Informal interprofessional learning: an untapped opportunity for learning and change within the workplace

Abstract

In this paper, we explore the educational and workplace learning literature to identify the potential and significance for informal interprofessional learning within the workplace. We also examine theoretical perspectives informing informal workplace interprofessional learning. Despite numerous studies focusing on formal interprofessional education programs, we suggest that informal interprofessional learning opportunities are currently unrealized. We highlight reasons for a focus on learning within the workplace and the potential benefits within an interprofessional context.     

Friendship fosters learning: The importance of friendships in clinical practice

This paper reports on one of the key findings from a recent ethnographic study (Roberts, D., 2007. Friendships and the community of students: peer learning amongst a group of pre-registration student nurses. Unpublished PhD Thesis, University of Salford, UK) and aims to highlight the importance of friendships for student nurses in clinical practice. An interpretive ethnographic approach was taken in order to reveal the student experience during their pre registration programme. Data was collected using ethnographic interviewing (Sorrell, J.M., Redmond, G.M., 1995. Interviews in qualitative nursing research: differing approaches for ethnographic and phenomenological studies. Journal of Advanced Nursing 21, 1117–1122.) and participant observation. Within this paper I argue that student nurses exist on the edge of the community of practice (of the qualified staff) and therefore form their own parallel community where students are all seen as being in the same boat. In particular students use the friendships they develop in clinical practice to enable them to learn; developing an ‘ask anything’ culture where all students are perceived as valuable sources of knowledge. Furthermore, it appears that knowledge is contextually bound and not therefore linked to seniority, or length of time served on the course.     

Speeding Up Learning: Accelerated Distance Learning in Rehabilitation Education

Distance learning in higher education involves a continuum of technologies ranging from teleconferencing to video streaming. The United States is approaching a crisis in personnel shortages in rehabilitation counseling and education. Because of these shortages, higher education is called upon to produce counselors in an abbreviated period of time. Thus, distance learning is recognized as an integral part of education, especially for adult learners. This article provides an overview and discussion of the relevance of distance and accelerated learning in rehabilitation and higher education.     

High-Frequency Learning Goals: Using Self-Regulated Learning to Influence Day-to-Day Practice in Clinical Education

Problem: Although self-regulated learning (SRL) is considered a fundamental skill that must be developed in physician training, many programs of SRL utilize learning goals that are generated only at the beginning of learning experiences or are widely spaced apart in time. These goals are often not formally shared with those actually working with the learner in the clinical setting. Intervention: We developed a program of written, student-generated weekly learning goals in which students focused on processes of becoming better doctors for their patients. These goals were shared at the beginning of each week with students' clinical teams for feedback and incorporation into the work. Context: The weekly learning goals program was developed and implemented as part of a required 3rd-year neurology clerkship. At the end of each 4-week clerkship, students were asked to evaluate the program through an anonymous electronic survey utilizing quantitative and open-ended qualitative questions. Outcome: Seventy-six of 82 students completed the evaluation survey (93% response rate). Eighty-six percent reported that the weekly learning goals increased their awareness of their thoughts and actions. Seventy-eight percent reported that the learning goals helped to improve their clinical performance to some degree, and 57% reported that the learning goals increased their focus on patient care. Students described a greater sense of focus on self-assessment and accountability from their goals. Students often commented that engagement from attendings and residents regarding their goals was a key element for successful learning from their goals. Lessons Learned: Student-generated weekly learning goals on a neurology clerkship appear to be an effective method to operationalize SRL. For most students, the frequency of the goals allowed for close self-monitoring, and the act of sharing goals with the team opened a new avenue for dialogue between students and their supervisors.     

RecON: Online learning for sensorless freehand 3D ultrasound reconstruction

Sensorless freehand 3D ultrasound (US) reconstruction based on deep networks shows promising advantages, such as large field of view, relatively high resolution, low cost, and ease of use. However, existing methods mainly consider vanilla scan strategies with limited inter-frame variations. These methods thus are degraded on complex but routine scan sequences in clinics. In this context, we propose a novel online learning framework for freehand 3D US reconstruction under complex scan strategies with diverse scanning velocities and poses. First, we devise a motion-weighted training loss in training phase to regularize the scan variation frame-by-frame and better mitigate the negative effects of uneven inter-frame velocity. Second, we effectively drive online learning with local-to-global pseudo supervisions. It mines both the frame-level contextual consistency and the path-level similarity constraint to improve the inter-frame transformation estimation. We explore a global adversarial shape before transferring the latent anatomical prior as supervision. Third, we build a feasible differentiable reconstruction approximation to enable the end-to-end optimization of our online learning. Experimental results illustrate that our freehand 3D US reconstruction framework outperformed current methods on two large, simulated datasets and one real dataset. In addition, we applied the proposed framework to clinical scan videos to further validate its effectiveness and generalizability.     

