Book Club: The Great Brain Race: How Global Universities are Reshaping the World.

Book: Wildavsky, B. (2012). The great brain race: How global universities are reshaping the world. Princeton University Press. [Chapter 1]

The internationalision of student mobility and how “every year, nearly three million international students study outside of their home countries, a 40 percent increase since 1999”. Higher education and research is a global activity and is now considered border less.

University Challenge

How the top Universities in developing countries are partners with the top ‘traditional’ old world universities from the developed world. The resources, campus, teachers of these new competitors are providing world class facilities to their student population. What they lack in history, they provide an innovative and technological driven education.

World Rankings

The now border less world of higher education and the importance of world rankings of universities to attract both students and teachers in the ‘global supermarket‘ of education.

The Brain Drain

With this worldwide expansion of higher education and a mobile student group, the effect has been a “brain drain”. The best students have been taken from their home countries to assist in the brain gain and growth in the land of their university where they then undertake their working career. Foreign students bring both academic and economic competitiveness. They boost this economy but their home economy looses out, until they return home.

With the new universities challenging the traditional and also free world trade, it is possible that there will be a change to the brain drain to create an equilibrium of brain circulation.

Image by jesse orrico


Wildavsky, B. (2012). The great brain race: How global universities are reshaping the world. Princeton University Press. [Chapter 1]


John Heron’s Six‐Category Intervention Analysis

Resource: Heron, J. (2001). Helping the client: A creative practical guide. Sage.


Heron’s Six‐Category Intervention Analysis is a conceptual framework for understanding interpersonal relationships.

What Is Intervention?

Heron’s meaning of intervention is an “identifiable piece of verbal or non- verbal behaviour that is part of the practitioner’s service to the client”.

“The practitioner is anyone who offers a professional service to the client. This would include such disciplines as nurses, doctors, dentists, psychiatrists, psychologists, counsellors” (Rungapadiachy, 1998).

Heron’s Six‐Category Intervention Analysis

Enhancement of growth and development is seen as therapeutic activity. Heron’s 6 categories of counselling interventions are based around 2 styles of authoritative and facilitative:

  • Prescriptive: Seeks to direct the client’s behaviour.
  • Informative: Seeks to impart knowledge to the client.
  • Confronting: Seeks to raise the client’s awareness or consciousness about attitudes or behaviours of which they are unaware of.
  • Cathartic: Seeks to enable the client to discharge painful emotions.
  • Catalytic: Seeks to encourage the client into self-discovery, self-directing and problem-solving approach.
  • Supportive: Seeks to affirm the client’s worth and value and understand their qualities, attitudes and actions.
  • to understand how we are interacting with people.
  • to understand how we are received.
  • to understand ourselves.
  • to understand our client.


Keywords: Heron; Six‐Category Intervention Analysis; Interpersonal Relationships.


Heron, J. (2001). Helping the client: A creative practical guide. Sage.

Rungapadiachy, D. M. (1998). Interpersonal communication and psychology for health care professionals: Theory and practice. Elsevier Health Sciences.

Sloan, G., & Watson, H. (2001). John Heron’s six‐category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United KingdomJournal of advanced nursing36(2), 206-214.

Create an Online Journal Club for Nurses

This post is to help guide the nurse educator on the creation of an online journal club for healthcare practitioners, and focuses on the theory of initiation and engagement aspects. Reasons for a journal club could be to increase uptake of evidence based practice, changing culture, improving patient outcomes or education development.

