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Open Data as Educational Resources: The Case of Medical Education

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Open data as OERs offer new opportunities for innovation in medical education which merit further exploration and research.  Specific areas of potential include topics such as public health, global health, prescribing and patient safety, health inequalities.  There is also potential to integrate open patient data into simulation to support authentic learning.

There is no doubt that Medical Education, albeit slowly, is starting to conceptualise innovative ways to make use of open data. The literature documenting case studies is still scarce, therefore medical educationalists currently need to rely on their own creativity and pedagogic expertise to design educational interventions based on open data.

If this interests you, please read this Blog post.

This was written by Natalie and myself for the Open Education Working Group Blog, and it is a call for Medical Education practitioners that are experimenting in this largely unexplored area to share their experiences and good practice. We look forward to discussing and sharing ideas :)

 

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Why Open Data is key to teach democracy and citizenship

After having just completed a short communication for the journal “Tecnologie Didattiche” on OER for teaching social cohesion, in particular which in the refugee emergency, I embrace these words completely. We, as educators, need, now more than ever, to reflect how our practice can make this whole situation take a turn for the better…

Thoughts on Open Education

It has taken mi few days to reflect about what has happened in the country I called home for the last few days, it has been sad, confusing and overwhelming.

Not long ago, with my colleague Leo Havemann (@leohavemann) started doing some research about the value of Open Data as Open Educational Resources, and with a little help from our friends, we published a book and a paper, but until this point this was just an idea in our heads, Open Data is key to teach citizenship skills and to understand democracy, and we did lots of research about it, and we saw its value at theoretical level, but when I woke up on Friday, in despair, I noticed that as Open Data and Open Education community we haven’t done enough to educate others, because the voters in the UK have been misleading with false claims and manipulated…

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Seven complex lessons in education for the future

Just a quick post to share something I’ve been thinking about lately. Some of my colleagues will know how much I like a book from French sociologist Edgar Morin: Seven complex lessons in education for the future (2002). As the years go by this is probably the one book I would suggest reading to all teachers, but also students and generally to those involved in education. 

In his book, Morin describes seven basic principles for future education, which are fundamental yet too often ignored. These seven principles highlight the importance to educate future generations to understanding the human condition, how knowledge is formed and what are the possible errors in this process, the importance of understanding each others and confronting and accepting uncertainty and complexity.

These subjects are not only very contemporary, but also particularly important in healthcare education, where students need to raise their eyes from the micro-cosmos of the  basic sciences to the macro-cosmos of social health issues, understanding how the two are interwoven and continuously inter-influenced.

As this week I was thinking about how “Human Sciences” subjects are being assessed in medicine, I had of course think of how they were taught. It would be nice to see if Open Data could be used to teach students about the “human condition” and general World Health issues. Something is starting to move in this direction. How could open data be used in Medical Sociology teaching, for example?

I would be particularly interested to see whether using open data as OERs, to facilitate students’ critical understanding of socio-cultural elements influencing , for example, health issues could nurture compassion.

However, all this to say that I really recommend reading this book, which will probably make you want read another gem: “On Complexity“, which is about… the complexity of human being. I won’t say more, for now :)

 

CoP in Education – thoughts from a workshop

I have recently attended the ASME Annual Scientific Meeting – #ASM13 – in Edinburgh and I had the luck of being involved, directly and indirectly, in few projects, including the #FOAMed workshop which I co-ran with @nlafferty and @rakeshpatel (have a look at the slides!). The other one I was directly involved with was aimed at introducing Communities of Practice (CoP) theory to medical educators and was ran by myself, @alismithies, @suzanneeve, @r_ajjawi (here are mine and Suzanne’s slides). I had had in mind to organise such a workshop for a while now,  the fact I am using CoP theory to ground my research in my doctoral studies gave me the inspiration to start writing an abstract. This does not mean that I feel necessarily confident enough to “teach” such a theory to clinicians and educators in general. My knowledge of this theory is in continuous transformation and, while the key points and assets of CoP are quite precise, I have my own views of how to apply it to my own practice and research and I wouldn’t want to influence listeners with these. However if it is true that we negotiate meaning and knowledge in any interaction with others, then I can be sure “novices” will elaborate what I said and integrate it with the information contained in books, articles and other sources.

This is why I love workshops in conferences and I tend to stick to these instead of submitting abstracts for talks or symposia. I like the informal character of these practice-based, interactive conversations, I like the idea of sharing my knowledge with others and discuss it, test it, reconfigure it. In a time where everything is going “massive” I find the comforting dimension of a small room the occasion to reflect on the dynamics of a small, newborn, maybe temporary learning network and of my ability to explain my thoughts to others while acknowledging different views and added information.

