Accessible sharing

We´re all familiar with the expression “sharing is caring” but what if what you share is not great? Imagine if not everyone can use and receive what you share. That is not good care! Is that a problem or not? Until now I have thought that good is enough but now I realise that good is not always enough anymore. This week I have undergone an eye opening process where I´ve starting to be aware of that I have a big responsibility to make my sharing accessible to everyone. It´s a pity that I haven´t become conscious of it till now but better late then never, right?

When you sit in a wheelchair it´s kind of obvious that you’re in need of some accessibility to be able to move around at for example pavements. In the digital world your requirements are not always that clear. For those in need, I know that there is a lot of “aid-tools” which enable accessibility but for me, the big question is… – Where do my trustworthiness begin?

When David Wiley is talking about sharing he says that we have to overcome the inner 2 year old in us. We have to stop thinking… -Mine, mine, it´s mine!!! We have to act against a culture of withholding and instead he argues for giving, generousness and openness in education. So, I guess that I´m an adolescence when it comes to sharing. I love to share, if someone think it´s good enough for them to use I gladly share it with them. No problem at all! It´s almost like a recognition for my ego (as the self-centred youth I am) if someone asks if it´s OK to use some of my teaching material. Feel free!

Now, one of my next goal is to enter the adulthood (after all I´m 46 years old). This is of cause going to be a process but I´m good at focusing when I´m motivated so I believe I can cross the finishing line before the end of 2017. I have to make all my prerecorded content accessible for everyone. The main thing that I have to learn (and then do) is to add subtitles to my lectures. I also have to think of colors in some slides. Are there other things I have to consider?

Reference
Wiley, David (2010) Open education and the future TED-talk.

Photo: Awesome and beautiful Linnea Blomberg by Karen Blomberg.

Learning by doing

Is it Dewey who coined the phrase “Learning by doing”?

Dewey claims that there is a relationship between knowledge and active inquiry. He also advocated that action, reflection, emotion and theory is prerequisite for continues life-long learning. The teachers role is to facilitate learning by assisting creation of a cooperative learning exercise. The teachers leadership includes e.g. being aware of past experiences, needs and capacities. To be prepared and have the ability to suggest further learning activities based on the class experiences and by this achieve continued growth (Jarvis, 2010).

I found a quote about learning and doing on the internet, from the book “The Cardturner: A novel about a king, a queen and a joker” written by Louis Sachar. It goes like this:

“I hope I remember everything,” said Toni.
“You won’t,” said Trapp. “That’s how you learn. But after you make the same mistake one, or two, or five times, you’ll eventually get it. And then you’ll make new mistakes.”  

I would like to use these insights in my work as a teacher with nursing students. To know and “feel” their needs and to let them fail, and fail again and just encourage them to keep on trying until they get it right. The diversity of different students and their needs are just as big as they are numbered. I believe that diversity is so much more that cultural and ethnically differences. We are all different human beings with different experiences and my job as a teacher is to greet these differences and to facilitate their learning experiences. Some are introvert and maybe they need the courage to speak up, while the opposite to this is them who often say what they think and sometimes in the need of listening. As a teacher I have to pay attention to this diversities so that I can facilitate the learning experience in a correct way.

Chemo_treatment_by_Jenny_Mealing_CCBY_SA_2.0
Chemo treatment by Jenny Mealing (CC BY-SA 2.0)

One concrete example of how I try to work with facilitation and diversity is when I see my nursing students at our clinical training center. In the introduction, I usually start out with asking them of their experiences of administer and handle central venous catheters. You could say that I use this as a baseline for the rest of the class. As often as I can, without being to excessive, I connect and refer back to what they told me. I try to ask questions like, -What if this…? and -What if that…? to students that I have identified in need for it. It has not always been a delightful and easy way to go cause some of them have had tough experiences of those damn catheters. Often relatives in connection with cancer treatment (some alive and some dead). Even themselves who sometimes have been through the cancer treatment – and yes, we have had tears and both physically and mentally reactions but in the end I am confident in my decision to use the students own experiences since I can see that it enhances their motivation to learn.

I strive to be student-centered and one key to that is to motivate. In 2013 The Swedish Federation of Student (not sure of the correct translation) released a report (SFS, 2013). When it came out it got lots of attention and still… we really need to work with these issues. The report argued for the lack of pedagogical and teaching skills of Swedish teacher in higher education. One thing to make it more student-centered is, as I mentioned, to motivate the students while facilitating a learning activity. The students are also eager, if motivated, and requesting activity. I take along this thought and will try to design some student-centered learning activities with hands-on training.

