Monday 24 September 2012

Organisations


Organisations – vision for the future of tertiary education

It seems to me that the main vision that both OP and the Government are calling for is being able to provide the best quality education for the least amount of money. I read this as meaning tertiary education to be up to date and needs to keep abreast of what is happening and be able to predict what industry wants, i.e. being able to educate students to meet the growing needs of industry, at the least possible cost.

OP has a vision of being an ‘Open Polytechnic’, inferring that the direction will be online and etaught. I endorse this vision to a certain extent. However the limitation for this is that in nursing students are required to complete specific courses and have clinical hours. The School has sought feedback from students annually and they all say they want more lectures and face to face interaction with lecturers; which really goes against OP’s vision. That leaves the question of how we meet the needs of the students and work towards OP’s vision.

One way we can do this is by promoting the use of technology and this can happen by having a ‘flexible learning’ approach. I will use an example from my teaching in primary care. Primary health care has a dictum of 5 A’s: approachable, available, appropriate, accessible and achievable. Flexible learning is available, accessible, anywhere, anyhow, any time; and I could also add a 6th A – adaptable

The OP vision acknowledges the special nature of the institution, in that it has campuses throughout the region. The School of Nursing does not have courses available from other OP campuses however we do have a cohort of students based in Timaru. If more of the courses could be etaught, it would make nursing more able to be accessed from the campuses in Central Otago area.

One of the goals for OP is to foster lifelong learning. This is essential for all, but particularly in nursing. There is a saying “once a catholic, always a catholic’ and in nursing it is “once a nurse, always a nurse”. Basically, this means that nurses are never ‘off duty’, hence, it is important for the School to prepare nursing students to be work-ready and to have a commitment for life-long learning.

Monday 17 September 2012

Sustainable practice and the learning environment


Sustainable practice and the learning environment
For this post I am going to raise two issues that I think that directly relate to sustainability in nursing education; the nature of health care systems being global and collaborative learning as an approach to save trees (which follows on from my post on technologies in teaching and learning). Both are closely related.
Keeping global health at the centre of this blog, sustainability has been defined by the World Health Organization (2002) as “the ability of a project to continue to function effectively, for the foreseeable future with high treatment coverage, integrated into available health care services, with strong community ownership, using resources supplied by the community and government” (cited by Leffers & Mitchell, 2011). In this sense, sustainability does not necessarily refer to saving trees, but to sustaining programs that are put in place. Often this becomes a political issue with many sustainable programs that impact on the health of communities becomes a political football, for an example in my nursing practice as a public health nurse, I see a more liberal government introduces health programmes that promote good health for children like ‘fruit in school’ while a more centre-right party may feel that health is a responsibility of the individual. My question is, ‘is this the case in education too?’ I suspect it is so. In Casey and Wilson (2005) article, the following questions should be asked about education programmes in order for them to be sustainable:
        Can the module be run repeatedly?
        Continuity of courses and curricula.
        The real costs of operation. Mainstream course costs are often far from transparent or even discoverable; they are buried deep in general institutional costs. Flexible courses tend to be ‘bolted on’ and may be more visible, and hence are an easy target for cuts.
        Teacher workloads  and capacity
        Can the module be taught without the original author?
        The storage of materials and supporting notes
        Course evaluation.
Leffers and Mitchell (2011) claim that sustainable programs need to have “tools [that] are on-going assessments across organizational levels, strong infrastructure development for capacity building, collaboration among stakeholders, key leadership, expertise, program champions, opportunities for transition of leadership, appropriate resources, fit between the partnering stakeholders, adaptability, and ongoing education” (p 92-93). All these are applicable to OP and the School of Nursing.
The concept of global health was raised in a current article by Kulbok, Mitchell and colleagues (2012). One of the issues that these authors discuss, is that globalization of health has an impact on the sharing of information, policies, practices and outcomes, and that the sharing of this information needs to happen in the higher education institutions as much as in clinical practice, because one informs the other. They make this claim because they see that with globalization, the majority of nurses are going to work and practice either in another culture or with patients/clients/consumers from another culture, and with that in mind nursing students need to have a good understanding of the culture of their clients. An example is that this year there are 3 elective nursing students doing their “transition to RN” paper in Africa, and I wonder how well we have prepared them for this. Admittedly not all students will work in Africa, but it isn’t a huge leap to think that a large proportion of our students will work either with an African colleague or will nurse someone from the African continent, either in NZ or elsewhere.
 