 To Do List

  • Outline of the purpose of the journal club.
  • Set some short and long term goals.
  • Set up regular meeting dates- routines help.
  • Voluntary or mandatory attendance?
  • Closed or public journal club?
  • A journal club leader to facilitate discussion.
  • Set a code of conduct for respectful discussion.
  • Determine process to choose topics of the papers.
  • Flipped classroom- circulating papers prior to the meeting.
  • Decide on a critical appraisal process.
  • Managing the online resource and enable sharing for those not able to attend.
  • Inclusive: providing training or resources for those nurses not familiar with the online journal club resources.
It is advisable to share and discuss articles on one platform for simple access for participants and to focus all discussion in one area. The articles and links could be shared via a learning management system, blog, Wiki resource, Google+ community, Twitter or a Facebook group. Limiting the number of social media tools also reduces the facilitators workload. Deciding on the privacy settings should be decided by the facilitators, remembering that workplace and nursing have code of conducts and you will be the moderator. The copyright rules for sharing publications will have to be followed as well, so use hyperlinks to the relevant journal page for participants to access or consider using open access articles. Having a journal club code of conduct with  information regarding confidentiality, engagement and respect is advisable.
Critical Appraisal Tools
Chan, T. M., Thoma, B., Radecki, R., Topf, J., Woo, H. H., Kao, L. S., … & Lin, M. (2015). Ten steps for setting up an online journal clubJournal of Continuing Education in the Health Professions35(2), 148-154.
Deenadayalan, Y., Grimmer‐Somers, K., Prior, M., & Kumar, S. (2008). How to run an effective journal club: a systematic reviewJournal of evaluation in clinical practice14(5), 898-911.
Greenhalgh, T. (2001). How to read a paper: the basics of evidence-based medicine. (2nd ed.) BMJ Publishing.
Greenhalgh, T. (2014). How to read a paper: the basics of evidence-based medicine.(4th ed.) John Wiley & Sons.
Intensive Care Network (2017) How to make journal club work.


Tag Team Simulation: Journal Club

Journal Club Article: Levett-Jones, T., Andersen, P., Reid-Searl, K., Guinea, S., McAllister, M., Lapkin, S., … & Niddrie, M. (2015). Tag team simulation: An innovative approach for promoting active engagement of participants and observers during group simulations. Nurse education in practice, 15(5), 345-352. [abstract]

Rationale for the Study

The authors state that “when simulations are conducted in large groups, maintaining the interest of observers so that they do not disengage from the learning experience can be challenging. We implemented Tag Team Simulation with the aim of ensuring that both participants and observers had active and integral roles in the simulation.”


“However, in nursing programs, where there may be hundreds of students, resource limitations often lead to simulations being conducted as group activities. Evidence suggests that when this happens, learners who take on an observer role instead of being an actual participant in the simulation, can lose interest and disengage from the learning experience” (Kettlewell, 2012; Harder et al., 2013).

The importance of active participation in education and simulation is highlighted. However, in simulation an observing role from watching through one way glass, auditorium or via video conference is part of increasing engagement and providing an alternative view or ‘lens’ from the non-active members. Learning can occur from this observation aspect, but the authors highlight the issue of a passive role, less immersion and boredom ensuing.

One of the most innovative parts of this article is that the idea was taken from performative theatre. It’s really interesting to take ideas from other professional fields and try them in the nursing environment and take some risks and consider new approaches to education delivery.

Tag Team Simulation (TTS)

“TSS is designed for groups of approximately 20 learners, with each participant and observer having a specific, active and integral role in the simulation.

  1. The narrator/director (the educator).
  2. The protagonist  (leading character- trained simulator actor, student or educator).
  3. The actors (the students).
  4. The audience (active observers).
  5. The set ( an authentic learning environment with high level of fidelity).
  6. The play (simulation scenario)

One of the unique features of TTS is that there are no formal scripts. The TTS play is comprised of a prologue, two acts, an intermission, a debrief and an epilogue.”


The Satisfaction with Simulation Experience Scale (SSES) was used to measure student’s perceptions.

444 second year nursing students submitted the surveys from a population of 536 giving a response rate of 83%.

“The results of an independent sample t test revealed that those who participated in the simulation experience (the actors) reported slightly higher satisfaction with the simulation experience than observers (audience). However, the difference was not statistically significant on the SSES or any of the three subscales.”

Take Home Messages from the Article:

  • Simulation observers can lose interest and disengage from the learning experience.
  • Tag Team Simulation ensures that both participants and observers have equally active and integral roles in simulation.
  • A Tag Team pain simulation implemented with second year nursing students revealed no significant difference in satisfaction scores.


The holy grail for the perfect education approach continues, but this is a reasoned approach to the very real challenge of large group sessions and how to improve the educational approach. One question that I would like to know in regards to nurse training, relates to the increasing deregulation on the number of nursing enrollments in higher education and universities and the impact on the quality of education (I presume this is becoming a global phenomena with the predicted global nursing shortage?). Many simulation courses provide a 1:6 or 2:6 instructor to participant ratio for a quality learning experience. Is this article just responding to changing times and the stretch on nurse education resources?