Learning to learn self-regulation in practice: a 2 cohort evaluation

The transfer of nurse training into higher education following ‘Project 2000’ dramatically changed the status of student nurses. While the majority received a grant or bursary, students were no longer regarded as belonging to the hospital staffing complement. Elcock et al. (2007), argue that the intended advantage of supernumerary status following the move of nurse education into higher education has not been reflected in the student learning experience. Students have reported difficulties in being accepted into the community of practice, as they are no longer viewed as belonging in the professional sense to the practice environment (Cope et al., 2000).Students must therefore be prepared for their supernumerary role through the development of appropriate skills for learning in practice (Elcock et al., 2007). The Thames Valley University pre-registration nursing curriculum promotes the effective socialisation of students into the professional role (Fitzpatrick et al., 1996) through a 35-day practice orientation programme in the Common Foundation Programme.The results of a 2 cohort evaluation of a 35-day programme facilitated in the Brent and Harrow learning community indicate that novice pre-registration students will not always possess the self-directed ability to spontaneously engage with nursing care in practice. Students must be provided the opportunity to develop the skills that define the self-regulated learner (Langendyk, 2006). Students must be empowered to self-assess what they know and what they do not know. It is argued that in order to learn during practice experiences, the student nurse of today must first learn how to be self-regulated.     

Guided group reflection: A question of organisation and support for baccalaureate nursing students: Part1

This paper focuses on an innovation and development of a guided reflective approach currently offered at a university in Ireland. Significant collaborative structures and processes were created and implemented in providing guided protected reflective time for fourth year pre-registration BSc Nursing and Midwifery students. This initiative is explored within a case study approach. Undergraduate preregistration programmes aim to develop practitioners towards becoming fit for purpose, compassionate and competent in meeting global health care needs. In the current educational literature, there is much about reflection from a theoretical learning stance. Minimum attention has been given to the practicalities surrounding the structures and processes providing learning spaces where reflection can flourish. Reflective practice offers learning opportunities to guide the development of self and practice critical for future learning. Guided reflection is described as an appropriate learning strategy influential in sense making for practice for final year pre-registration BSc undergraduate students.     

Interprofessional learning at work: what spatial theory can tell us about workplace learning in an acute care ward

Abstract

It is widely recognized that every workplace potentially provides a rich source of learning. Studies focusing on health care contexts have shown that social interaction within and between professions is crucial in enabling professionals to learn through work, address problems and cope with challenges of clinical practice. While hospital environments are beginning to be understood in spatial terms, the links between space and interprofessional learning at work have not been explored. This paper draws on Lefebvre’s tri-partite theoretical framework of perceived, conceived and lived space to enrich understandings of interprofessional learning on an acute care ward in an Australian teaching hospital. Qualitative analysis was undertaken using data from observations of Registered Nurses at work and semi-structured interviews linked to observed events. The paper focuses on a ward round, the medical workroom and the Registrar’s room, comparing and contrasting the intended (conceived), practiced (perceived) and pedagogically experienced (lived) spatial dimensions. The paper concludes that spatial theory has much to offer understandings of interprofessional learning in work, and the features of work environments and daily practices that produce spaces that enable or constrain learning.     

The Lean Methodology Course: Transformational Learning

Today’s graduate students need scientific problem-solving skills to be competent and competitive in an evolving global work environment. Lean Methodology is a rigorous improvement system designed to transform waste into value from the customer’s perspective, providing students with problem solving principles and tools. The Lean Methodology course, taught at a school of nursing located in the southeast, is designed to push the boundaries of traditional disciplinary academic education and provide practical, philosophical, scientific underpinnings for graduate learning. This course provides the next generation of improvement scientists with Lean tools, strategies, and principles that bring value to everyday work processes. This course is also a scientific, experiential, transformational approach to learning that ensures sustainability of work processes into the future and creates lifelong value for the graduate student.     

Neonatal education in the North East: A collaborative venture

This article describes a change in the teaching and learning strategy for newly qualified neonatal nurses who wish to become qualified in the speciality (QIS) of neonatal nursing. Two modules have undergone revision in the light of feedback from the Regional Neonatal Network and evaluations from stakeholders. This paper provides the rationale for change and discusses developments in teaching and learning strategies, and the planning and implementing process involved in the change. Factors to take into consideration when evaluating the change and implications for future developments are also briefly discussed.     

Shared learning in primary care: Participants' views of the benefits of this approach

This is a study exploring participants' views regarding a series of shared or interprofessional learning sessions carried out in a primary care setting in Bradford, UK. One-hundred-and-twenty-four participants including doctors, practice nurses, nurse practitioners and health visitors attended six expert-led, case-based learning sessions on clinical topics relevant to their work. The evaluation of the sessions is presented, from questionnaire feedback including open responses. Participants had high expectations of shared learning, which was largely met in terms of sharing ideas regarding professional roles and sharing clinical knowledge and skills. Variations between professionals, and between sessions, are noted and discussed. It was concluded that shared or interprofessional learning in the workplace is valued by clinicians, can help improve understanding of professional roles and also enhance clinical learning.     

