Google Drive as an implementation platform for PHT403
Dr Tania Steyl
Framing of the case
• Feedback form external examiners: final
year PT students lack reasoning and critical
reasoning in clinical examinations
• Initiated the change from didactic →
theoretically informed blended approach to
T & L
• 2014: PHT403 module had to be changed
to accommodate this change in teaching
• PHT403: theoretical and practical
• pathology, clinical presentation and
therapeutic management of conditions seen
in the adult and paediatric ICU
• Previously: course readers and a
predominantly lecture-based format
• lack of critical thinking and reasoning
reported during clinical exams
• case-based, blended approach to teaching
Applied Physiotherapy implemented in 2012
• Had to adapt PHT403 for 2014.
• To have a platform where students could work
collaboratively and become critical thinkers.
• To give the students the opportunity to voice their
opinions regarding their understanding of the
• To allow students to view knowledge as a set of
tools for problem solving in a process of learning.
• To improve communication which could enhance
the learning process through meaningful discussion
• To give the students feedback timeously on a
regular basis and guide them if the headed in the
Intended outcomes cont.
• To allow lecturers and fellow students to give
constructive feedback so that the final product is
of good quality.
• To give students the opportunity to re-think their
answers and brainstorm the concepts
• To allow students to see other groups’ case notes
and compare it to their own notes (could further
assist with ‘critical thinking’ as students could think
why are the other group directing towards those
specific thoughts while our group are steering
towards another way of answering the question)
• Clinical cases had to be developed.
• Although students were familiar with the use of Google
Drive/Docs, the format of PHT403 was different to
what they were used to (PHT203 and PHT303: a
case ran over 3 weeks; PHT403: a case ran over 2
days due to time constraints)
• There is not enough engagement and contribution
from ALL students when doing the clinical cases.
• I would like to see the contribution from each
student towards the task and also guide them in the
• The students should also be able to give
constructive feedback to each other’s contributions.
• PHT403 has a theoretical and practical
• It includes the pathology, clinical
presentation and therapeutic
management of conditions seen in the adult
and paediatric ICU.
• Students received course readers
• A predominantly lecture-based format
was employed in teaching.
Impact / affordances of emerging
• Although a change in the understanding of how learning happens,
emphasise still on the transmission of content (Graffam, 2007)
• = the teacher-centered approach to learning
• Didactic methods of teaching:
** ≠ opportunity to voice opinions regarding understanding
of the content
** separates knowledge from context
** resulting in students viewing knowledge as a product of
learning, rather than seeing knowledge as a set of tools for
problem solving in a process of learning (Herrington & Oliver, 2000)
• Lecturer should assist the student in how to think, and not only
teaching students what to know and what to do (Fraser & Greenhalgh,
• Authentic learning is a style of learning that could be employed to
encourage students to become critical thinkers. One of the nine
principles of authentic learning, according to Herrington (2006) is:
Support collaborative construction of knowledge
• The social constructivist paradigm is associated with
• Encourages students to actively seek new information in order
to construct new knowledge (Hallas, 2000).
• An approach based on development and associated with
students taking a deep approach to learning (Ramsden, 2003).
• Lecturer’s role changes from communication knowledge to
facilitating and supporting students in developing
metacognitive processes (Torrisi & Davis, 2000).
• It allows students to engage with real life tasks and to create a
product that they can share with fellow classmates (Herrington &
• Digital technology could improve communication which could
enhance the learning process through meaningful discussion
• NB! that students learn with technology to change from
knowledge users (teacher-centered learning) to knowledge
constructors (student-centered learning) (Jonassen, 2000)
= constructivist approach to learning
• Collaboration = a process where two or more people work
together by sharing knowledge, learning and building consensus
to reach a common goal (Chu & Kennedy, 2011).
• Affordances = the ability to match your teaching and learning
tasks with appropriate educational technologies (Bower, 2008).
= a way of focussing on the strengths and weaknesses of
technologies with respect to the possibilities they offer the
people that might use them (Gaver, 1991).
• Must keep in mind how the chosen technology will support the
learning task and how the students will experience the use of it
• Google Drive = free web-based tool that enables multiple
persons to work together in real time.
• It enables concurrent document editing and collaboration in
constructing knowledge by multiple users and thus could
potentially enhance the learning experience of students (Rowe,
Bozalek & Frantz, 2013; Chu & Kennedy, 2011).
