Monday, November 3, 2008

Developmental ideas and implementation plan CCEL)

Hi there

I've come quite a long way with my thinking...Here is the final plan...

One of the exciting things I have learnt while doing this teaching certificate is about constructivism (learners constructing their knowledge) and applying this to my course. It is very easy for me as the ‘expert’ to think I have the knowledge to teach the students everything they need to know. But the more I’ve thought about this, the more I realize how limiting this is for the student. I admit my specialty is neurology and I could teach for ever around this topic. Recently I’ve spent a lot of time on cardiac wards with the students and have had to facilitate the students learning due to my limited knowledge in this area. This has helped me to grasp how in clinical settings there is so much contextual learning going on, and it is so much better to help the students make sense of this learning rather than me teach them what I think they should know.

As I’ve thought about this I’ve began to imagine how much more the students can learn by sharing experiences with each from their situational/contextual learning while on clinical placement. We do this already in our tutorials but this only reaches a limited number of students (about 8 in the tutorial). If the students were able to put this learning on line and also utilize reflection to expand on their learning then this could be accessible to all the 96 students enrolled in BN 233 throughout the year (96 students).

This is where the theory of connectivism, described as the learning theory of the new digital age (Siemens, 2004), has sparked my interest. Also an article Mereana talked about titled ‘using technology to foster reflection in higher education’ has been helpful. Connectivism is about learning as a process where people share a variety of opinions and viewpoints via connections that may include networking via technology.
Individuals feed information into the network, which then feeds information back to individuals as part of a cycle.
This is beneficial because information is always changing. This is very evident in healthcare. Connectivism allows people to connect with new information that is generated on an ongoing basis. Siemens (2004) is quoted as saying ‘while there is a right answer now, it may be wrong tomorrow due to alterations in the information climate affecting the decision”.
This theory has led me on to exploring the use of e portfolios. We already ask the students to construct a portfolio to evidence their learning as this is really the only way we have to assess them at present, i.e. looking at the portfolio they hand in, listen to what they tell us and to a small extent preceptor/ward feedback. The reason preceptor feedback is not given high priority is because the RN is often assessing different things from us (technical skills and relating well to patients and staff is what they often comment on). The RN may not understand what we as a nursing school are trying to assess in the way of knowledge and meeting nursing council competencies.
The development of e portfolio’s has been driven by the changing forms of learning such as; more student centred, greater emphasis on lifelong learning, flexible delivery and more emphasis on competency based assessment, (very evident in nursing). Our student population has also changed, many having been bought up with technology and a lot of students very use to social networking….New learning is also often described as been experiential, networked and facilitated by mentors. Another interesting fact I have learnt is that formal learning only accounts for about 15% whereas informal learning account for about 85%. Therefore it is important that we facilitate this informal learning to help students increase their knowledge in our course.
Issues of e portfolios…
Who owns the portfolio…i.e student not teacher..this means they decide what goes in it…closed or open system…in our course we would have it closed due to potential confidentiality issues with patients
Interestingly enough I asked my students the other day if they liked having to do a portfolio considering so much work was involved. They responded with a resounding YES it was essential for them to 'make' them learn the work.
June 2004 from Using technology to foster reflection in higher education

My Course (This is in smaller font to differentiate from the new course)

Following satisfactory completion of this course, students will be able to:

1 Safely demonstrate clinical practice in the medical surgical care settings. This includes social, physical, intellectual, cultural, emotional and spiritual safety, and making safe informed professional judgements within their scope of practice;

2 Demonstrate professionalism in all aspects of nursing practice. This will include participation in the inter-professional process and taking responsibility for the direction of their learning needs;

3 Recognise and articulate legal and ethical issues that impact on their practice;

4 Demonstrate the development and utilisation of therapeutic relationships with patients in the medical/surgical care settings. This will include the use of effective communication skills and respect for the boundaries of a professional relationship;

5 Recognise and utilise opportunities for patient teaching and learning incorporating the principles of rehabilitation and recovery;

6 Utilise an appropriate framework for the assessment, planning, implementation and evaluation of medical/surgical nursing care, including aspects of rehabilitation and recovery;

7 Demonstrate the use of reflection to uncover the meaning of illness/hospitalisation experience in the medical/surgical setting for patients and implications for the student’s practice. This will include the uncovering of theory embedded in practice.

