Life Connected: Creating a Blog in Nursing

This blog is 18 months old, has 170 posts and increasing numbers of visitors so it’s going well in its little niche area of nurse educator resources. The ‘we’ has become ‘me’ in the last 12 months due to other work commitments, training and exams for my co-creator. So here are a few things I have reflected on during the blogging journey:

  1. Writing skills – I keep the posts short and hopefully focused for learning on the go. I just don’t have the storytelling skills that I see other blogger’s use. I feel more confident in using an approach that is comfortable for me, and hopefully others find useful.
  2. Positive Approach- The sharing and discussion around resources, rather than the critique continues to be the focus. I am not a professor or an academic so I will leave the critiquing to the experts.
  3. Lifelong Learning – I love all the clinical, education and other array of resources that I read as preparation for the blog posts. I have continued with reading education focused books post qualification which is a major positive part of ongoing development.
  4. Learning Networks –  Mainly through social media platforms has expanded from the critical care community to a wider nursing network, but also wider to those in school and higher education, business leaders and motivators and authors/journalists. With this, the topics I am exposed to are so varied.
  5. Social Media – Tricky one with recent privacy issues in the news, but let’s focus on the agile sharing and discussion of evidence based practice.
  6. Discussion – there has been a few comments on posts but not as much discussion as I thought may be generated directly on the blog. However, discussion is occurring on other social media platforms so it may be just how people prefer to communicate in different media.
  7. Education not clinical focused – I have avoided any clinical nursing discussion and hopefully this keeps the blog away from the grey areas of clinical advice, accountability and professionalism!
  8. Slide-ology – I have tried to make the blog more visual, but this is okay if you have the internet bandwidth. I wonder if the images and embedded videos need to be removed and keep it plain text to enable true accessibility.
  9. FOANed – It’s still advert free and independent- but I have to work a few extra shifts to pay for the yearly costs of running the blog.
  10. Open Access – it’s complicated, but I do think all of healthcare (including patients/consumers) needs access to the best current evidence and this is not the case.
  11. Heutagogy –  amazing online resources being created by nursing students across the world. Impressed and in awe of their knowledge, awareness, mindfulness and reflections.
  12. Frequency of posts – It’s a balance with work, study, other projects and something called free time. I have at times been prepared with posts ready for the next 2 months, then in contrast it has ran on a week to week basis. Balancing work and formal study, the frequency has reduced from a post every 3 days to once per week but all academic assignments and deadlines were met.
  13. The blog is my organised notes – I can refer back to posts and resources with such ease, rather than searching through note books and folders.
  14. CPD – my hours are well and truly met.
  15. Coding – still on the to do list!
  16. Community of Practice – Part of the nurse blogging “WeNurses” community as part of the #NHS70 celebrations.
  17. Does the blog need a peer review process or keep it agile? One to ponder for the future.
  18. Fun – it’s actually been a rewarding experience.

Bloom’s Taxonomy & Constructivism

The use of Blooms Taxonomy to provide focus for the delivery of education and meeting educational objectives is a commonly used structure. The taxonomy can aid developing curriculum learning objectives, assessments and activities to align and scaffold education delivery. Organising levels of expertise of Bloom’s taxonomy categorises and orders from simple to complex and from concrete to abstract, and cover the learning objectives in the cognitive, affective and sensory domains.

Bloom's Taxonomy

For The Educator

“This connection between the ‘teaching objectives’ (what lecturers say they want to do) and their ‘teaching activity’ (what they actually do) – a lack of relationship between intention and performance. This unrecognised contrast between intent and the effects of teaching is often expressed as a distinction between the formal and the hidden’ curriculum” (Entwistle et al, 1971, pg. 12).

  • What are the aims of the education?
  • What level of knowledge and understanding is expected of the student?
  • Scaffolding towards critical thinking.
  • Guides and aligns type of assessment.

For The Student

  • What is expected of me (what educators want students to know)?
  • What am I going to develop by attending this course?
  • Are values, attitudes, and interests affected?
  • To understand and use concepts, to demonstrate particular skills.