Keywords: Tag Team Simulation; TTS; Simulation;active participation


Levett-Jones, T., Andersen, P., Reid-Searl, K., Guinea, S., McAllister, M., Lapkin, S., … & Niddrie, M. (2015). Tag team simulation: An innovative approach for promoting active engagement of participants and observers during group simulations. Nurse education in practice, 15(5), 345-352. [abstract]

The Clicker Session & Classroom Response Systems

Journal Club Article: Shapiro, A. M., Sims-Knight, J., O’Rielly, G. V., Capaldo, P., Pedlow, T., Gordon, L., & Monteiro, K. (2017). Clickers can promote fact retention but impede conceptual understanding: The effect of the interaction between clicker use and pedagogy on learning. Computers & Education, 111, 44-59.\

Audience response system App

It is important to fully understand the effect on learning of clickers, and the conditions in which it is beneficial, and best practices for instructors using different pedagogical styles. The aim was to determine whether clicker-enhanced fact retention and conceptual understanding. The study also looked at the overall pedagogical approach used by the instructor, assignments or activities required outside of class meetings, and the instructor’s learning goals for students.


Little work has been done to isolate the effect of clickers on conceptual understanding in courses that do not also provide other scaffolds for deep learning.

Evidence Base

The evidence for the effect of clicker questions on factual knowledge gains is fairly compelling, though the evidence for improvement of deeper, more conceptual understanding is less clear. Just in case anyone is jumping up and down saying that clickers work, see references below for a more balanced look at this.

Shapiro et al. (2017) state that “clickers may not particularly help students who possess attitudes and skills that effectively promote learning. Because those students will tend to engage in activities that lead to deep understanding and retention of material, it is likely they will do equally well with or without clickers. Contrarily, we would expect students who had attitudes and learning habits that are less effective for learning to be helped by clickers.”

The Study

  • The research was conducted in a live classroom.
  • A total of 858 undergraduate students over four consecutive semester in an introductory to biology subject.
  • No students declined participation. How you may ask, well a small amount of extra credit was offered in each course for completing a survey about learning habits and behaviors, and students were offered the opportunity to earn the extra credit through an alternative assignment should they choose to opt out of the study. No students declined participation.
  • Four conditions were developed to test the study’s hypotheses. Two of the conditions directly tested clicker effects, as they involved presenting students with clicker questions designed to probe information needed to answer specific exam questions. The other two conditions were controls. The simple control was a simple “do nothing” control condition, while the enhanced control condition directed students’ attention to the importance of the relevant material while refraining from offering clicker questions.


“In sum, the results support our first hypothesis and replicate prior studies that report factual and conceptual clicker questions increase factual knowledge retention over a simple control condition. Our second hypothesis, that conceptual clicker questions will enhance conceptual exam question performance, was not supported. Our third hypothesis, that student variables would mediate clicker effects, was partially supported by the analysis of deep learning strategies. Specifically, we found that clicker questions brought overall exam performance of students who do not employ deep learning strategies to the level of their deep strategy-using peers. Thus, we have shown that clicker questions have differential effects depending on students’ learning orientation.”


Clickers can promote fact retention but impede conceptual understanding.  Students can make the mistake of familiarity over knowing subject matter or overestimate their actual level of understanding.

Practical Stuff

Like anything in education, it seems to be if the situation warrants then give it a try but just don’t over do it by using the same approach in every session. Mix it up in the delivery method to suit the learners, content, resources or environment needs. If something encourages engagement and interest, then give it a try. Find some free software or borrow a system to give it a try to see the response. There are also many ways to deliver audience responses, just consider your budget and assess which suits your needs, environment and class size first.

References (for clickers improving student learning)

Bruff, D. (2010). Multiple-choice questions you wouldn’t put on a test: Promoting deep learning using clickers. Essays on Teaching Excellence, 21(3).

De Gagne, J. (2011). The impact of clickers in nursing education: A review of literature. Nurse Education Today, 31(8).

DeBourgh, G. A. (2008). Use of classroom “clickers” to promote acquisition of advanced reasoning skills. Nurse Education in Practice, 8(2), 76-87.

Fifer, P. (2012). Student perception of clicker usage in nursing education. Teaching and Learning in Nursing, 7(1), 6-9.

Zurmehly, J., & Leadingham, C. (2008). Exploring student response systems in nursing education. CIN: Computers, Informatics, Nursing, 26(5), 265-270.