Lately I am hearing the term CoP more and more frequently. One of the aims of the workshop was to try and clarify what makes a CoP, differentiating it with a network of learners, and how/if this network can be “nurtured” to become a Community of Practice. How can we do so in educational contexts and what benefits would this bring? Would this even be possible?

My attention is currently focussed on one of the themes we touched at the workshop: the relationship between participation, learning and practice in an apprenticeship based educational environment, such as what we often have in medical education and is often not recognised as a “real” learning experience. Jean Lave and Etienne Wenger studied apprenticeship as a learning model, observing that learning takes place through a complex set of social interactions where everyone learns – both experienced and less-experienced participants. These are the origins of the CoP theory (6), however the term “legitimate peripheral participation” (LLP) was coined to describe the process by which individuals learn not by observing a master performing a task but directly participating in the process and learning from all participants through social interactions.

A slide from my presentation

A slide from my presentation

It is apparent that participation – and non-participation – influences practice, which influences learning and vice-versa. When I think about this relationship and the concept of CoP in its integration in educational practice, many thoughts and questions flow in my mind:

If

– Learning can happen through practice
– Engagement is vital in order to have meaningful learning

then

– How do we make sure that practice is valued by students? How is this learning embodied?
– As educators, do we value practice and the learning that comes from it?
– Do we need to measure this learning it in order to recognise it and do we do so?
– In what extent can we “cultivate” a CoP with students?

Learning through practice is not a new concept, I have already mentioned Socrate’s method, called maieutics, which involves helping learners discovering knowledge by guiding them in a reasoning process. John Dewey‘s concept of pragmatism explains quite well that the “practice” can not only be associated with the “end product”, the “artifact”, but the practice itself determines the situation, it comes into life within a social environment where actors interact to solve a problem. So we look at the process and the end at the same time.

Is this applicable to CoP dynamics? Definitely. But, can we tell students or team members “we are now a CoP”, and just expect people start behaving like one? I doubt this would work. I think it is possible to use CoP assets to benefit students in an educationally-led intervention and observe, looking through the lenses of this theory, how to facilitate knowledge creation and flow. When I asked Etienne Wenger if he thought it was interesting to analyse an online CoP of medical students to see how learning was happening, his answer was: “I think you should first determine IF a CoP is actually emerging”. This is important and true. Critically observing students in their environment, in their interrelated activities and multiple membership in different communities of learners is probably the key to facilitate engagement in a shared practice.

I wonder if the following reflections could help introducing a CoP approach in educational practice:

– Give recognition / value learning

This can even have a simple psychological value: recognition of people’s work, effort, role or learning – in any context – brings a positive flow to the practice. This is directly linked to the engagement process, because recognition itself reinforces good practices and participation, therefore learning and identification, both personal and professional.

If practice is both learning in action and its representation then, in order to make learning apparent, do we necessarily need proper assessment? We can make a learning process apparent by observing it through an interpretive paradigm where the comprehension process will be iterative, based an a continuous evaluation and re-evaluation of the learners in their environment, acknowledging psycho-social factors, interactions and social dynamic, while making causal connections between these.

Wenger says that while many argue that knowledge resources can’t be measured, because knowledge is socially distributed, dynamic and tacit, it is possible to measure and manage the “knowledge system”, the flow through which knowledge creates value (7, p166). Wenger identifies 2 knowledge processes: production and application – if we think about these processes it is possible to manage them, identify the key people involved, coordinate their activities.

In my opinion this is a great way to help students making sense of their learning through participation, using it as a scaffolding resource for reflection and ready to be  embodied in future practices.

– Magnify opportunities for learning

This is a matter of identifying affordances and constraints for learning. I think the #FOAMed workshop gave a good overview on this. While this workshop was aimed at identifying free open access online resources for learning, its roots were pedagogically led and applicable to other educational settings. The problem is to find the appropriate way or community-oriented technology – in a critical pedagogy sense: taking into account the particular time, environment, history, student group – to support students’ engagement in order to become legitimate participants of the community of learning and help them moving towards a full, mature participation – or “from less to more competence”, whatever fits better your vision. Student-led projects can be developed by using a CoP approach, nurturing students’ individual abilities and interests and creating interprofessional relationships. 

– “Walk the hall” and transform problems in to good practice (thanks Suzanne for the inspiration)

Walk the hall is a metaphor (from Wenger) of having direct contact with people/students, talking, asking about their activities, their leaning needs, negotiating a way to work together while giving them the freedom to create and develop practices and educational resources. It seems almost assumed that educators should have direct contact with students but what if we started creating a community of learning with them, developing an “enabling leadership” which promotes student flourishing, facilitates effective learning relationships and envisages a learning environment that is actually shaped by learners.

By taking into account the complexity and uncertainty of this process we can accept that meaningful moments of learning can come from moments of impasse, where problems, such as non-participation or non-engagement can be used to create a sense of community by finding a real connection with students. Hearing and valuing their voice, their identity, their creative skills and, in particular, their awareness of their own learning needs.

