I became interested in this problem when I realised that we were graduating people who knew about physiotherapy, as opposed to graduating physiotherapists. So, I started to wonder how we can graduate people who have a deeper understanding of what it means to be a physio, rather than trying to figure out how they can get higher marks .
So we want to produce better physio's, which can probably also be stated as wanting to produce people with a better understanding of clinical practice, or who have a deeper understanding of practice knowledge...but this isn't easy at an UG level. Clinical problems change all the time. Any intervention will change the dynamic of the relationship, and trying to establish a balance between what you're doing and where you're trying to get to is a hard problem to solve. We also know that practice knowledge is the product of many years of learning, unlearning and re-learning, so it's hard to say where the knowledge came from or how you got to it.
In other words, tacit knowledge is hard to teach, but it is nonetheless important to develop, and one of the ways that we know works quite well, is...
...reflection, which has been recognised as an important component of clinical practice since we realised that the positivist approach could not in itself effectively describe practice knowledge Reflection is a mental process that has purpose that is applied to relatively complicated problems for which there is no obvious solution” So, developing practice knowledge is a challenge, and reflection on and in practice is one way that can help But it turns out that...
...reflection is also hard to teach.
...and yet we have to find new and interesting ways of developing this skill because it can't be learned from a book, and students don't always appreciate it's benefits. David Cameron is presenting a paper later on what exactly students think of reflection. These challenges force us to find innovative ways of guiding students through a curriculum where memorising content is less important than their ability to make meaning of it through reflection.
One of the ways that we can find meaning is by sharing knowledge and experiences in a collegial environment, which has the effect of: - internalising practice knowledge - developing problem solving strategies - promoting critical and reflective thinking, and - challenging unshared biases OK, so sharing knowledge is good...
...but what is knowledge? As a result of an increasingly connected society, our concept of knowledge is being redefined as a negotiated outcome of social learning experiences that are integrated within the network, rather than within individuals.
In addtion, the rise of social media has facilitated a new communication paradigm that is constructed through community interaction and participation, which enables the formation of loosely connected groups with relative ease.
Taking all of that into account, I started to wonder if there might be an advantage in sharing knowledge and experiences in a social environment, and if that might in turn lead to an earlier development of practice knowledge in undergraduate students?
Which brings us to social networks. For the purposes of this talk I'll use a superficial working definition of “social network” to include any online platform that enables enhanced communication between members via multiple channels.
To determine the impact of participation in a social network on reflective practices in a south african undergraduate physiotherapy department
I installed a social network on a private server and all students and staff were registered. Four lecturers then volunteered to integrate each of their module assignments into the social network. I conducted a survey prior to the start of each assignment, as well as a workshop to introduce students and staff to the platform. The results of that survey are not included here. Following completion of each assignment, an additional survey will be completed in order to determine student and staff experiences of using the network, and the results of that survey will be presented at next year's conference. Ethical considerations were taken into account
For assessment purposes, you might like to know that you can see in detail what each student has contributed to the conversation.
I wanted to highlight this group that was created by one of the second year students to share and discuss clinical experiences. They've just started with their first patient encounters and are all very nervous and excited about it, and want to learn about what all the other students are going through. They're also talking about sharing location-specific information about the actual placements, so that following groups will be able to better prepare themselves before arriving.
We're seeing spontaneous group formation. Each of the groups in this list was created by a student. My favourite conversation happening right now is in the Ethics and Human Rights group at the top. But you can also see that students have started using it to co-ordinate their 4 th year projects. We even had one guy start a group for students who had experienced the death of a patient, and was asking others if they had shared this experience and how they had dealt with it.
Possibly the most exciting development I've seen is that most student activity is happening outside of the boundaries that the lecturers set for their assignments. Most students completed their assignments and then that's it, tick. But there are others who are curious about what they can do with the platform and are using it in ways that I didn't imagine they ever would. And they're not doing it because they'll get extra credit, or because it's required. They're doing it because they're genuinely interested in exploring ideas.
There were the usual problems with access to computers and the internet, although all students did have access when on campus. Digital and information literacy were problems, with many students having a poor understanding of how to use the tools within the network, even after attending the workshop. In terms of activity outside the assignment, relatively few students and lecturers were active in the network, but remember that these were activities that arose spontaneously with no facilitation and with no obvious payback for the student.
I'm going to conclude by saying that it's too early for any real conclusion. However, I think I can say confidently that the answer to each of these questions is “No”, and so it should be. We shouldn't expect that just putting students into any kind of environment will automatically produce the behaviour we're looking for. It's clear that in most cases, reflective practice isn't happening by itself. Yet, in cases where a student takes initiative, or asks a question, it can lead to discussion and the sharing of ideas that are reflective. Finally, even though I'm looking at reflection, there's no reason that this approach isn't relevant to many of the generic skills that have been mentioned over the past few days.
So, I'm hoping that the emergent behaviour I've described today, taken together with the results from the surveys, will be able to demonstrate that engaging with students within social networks has potential in accelerating the development of practice knowledge, so that we can start graduating physiotherapists, and not just people who know about physiotherapy.
Social networks and reflective learning
social networks as platforms to develop reflective learning michael rowe physiotherapy department university of the western cape
clinical practice the healthcare practitioner must constantly review and re-prioritise existing and new problems in an enterprise of active interpretation thornquist (2001a, 2001b) practice knowledge exists as a relation between questions and answers in a context of meaning that is often intuitive and hidden higgs, et al. (2004)
reflection an important component of clinical practice schon (1987) “...a mental process with purpose...applied to relatively complicated...problems for which there is no obvious solution” moon (1999)
but reflection is also hard to “teach” boud & walker (1999)
making meaning through reflection is more important than memorising content
sharing knowledge and experiences in a collegial environment 1. enables external knowledge to be internalised 2. develops problem solving strategies 3. promotes critical reflective thinking 4. challenges unshared biases mason (1998), hanko (1999)
knowledge: a negotiated outcome of social learning experiences that are integrated within the network siemens (2004)
“ a new communication paradigm is being constructed through community interaction and participation, which enables the formation of loosely connected groups with relative ease” wesch (2009) http://bit.ly/8ZaA6g
sharing knowledge and experiences in a social environment?