The referential and structural conceptions of group work learning

Research Doctorate - Doctor of Philosophy (PhD)The traditional context of learning in a University is that of a student engaged in learning and assessment as an individual learner (a solo learner), in a behaviorist model of teacher centered instruction. Most of the educational research undertaken which reviews students’ conceptions of learning and the qualitative outcomes of learning, has been undertaken in the solo learner context, in a direct instruction model of teaching. In the mid-1980s Australian workplaces identified the need for graduates to have a wide range of skills which made them highly adaptable to the modern workplace. These skills included those associated with working in teams. By the late 1990s Australian universities were introducing group work learning as a way to provide graduates with an experience in collaborative learning and social constructivist learning contexts. However, little research has been conducted that identifies the learning outcomes of group work learning. The research reported in this thesis is undertaken entirely in the context of group work learning. Two studies were undertaken to explore the conceptions of group work learning, and the qualitative and quantitative analysis of the structural elements of group work learning, held by Medical Radiation Science students working in collaborative teams over an extended period of time. Study 1 was a longitudinal study (1997-2002) where students, on completion of a 10 week group work learning poster development research task, responded to an open ended short answer questionnaire which asked them to identify their three most important learning outcomes as a result of undertaking the group work learning task. The topic of the group work research task was self selected by the student groups based on their mutual shared interest for the topic of study in an attempt to engage their intellectual curiosity about their academic and professional world. The questionnaire in study 1 was analysed for the conceptions of group work learning held by students, and the associated structural elements (content) of their group work learning, as described by their responses to the questionnaire. The questionnaire was undertaken on completion of the group work task, so that students could reflect on the entire learning process associated with the task. There were 328 students enrolled and eligible to complete the group work task during 1997-2002. In total 276 questionnaires containing 818 written responses were analysed in study 1. Study 2 was a prospective study, conducted in 2008, which used a forced choice questionnaire developed entirely from the outcomes of study 1. The questionnaire required students to nominate from the list of learning outcomes the three most import things they learned in completing the group work task. Study 2 allowed the qualitatively described conception constructs uncovered in study 1 to be tested in a prospective close ended questionnaire format. In 2008 there were a range of changes made to the group work task: these changes included reducing the time period to complete the task to 6 weeks, and loss of freedom to select the topic. Study 2 therefore allowed the research to compare any possible changes in the priorities of group work learning for students, from study 1 to study 2, when changes to the poster task were made. There were 148 students were enrolled and eligible to complete the group work task in 2008. In total 97 questionnaires containing 291 responses were analysed in study 2. The analysis of the responses to the questionnaire in study 1 identified four conceptions of group work learning held by students. One of the conceptions was similar to conceptions of learning identified in solo learning contexts, and is associated with an ‘acquiring facts’ approach to learning, a surface level learning construct. The other three conceptions, ‘developing meaningful interpretations’, ‘negotiating social structures’, and ‘recognising expertise and creativity’ are associated with deep and meaningful learning outcomes and are strongly associated with both the process and outcomes of the social constructivist leaning environment that students engaged in to complete the task. Two of the conceptions have not been formally reported previously. In terms of the analysis of the content of what students learned (structural elements of learning), five major categories of description emerged of which collaboration in learning (characterised by 5 sub-descriptions) was overwhelmingly the largest content learned. Study 1 also allowed for the analysis of the interest orientations of the students in undertaking their research project, as the topic of the task was driven by selected research group work project topic. This analysis demonstrated that students in different strands of the Medical Radiation Science professional programs (Diagnostic Radiography, Nuclear Medicine and Radiation Therapy), even with a large shared amount of academic content, develop interest orientations in line with a clinical profile of the professional degree they are enrolled in and which are significantly different from the other programs. Study 2 identified that reducing the time to participate and complete the group work task, and removing the students’ interest based choice of topic, to study to one which was selected for them, resulted in a change of learning priorities from study 1. In study 2, students indicated that they were more focussed on researching to get information to complete the project on time, and on learning about the topic, than they did in study 1. While collaboration in learning was still the number one structural element of learning its priority as a focus for group work learning was significantly reduced from study 1. The results indicate that group work learning is a powerful learning environment whichcan provide learning outcomes that have been previously unidentified, and possiblyunachievable, in the solo learning environment. The outcomes of group work learning are strongly associated with those graduate attributes identified as important in themodern Australian workplace

The level of confidence and responsibility accepted by Australian radiation therapists in developing plans and implementing treatment