References:
Casey, J. & Wilson, P. (2005). A practical guide to providing flexible learning in further and higher        education. Quality Assurance Agency for Higher Education (QAA)
Kulbok, P., Glick, E., Mitchell, D., & Greiner D. (2012).International experience in nursing education: A review of the literature. International Journal of Nursing Education Scholarship. (9)1,1-21.
Leffers, J., & Mitchell, L. (2011). Conceptual models of partnership and sustainability on global health Public Health Nursing. (21)1, 91-102.



For this post I am going to raise two issues that I think that directly relate to sustainability in nursing education; the nature of health care systems being global and collaborative learning as an approach to save trees (which follows on from my post on technologies in teaching and learning). Both are closely related.

Keeping global health at the centre of this blog, sustainability has been defined by the World Health Organization (2002) as “the ability of a project to continue to function effectively, for the foreseeable future with high treatment coverage, integrated into available health care services, with strong community ownership, using resources supplied by the community and government” (cited by Leffers & Mitchell, 2011). In this sense, sustainability does not necessarily refer to saving trees, but to sustaining programs that are put in place. Often this becomes a political issue with many sustainable programs that impact on the health of communities becomes a political football, for an example in my nursing practice as a public health nurse, I see a more liberal government introduces health programmes that promote good health for children like ‘fruit in school’ while a more centre-right party may feel that health is a responsibility of the individual. My question is, ‘is this the case in education too?’ I suspect it is so. In Casey and Wilson (2005) article, the following questions should be asked about education programmes in order for them to be sustainable:
        Can the module be run repeatedly?
        Continuity of courses and curricula.
        The real costs of operation. Mainstream course costs are often far from transparent or even discoverable; they are buried deep in general institutional costs. Flexible courses tend to be ‘bolted on’ and may be more visible, and hence are an easy target for cuts.
        Teacher workloads  and capacity
        Can the module be taught without the original author?
        The storage of materials and supporting notes
        Course evaluation.

Leffers and Mitchell (2011) claim that sustainable programs need to have “tools [that] are on-going assessments across organizational levels, strong infrastructure development for capacity building, collaboration among stakeholders, key leadership, expertise, program champions, opportunities for transition of leadership, appropriate resources, fit between the partnering stakeholders, adaptability, and ongoing education” (p 92-93). All these are applicable to OP and the School of Nursing.
The concept of global health was raised in a current article by Kulbok, Mitchell and colleagues (2012). One of the issues that these authors discuss, is that globalization of health has an impact on the sharing of information, policies, practices and outcomes, and that the sharing of this information needs to happen in the higher education institutions as much as in clinical practice, because one informs the other. They make this claim because they see that with globalization, the majority of nurses are going to work and practice either in another culture or with patients/clients/consumers from another culture, and with that in mind nursing students need to have a good understanding of the culture of their clients. An example is that this year there are 3 elective nursing students doing their “transition to RN” paper in Africa, and I wonder how well we have prepared them for this. Admittedly not all students will work in Africa, but it isn’t a huge leap to think that a large proportion of our students will work either with an African colleague or will nurse someone from the African continent, either in NZ or elsewhere.

 

References:

Casey, J. & Wilson, P. (2005). A practical guide to providing flexible learning in further and higher        education. Quality Assurance Agency for Higher Education (QAA)

Kulbok, P., Glick, E., Mitchell, D., & Greiner D. (2012).International experience in nursing education: A review of the literature. International Journal of Nursing Education Scholarship. (9)1,1-21.

Leffers, J., & Mitchell, L. (2011). Conceptual models of partnership and sustainability on global health Public Health Nursing. (21)1, 91-102.