These are all situated practices, embedded in a socio-cultural environment but also, and more significantly, in a knowledge process that is embodied in context and involves:

– transdisciplinarity
– eterogeneity
– social accountability

These strategies need to value and make the most of social relationships by acknowledging their dynamic nature. They also need to allow autonomy by supporting learners while nurturing their accountability to other leaners, educators and the Institution.

This is such a vast subject for a simple blog post! I have more questions than answers… Surely there is no written recipe on how to embed a CoP approach in educational settings, however the following resources can help articulating a personal approach.

References and further reading:

  1. Communities of Practice Design Guide
  2. Distinctions between Communities of Practice and other structures
  3. Gibbons, M. et al.1994, The New Production of Knowledge:The Dynamics of Science and Research in Contemporary Societies, SAGE, London.
  4. Laurens, H. and van Lente, H. 2008. Re-thinking new knowledge production: a literature review and a research agenda. Research Policy. 
  5. Sfard, A. 1997. On two metaphors for learning and the dangers of choosing just one. Educational Researcher. 27 (2) – recommended by Rola
  6. Wenger, E., 2002. Brief Introduction to Communities of Practice.
  7. Wenger, E. et al. 2002. Cultivating communities of practice: a guide to managing knowledge. Boston, Mass., Harvard Business School Press.

Conexus fortuna iuvat: can learning happen by chance? – The serendipitous Twit-learning

“Fortuna iuvat eum qui conexus(est)” – fortune favours the connected – is an adaptation of the famous Latin proverb “audentes fortuna iuvat” – fortune favours the bold – which came from a short conversation I recently had on Twitter with @conquestfrca

It is apparent that being “connected”, being part of a network, helps finding information quickly and more effectively. I have experienced this many times on Twitter: I found information, suggestions, experiences just by sending a tweet, I got papers I couldn’t access because of the dreaded pay wall, I engaged in interesting discussions and connected with varied people. I lurked. I learnt.

However this purposeful learning mechanism often gives space to a less organised one, where learning happens by chance. The way in which Twitter is constructed makes it a malleable tool which utilisation can be shaped by users around their needs and preferences. This means that, depending on the quantity and quality of connections, the use of hashtags and lists, and even the platform used, it is possible to read tweets from the most disparate people and find unexpected, unconventional connections.

In an interesting paper by Rita Kop, a sentence from Latin philosopher Heraclitus sums all this quite well: “the unexpected connection is more powerful than one that is obvious”.

The twitter stream is a dynamic, ongoing conversation where information is collaboratively shaped by users. Learners need to “move” inside this stream, managing and filtering information, using it in original ways and – possibly – keeping this openness for others to enjoy and fit-in. Sometimes I think of tweets as small notes shared with an open community of learners. Sometimes they are relevant to our own learning, sometimes they are not directly connected to it but, just because they are so unexpected, they can bring insights and take us to new learning paths, original ideas and new perspectives. These tweets however need to attract our attention, personal interest, something we are engaged with, in order to stimulate learning.

This serendipitous character of twit-learning is important because it can stimulate creativity and critical thinking, urging us to use lifelong learning skills. I think Twitter is a great arena for students to practice and master their self-learning skills, especially because of the less controlled environment in which they have to find their way, select information, manage procrastination, too. However I believe we need to first introduce this tool to students as a specifically designed learning activity, in a way that they can gradually discover its value and then learn taking part in the conversation in a meaningful way.

Peeragogy – a recent example in Medical Education

While doing some rather solitary reading and scribbles for my DEd earlier, my attention was caught by this particular tweet:

I had a quick look at @twitfrg profile and the blog post explaining how this “Twitter-mediated revision” is going to work and I was positively surprised by the explanation of this initiative. As @nlafferty noted, this is not a first…

…but still, I was impressed by the pedagogical reasoning involved in the organisation of this activity. The inclusion of a revision document coupled with some MCQs to be answered before the discussion is excellent, in particular I liked the fact that students will be discussing the answers and “how they arrived at them”. I think this is an excellent way to reveal, break apart in a way, the clinical reasoning involved in the process of finding the answers to these MCQs.

I recently came across another, however different, peer-learning initiative: the “Peeragogy Handbook, a Resource for Self-organizing Self-learners”. This site contains resources and information on peer-learning  and provides a theoretical background which the authors call “paragogy”, a set of principles to understand the process of learning together.

