Introduction

In the past seven weeks, I have been studying academyEX’s Digital and Collaborative Teaching and Learning micro-credential. In this blog post, I will critically analyse contemporary thinking in education. I will then critically analyse the role of digital and collaborative learning in contemporary education. In the second half, I will evaluate my practice against digital and collaborative learning and teaching. Finally, I will evaluate my practice against relevant aspects of sustainability.

Contemporary Thinking in Education

Behaviourism was the main learning theory utilised in my medical training and is reflected in the way I provide teaching as a doctor. Extrinsic motivation was provided by medical school through the set curriculum. I felt like a passive recipient of knowledge and  I was tested on my ability to repeat the vast content provided over many years. This continued in the setting of medical specialist training where even more information was memorised and regurgitated during exams. A lot of knowledge is acquired but is not otherwise utilised, thus retention is poor. Learning was shallow and given the time spent it remains unclear if the return on investment is of high enough value. Other theories of learning need to be considered.

 Constructivism takes a learner-centred approach. People are not completely blank slates when they arrive in medical school and may have come from various backgrounds. Some of us may bring skills and knowledge from our previous work and life experiences. The role of the mentor is to assess our prior knowledge and guide the extension of our development.

Constructionism theory involves the students creating new knowledge structures. Social products are created, and learning is by making and can be aided by technological tools such as the Google Suite and many other apps. Students are encouraged to own their learning and to make it more engaging for themselves.

The medical school shifted to experiential learning in the clinical years when we started seeing patients. I learned by dealing directly with patients and their families. Learning was by doing we were provided with hands-on opportunities. It was more engaging when I was given a chance to assess patients and come up with my own management plans. I practised doing interventions with the use of patient simulators and actors. Time for reflection was provided when I presented my findings to tutors and this also involved review of video footage of assessments. This allowed for the practice of clinical skills in simulated situations.

The role of digital and collaborative learning in contemporary education 

Older education approaches may have taken a cooperative approach in which group members would be assigned various parts of a learning task to do themselves. They would all come back together to present their information to each other. This is similar to a potluck dinner in which the meal that you eat together may be a random collection of dishes which may or may not work together well. 

Contemporary education requires a collaborative approach in which students come together and discuss how they will learn together, utilising a horizontal division of labour. An analogy is when people gather to cook a meal with each other. New skills and knowledge can be learned together. Everyone has a role in putting together the meal and there is a more cohesive outcome. This also helps to model how doctors could work together in collaboration with others. Garnering opinions and information from team members rather than all working completely independently. Complex wicked problems demand input from all team members who each have their individual roles to play. Everyone has a role to play in the learning situation and it models good future behaviour. Collaborating with other doctors or other services is considered good healthcare practice.

How can digital tools be incorporated into this learning? The potential audience of any digital artifacts could be vast, we don’t need to limit ourselves to face-to-face teaching any more. In 2013, when I engaged with online learning companies I was quoted $ 100,000 for the production of four 15-minute modules. In 2023 I can create my own using readily accessible apps, at low or no cost apart from my own labour.

Evaluation of my educational practice against digital and collaborative learning and teaching 

The Covid-19 pandemic forced medical education to try new ways of engaging. The traditional face-to-face tuition could not be done during the many Aotearoa/New Zealand lockdowns we experienced from 2020 onwards. We learned how to do virtual assessments including home visits, clinic sessions and joint visits via the use of video-calling technologies. Joint visits allow different members of the multidisciplinary team to assess a patient together, with each member assessing the situation from their own point of view. One or more members of the team could be present either in person or virtually in a more collaborative approach.

In medical training, experiential learning is via doing with real cases being worked on together. Standard medical assessments involve assessing patients face-to-face. This assessment formulates a problem list and differential diagnoses are considered. A management plan is then drafted to treat the problems identified. Online resources could be checked to assist with any of the prior steps. The case is then presented to the clinical supervisor(s) and together a joint management plan is finalised. As the trainee becomes more experienced their level of supervision decreases until they can work independently. In the future sophisticated patient simulations could be created and could involve various team members assessing the simulated patient at the same time. As artificial intelligence improves, these scenarios could become more and more realistic. Virtual reality technology could allow virtual face-to-face interactions between clinicians and patients regardless of distance. Wearable devices could allow remote physical examination of patients. Communication between clinicians, patients and families could be improved with technology. 

Evaluation of my educational practice against relevant aspects of sustainability 

My educational practice involves teaching various clinicians, patients and their families about palliative care. Western medicine including palliative care has historically been a white person’s medicine and one size has never fit all. Extra effort has been required to take into account people’s cultural origins and particular emphasis has been placed on becoming culturally competent practitioners, to make our environment feel safer for all. Bilingual signage and the use of Te Reo Maori in daily conversations are now part of my workplace. We want our staff/volunteers/students to learn by immersion. 

I work in a healthcare training institution but we are also citizens of the world and must play our part when it comes to climate change. Our organisation has focused on place-based learning. We have removed individual rubbish bins, have centralised waste collection and only have bins available at certain sites on our campus. We want people to actively think about where their waste will end up. What can be composted is put in the appropriate bin as is recyclable material, with an overall effort to reduce what goes to landfill. Upgrading of equipment to more energy-efficient versions continues to be done. Shifting our fleet from a fossil fuel one to an electric vehicle fleet has begun. Simple things such as providing our staff members with reusable cups and water bottles are part of the subtle encouragement of environmental sustainability.

In terms of educational sustainability, we have switched from paper-based materials to the use of digital artifacts. Short video tutorials are available on our intranet and internet sites where educational material has been curated. There is a lot of great content out there already and we encourage our staff and students to create content. We foster a culture of ongoing life-long learning. Our students are encouraged to learn how to find information rather than commit it to memory. They are encouraged to think for themselves on important issues especially how we can prepare for the future. Open questions are asked to stimulate the exploration of topics in a deeper fashion.

Conclusion

I have worked as a medical doctor for almost 24 years. When I graduated it was the start of my life-long learning. Over time, without any training, I have also become a teacher. My teaching style has been behaviourism-based as that was how I was taught. AcademyEX’s digital and collaborative teaching and learning micro-credential has exposed me to contemporary learning theories including online tools to aid teaching. It has made me ponder much about sustainability in all of its forms. It has further opened my mind to new possibilities for student engagement and to consider that my teaching needs a wider audience than people who work in the hospice.  People have all sorts of preconceptions about things especially if they don’t know about them. Many people are still afraid of hospice. How can I use the skills and knowledge I have learned to make hospice/palliative care more widely known? Maybe I’ll write some more blog posts…

References

Olsen, M. & Hergenhahn, B. (2013). An Introduction to Theories of Learning (9th ed.) Pearson.

Cashman et al. (2005). Teachers Discovering Computers: Integrating Technology and Digital Media in the Classroom (4th Ed.) Course Technology.

Kolb, D.A. (1984). Experiential learning: experience as the source of learning and development. Prentice Hall.

Liu, C. H. & Matthews, R. (2005). Vygotsky’s Philosophy: Constructivism and Its Criticisms Examined. International Education Journal, 6(3), 386-399.

Papert, S. & Harel, I. (1991). Constructionism. Ablex Publishing

WikiBooks (n.d.). Blended Learning in K-12/Definition. https://en.wikibooks.org/wiki/Blended_Learning_in_K-12/Definition

Kozar, O. (2010). Towards Better Group Work: Seeing the Difference between Cooperation and Collaboration. English Teaching Forum, 48(2), 16-23.