Tuesday 11 September 2012

Technologies for learning & teaching


Technology for learning and teaching

 What an amazing document the NMC 2012 Horizons Report on technology in higher education (2012) is. It reviews the current trends in technology being used currently and in the near future in education.

I was fortunate enough to be given not only an iPad but an iTouch this year and have been (like many) totally absorbed by the technology and it’s uses. I can now see what people are talking about and can see the potential in education for their uses. Without having my own devices I wouldn’t have the imagination or the ability to understand their potential application. So for this aspect of FL, I will discuss how I will use tablets and iPhone/iTouchs in the 1st year primary care paper.

Primary health care is a clinical paper as opposed to a theory paper, and it involves having clinical placements in the home with families and an older adult.  There are about 18 students in each tutorial group. The indicative content related to the learning outcomes includes undertaking a community assessment, a windshield assessment, health promotion and general safety assessment in the home. Other aspects that students need to complete are reflective writing and journaling. All aspects are assessed in their portfolio at their formative and summative.  I can see the use of different technologies for all these aspects of this paper.
Community assessment: This is undertaken by a group of 2-3 students who then report back to the tutorial group. This is part of learning beginning research skills and uses both visual cues and internet based research. Here the students visit an area in Dunedin and review what makes up the defined community. This year all groups used PowerPoint for their presentation and all used photographs as visual representation of their community using their cell phones.  None used videos, but with the use of tablets and smartphones or iTouch, they could use this medium rather than a PowerPoint. I am unsure how the students communicated together but there is capacity for them to use a private Facebook, twitter or other social media to share the information together.

Windshield: This is a smaller version of the community profile and is completed by individual students rather than as a group. The students are expected to look around and describe the community that their clinical placement client lives in. They should be able to describe the topography of the area and the obvious associated hazards e.g. hills, icey roads and poor road lighting. They also describe the services or agencies that the placement may use in their community e.g schools, shops, cafes, police etc. This year, all students listed these, but again this could be done using videos/cameras on their cell phones and tablets. They can then represent these either in the form of an ePortfolio or printed  and placed into their portfolio.
Health promotion: The students need to show they have an understanding of the theories of health promotion and its application. Most of the students this year did a project with their clinical families on things like oral hygiene and nutrition with the children in the families they visited. Again this could be completed by video or photography using a cell phones /iTouch or tablets. This could also be transmitted using facebook or other social media. Rather than creating their own health promotion message, I will encourage the students to look for something that has already been done using a social media forum.

Health and safety and hazards in the home: the students list the health and safety hazards int he home and what can be doen to avoid injuries. Depending on consent by the placement, this could be videotaped/photographed and placed into their portfolio.

Journaling and reflective practice: As this is an essential skill for all students to learn, there is limited capacity to use technology with this or to use in a collaborative manner.

There is scope however to use scenario-based learning or networked learning as part of this paper, particularly on linking theories from other papers to the learning outcomes of this paper, for example on child development when working with families and with the aging process when working with the older adult. This could be achieved by having a ‘virtual family’ with 3 children of different ages with different developmental issues, or with older adults with health related issues associated with age, e.g. Parkinsons, Diabetes, Stokes (CVAs). Students could work in groups of 3-4 using ‘dropbox’, google docs or other cloud-based technologies to work collaboratively to develop the scenario. The students could review information on the pathophysiology, search for the relevant social or community-based agencies and develop health promotion messages using technology. Each member of the group would be expected to build part of the picture with  the group dynamic and participation being part of the evaluation. The lecturers role is again as the facilitator. This fits within numbers 1, 2, 3, 5 and 6 of the Horizon Report’s (2012) list of trends in higher education.

The Report also includes what technology will be used in the near term (within the year), mid-term (within 2-3 years) and far term (4-5 years) and this type of teaching and learning fits with the technologies of the near term and has potential for the mid-term. If this is implemented next year it could include using mobile apps (if there has been ones designed for this and I’m sure there will be) and tablet computing (near term).

One of the things that this has raised for me is it has the potential for the tutorials to be more interactive. As it is most of the tutorials are discussions with the lecturer’s role as the facilitator. If students have more access to tablets they could share more of the work together including researching different web and social media sites.