Summary

The updated taxonomy by Krathwohl (2002) using the knowledge and cognitive domains states that “the Taxonomy of Educational Objectives is a scheme for classifying educational goals, objectives, and, most recently, standards. It provides an organizational structure that gives a commonly understood meaning to objectives classified in one of its categories, thereby enhancing communication”.

References 

Krathwohl, D. R. (2002). A revision of Bloom’s taxonomy: An overviewTheory into practice, 41(4), 212-218.

Iowa State University (2016) Revised Blooms Taxonomy. Center for Excellence Learning & Teaching.

Educational Origami (2017) Blooms Digital Taxonomy.

Nursing Education Network (2016) Intended Learning Outcomes

 

Workplace Training: Informal Learning?

Workplaces as Centres of Inquiry

Workplace learning and experiences are often seen as informal and subsequently ‘informal learning’ occurs. Billet (2002) states that an educational workplace pedagogy exists, and that learning does not just occur in schools and higher education. Workplace education delivers structured goal-directed activities and work practice relevancy so this ‘informal’ tag is actually incorrect. Learning is deemed as being “interdependent between the individual and the social practice” (Billet, 2002). This structuring of learning experiences is shaped and directed towards sustaining the continuity of current practice.

“Workplace practices and affordances, are dynamic, as their tasks, goals, interactions, participants and relations are likely to be constantly changing” (Billet, 2002, pg. 64).

Learning through work, and the participation and engagement in the social practice is an essential aspect. Just think of the importance of role modelling to set the culture of your workplace environment. Vocational learning is often considered of lower quality than education provided by educational institutions, but with current lifelong learning policies, the role of workplace learning is essential. Workplace participation and sustaining practice are required for positive learning experiences and outcomes. Workplace training can vary between ad-hoc to over structured teaching, which have contributed to some of the negative terms for workplace learning. If we think of the learners motivation to learning, there will likely be a difference in the learners level of engagement of learning in those opportunities chosen by the individual to that of enforced learning (such as mandatory training). Just think to the last time you went to an education event of your choice and compare to one you were ‘encouraged’ to attend, likely you experienced very different motivators. The workplace will have more mandatory training requirements so enthusiasm is likely to be low for such training, as the educator you will need to find a way to make the training meaningful for the participants.

Pathways of learning activities as part of a constructivist approach for skill development are approaches in contemporary work settings. Mentoring and apprenticeships are important learning pathways to navigate workplace practices and learn from experienced practitioners, again part of the social learning experience. Continuity of social practices and the opportunities of unintended learning is a product of these mentorship experiences in the work setting.

Relevancy in Nursing 

Nurse training is forever looking for the right balance between providing higher education and workplace experience for nurse training. Finding the perfect mix of theoretical with the hands on learning experience in the actual clinical setting is the overall aim. The mentor model is an essential part of nurse training in providing learning in the workplace setting. Workplace education is commonly more hands on and has a practical focus, combining theoretical and clinical. With simulation increasingly part of formal educational approaches to nurse training, a more hands on experiential learning approach is being embraced over the traditional ‘sage on the stage’ lecture approach. The multi-disciplinary teamwork and bonding that can occur in workplace training is vital as part of building a positive team culture.

Educator Program Aims

  • Professional growth and change (transformative practice).
  • Personal Change- Reorientation of values of attitudes.
  • Self-esteem linked to workplace confidence.
  • Teamwork and community of practice.

References

Billett, S. (2002). Critiquing workplace learning discourses: participation and continuity at work. Studies in the Education of Adults, 34(1), 56-67.

Harteis, C. & Billett, S. (2008). The workplace as learning environment: Introduction

Global Adult Education Policy, Agendas and Ideologies

Nurse educators often work in their own speciality areas of nursing and so I thought this post on global adult education may provide a brief overview on wider education policy, agendas and ideologies in the globalised world we now work in.