The 33 theory and laboratory hours will be met in this course by the student attending 6 hours a week in each theory week (30 hours) plus 3 hours from the year two introductory week. The 17 self directed hours are allocated to allow the student to complete a portfolio, assessment and care plan while in the clinical setting. Students meet the 190 clinical hours by working in the acute care medical/ surgical setting with a Registered Nurse (RN) as a preceptor and with a lecturer from Otago Polytechnic providing supervision. Tutorials are included in the clinical hours.

Clinical assessment will be collaborative between the student, lecturer and registered nurse preceptor/s. Clinical assessment will be formative and summative, and result in an overall grade that reflects both the medical and surgical placement. A case study and care plan will be developed on either the student’s first or second placement and will include the assessment of a patient and the planning of nursing care. The case study and care plan will be assessed and graded by the lecturer and will contribute to the students overall clinical grade. The case study and care plan must be submitted to achieve outcomes of this course. A clinical portfolio will be developed by the student during their clinical placements that will support and evidence the meeting of outcomes of this course. The portfolio is also graded and contributes to the overall clinical grade of the course

My Revised Course

My Outcomes will not change because this is a curriculum issue; it is my learning strategies that I intend to change to meet outcome 2 and 7. Instead of compiling a hard copy portfolio, I intend to change this to compiling an e-portfolio. The reason I am changing this is because of the connectivism theory; this will allow students to connect with each others learning and construct new knowledge.


The purpose of this is for the students to construct their own knowledge from their clinical learning experiences. By commenting and reading other students work it will help them to increase their knowledge for the area they are working in.

A course wiki has been set up http:/ Each student needs to enrol themselves as a participant in BN 233. Each clinical placement has it own wiki set up. If a student is placed in ward 4A then they will need to access this wiki. In this site they will need to make at least two contributions (they are welcome to make more) with at least one link to an interesting related article. There contributions can be about anything they have learnt during the 3 weeks. The more thought and effort they put into this, the more it will show us they are critically thinking and will impact on their grade. There will also be another page set up titled reflections. They need to place at least one reflection (utilising a framework such as Gibbs or de Bono) for each placement on this site. They will also be required to comment on at least one other reflection they have read.

They will not need to put there name on any of the work they submit however it is essential that they let the lecturer know in some way which is there work.

The e-portfolio learning activity links with outcome 2 and 7.

Learner analysis

In my learner analysis I talked about older, male and international students sometimes struggling with compiling a portfolio, because of the writing involved. I’m hoping that these students will benefit from seeing other peoples work, as it may help them to see how to write or how to lay things out. I also think that for the students who are struggling, the information that other students provide may be more at their level and will help them. Also the school leavers will probably enjoy been able to use technology because they are quite comfortable with it.
Our professional body, the Nursing Council of New Zealand (NCNZ) expects students and Registered Nurses to be able to articulate how they are meeting the NCNZ competencies in the form of a portfolio. This is one way of students learning from each other, how they can demonstrate these competencies.


I have already spent some time with Terry Marler and have the site set up. I also have a book titled “Using Moodle’ (Cole & Foster, 2008) borrowed from the university library which I’m finding very helpful. I will need more time with Terry when I am ready to put more things online. Ruth Wilson-Salt one of the lecturers is very experienced in blackboard and is keen to help me set up this site.

I will allow one of my early lectures to teach the students the basics of navigating the BN 233 course sites and explain things such as how to hyperlink. Before lectures start the lecturers will get together to make sure they can understand how to use the site.


September 2008 Contact Terry and get a site set up on blackboard and attach
videos of OSCES and links to helpful sites for students.

October 2008 Finish my plan and assignments completed for course

November 2008 Begin to set up site with clinical wiki’s, titles and links

December 2008 Reflect changes in new course outline and present to year two
team to go over and make suggestions

February 2009 Get together with lecturers to learn about moodle site, seek help
with any difficulties

March 2009 Be ready to go

May 2009 Meeting with lecturers to evaluate if things are going okay

July 2009 Evaluate semester one course and determine if changes need to
be made for semester 2.

November 2009 Evaluate semester 2 and present to nursing school a summary of
how the changes went

Cole, J. & Foster, H. (2nd ed.) (2008) Using Moodle Teaching with the Popular Open Source Course Management System. OReilly Community Press: California