Reference:

NMC (2012). Horizon report: High education edition. Retrieved from http://net.educause.edu/ir/library/pdf/HR2012.pdf

 

Monday 10 September 2012

Open education resources


Thoughts on open education resources – Activity 6 Flexible learning

 
 
Open educational resources (OER) is the term adopted by UNESCO in 2002 and is defined as “educational materials and resources offered free and openly for anyone to used with copy rights to re-mix, make improvements and to redistribute the resources” (Blackall, 2007; p.26; Wikiversity). This means that OER are produced with the expectation that they will be used and re-mixed/adjusted by others at no cost and without being affected by copyright laws. However, any OERs used are required to be attributed to the original authors. OERs are used by constructivist theorist.

 
With constructivist theories of pedagogy in mind, Blackall (2007) claims that the use of social media in teaching is increasing as educators become more familiar and confident using this method for facilitating learning. Social media has the potential to provide an alternative to formal classroom teaching. However, there are many forms of both social media and web-based programmes that student’s access. They can access these through ‘apps’ (applications) through a huge range of electronic devices. Students are no longer restricted to desk-top computers or even lap-tops to access digital libraries and information. They have iPads, iTouchs, iPhones and other smart phones, all of which can access the internet and digital libraries at any time. That aside, many of our nursing students are not familiar with the library within meters of the lecture rooms. However the growing use of multiple devices can cause some issues for educators, with restrictions on funding for institutions like OP, who are not able to keep the educators with up to date equipment. From my experience it is more common that students are more familiar with various digital devices than the educator, which creates a barrier for the use of OERs in the curriculum. Additionally, educators are not necessarily comfortable with all forms of devices and the various forms of social media.

 
I found this wonderful quote by Daryl West on OER and tedhnology in education;

“By itself, technology will not remake education.  Meaningful change requires alterations in technology, organizational structure, instructional approach, and educational assessment. But if officials combine innovations in technology, organization, operations, and culture, they can overcome current barriers, produce better results, and reimagine the manner in which schools function.” (West, 2011)

 
References:

Blackall, R. (2007). Open educational resources and practices. Scope Contemporary Research Topic: Flexible Learning 1.  University of Otago Print: Dunedin, New Zealand.

West, D. (October 2011). Using Technology to Personalize Learning and Assess Students in Real-Time. Retrieved from http://www.brookings.edu/research/papers/2011/10/06-personalize-learning-west

Wikiverstiy. Open educational resources. Retrieved from, wikiversity.org/wiki/Open_educational_resources#What_are_OERs.3F

Cultural sensitivity and indigenous learners


Cultural sensitivity and indigenous learners

Laurie’s Flexible learning: September 2012

 

From my perspective, nursing as a profession is under-represented by Māori, Pacifica, Asian and other minority groups. I have no idea what the breakdown of ethnicities in our School is currently, but I would be surprised if it comes anywhere near representing the ethnic breakdown of NZ society. However, Otago does not have a high percentage of minority groups in the population to call on. BUT  given that not all our students come or will continue to live in the Otago region, we as a School, should be preparing our students to be able to provide good, culturally safe nursing practice to all the clients/patients (and now called consumers) in the health arena.

 
The last census was taken in 2006 and the following graph shows the ethnic breakdown of Dunedin and NZ (NZ Statistics, 2006)
                                                                            

Ethnic Groups in Dunedin City, 2006 Census
 
     
 
Male (%)
Female (%)
European
77.4
80.1
Māori
6.7
6.2
Pacific peoples
2.4
2.1
Asian
5.1
5.6
Middle Eastern/Latin American/African
0.8
0.6
Other ethnicity
     
New Zealander
14.6
12.5
     
Other ethnicity–other
0.0
0.0
     Total
14.6
12.5

 
Ethnic Groups in New Zealand, 2006 Census
 
     
 
Male (%)
Female (%)
European
66.7
68.4
Māori
14.6
14.7
Pacific peoples
7.0
6.8
Asian
9.0
9.4
Middle Eastern/Latin American/African
1.0
0.8
Other ethnicity
     
New Zealander
11.8
10.4
     
Other ethnicity–other
0.0
0.0
     Total
11.9
10.5

Professor Mason Durie (2009) stated that tertiary or higher education, has changed over the last decade and instead of isolating and excluding Māori , the sector is now in a position where they/we should promote social cohesion and prepare Māori  students to be potential leaders and role models. He said that although there are still significant gaps in the education outcomes for Māori , curriculum’s are more inclusive of Māori  issues, with more Māori  students enrolled in tertiary education, and there is more research being completed by and for Māori .