One model is all you need: Multi-task learning enables simultaneous histology image segmentation and classification

The recent surge in performance for image analysis of digitised pathology slides can largely be attributed to the advances in deep learning. Deep models can be used to initially localise various structures in the tissue and hence facilitate the extraction of interpretable features for biomarker discovery. However, these models are typically trained for a single task and therefore scale poorly as we wish to adapt the model for an increasing number of different tasks. Also, supervised deep learning models are very data hungry and therefore rely on large amounts of training data to perform well. In this paper, we present a multi-task learning approach for segmentation and classification of nuclei, glands, lumina and different tissue regions that leverages data from multiple independent data sources. While ensuring that our tasks are aligned by the same tissue type and resolution, we enable meaningful simultaneous prediction with a single network. As a result of feature sharing, we also show that the learned representation can be used to improve the performance of additional tasks via transfer learning, including nuclear classification and signet ring cell detection. As part of this work, we train our developed Cerberus model on a huge amount of data, consisting of over 600 thousand objects for segmentation and 440 thousand patches for classification. We use our approach to process 599 colorectal whole-slide images from TCGA, where we localise 377 million, 900 thousand and 2.1 million nuclei, glands and lumina respectively. We make this resource available to remove a major barrier in the development of explainable models for computational pathology.     

Approaches to learning on placement: the students' perspective

Background and Purpose . With Continuing Professional Development activity, a requirement of Allied Health Professional registration in the UK and said to be most effectively supported by practitioners who adopt a deep approach to learning, a UK university has been exploring how its pre‐registration curriculum influences learner development. This paper investigates the possible influences of the clinical placement component of the curriculum that is structured as four 4‐week blocks during both Years 2 and 3 of the 3‐year BSc (Hons) programme. A range of placement models are used within this structure including the traditional 1:1 educator : student ratio and those that have a higher ratio of student(s) : educator(s). Methods . This phase of the larger project used a case study design framed about students from two academic year groups on one UK undergraduate, pre‐registration physiotherapy programme. Three questionnaires comprising a learning approaches inventory, a demographic questionnaire and a placement self‐assessment form were posted to Year 2 and 3 students during one clinical placement. The students were invited to complete the questionnaires halfway through their placement, but in advance of the first, formal placement education feedback meeting. The need for students' self‐assessment prevented follow‐up data collection. Results . Analysis of the data from the learning approaches inventory against the demographic variables and placement assessment scores suggest that students' learning strategies depend upon the number of students, educators and assessors involved in their placement. The paper explores the possible links between placement experience, learning strategy and academic outcome. The authors question assumptions about the perceived benefits of some placement education models. Conclusion . Increasing the ratio of student : educator or educator : student may have a detrimental effect on students' learning development when placements are of 4‐week duration. If such placement models are adopted, then students and placement educators must be adequately prepared and supported so that students' learning development towards the deep‐learning autonomous professionals of tomorrow can continue through placement education. Copyright © 2008 John Wiley & Sons, Ltd.     

Technology usage for teaching and learning in nursing education: An integrative review

BackgroundThe increasing availability of technology devices or portable digital assistant devices continues to change the teaching-learning landscape, including technology-supported learning. Portable digital assistants and technology usage have become an integral part of teaching and learning nowadays. Cloud computing, which includes YouTube, Google Apps, Dropbox and Twitter, has become the reality of today’s teaching and learning and has noticeably improved higher education, including nursing education.ObjectivesThe aim of this integrative literature review was to explore and describe technology usage for teaching and learning in nursing education.MethodA five-step integrative review framework by Whittemore and Knafl was used to attain the objective of this study. The authors searched for both empirical and non-empirical articles from EBSCOhost (health information source and health science), ScienceDirect and African Journals Online Library databases to establish what is already known about the keywords. Key terms included in literature search were coronavirus disease 2019 (COVID-19), digital learning, online learning, nursing, teaching and learning, and technology use.ResultsNineteen articles were selected for analysis. The themes that emerged from this review were (1) technology use in nursing education, (2) the manner in which technology is used in nursing education, (3) antecedents for technology use in nursing education, (4) advantages of technology use in nursing education, (5) disadvantages of technology use in nursing education and (6) technology use in nursing education amidst COVID-19.ConclusionTechnology in nursing education is used in both clinical and classroom teaching to complement learning. However, there is still a gap in its acceptance despite its upward trend.ContributionThe findings of this study contribute to the body of knowledge on the phenomenon of technology use for teaching and learning in nursing education.