OM152A_Centrala_infarter_Design_HT16

I am, obviously not a graphic designer but I have tried to do a simple sketch of how the workflow of the training cessions are supposed to look like. We have a common introduction and then I divide the students into two smaller groups. One group will work with wound dressing and the other one with injections. After a coffee break, fika as we say in Swedish, the groups are swapping subject to the other. You can´t have too many fika so we go for that one more time and after that we have a common discussion around cases. At the end of the session we summarize. When they are training wound dressing and injections the students are doing it hands-on. In our training center we have dolls for simulation. The students are prepared theoretical by flipped classroom pedagogy and they will also get a film of how the procedure can be done. The task they are supposed to achieve is to train the procedure. Meanwhile a peer is observing using a checklist on the correct procedure, ready to give feedback when finished. So the students are active both by doing and observing. The students will be like critical friends to one another. I cross my fingers that this will work out!

References
Jarvis P (2010) Adult education and lifelong learning. Theory and practice. 4th edition. New York, Routledge.

SFS (2013) Studenternas läranade i centrum. Stockholm (In Swedish)

Photo: Aniversário do Henrique by Tony Cavalcanti (CC BY-NC-ND 2.0)

Totally not right

Hopefully, we all have visions of a brighter future and then there is the harsh reality…

In his own words, John Biggs tells us how it suddenly stuck him of how irrelevant it was to ask students to tell, in a final exam, of how he had told them about how psychology could be applied into teaching. Instead, he asked the students (in accordance to the intended learning outcome) to do a portfolio in where they themselves described how they knew psychology could be applied to improve their teaching decisions. Biggs describes this event as one of his peak regarding to teacher ratings and luckily for us the constructive alignment was born. Constructive alignment is a concept of how to use outcome-based education (Biggs & Tang, 2011). It all starts with the intended learning outcome and in my case, in this particular course, it is:

“To administer and handle central venous catheters in a way that is patientsafe”.

The active verb is to administer and handle and that is what my students are intended to learn. According to, my institutions own educational platform (MAH, 2016), all teaching and assessment are supposed to harmonize with each other as well as to the intended learning outcome. The students are expected to participate in an active way and the design of the course should be in accordance with this alignment.

So, I have a dilemma – what I am doing now is totally not right.

The ultimate assessment to administer and handle should be something practical. As I see it the student should be tested in how they administer and handle instead they are asked to answer a web-based multiple choice quiz about how they are supposed to administer and handle. I tried to think about this when I constructed the questions. Most of them are about how different skills in action can avoid or prevent complications…but still, now actually action only words about it. As you see, the reality isn´t always inline with the intentions. But I think I have a good position for negotiation with my employer.

References
Biggs, J. B. & Tang, C. (2011) Teaching for quality learning at university. (Fourth edition). Maidenhead, Open University Press.

MAH, Pedagogisk plattform för institutionen för vårdvetenskap (2016) Fakulteten för hälsa och samhälle, Malmö högskola. (In Swedish)

Photo:Wrong by Kerry Lannart (CC BY-NC-ND 2.0)

Clinical training center

This summer I went on a vacation to Italy. Me and my family stayed in a house for rent, somewhere in the middle of nowhere, at the Italian countryside. The weather was fine, it was hot and sticky, so we mostly choose to hang around the pool… or at least nearby. For two days we visited Rome and then again back to the cooling water.

Guardea_2016 (2)

The vacation lasted for two weeks and we all had a great time. Italy gave me a taste for more since it showed itself from its best side. Next time I would love to see other regions of Italy. One region to visit could be Emilia-Romagna and the city of Bologna. Speaking of Bologna… In 1999 there were 29 European countries how choose to sign a declaration about the standards and quality of higher education qualifications. Nowadays it is more then 45 countries that are connected. The main focus is:

  • the introduction of the three cycle system (bachelor/master/doctorate)
  • strengthened quality assurance and
  • easier recognition of qualifications and periods of study

Did you know that the town of Bologna hosts the oldest university in the world, founded in 1088, the University of Bologna? One of the most important buildings at the university, Archiginnasio, situates the Anatomical Theatre, used at the medical school for anatomy lecturers.

