCT Open Content Six Step Spiral for Critical Reflexivity (SSS4CR) Thanks to Dr Kevin Williams, Prof Athol Kent, Nariman Laattoe, Dr Simone Honikman, Sarah Crawford-Brownehttp://opencontent.uct.ac.za/Health-Sciences/Probing- Professionalism-Towards-Positive-Practice
  30. 30. Vula UCT’s Learning Management System
  31. 31. Cognitive conflict is recognized valued supportedMoving beyond conversations Consensus for the need to work collaboratively towards change
  32. 32. Students’ feedback:• good to normalize and debrief experiences• critical friend opens new insights• good to reflect on own role as students in upholding human rights• gives a structured approach to difficult problems• helps to visualize how the different concepts interact with each other
  33. 33. Collaboration with Department of HealthDepartment meetings, Facility workshops Government: New Codes of Practice Accreditation towards:Mother and Baby friendly Institutions Value students’ voices CC-BY-ND-NC http://www.flickr.com/photos/hikingartist/5726834773/sizes/s/in/photostream
  34. 34. Student Abuse handout http://opencontent.uct.ac.za/Health-Sciences/Public-Health-and-Family-Medicine/Enhancing- Professionalism-Human-Rights-Me-the-University-of-Cape-Town
  35. 35. Probing Professionalism http://www.uct.ac.za http://opencontent.uct.ac.za/Health-Sciences/Probing-Professionalism-Towards-Positive-Practice
  36. 36. Challenges Resistance to reflection why do we have to do this? reflection is for mirrors Hijacking online comments Reflections are private Group work dynamics & participation levelsUnintended consequences – nurses at MOUs
  37. 37. Making a difference to forge ahead Students better prepared and equipped to confront uncertainty, dissonance and supercomplexity of practice CC:BY|:SA http://www.flickr.com/photos/29604926@N08/4033334428/sizes/z/in/photostream /Barnett 2000
  38. 38. Evidence of successPromoting critical reflectionStudent awareness & advocacy growingStrengthening students’ resilienceClinical curricular shift expanding to population concerns beyond patient / doctor interactionsPartnerships towards improving maternal healthcareNew Code of Practice for mothers and babiesOpen Educational Resources – sharing, openness
  39. 39. Kofi Annan “health will finally be seen not as a blessing to be wished for, but as a human right to be fought fors
  40. 40. Medical students’ awareness
  41. 41. Thank You .ReferencesBarnett, R. 2000. Supercomplexity and the curriculum. Studies in higher education. 25.3: 255-265.Herrington, J., Reeves, T. & Oliver, R. 2010. A guide to authentic e-learning. Routledge. London.Zembylos, M. 2012. Critical pedagogy and emotion: working through ‘troubled knowledge’ in posttraumatic contexts,Critical Studies in Education.Stacey Stent Illustrations CC:BY http://www.flickr.com/photos/44442807@N07/4084275497/sizes/z/in/photostream/

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