Harvard Macy Institute Community Resources

This post is to share a fantastic health care education resource that provides resources, discussion, hot topics and is a global community of practice. One to definitely follow.

Harvard Macy Community Blog: “Fostering the ongoing connectedness of health professions educators committed to transforming health care delivery and education”

Resources

Key terms: Social learning; situated learning; community of practice; innovation; incubator; social media; global citizen

Note: No affiliation with any of the recommended resources (I wish!)

Peer Assisted Learning (PAL)

What Is PAL?

“People from similar social groupings who are not professional teachers helping each other to learn and learning themselves by teaching” (Topping, 1996).

“A two-way, reciprocal learning activity” (Boud, 2001).

Simply put “PAL is the umbrella term and encompasses all programmes in which students learn from students” (Olaussen et al, 2016).

Benefits for the Learner

  • Increased knowledge
  • Increased psychomotor skills
  • Increased self-confidence
  • Improved communication skills
  • Emotional support
  • Learn the ‘hidden curriculum’
  • Able to admit areas of development in a flattened hierarchy

Benefits for the Tutor

To teach is to learn twice” by Joseph Joubert.

  • Revision and reinforcing learnt knowledge
  • Improved teaching skills
  • Improved feedback skills
  • Improved communication skills
  • Increased knowledge
  • Increased confidence and responsibility

For the Team

The role modelling, communication and working together may improve teamwork practices.

Limitations

Some studies found PAL programs provided no benefit or effect, or the benefit of improved learning occurred for the tutor rather than the learner (the power of reinforcement).

The evidence of PAL in healthcare is predominantly from the student setting so questions remain on introducing PAL in the workplace.

PAL Presentation

References

Olaussen, A., Reddy, P., Irvine, S., & Williams, B. (2016). Peer-assisted learning: time for nomenclature clarification. Medical education online, 21(1), 30974. [abstract]

McKenna, L., & French, J. (2011). A step ahead: Teaching undergraduate students to be peer teachers. Nurse Education in Practice11(2), 141-145. [abstract]

Topping KJ. The effectiveness of peer tutoring in further and higher education: A typology and review of the literature. Higher Ed 1996; 32: 321–345. [view pages 1-25]

Ten Cate, O., & Durning, S. (2007). Peer teaching in medical education: twelve reasons to move from theory to practiceMedical teacher29(6), 591-599.

Kotter 8 Step Change Process

See below resources around a change model by Dr. John Kotter to consider implementing when designing a project plan.

Resources

Bush, H. (2017). How to Embrace Change. Ausmed.

Campbell, R. J. (2008). Change management in health careThe Health Care Manager27(1), 23-39.

Kotter J & Cohen D 2002, The Heart of Change, Harvard Business School Press NHS Improvement Foundation, Boston, MA [summary]

Kotter International. (2019). 8 Steps Process. Kotter International, Boston, MA.

Small, A., Gist, D., Souza, D., Dalton, J., Magny-Normilus, C., & David, D. (2016). Using Kotter’s change model for implementing bedside handoff: a quality improvement projectJournal of Nursing Care Quality31(4), 304-309.

Heutagogy

Introduce and provide an overview of heutagogy:

  • What is heutagogy
  • Challenges of sandpit approach in healthcare

This is part of the presentation series from Nursing Education Network. All based on microlearning, they will be short quick snippets on education topics to provide an introductory overview.

Resources

Nursing Education Network. (2018). Heutagogy & Nursing.

Kirkpatrick 10 Requirements for an Effective Training Program

Learning & Development

Training & Evaluation guidance for delivering quality education programs: ” we strongly suggest that you take the right steps to ensure that training is actually accomplishing what it was intended to do and contributing to the bottom line. Don’t think about evaluation in terms of demonstrating overall value until you are sure you have done all you can to ensure that your training programs are effective” (pg. 3, Kirkpatrick & Kirkpatrick, 2009). 

Ten Requirements for an Effective Training Program

  1. Base the program on the needs of the participants.
    • Needs analysis from the learners on what they need to learn and also what the organisation needs to develop.
    • View from the perspective of managers and the organisation.
  2. Set learning objectives.
    • What is expected to be learned
    • Any behaviour or cultural changes?
  3. Schedule the program at the right time.
    • Best method of delivery and time/day for the learners. Engage a positive mindset from the start.
  4. Hold the program at the right place with the right amenities.
    • Right location for appropriate amenities and travel time.
  5. Invite the right people to attend.
    • Right number, right mix of hierarchy within team members.
  6. Select effective instructors.
    • Internal or external subject matter experts.
  7. Use effective techniques and aids.
  8. Accomplish the program objectives (return to point 2).
  9. Participant satisfaction.
  10. Evaluate the program

Reference

Kirkpatrick, D. L. & Kirkpatrick, J.D. (2009). Implementing the four levels: A practical guide for effective evaluation of training programs. Berrett-Koehler Publishers [exerpt].

Kirkpatrick Model of Evaluation

Learning and Development

Level 1: Reaction

Gain insight into the learners reactions and attitudes to the training by analysis of the feedback. Consider what changes could be made following review of the responses. Some ideas for questions:

  • How engaged was the learner
  • Was the training valuable to your learning?
  • 3 most important things learned?
  • Was the training successful?
  • What were the biggest strengths and weaknesses of the training?
  • Were the training engaging?
  • Was the training worth your time?