Anatomy_theatre_Palazzo_del_Archiginnasio_by_Terry_Clinton_CCBY_NC2.0
Photo: Anatomy theatre, Palazzo del Archiginnasio by Terry Clinton (CC BY-NC 2.0)

Nowadays, when we teach our students we don´t do the whole “theatre thing”, we invite them to our clinical training center and sometimes I´m a teacher there. The center gives the nursing students a chance to practice their skills in a safe environments before they meet patients. Generally, both students and teachers are enjoying the skill training since we all  have a feeling of finally doing it “for real”. I think it is extremely important that we take advantage of the opportunity to do workshops based on “hands-on” activities. I would like to leave the theory lecturing outside of the training center. The course I teach in has, for the moment, a course design of teaching/learning activities that starts out with a theoretical lecture for approximately 45-60 minutes. Only after the lecture the students are allowed to actually get their hands on the different training scenarios which sometimes can be utterly frustrating for all of us. I would like to change this into a flipped classroom design, but first things first… Let´s start with the learning outcome.

Biggs & Tang (2011) describe different stages of how to design constructively aligned teaching and assessment. First of all, the intended learning outcome, shall be described. The active verb of the learning activity is “administer and handle“. Second, its object or the content is “central venous catheters” and last the standard the students are to attain is “in a way that is patientsafe“. In fact, as it is now, the learning outcome consists of the verb and the content. I would like to add the last part about the patientsafety since the whole core in administer and handle is about how to prevent complications.

Back to the design of teaching/learning activities. To be able to administer and handle something I believe that you have to use your hands and mind together. By flipping it around and letting the students work with the theoretical background of the topic before they come into the training center, they can get most out of their skill training. For me this is a question of quality and efficiency. Therefore, my intention is to record my theoretical lecture in short film clips which the students get access to minimum a week before they´re scheduled to the skill training.

Flip_by_Oscar_Rohena_CCBY_NC_ND2.0

Photo: Flip by Oscar Rohena (CC BY-NC-ND 2.0)

Recently, two of the major journals for nursing education have published a respective review articles about flipped classroom approaches in nursing education (Betihavas et al, 2016; Presti, 2016). Both articles refers to a book by Benner et al in their introductions. The book title says it all: Educating nurses: A call for radical transformation. The authors argues for BIG changes in how we educate nursing students and that we teachers have to acclimatize into the 21th century. We have to embrace student centered methods in our pedagogy. Flipped classroom can be one example of how to meet our students in other ways then we nursing teachers by tradition are used to. Presti (2016) claims that flipped classroom enhance active learning but asks for further research since evidence of learning outcomes are missing. Even Betihavas et al (2016) argues for more evidence but the authors conclude that the flipped classroom has a potential to reform nursing education. Although, fully evidence to the method flipped classroom is lacking I feel confident that optimizing the time in the clinical training center is a good thing thus the learning outcome is to administer och handle. Of course I have to evaluate the flipped method and if it doesn´t work out I would like to give a theoretical pre-lecture face-to-face before entering the training center.

References
Betihavas, V. Bridgman, H. Kornhaber, R. & Cross, M. (2016) The evidence for “flipping out”: a systematic review of the flipped classroom in nursing education. Nurse Educ Today, Mar(38), 15-21.

Biggs, J. B. & Tang, C. (2011) Teaching for quality learning at university. (Fourth edition). Maidenhead, Open University Press.

Bologna process (2016) European higher education area. Official website.

Bolognaprocessen (2016) Bolognaprocessen/det europeiska området för högre utbildning. Universitets- och högskolerådet, Stockholm. (In Swedish)

Presti, CR. (2016) The flipped learning approach in nursing education: a literature review. J Nurs Educ, 55(5), 252-257.

Diversity

Earlier today at the course “Academic teaching” (which I participate) we were discussion diversity. The learning outcome for me regarding to this topic is:

“Develop different strategies for equal treatment in the meeting with students / participants in heterogeneous groups.”

So, I´ve been thinking of how to embed this in my teaching to nursing students. The topic I teach is about how to administer and handle central venous catheters. One of the learning outcomes is that the students are expected to reflect over risks and how to avoid them.

The university I work in has a strategic platform (Strategy 2020) and Malmö University wants to base its work on four core values; diversity, creativity, quality and commitment to the community. I came up with the idea of using cases to reflect diversity.

In Sweden (were I live and work) we of course have a law for higher education (SFS 1992:1434). For instance, the students are expected to develop their ability to critical thinking and problem solving.