The purpose of this research was to assess (i) how confident Radiation Therapists (RTs) are in developing a series of plans that have increasing levels of difficulty, and (ii) the level of responsibility that they are willing to accept in relation to these treatments being implemented without the Radiation Oncologist (RO) reviewing or countersigning the plan. A self-administered questionnaire was designed around a set of six clinical planning scenarios demonstrating increasing levels of difficulty. Two hundred and three Radiation Therapists returned a completed questionnaire. All RTs indicated that they were confident to complete all the plans regardless of difficulty (p < 0.0001) except for newly qualified RTs in their first year of practice who indicated a lack of confidence with the most difficult case only. Contrary to the high levels of confidence, RTs overall were only willing to accept responsibility for implementing treatment for the two basic level scenarios (p < 0.0001). To gauge the clinical usefulness of this finding a clinical centre audit was conducted that indicated that basic level procedures account for around 30–40% of a department's workload. RTs indicated a number of issues as barriers to accepting responsibility for more advanced work

Acute skin reaction and psychological benefit of washing with a mild cleansing agent during radiation therapy to the breast or chest wall: a randomised control trial

Purpose: i/ To compare the differences between the acute skin reaction of patients undergoing radiation therapy to the breast or chest wall washing with water and a mild cleansing agent (pH=7), and patients washing with water only, and ii/ to determine whether there is any psychological benefit for those patients washing with water and a mild cleansing agent compared to those washing with water only. Methods: Forty three (43) patients receiving tangential radiation therapy for early stage primary breast cancer were randomised to one of two treatment arms: Group 1 - washing with water and a mild cleansing agent (21 patients). Group 2 - washing with water only (22 patients). Acute skin reaction was assessed weekly by a radiation oncologist and radiation therapist using a modified EORTC/RTOG skin reaction scale. Acute skin reaction and psychological benefit was assessed by the patient using a weekly diary skin assessment card. Statistical analysis of the differences in skin reaction and the psychological benefit between the groups was tested. Results: No statistically significant difference between the two treatment groups was found for the degree of skin reaction for weeks one through to five. The study measured a statistically significant psychological benefit for those patients washing with water and a mild cleansing agent (p=0.016). Discussion: Given that there is no statistically significant difference in acute skin reactions between the two groups, the psychological benefit provided to those patients allowed to use a cleansing agent supports the skin care regime of washing with water and a mild cleansing agent

An analysis of the professional and academic interest of medical radiation science students

This research analyses the interest that medical radiation science (MRS) students have about their academic and professional world when they are given the independence to freely choose a topic to research. The research setting includes students of three different MRS degrees who have had, up until the point that this research was carried out, more common learning than degree specific learning. To analyse student interest, a thematic analysis of the self selected topics to be researched for a group work project was undertaken. The results indicate that there are statistically significant differences in interest between students of the three MRS degrees, with students within a degree sharing a strong single unifying common interest in their academic or professional world

Developing a qualitative framework for analysis of student journals

Learning from work is an important aspect of student and professional life when working within the health profession. Personal journals are one way that health professionals are able to document their experiences. These journals also hold a wealth of information about the student experience on placement. To analyse the content of journals a qualitative research analytical method is required. There are many different methodological underpinnings or approaches within qualitative research and it is important that the researchers consider their own world view and the context of the research and the data to be evaluated when selecting a qualitative methodology to utilise. This paper discusses an overview of the process of choosing a qualitative framework for the analysis of the descriptions contained within student personal journals. The paper describes the development and validity checking of a coding or sourcebook for qualitative descriptive analysis of student personal journals

Using Nominal Group Technique to Develop a Consensus Derived Model for Peer Review of Teaching Across a Multi-school Faculty

This paper describes the development of a peer review of teaching model for the Faculty of Health at the University of Newcastle, Australia. The process involved using the nominal group technique to engage Faculty academic staff to consider seven key decision points that informed the development of the peer review of teaching model. Use of the consensus based nominal group technique established collegial discussion and networking among participants, and has expanded the discussion within the Faculty about peer review of teaching. Although the academics come from a diverse multi-school and multi-program Faculty, there was high levels of consensus on the structure and process of the developed peer review of teaching model

A retrospective planning analysis comparing intensity modulated radiation therapy (IMRT) to volumetric modulated arc therapy (VMAT) using two optimization algorithms for the treatment of early-stage prostate cancer