Neoliberalism

Global neoliberalism policies have been progressively applied either directly or indirectly to education systems, similar to economic policy with the aim to deregulate education systems (Moutsios, 2009). Human capital production enhancement through systems of education, improving the cost effectiveness of education, promoting ‘lifelong learning’ and the proliferation of indicator markers are some of the developments in globalization education ideologies (Walters, 2006). These provide a transnational education policy for prominent globalized organizations such as the World Bank and International Monetary Fund (IMF), and adult education ideology has acquired a transnational voice by actors such as UNESCO (Milana, 2012). These actors have shifted the vocabulary from adult and continuing education to lifelong learning for the acquisition of marketable skills (Milana, 2012). Reports such as Lifelong Learning for all from OECD (1996) and UNESCO international commission on education and learning for the twenty first century have placed increasing substance on lifelong learning.  Lifelong learning is part of the relationship between education, work and socio-economic which is part of the globalized education ideology (Bond, 2001).

World Bank

Education from the World Bank (2011) perspective is seen as a “powerful driver of development and is one of the strongest instruments for reducing poverty and improving health, gender equality, peace, and stability”.  Education for the World Bank has consistent returns in terms of income and improves equality, and to do this their aim is raise low learning levels in the developing world. This ideology is prevalent throughout the World Bank education strategy plan for 2020.

Performance measurements, indicators and targets are prominent in World Bank policy. Measurements such as Programme for International Student Assessment (PISA) and Trends in International Mathematics and Science Study (TIMMS) are exemplified by the World Bank as better predictors of economic growth than number of schooling years (World Bank, 2011). This economic and workforce philosophy is similar for adult education, where the emphasis is on work skills to increase employability and the knowledge economy (World Bank, 2015).

Education and financial support from the World Bank are linked to these concepts of human capital needs and the impacts on national policies are influenced through these financial agreements (Bond, 2001).  What this means, is the World Bank are influencing national policies and ideologies on education through economic support to create open market conditions.

International Monetary Fund

As the IMF has fiscal responsibility of international monetary markets, then education policy and ability to reduce income inequality is part of the IMF policy. As IMF is involved with social policies and lending constraints, then a countries macro-economics are designed for growth and poverty reduction (IMF, 2001).

UNESCO

UNESCO policy sees adult education as a means for governments to globally overcome disadvantages (Milana, 2012). The UNESCO “Hamburg Declaration” considers education as a right for adults and part of participating fully in society (Milana, 2012). The idea of lifelong education “is the keystone of the learning society (Medel-Añonuevo, Ohsako & Mauch, 2001).  

Lifelong Learning

The shift from education to lifelong learning is now a consistent global policy, which Delors et al (1996) report to UNESCO, emphasised the shifting the “education paradigm” from a local to world scale to allow democratic participation and economic growth to human development. UNESCO’s (2001) publication ‘Revisiting lifelong learning for the 21st century’ visions were guiding principles utilised by other transnational organizations such as the World Bank to guide lifelong learning educational agenda (Milana, 2012).

Globalisation (+ Noam Chomsky)

Keywords: Neoliberalism; Globalisation; Noam Chomsky; Lifelong Learning

References 

Boeren, E. (2016). Lifelong Learning Participation in a Changing Policy Context: An Interdisciplinary Theory. Springer.

Bond, P. (2001). The IMF and World Bank Reconsidered. In Development: Theory, policy and practice (pp.230-249). Oxford University Press Southern Africa.

International Monetary Fund (2001) Social Dimensions of the IMF’s Policy Dialogue.

Medel-Añonuevo, C., Ohsako, T., & Mauch, W. (2001). Revisiting Lifelong Learning for the 21st Century. UNESCO.

Milana, M. (2012). Globalisation, transnational policies and adult education. International Review of Education58(6), 777-797.

Milana, M. (2012). Political globalization and the shift from adult education to lifelong learning. European journal for Research on the Education and Learning of Adults3(2), 103-117.

