'The game is in the tutorial' : an evaluation of the use of an e-portfolio for personal and professional development in a medical school

An e-portfolio system was introduced into the personal and professional development curriculum at the University of Western Sydney School of Medicine (UWSSoM) during 2011 and 2013. Adopting the methodology of Design-Based Research and an interpretive framework informed by Activity Theory we developed a set of educational design principles based on the analysis of the use of the e-portfolio system by students and tutors. These principles contain a range of insights applicable to the local context and may also be of interest to curriculum designers working in other domains

How do medical educators design a curriculum that facilitates student learning about professionalism?

Objectives: This study analyses the ways in which curriculum reform facilitated student learning about professionalism. Methods: Design-based research provided the structure for an iterative approach to curriculum change which we undertook over a 3 year period. The learning environment of the Personal and Professional Development Theme (PPD) was analysed through the sociocultural lens of Activity Theory. Lave and Wenger’s and Mezirow’s learning theories informed curriculum reform to support student development of a patient-centred and critically reflective professional identity. The renewed pedagogical outcomes were aligned with curriculum content, learning and teaching processes and assessment, and intense staff education was undertaken. We analysed qualitative data from tutor interviews and free-response student surveys to evaluate the impact of curriculum reform. Results: Students’ and tutors’ reflections on learning in PPD converged on two principle themes - ‘Developing a philosophy of medicine’ and ‘Becoming an ethical doctor’- which corresponded to the overarching PPD theme aims of communicative learning. Students and tutors emphasised the importance of the unique learning environment of PPD tutorials for nurturing personal development and the positive impact of the renewed assessment programme on learning. Conclusions: A theory-led approach to curriculum reform resulted in student engagement in the PPD curriculum and facilitated a change in student perspective about the epistemological foundation of medicine

Student resistance to new technology

The content management system of the University of Western Sydney does not allow students to maintain a continuous record of their work from one year to another. Nor does it facilitate the provision of timely formative feedback as students work develops. Records of student learning are static finalised products to be uploaded for assessment, not dynamic documents which can be changed upon further reflection or in response to feedback provided by teachers and peers. At the School of Medicine we decided to introduce an electronic learning platform called Pebblepad to enable our first and second year medical students to develop a portfolio to record and reflect on their professional development across the 5 years of their undergraduate education

The introduction of an online portfolio system in a medical school : what can activity theory tell us?

In this paper we discuss innovations in the personal and professional development (PPD) curriculum that were introduced at a medical school in a major metropolitan university in Sydney, Australia. The review of the PPD curriculum involved the development of new content as well as the exploration of technologies that could be used to underpin the various collaborative, self-directed and reflective learning activities of the new course. An online portfolio system (PebblePad) was selected as the technological platform to deliver the new curriculum. Student feedback relating to the new technology has been critical and activity theory (AT) is used to broaden our understanding of the wider cultural forces - what we call the ‘negative discourse of PPD’ - that can potentially shape attitudes to technology and learning in the PPD component of a medical degree

Tottel's communications law : journal of computer, media and telecommunications law

Previous research has pointed to the role television can play in informing health practices and beliefs. Within the academic setting in particular, some educators have raised concerns about the influence of medical dramas on students. Less research, however, draws on the perspectives of students, and this study therefore explores medical students’ perceptions of medical practice and professionalism in popular medical television programmes. Qualitative data from surveys of Australian undergraduate medical students showed that students perceived professionalism in dichotomous ways, with three main themes: cure–care, where a doctor’s skill is either technical or interpersonal; work–leisure, where a doctor is either dedicated to work or personal life; and clinical–administration, where work is either direct patient care or administration. There continue to be imagined divisions between curing and caring for students, who express concerns about balancing work and leisure, and expectations that doctors should have little administrative work. Given students were able to identify these important contemporary issues around professionalism on television, there is pedagogical value in using popular images of the medical world in medical education

Medical student changes in self-regulated learning during the transition to the clinical environment

Background: Self-regulated learning (SRL), which is learners’ ability to proactively select and use different strategies to reach learning goals, is associated with academic and clinical success and life-long learning. SRL does not develop automatically in the clinical environment and its development during the preclinical to clinical learning transition has not been quantitatively studied. Our study aims to fill this gap by measuring SRL in medical students during the transitional period and examining its contributing factors. Methods: Medical students were invited to complete a questionnaire at the commencement of their first clinical year (T0), and 10 weeks later (T1). The questionnaire included the Motivated Strategies for Learning Questionnaire (MSLQ) and asked about previous clinical experience. Information about the student’s background, demographic characteristics and first clinical rotation were also gathered. Results: Of 118 students invited to participate, complete paired responses were obtained from 72 medical students (response rate 61%). At T1, extrinsic goal orientation increased and was associated with gender (males were more likely to increase extrinsic goal orientation) and type of first attachment (critical care and community based attachments, compared to hospital ward based attachments). Metacognitive self-regulation decreased at T1 and was negatively associated with previous clinical experience. Conclusions: Measurable changes in self-regulated learning occur during the transition from preclinical learning to clinical immersion, particularly in the domains of extrinsic goal orientation and metacognitive self–regulation. Self–determination theory offers possible explanations for this finding which have practical implications and point the way to future research. In addition, interventions to promote metacognition before the clinical immersion may assist in preserving SRL during the transition and thus promote life-long learning skills in preparation for real-world practice

Application of Cytoscape to the analysis of diagrams of mechanisms underlying patient problems

In problem based learning (PBL) tutorials in a medical context, students solve authentic patient problems with the educational aim to develop their reasoning capacity. A key activity to facilitate development of their reasoning capacity in a tutorial is the construction of diagrams of mechanisms that explain patient problems. These diagrams are networks of discrete elements (such as headache) of patient problems. Analysis of these diagrams may yield insights into students’ reasoning styles. To achieve this aim, we employed an application called Cytoscape, which is capable of visualising and analysing networks, to study these diagrams. In this preliminary study, we showed that Cytoscape can be used to analyze these diagrams of mechanisms produced in PBL tutorials. We found that students tend to reason in a hierarchical manner. Parameters are also defined that can be used to identify incorrect and missing links in their reasoning processes