Level 2: Learning

The important stuff, what was or wasn’t learned? So measure against the specific learning objectives that were outlined in the program.

  • Testing pre and post program
  • Measures what learners may able to do differently as a result of the training
  • New skills, knowledge, attitudes
  • Measure confidence levels, skills, attitudes and knowledge

Level 3: Behaviour

The aim is to understand how people apply their training.

  • What changes occured post training?
  • How was the training knowledge and skills applied?
  • Are there any behaviours changes?
  • Are trainees able to teach their new knowledge, skills or attitudes to other people?

With results in an organisation workplace the aim would be to encourage, reinforce and reward positive changes in behavior.

Level 4: Results

  • What are final results of your training?
  • Conduct analysis of the outcomes.
  • Was the program a success?
  • A positive return on the investment in the program?

Cautionary Point: This model was first designed in 1959, although has been updated.

See our post on Kirkpatrick 10 Requirements for an Effective Training Program.

Update from social media discussion following this post was a resource shared called Learning Transfer Evaluation Model (LTEM) by Work-Learning Research, which “is an improvement over the Kirkpatrick-Katzell Four-Level Model in many respects, notably providing significant improvement and specificity in regards to learning outcomes. Where the Four-Level model crammed all learning into one bucket, LTEM differentiates between knowledge, decision-making, and task competence—enabling learning teams to target more meaningful learning outcomes.”

References

Kirkpatrick, D. L. (2009). Implementing the four levels: A practical guide for effective evaluation of training programs. ReadHowYouWant.com [excerpt].

Kirkpatrick Partners. (2019). The Kirkpatrick Model.

Kurt, S. (2016). “Kirkpatrick Model: Four Levels of Learning Evaluation,” in Educational Technology.

The Science of Learning: Quick Revision Tips

Here are a few quick revision tips to put into practice when studying.

Chunking Theory: Make it bitesize the content you are learning. It’s unlikely you can remember entire chapters, so take keypoints and relate them to the clinical environment (make the hooks to link theory to clinical situations)

Challenge: Test yourself, check the textbooks you are using and often you will find questions to challenge your knowledge.

Recall: Try to recall the main ideas when you have completed an article or chapter. Repeat this recall at a different time, maybe when exercising or sitting on the bus. Can you recall all the salient points?

Spaced learning: short bursts, repeated over a set time period.

Interleaving: “Interleaving two or more subjects during practice also provides a form of spacing” (Brown, Roediger & McDaniel, 2014).

For more information on studying try this post on Good and Bad Studying.

12 Tips for Applying the Science of Learning to Health Professions Education.

Journal Club Article: Gooding, H. C., Mann, K., & Armstrong, E. (2017). Twelve tips for applying the science of learning to health professions educationMedical teacher39(1), 26-31.

Background: There is a vast amount of data around the science of learning. The evidence comes from an array of specialties, from cognitive psychology, neuroscience, sociology, anthropology and behavioral economics. Much of the evidence is siloed within each speciality and/or level of education practice from school grade, higher education and the professional workplace domains.

Aim: 6 themes are identified that highlight the complex relationship in supporting education. 12 practical tips are provided for utilising the principles around the science of learning.

  • Improving the processing of information: Cognitive Load Theory: working memory and processing only certain amount of information and stored in long term memory for later use.
    • Reduce extraneous load whenever possible, especially relevant for the teacher during course design or presenting new information.
    • Help learners manage intrinsic load: build schemas through starting by using simple examples then building to complex tasks. Chunking content into manageable or ‘bitesize’ worloads.
  • Promoting effortful learning: If not used regularly what is learned is often forgotten.
    • Retrieval practice: by retrieving information from long term memory aids and strengthens neural connections.
    • Spaced retrieval and interleaving content
  • Applying learned information to new and varied contexts:
    • Applied what has been learned to new and different contexts, known as ‘transfer’.
    • To build schemas with clinical reasoning and problem solving.
  • Developing expertise: Promote the development of novice to expert.
    • Deliberate practice: practice like you play.
    • Encourage learners to create learning-orientated goals.
  • Harnessing the power of emotion for learning: Recognize emotional state and impact on learning
    • Create safe learning spaces.
  • Teaching and learning in social context: social learning theory (Bandura, 1986)
    • Learning occurs dynamically with interactions in the environment, learning is social.
    • Social nature of learning through the values, language and skill in the community.
    • Create authentic experiences in workplace learning. In adult learning it needs to be authentic and relevant for the learner.
    • Metacognition: thinking about thinking.

Further Reading

Bandura, A. (1977). Social learning theory. Englewood Cliffs, N. J.: Prentice-Hall.

Mayer, R. E. (2008). Applying the science of learning: Evidence-based principles for the design of multimedia instructionAmerican Psychologist63(8), 760.

Young, J. Q., Van Merrienboer, J., Durning, S., & Ten Cate, O. (2014). Cognitive load theory: Implications for medical education: AMEE guide no. 86Medical teacher36(5), 371-384.