Moutsios, S. (2009). International organisations and transnational education policy. Compare, 39(4), 469-481.

Moutsios, S. (2010). Power, politics and transnational policy‐making in education. Globalisation, Societies and Education, 8(1), 121-141.

Walters, S. (2006). Adult learning within lifelong learning: a different lens, a different light. Journal of education, 39(1), 6-26.

The World Bank (2011) Learning for All: Investing in people’s knowledge and skills to promote development.

The World Bank (2015) Education overview.

 

Power & Foucault for the Nurse Educator

Hierarchy and traditional roles such as doctor to nurse, nurse to student, genders, patient to nurse/doctor are some of the relationships which come to mind when thinking of power in a hospital setting.  For this post we are looking at Michel Foucault and the theory of the relationship between power and knowledge. Thinking about power can be insightful to consider all other parties who may be effected by planned change and to ensure equality ensues.

Foucault Theory

According to Foucault, power is everywhere, in relationships, learning and shapes people’s behaviour. Foucault’s theory states that “knowledge is power” (1998, pg.93).

“Knowledge linked to power, not only assumes the authority of ‘the truth’ but has the power to make itself true. All knowledge, once applied in the real world, has effects, and in that sense at least, ‘becomes true.’ Knowledge, once used to regulate the conduct of others, entails constraint, regulation and the disciplining of practice” (Foucault 1977, pg. 27).

The metaphor for power discourse is the panopticon according to Foucault (see image below). The panopticon allows one guard to view and control hundreds of prisoners, the prisoners have no way of knowing when they are being observed, which places all power to one person. The armed forces, schools, factories, technology and hospitals are all modern disciplinary power settings where a form of power, where no bars, chains, and heavy locks are necessary for domination to occur.

Power Play in Nursing

The relationship of the educator and student in nursing highlights the potential healthcare hierarchical regime.  Students can be undergraduate or postgraduate (meaning they are employed professionals), all which may create power play within the educator-student relationship in the process of completion of appraisals or assessments. The stakes are high, as success for a student could mean their first job or ongoing employment for the postgraduate student. Is the structure in hospital set up to allow speaking up and junior staff to question care?

Clutterbuck (2004) highlights the locus of power in mentoring relationships and, that mentors should work with mentees to increase empowerment and the independence of mentees. Clutterbuck (2004) states mentors should respond to mentees’ developmental needs, and the mentee should accept increasing responsibility for managing the relationship. Employment, hierarchy, culture and ‘speaking up’ are all likely power constraints.

“Adult educators talk emphatically of empowerment as a process through which adult learners find their voices and develop the self-confidence to take control of their lives” (Brookfield, 2001).

Keywords: power; Foucault; panopticon.

References

Brookfield, S. (2001). Unmasking power: Foucault and adult learning. Canadian journal for the study of adult education, 15(1), 1-23.

Clutterbuck, D. (2004). Everyone needs a mentor: Fostering talent in your organisation (4th Ed.). Chartered Institute of Personnel and Development: London.

Foucault, M. (1998). The History of Sexuality: The Will to KnowledgeLondon, Penguin. [Goodreads blurb]

Foucault, M. (1977). Discipline and Punishment. London: Tavistock. [Goodreads blurb]

Wikipedia (2016) Michel Foucault

Internet Sheep: Ask Questions

We are anonymousThe World Wide Web developed by Tim Berners-Lee was created with public domain rights, but the internet creates much discussion and opinions on open source, copyright, privacy, financial and political  views.

“As a globally distributed network of voluntarily interconnected autonomous networks, the Internet operates without a central governing body. It has no centralized governance for either technology or policies (Wikipedia, 2016).”

In healthcare the potential for big data to improve knowledge and understanding of disease could be vastly improved with a global access to health records.  Below are some of the discussions around the internet, both good and bad.

The Internet’s Own Boy: The Story of Aaron Swartz

Anonymous – It is time to know the truth 2017

Here’s How We Take Back The Internet: Edward Snowden 

Keywords: curiosity; thinking; knowledge; global citizen; we are legion.