Lynn (1999) writes about the differences between case teaching and research cases. Lynn argues that when teachers use cases from research as an example or illustration the whole idea of case as a method fails thus the thinking has already been done and the conclusion is already made. The research case is more like a lecture where there is “a true” solution to the problem. Therefor, when using case as a method for develop skills in critical thinking the cases have to contain questions to raise. There should be no right answer and the students should be exposed to different problems, issues and choices. Lynn means that the students are supposed to come up with a solution and proposed action regarding to the present dilemma to succeed and develop their critical thinking.

When writing the cases I have to keep this in mind! I don´t want them to have only one right answer. Back to diversity. I will use name, age and gender as a base and they will all represent a diversity of people. Each case will have a picture of the “patient” and I will choose the pictures carefully so that they shows my intended diversity. I will give you one example of a case.

Muslim woman
Photo: Muslim woman by Peter Dahlgren (CC BY-NC 2.0)

Aisha, a female patient, is treated with total parenteral nutrition (TPN). She has a central venous catheters on her neck (it´s like been given “food” straight in to your blood). Aisha is wearing veil. The veil is “hiding” her central venous catheter so you can´t see the venous access or it´s connections.
-What should you, as a nurse, do?

It is very important to be able to observe the venous access and it´s connections on a daily bases. When having a ongoing infusion (TPN) it´s even more required.

I can think of some different paths to go in the discussion. The students can choose to talk about the ethic part of wearing a veil (the patients religious need vs. patients safety need). I will try to provoke the students a bit if they “chicken out” on the dilemma and I want them to give me an answer of how they think and why. I would also like them to talk about hygiene. The right answer is that the veil has to be change every day… but how will they make this happen? As I see it, they can choose different solutions to the problems.

I’m eager to try this out and I think (and hope) that we can talk to each other and have really constructive discussions of how to solve the different dilemmas. I am aware of that this is an example of how to work with diversity in teaching material. A further challenge would be to describe and have a well founded intention to work with diversity in the group of students, but that´s another blog post.

References
Lynn, L (1999). Teaching and learning with cases. A guidebook. Seven bridges press, New York.

SFS 1992:1434 (2016) Högskolelagen. Utbildningsdepartementet, Stockholm. (In Swedish)

Strategy 2020 (2016) Strategic Platform. Malmö University.

Photo: Diversity by Meena Kadri (CC BY-NC-ND 2.0)

Self-paced learning

What I should be doing isn´t what I am doing right now. I´m supposed to correct and modify my scheme for next semester. Other things on my ToDo list are,

  • Register participants from CPR-training
  • Construct a new website
  • Fill the new website with useful content
  • Making videos (several) of safe management of central venous catheters
  • Edit a video about parenteral nutrition

Instead of preparing the last things before summer break I found myself searching the internet of how to make learning videos like Khan academy. What software do they use? How do they draw on the “blackboard”? The questions were raised at a meeting earlier this week and I said that I could investigate it and get back to my colleagues. After a quick googling session I now think that I know how they do it.

This is where I would have stopped and getting on with my other commitments. I failed and I couldn’t stop due to lack of self-control.

I remember when Khan academy came, that was long before I was a teacher. It really was a Khan-hype! Salman was everywhere in 2011 and all learning blogs had posts telling the story’s of a former hedge fund analyst. The Twitter feeds were massive about the sensational non-profit academy. A year ago, when I became a lecturer I started to use Khan academy myself and I also recommend some of the videos to my students. It has become a natural resource which I have taken for granted…until now. Today, I realize how amazing the academy is! I´ve been looking on this TED-talk where Salman is talking about humanizing the classroom. He also gives great examples of how videos can be positive for learning. I reflect on self-paced learning and the power of it, because it is essential for understanding and the personal learning curve to learn in a pace that suits you – just you and not someone else. Videos can give students this opportunities.

OK, now I really have to get on with my highest prioritized ToDo task this evening, since I´ve been invited to participate at a Skype connection at the EDEN conference on Friday. I will be talking about my experiences of participating in the ONL161 for 5 minutes. I´m full of expectations!

Photo: Tempo Relativo by Marcelo Maia (CC BY-NC 2.0).

Embedded learning

I believe in lifelong learning and Jarvis (2010) has defined learning as:

the combination of processes throughout a lifetime whereby the whole person – body (genetic, physical and biological) and mind (knowledge, skills, attitudes, values, emotions, meaning, beliefs and senses) – experiences social situations, the content of which is then transformed cognitively, emotively or practically (or through any combination) and integrated into the individual person´s biography resulting in a continually changing (or more experienced) person.

The definition is hopelessly complicated and if you want a catchy slogan to promote learning, this is not the one. Yet, I can´t help myself – I love it! I think it is brilliant and the more I learn about learning the more I get to adore the definition.