Change Theory: 6 Thinking Hats Theory


Edward De Bono’s Six Thinking Hats tool is a powerful change process technique and is used
to look at different points of view or lens to aid change management. This provides a team orientated and more rounded view of a situation and more effective group thinking.  The processes involve a detailed and cohesive way to drive thinking processes to work together more effectively (De Bono, 1985).

6 Thinking Hats

Each hat is a different colour and represents a different style of thinking:

  • White Hat – facts, figures, and objective information.
  • Red Hat – emotions, feelings, hunches, intuition.
  • Black Hat – logical negative thoughts, “devil’s advocate,” why something will not work.
  • Yellow Hat – logical constructive thoughts, positive aspects of why something will work.
  • Green Hat – creativity, generating new ideas, provocative thoughts, lateral thinking.
  • Blue Hat – control of the other hats, thinking about the thinking process, directs attention to
    other hats to facilitate “mapmaking” thinking” (Carl, 1996).

This provides “parallel thinking” where all the team members are focusing on the problem and a collaborative approach ensues.

Practical Tips 

  1. “The meeting may start with everyone assuming the Blue hat to discuss how the meeting will be conducted and to develop the goals and objectives.
  2. The discussion may then move to Red hat thinking in order to collect opinions and reactions to the problem. This phase may also be used to develop constraints for the actual solution such as who will be affected by the problem and/or solutions.
  3. Next the discussion may move to the (Yellow then) Green hat in order to generate ideas and possible solutions.
  4. Next the discussion may move between White hat thinking as part of developing information and Black hat thinking to develop criticisms of the solution set.

Because everyone is focused on a particular approach at any one time, the group tends to be more collaborative than if one person is reacting emotionally (Red hat) while another person is trying to be objective (White hat) and still another person is being critical of the points which emerge from the discussion (Black hat). The hats aid individuals in addressing problems from a variety of angles, and focus individuals on deficiencies in the way that they approach problem solving” (Wikipedia, 2017).

Some useful handout resources:


De Bono, E. (2017)

De Bono, E. (1999). Six thinking hats (Vol. 192). New York: Back Bay Books. [presentation]

De Bono, E. (1985). Six Thinking Hats: An essential approach to business management. Little, Brown, & Company, New York, USA.

Carl III, W. J. (1996). Six Thinking Hats: Argumentativeness and Response to Thinking Model.

Wikipedia (2017) Six Thinking Hats.


University 4.0: The Ecological University

Barnett (2011) asks us to consider “just what is it to be a university?“. Also in relation to the previous post on Industry 4.0, we could also consider what is the point of a university?

Clare College And Kings Chapel, Cambridge University, UK.
The university has been around for 1000 years and in various incarnations according to Barnett (2011):

  • Version 1.0 was the metaphysical university,
  • Version 2.0 the post-industrial research university,
  • Version 3.0 the entrepreneurial university,
  • Version 4.0 is being dubbed the ecological university.

Ecological University

According to Barnett (2011, pg. 451-452), the future could hold:

“Perhaps the university—as it unfolds into the 21st century—can be both authentic and responsible. These two dimensions, of authenticity and responsibility, may be seen in what we may term the ecological university. This is a university that takes seriously both the world’s interconnectedness and the university’s interconnectedness with the world”.

“There is increasing attention being given to the idea of students as global citizens. As global citizens,
students come to have a care or concern for the world and to understand their own possibilities in the world and towards the world”.

“As the ecological university, it does all this by forming and widening its networks across society, a task which – unlike the entrepreneurial university – it performs not in its own interests but in the interests of the world; indeed, worlds, for it acts in the interests of both the human and physical worlds. This is a university neither in-itself (the research university) nor for-itself (the
entrepreneurial university) but for-others.”


Universities ability for self-renewal has been evident for over a 1000 years, the question is how the university of tomorrow will develop to be more collaborative with industry and be considered relevant in the era of Industry 4.0.

Keywords: Industry 4.0; University 4.0; Digital Citizen; Interconnectedness; Ecological University.


Barnett, R. (2011). The coming of the ecological university. Oxford Review of Education, 37(4), 439-455. [abstract]

Barnett, R. (2016) The Coming of the Ecological University.

Barnett, R. (2015) Realising the Ecological University.

Ross, P. (2017) Industry 4.0: The Future of Work. Nursing Education Network.