References

Marrt, B. (2015) How Big Data is Changing Healthcare. Forbes

Wikileaks (2016) https://wikileaks.org/

Wikipedia (2016) World Wide Web

 

Book Club: The Pleasures and Sorrows of Work

Book: The Pleasures and Sorrows of Work by Alain De Botton (2010).

Ever wondered about the exciting world of biscuits? Me neither, but we don’t often think of the research and design, marketing, sales techniques and all round effort put into a simple biscuit but this book explores different occupations and into a large part of our adult lives, namely work. If we do indeed spend 1/3 of our lives at work, then understanding such environments is important.  From inspiring jobs to soul-destroying jobs, De Botton explores ten different professions and how they exist in the modern world. The reflection aspect by De Botton, where he makes the reader consider how we ended up in our professions, often stemming back from choices made as 16 year olds (our unthinking selves).

Some Points:

  • How products are made, the front end understanding only as technology underneath renders most of us helpless.
  • Specialisation of jobs, it will be a case of what can be automated in the future.
  • Mass production and megafactories moving away from local small-scale production.
  • Globalisation: in the food industry it is possible from source to table across the world in less than 72 hours is such an amazing feat, so when you shop you may never notice seasonal changes in food availability. Don’t even consider relating this to the postal service!
  • Consider all the things we are surrounded by and how they came to be there – any idea?

“The Pleasures and Sorrows of Work is an exploration of the joys and perils of the modern workplace, beautifully evoking what other people get up to all day – and night – to make the frenzied contemporary world function” (De Botton, 2010).

 

Reference

De Botton, A. (2010). The Pleasures and Sorrows of Work. Emblem Editions. [Goodreads blurb]

Human Centred Design

I recently attended a really engaging creativity meeting on Human Centred Design which focused on project development and rapid prototyping. These are my ‘novice’ notes, and resources  that the facilitators used, so thanks to the organisation developers who shared their experience and knowledge.

What Is Human Centred Design?

Human-centered design consists of three phases (IDEO.org):

  1. Inspiration Phase: learn directly from the people you’re designing for as you immerse yourself in their lives and come to deeply understand their needs.
  2. Ideation Phase: you’ll make sense of what you learned, identify opportunities for design, and prototype possible solutions.
  3. Implementation Phase: you’ll bring your solution to life, and eventually, to market.

 

 

Design Principles

 

 

Service Design Thinking

5 principles of service design thinking by Stickdorn et al. (2011, pg. 26):

  1. User-centred: Services should be experienced through the customer’s eyes.
  2. Co-creative: All stakeholders should be included in the service design process.
  3. Sequencing: The service should be visualised as a sequence of interrelated actions.
  4. Evidencing: Intangible services should be visualised in terms of physical artefacts.
  5. Holistic: The entire environment of a service should be considered.

 

Root Cause Analysis

Ishikawa Fishbone Diagram

Interactive Designing

Keywords: Human Centred Design; Prototype; Project Development

Resources

IDEO.org

Design Thinking For Educators from IDEO.org

Learn To Prototype Course from IDEO.org

Health XO from IDEO.org

Stickdorn, M., Schneider, J., Andrews, K., & Lawrence, A. (2011). This is service design thinking: Basics, tools, cases. Hoboken, NJ: Wiley.

Wikipedia (2016) 5 Whys

Civil Society & Global Health

Gallen (2000) defines civil society as “a group or organisation with common interests or goals whose collective actively represent citizens in an independent manner”. Civil society in a more general sense can be seen as “the elements such as freedom of speech, an independent judiciary, etc, that make up a democratic society” (Collins English Dictionary). Seen as in contrast to the state, Gallen also highlights that civil society is “synonymous with the voluntary sector (the so-called Third Sector)”.   Movements such as non-government organisations (NGOs), charities, advocacy groups, social movement agents and human rights organisations are all considered civil society.   The World Health Organisation (WHO, 2015) itself has a civil society initiative originally set up in 2001, “to ensure that the changing roles and expectations of civil society are more adequately reflected within WHO”.  It is these changing relationships between the state and the civil society that the WHO promotes understanding of trends at local, national and global level.  Gallen (2000) describes the role of civil society as the voice of the underprivileged and promoter of democratic ideas.