“There has been a deliberate attempt to build on those indigenous foundations that have continuing relevance for new generations of Māori living in urban situations, and to reshape higher educational institutions as places where Māori culture, learning and aspirations can flourish.” ( Durie, 2009; p.3).

Durie is one of the most influential researchers/academics advocating for Māori and other minority groups in NZ. He lays down a challenge for the tertiary education sector to reduce barriers for Māori, and  claims that they need to reduce socio-economic barriers for students and for the sector to embrace indigenous worldviews in order for “pedagogies, research methodologies, campus facilities, and the academic staff can endorse cultural identity and inspire students” ( Durie, 2009; p. 4).

This is the challenge for nursing to aim to meet. I believe that both these factors can be met by the institutions themselves by providing subsidies and scholarships for indigenous students and to ensure that the pedagogies are inclusive rather than mono-cultural. The latter is close to the heart of the School of Nursing curricula and it is up to individual lecturers to embrace the various worldviews. I do this by ensuring that models of Māori  health (Whare Tapu Wha) are included in lectures on family violence and in the primary health tutorials that I give, and by role modelling sound culturally sensitive practice. An example of the latter is that recently I have been working with 1st year students in the clinical laboratories, and I noticed that the students have become very lax in not ensuring good standards of cultural safety. For instance as a new lecturer in the labs, many of the students don’t know me and were sitting on tables and the beds, and I have been able to change the culture to ensure they are respectful and set more professional rules of behaviour in the labs.

The Māori Tertiary Education Framework (MTEF) (2003) is a strategic document that guides the direction for the tertiary education sector and provides a resource for Education. There are three tiers to guide the sector with the first tier providing general advice on how the framework can be applied. The second tier commences by quoting Durie’s vision for the sector as:

·         “To live as Māori

·         To actively participate as citizens of the world

·         To enjoy a high standard of living and good health” (Ministry of education, 2003, p. 14)

The third tier provides the 5 guiding principles for this document, these are;

·         Ngā Kawenga or responsibilities where the sector is accountable for and to Māori


·         Tino Rangatiratanga or authority/self determination by supporting Māori  to make their own decisions

·         Toi Te Mana or  ability to influence and empower Māori  to have an influence on the curriculum

·         Mana Tiriti /Ahu Kāwanatanga or contribution/partnership to have a shared vision

·         Whakanui or respect and inclusiveness in the education sector.

Following this the Ministry of Education identifies 7 key priority areas for the tertiary education sector to aim for; these are Māori  advancement, leadership, sustainability, Kuapapa services, inclusive learning environments, life-long learning pathways and Māori -centred learning. I will discuss only one of these areas, that being inclusive learning environments. I bleive all these priority areas are part of OP’s vision. I have attended several Treaty of Waitangi and Tikanga workshops over the years and always find them inspiring. I try to ensure that I pronounce names and te Reo words as accurately as possible and I encourage students to be familiar with the various models of health like Whare Tapu Wha. I am aware that I need to continually upskill my knowledge in order to pass this on to my students and to ensure that my teaching and nursing practice is culturally safe.

References:
Durie, M. (2009). Towards social cohesion: The indigenisation of higher education in New Zealand.  Presentation to Vice Chancellor’s forum. Kuala Lumpur, Malaysia. Retrieved from: http://www.universitiesnz.ac.nz/files/aper_for_ACU_Forum_-_Towards_Social_Cohesion.pdf.

Ministry of Education. (2003). Māori Tertiary Education Framework: A report by the Māori Tertiary Education reference group. Ministry of Education; Wellington, New Zealand