I have designed a learning activity and today I was trying to argue for what theoretical framework it has. The activity aims to enhance the students awareness of ethical dilemmas linked to CPR-resuscitation and what considerations to be highlighted. The students will be divided into small groups and they will get three short introduction videos to the topic,

  • Surviving CPR-resuscitation
  • Not surviving CPR-resuscitation
  • No active CPR-resuscitation

After watching them the students are supposed to discuss ethical considerations and argue for pros and cons. Finally they are asked to present a quick version of their discussion for the other groups.

At first it was not an easy task to take a theoretical stand but after some reading and thinking it ended up with me arguing for Vygotsky´s Sociocultural Theory… or at least from that tradition. Development and learning process is dependent upon collaboration, interaction and relationship. When I got feedback from my colleagues I learned that this learning activity also could be related to Variation Theory by Marton. At first sight CPR-resuscitation is all about saving lives. When diving into the topic, viewing from different angles students can learn throughout discerning differences about the topic.

It appears to me that teaching is a blessing thus you can pick and choose from a diversity of learning theories when designing learning activities. The main thing is to choose the right theory for the right purpose. The purpose of learning! As Jarvis definition implies, learning is a complex process, occurring both cognitively, emotively and in social contexts. Learning is truly embedded into a persons whole lifetime.

References
Jarvis P (2010) Adult education and lifelong learning. Theory and practice. 4th edition. New York, Routledge.

Photo: Embedded by Simon Evans (CC BY-NC-ND 2.0)

 

 

In love…!

I don´t know if it is the excitement of spring or something else but the feeling I have is pure, present and real. It is official now – I am in love!

In love with Coggle! Its usability goes beyond my wildest dreams of what a free mind map tool could be like. It is:

  • User-friendly
  • Aesthetic
  • Collaborative
  • Accessible
  • Did I say easy-to-use?

I have to restrain from using it too much. Or at least not bombarding my students with it. I could not help myself for telling them about my obsession. I told them they could easy collaborate with each other when studying for the exams (eh… lifetime). I will be seeing them in a couple of weeks from now and it will be exciting to hear about their experiences of mind mapping together. To wrap this up – Coggle has really lived up to my expectations. To be honest, I´m craving for the Awesome version!

Photo: Love by LongitudeLatitude (CC BY 2.0)

 

Not so digital

OK, so encouraged by my facilitator Mr Creelman and wonderful group member Nour I would like to share a story and an idea for badges with you. It is not digital, it is simple, it is cheap (in a good way) and most of all it works.

A friend of mine is a nurse and works as a care developer. Some of her work includes implementation of guidelines. As a result of this she needed to promote and highlight some topics; nutrition, prevention of injures like fall and ulcer. The whole design of the intervention was less formal. Her ambition was actually to get her colleagues to talk and discuss the different topics. She had set up several stations, at the ward, for the nurses. During the day they could stroll along the corridor and pop in at a station and take part in an education or a discussions group. As an evidence of their participation she gave them a colored paper clip to attach on the uniform (green for nutrition/education, red for ulcer/discussion, blue for prevention of fall injures/discussion ect.)

At lunchtime those nurses who had not kept pace with the others flocked around the stations wanting to participate but most of all get the paper clips in the right colors. What happened next was even more surprisingly – the doctors at the ward started to ask about the paper clips. Why had all the nurses colored paper clips on their uniforms? What did the paper clips stand for? How could they get colored paper clips of their own?

Those patients who were able to mobilize to a station learned about for instance; how to prevent fall when coming home. Even relatives participated in the intervention. They all got colored paper clips.

At the end of the day the the entire workforce including some patients and relatives wore colored paper clip at their uniforms or clothes. The colored paper clips was a sign of their participation in a learning intervention but also a sign of simple motivation.

Level up

Twice a year I am teaching nursing student about how to administrate and handle central venous catheters. One of the learning outcomes is that the students are expected to reflect over risks and how to avoid them. As a motivation factor I will try to add some gamification elements for next term. I have designed different learning activities and everyone of them represent some sort of badge. I´m not sure of that it has to be digital but that would of course be most exclusive. I have to think about how to solve it. Nevertheless, when achieving a task the student earns a badge: recorded lecturer, group discussion, practical skill training (including several skills which merit a badge each), reflection on a dilemma, digital assessment. I am really looking forward to this – let´s level up!

Photo: Medals by Shane (CC BY-NC-ND 2.0)