“A healthy process for learning in paragogy consists in a direct evolution of the four principles of parliamentary democracy: (1) The right to speak; (2) The right to be heard; (3) The right to listen; (4) The right to cooperate in the proliferation of options, that is, the right to “co-lead” in the decision-making system.” – Fabrizio Terzi

                 From Peer Learning to “Peeragogy”

I wonder if students embarking in an activity like #twitfrg would be interested in reading about the theoretical background underpinning peer-learning, to plan it better and with a sound pedagogical setting; or they would rather learn-by-doing, organise in a way that answers their learning needs and just go with the flow. In this case I do not think the educational value of the activity would be lost. Of course careful planning, taking into consideration the learning needs and having clear in mind the aims of the activity would be the ingredients of a successful learning experience.

However, I immediately found this initiative quite interesting also for its connection with my doctorate subject, and, after a prompt re-tweet, I started observing the reactions. Not surprisingly the tweet called a lot of interest from many students and professionals, some offering help, others liking the initiative and starting to spread the world.

This could become a good example of multidisciplinary working other than a community of sharing, collaboration, co-construction of knowledge and I hope this initiative gets the participation and interest it deserves.

I am looking forward of seeing how this develops and I wish the best of luck to the organisers!

Musing on Critical Pedagogy, “care” and Medical Education – Part 1

I am in now in a stage where it seems that all I have been reading so far is not enough in order to write a decent literature review, so I am spending all the available time in full immersions of reading, jumping between several books and articles, following  a rather personal logic that often takes me to more reading and more information to digest. I wonder if I should just stick to a book at the time, being more organised and linear, or this approach is actually the normal result of an iterative reading, non-linear, where the connections with other resources are just part of the process.

Anyway, during the past few weeks I’ve been shifting between 3 books (see references) which made me think about the concept of care and how this is a bridge between education in general, the more specific area of medical education and more broad themes like co-belonging and formation/growth of the human being.

“Medical Education for the Future: Identity, Power and Location”. A particular passage has caught my attention:

“The traditional academic view of medical education as a translation of learning theory into clinical practice is no longer sufficient to help us face the culture of change and uncertainty in which doctors of the future will practice. To rise to the challenge facing medical education and practice for the future, medical educators need to develop a systematic and programmatic approach to research in the field and also to have a clear idea of what it is that they are researching, why they are researching it and what they hope to achieve. Medical educators— researchers, teachers and clinicians—need to look again at what they are doing, why they are doing it and how they can do it better. We argue in this book that all the answers to these questions can and should be found within the care of patients.” (Boldtype is mine)

I can see two big thematics here: one related to the concept of care, which is placed at at the centre of the whole medical education paradigm; and one related to the necessity of grounding medical education research, teaching and clinical practice within the social fabric, in a way that makes them intrinsically connected to the “here and now”. Both these concepts are at the heart of Critical Pedagogy.

Critical pedagogy gives full importance to the historical and social nature of educative process. This means that the educative process should start and be grounded on a critical theory of society, of science and of the subject. The meaning of the term “critic” here is to “explain and interpret the society in order to actively change it” (see Max Horkheimer).

In this sense I think critical pedagogy foundations should be applied to medical education, using a critical approach to research and teaching. This means really embedding these processes into the social environment to get full benefits, which will eventually improve patients care. This is not an innovative thought, in fact while reflecting on this I remembered about Virchow‘s social medicine, which I read about at the university. This 19th century’s German doctor stated that:

“Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution: the politician, the practical anthropologist, must find the means for their actual solution… The physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction.”

In fact, when he was invited to write a report on a typhus epidemic, he stated that that “the outbreak could not be solved by treating individual patients with drugs or with minor changes in food, housing, or clothing laws, but only through radical action to promote the advancement of an entire population, which could only be achieved by full and unlimited democracy, education, freedom and prosperity”. 5

He is not the only one to connect democracy, education and economy – just to mention some: philosopher and psychologist John Dewey, Economist Amartya Sen and sociologist Antony Giddens – but surely he connects these more explicitly with health. I will explore these connections further for my literature review.

Part 1 ends here, I need to translate some rather confusing itanglish sentences… Part 2 will be more about the concept of care and a wrap-up of both posts… Hopefully I’ll manage to do it tomorrow while travelling, or under the Sardinian sun perhaps!

 

References (3 and 4 are for Part 2):

1. Bernhard, A. (2006). Pedagogia critica : tendenze di sviluppo e progetti per l ’ avvenire. Collana di Studi Internazionali di Scienze Filosofiche e Pedagogiche Studi pedagogici, (1), 1-24.

2. Bleakley A, Bligh J, Browne J. Medical Education for the Future: Identity, Power and Location. New York: Springer, 2011.

3. Carlgren, I. From Teaching to Learning: The End of Teaching or a Paradigmatic Shift in Teachers’ Work? in Hudson, H & Meyer, M. A. Beyond Fragmentation: Didactics, Learning and Teaching in Europe. BB, 2011.

4. Granese A. Istituzioni di Pedagogia Generale: Principia Educationis. Padova: CEDAM, 2003.

5. Wikipedia http://en.wikipedia.org/wiki/Rudolf_Virchow