Introduction: The primary aim of this study is to compare intensity modulated radiation therapy (IMRT) to volumetric modulated arc therapy (VMAT) for the radical treatment of prostate cancer using version 10.0 (v10.0) of Varian Medical Systems, RapidArc radiation oncology system. Particular focus was placed on plan quality and the implications on departmental resources. The secondary objective was to compare the results in v10.0 to the preceding version 8.6 (v8.6). Methods: Twenty prostate cancer cases were retrospectively planned using v10.0 of Varian's Eclipse and RapidArc software. Three planning techniques were performed: a 5-field IMRT, VMAT using one arc (VMAT-1A), and VMAT with two arcs (VMAT-2A). Plan quality was assessed by examining homogeneity, conformity, the number of monitor units (MUs) utilized, and dose to the organs at risk (OAR). Resource implications were assessed by examining planning and treatment times. The results obtained using v10.0 were also compared to those previously reported by our group for v8.6. Results: In v10.0, each technique was able to produce a dose distribution that achieved the departmental planning guidelines. The IMRT plans were produced faster than VMAT plans and displayed improved homogeneity. The VMAT plans provided better conformity to the target volume, improved dose to the OAR, and required fewer MUs. Treatments using VMAT-1A were significantly faster than both IMRT and VMAT-2A. Comparison between versions 8.6 and 10.0 revealed that in the newer version, VMAT planning was significantly faster and the quality of the VMAT dose distributions produced were of a better quality. Conclusion: VMAT (v10.0) using one or two arcs provides an acceptable alternative to IMRT for the treatment of prostate cancer. VMAT-1A has the greatest impact on reducing treatment time

Comparing four volumetric modulated arc therapy beam arrangements for the treatment of early-stage prostate cancer

Introduction: This study compared four different volumetric modulated arc therapy (VMAT) beam arrangements for the treatment of early-stage prostate cancer examining plan quality and the impact on a radiotherapy department's resources. Methods: Twenty prostate cases were retrospectively planned using four VMAT beam arrangements (1) a partial arc (PA), (2) one arc (1A), (3) one arc plus a partial arc (1A + PA) and (4) two arcs (2A). The quality of the dose distributions generated were compared by examining the overall plan quality, the homogeneity and conformity to the planning target volume (PTV), the number of monitor units and the dose delivered to the organs at risk. Departmental resources were considered by recording the planning time and beam delivery time. Results: Each technique produced a plan of similar quality that was considered adequate for treatment; though some differences were noted. The 1A, 1A + PA and 2A plans demonstrated a better conformity to the PTV which correlated to improved sparing of the rectum in the 60–70 Gy range for the 1A + PA and 2A techniques. The time needed to generate the plans was different for each technique ranging from 13.1 min for 1A + PA to 17.8 min for 1A. The PA beam delivery time was fastest with a mean time of 0.9 min. Beam-on times then increased with an increase in the number of arcs up to an average of 2.2 min for the 2A technique. Conclusion: Which VMAT technique is best suited for clinical implementation for the treatment of prostate cancer may be dictated by the individual patient and the availability of departmental resources

Theory of reflection in learning for radiation therapists

Practicing reflectively can assist the radiation therapist to monitor their work, foster professional growth and encourage currency of skills. Reflection is an attractive and desirable component to a radiation therapist's skill base. To provide radiation therapists the skills necessary to engage in reflection, they need a basic understanding of the theory underpinning reflection and reflective practice, and how they can be applied in the context of radiation therapy. This paper discusses the modern pioneers of reflective theory, as well as the concepts surrounding reflection and professional practice. The concepts central to experiential learning and the role reflection plays in the experiential learning cycle are described. This paper supports the role of reflection in the radiation oncology workplace and simplifies the theories of reflection described in the literature. It is the first step towards facilitating and supporting skill development in reflective thinking for clinical radiation therapists

A qualitative analysis of radiation therapy students' professional placement journals

Purpose: Student experience on clinical placement is not well captured with traditional program evaluation tools. This study aims to complete a qualitative analysis of the reflective clinical journals completed during professional placement by radiation therapy (RT) students in order to uncover the issues that affect students on placement and how these change as the student's progress through the program. Materials and methods: A qualitative descriptive analysis (QDA) was undertaken on the descriptive content of student journals completed by 97 students over 3 consecutive years while undertaking professional placement in Radiation Oncology Treatment Centres within Australia. Two coders used a QDA sourcebook specifically designed for the research to independently analyse the descriptive content of the reflective journals for four main categories and 18 subcategories. Results: The result revealed a statistically significant increased tendency to discuss clinical environment and a decreased tendency to discuss the patient, 92·9–12·5% (coder 1) and 85·7–18·8% (coder 2), as they progressed through the program. Conclusions: The results of this study showed some similarities with studies completed in other health professions; however, the breadth of issues explored within the content of these RT student journals demonstrates the true diversity of the RT student experience on professional placement