• As an implementation platform, applied in the PT curriculum
recently: “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” (Rowe et al., 2013).
Google Drive was chosen as implementation platform because of
the following ‘affordances’:
• Allows for the development of the clinical cases for PHT403
• allows for students to work on the group’s case notes collaboratively
• have access to case notes of the other groups
• can be used in addition to face-to-face contact time, e.g. in class for
the creation of content (case notes) as well as afterwards when lecturers
give feedback on the case notes.
• Feedback can be given immediately / timeously
• enables the facilitators to ask questions regarding the students’
developed case notes at any stage to guide the students in the right
• Students can ask questions to clarify any uncertainties regarding the
feedback or their understanding of the concepts.
• The instant messenger feature allows students and staff to discuss
aspects of the case notes while at different locations.
• Critical thinking can be stimulated as comments from the lecturers and
peers can be structured in such a way that the students have to reflect
on their assumptions and reasoning.
• Because each group’s case notes will be different from the other groups,
it will teach the students that there are multiple solutions, rather
than one single answer to the tasks.
Description of intervention
thhopp60 students 3 facilitators
4 groups per
3 weeks; beginning of term 1
6-7 hours per day; work in small groups
2 days per case
Process: Case development
developed 2 clinical
Shared on Google
Example of case
Objectives for Case 2
By the end of this case student should be able to:
• Define terminology related to multiple fractures, the respiratory
system organs in the perineum and lower abdominal cavity.
• Describe the pathologies of the conditions presented in the
• Identify relevant concepts and the relationships between those
• Identify and prioritise problems as a result of the condition(s)
presented in the case
• Describe the holistic and multi-disciplinary management of a
patient with the described condition
• Identify potential internal (e.g. damaged structures) and
external (e.g. socio-economic) factors that might impact on the
• Identify gaps in their own knowledge through self-assessment
and to be able to design a strategy to improve their
Steps to follow
• Step 1: Clarify Terms
• Step 2: Define the problem/s the patient have,
according to the ICF
• Step 3: Brainstorming (list reason & implications of
• Step 4: Structuring and hypothesis (Must be based on
evidence from the case)
• Step 5: Formulating learning outcomes. In your small
groups, identify questions you need to answer based on
the information you have. The questions should start you
thinking about what information you need to gather in
order to solve the problems you identified in Step 2.
• Step 6: Gathering Information (Information regarding
pathology, surgery and possible complications)
• received a hardcopy of the case and it was available of
• creation of case notes collaboratively in Google
• Received feedback (comments and questions) from any
facilitators and peers from the same group to encourage
reflecting on their answer and reasoning
• Students had to respond and ask questions to clarify
• Complete and upload at a specific time
• further feedback from facilitators
• Students had to address the comments timeously to
improve the content of the case notes
• Thereafter shared with the rest of the class
• Before new case commence; upload of facilitators
guide and student information of completed case
Key points for effective practice
Google Docs allowed for: (Bower, 2008)
• easy navigation (accessibility) and it enhanced the learning
process in a more exciting way (read-ability; write-ability)
• greater participation, engagement and collaborative
construction of knowledge
• Students could focus on areas they found challenging and
needed support (highlight-ability)
• allows for editing to be in the form of a discussion (revise-
• The access control of Google Docs allowed for students to
only share (share-ability) the final ‘revised product’ with other
• Moved towards authentic learning (Herrington, 2006)
• students learn with technology to change from knowledge
users (teacher-centered learning) to knowledge constructors
(student-centered learning) (Jonassen, 2000)
• Google Drive allows the students to take ownership of and
responsibility for their own construction of knowledge and
learning (Rowe, et al., 2013).
• It afforded the students the opportunity to collaborate and
engage with each others’ work.
• The read-ability and write-ability (it allows for easy access and
quick response / comments), focus-ability (e.g. the aspects that
they did not understand or found challenging) and highlight-
ability (e.g. they could highlight the areas where they need
more assistance / guidance) affordances, as identified by Bower
(2008) all contributed to a positive experience by the students.
• Students to choose their own groups
• Or have a session regarding group dynamics (after
the 1st case)
• Include a session on ‘constructive feedback’
• Individual assessment (better monitoring)
**rubric for constructive feedback to at
least 2-3 other groups
**rubric for responding to the feedback
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