This document summarizes a study that evaluated the use of online learning strategies to develop clinical judgement in students. The study used a mixed methods approach, including pre-post self-assessments of 19 students, interviews with 4 students, and analysis of online discussion posts. Results found students reported the online learning approach was unlike other experiences and improved their clinical practice and judgement. Analysis of discussion posts showed students found the online discussions and peer support valuable to their learning. The study aimed to determine if online strategies could develop critical thinking for clinical judgement and understand students' experiences with such approaches.

1. Designing student centred and
online learning approaches to
develop clinical judgement:
The student experience
Helen Wozniak
Prof Hugh Grantham
Dr Clare Harvey
Prof Kay Morris Matthews
Dr Elaine Papps

2. Disclosure statement
• Faculty: Helen Wozniak & Hugh Grantham
• No relationships with commercial interests
• Mitigating bias: Teacher – student relationship:
independent researcher
http://www.shutterstock.com/video/clip-2438942-stock-
footage-lab-rat-taken-by-scientist-hd-lab-rat-hairless-taken-
from-a-glass-cage-by-a-scientist-in-two.html

3. “Signature pedagogy”
• Signature pedagogy will shape attitudes
towards the profession, implications of
their decision making and practice
• Learning to deal with uncertainty and
make judgements
Lee Schulman, 2005
Carnegie Foundation for the Advancement of Teaching

4. http://imgarcade.com/1/socrates-teaching/

5. Technological
Knowledge
Content
Knowledge
Pedagogical
Knowledge
Mishra & Koehler, 2006
Optimal
educational
outcome

6. What is a Learning Design?
Tasks Supports
Sequence
over time
Learning Outcome
Oliver et al 2002, Goodyear, 2010
Learning Activity
Resources

7. Online learning design + rationale
• Trigger video
• Readings, references
• Internet sources
• Weekly discussion
• MCQ with a difference
• Short answer Q or Mindmap task
• Intensive face to face
• Peers
• Lecturer- “guide on the side”, monitor

9. Research Questions
• Can online strategies be used to
develop critical thinking and judgement
based on best evidence?
• What was the student experience of
such approaches?
• Mixed methods
– Pre / post self assessment n=19
– In depth student interviews n=4
– Content analysis of discussion postings

10. Continuum of evidence-based
clinical judgements
1.
Protocol
2.
Protocol
+ other
3.
Modify
protocol
less rigid
4.
Challenge
practice +
evidence
5.
Autonomous
holistic
management
Pre Post

11. Student interview themes (n=4)
Style of learning
• Unlike other prior learning experiences
“messing with my head”, “bastard MCQ”
“learner’s high like a runner’s high”
Impact and outcomes on practice
• Seeks out feedback on patients
• Change in attitudes by work colleagues
• Student retention high

12. Content Analysis of Discussion Postings

13. “It certainly has been a journey, we have learnt a lot
along the way and hopefully remember much of it. We
are the first of many and will soon be on the road as
ICP's, its been a pleasure being with a good group of
people who have been respectful and entertaining in
both the discussion forums and our intensive weeks.”
“I have enjoyed the discussions Hugh.”
“I too have valued everyone's support, encouragement
and respect towards each other throughout the
course. Thanks to all for the great laughs and sharing of
personal and professional experiences and knowledge.”

14. References
• Goodyear, P. (2010) Teaching, technology and educational design:
The architecture of productive learning environments. Final report
Senior Fellowship, ALTC
• Mishra, Punya, & Koehler, Matthew J. (2006). Technological
Pedagogical Content Knowledge: A Framework for Teacher
Knowledge. Teachers College Record, 108(6), 1017-1054
• Oliver, R. & Harper, B., Hedberg, J., Wills, S., & Agostinho, S.
(2002). Exploring strategies to formalise the description of learning
designs. In A. Goody, J. Herrington & M. Northcote (Eds.), Quality
conversations: Research and Development in Higher Education,
Volume 25 (pp. 496-504). Jamison, ACT: HERDSA
• Shulman, L. (2005). Signature pedagogies in the
professions. Daedalus, 134(3), 52-59.