Social movements originate from worldviews and ideologies such as civil rights movements, religious groups and peace groups.  To be global is to “think, feel and act both globally and locally” (Walters, 1997, pg. 13). Interconnectedness and the notion of global civil society and active global citizenship connects through popular education methods (Mayo, 2011, pg. 27).  Social movement learning that takes place in civil society is often classified as informal amidst the creation of new knowledge (Hall & Clover, 2005). In health, research and action to promote greater health equity has a long tradition (Blas et al., 2010). It will be interesting to see in the future  if neoliberalism and the privatisation of healthcare is the approach in the globalised world, or a return to Nye Bevan’s ideology of accessible health for all.

Keywords: Civil society; Democracy; Global; Social movement; Interconnectedness.

References

Blas, E., Gilson, L., Kelly, M. P., Labonté, R., Lapitan, J., Muntaner, C., … & Schrecker, T. (2008). Addressing social determinants of health inequities: what can the state and civil society doThe Lancet, 372(9650), 1684-1689.

Gallin, D. (2000) Civil society a contested territory. Paper presented to Euro-WEA seminar on workers education and civil society, June 16-17, Budapest.

Mayo, M. (2011) Learning global citizenship? Exploring connections between the local and global. In Fragoso, A., & Kurantowicz, E. (Eds.), Between global and local: Adult learning and development. Peter Lang.

United Nations (2016) Civil Society

Walters, S. (1997). Globalization, Adult Education & Training. Impacts & Issues. Global Perspectives on Adult Education and Training Series. Zed Books, New York.

Wikipedia (2016) Civil Society.

World Health Organisation (2001) Strategic alliances The role of civil society in health.

 

 

Johari Window and Feedback

Across healthcare education, feedback is considered an important aspect for learning and performance development. In this post we are focusing on the Johari Window by Luft & Ingham (1961), which can be used to help people better understand their relationship with themselves and others. The Johari Window can be used to develop understanding between individuals, such as the nurse and nurse educator.

Johari Window is?

A model of interpersonal awareness by Joseph Luft and Harry Ingham which shows the four facets of self.

Johari Window

The 4 Facits

  1. Open or Arena: This quadrant represents what is known by the person about him/herself and is also known by others.
  2. Hidden or Façade:  Represents what the person knows about him/herself that others do not know. Peers are unaware of this information. It is then up to the subject to disclose this information or not.
  3. Blind Spot: This quadrant represents information that the subject is not aware of, but others are. Others can decide whether and how to inform the individual about these blind spots. Also known as the hidden area, hidden self or avoided area.
  4. Unknown: Represents the participant’s behaviours or motives that were not recognised by self or others. These traits may not be considered applicable or because there is collective ignorance of the traits.

Johari Window develops?

  • Self-awareness
  • Personal development
  • Improving communications
  • Interpersonal relationships
  • Group dynamics
  • Team development
  • Inter group relationships

Feedback Exercise

This exercise is from Rungapadiachy (1999, pg. 237) to reflect on past feedback to serve as a guide for self-awareness and how feedback should be delivered.

  • Who was it from?
  • How was it given (what was actually said?)
  • How did you feel after?
  • How did you respond?

Johari Meaning

The term Johari comes from mixing Joseph Luft’s and Harry Ingham’s first names!

References

Luft, J., & Ingham, H. (1961). The Johari Window: a graphic model of awareness in interpersonal relations. Human relations training news, 5(9), 6-7.

Rungapadiachy, D. M. (1999) Interpersonal communication and psychology for health care professionals. Theory and practice. Oxford: Butterworth-Heinemann.

Wikipedia (2016) Johari Window.