Progress on Blogs in Clinical Placements: Actual Stuff!

Academic Monitors Meeting (1)

It was noted that the point of engaging learners to reflective practice is to help them transfer academic knowledge to the clinical setting and to test practice with input from peers. All this leads to professional competency. It is a great skill to equip them for professional practice. The UK for example, sees reflective practice skills an integral part of the continuing professional development experience.

Students were randomly allocated to the Blog group (38), with a few minor alterations to compensate for web access etc.)

It was considered that this Blog experience has enormous potential to impace on different aspects of professional practice – eg. Clinical skills, ethics, professional practice, etc… Some of the topics that have been raised in the Blogs to date:

1. Conflict with supervisor
2. Patient education
3. Working with clients whose first language is not English
4. Time management in outpatients
5. Compliance issues with respect to treatment****
6. Grieving processes
7. Death and dying – aged care
8. Models of supervision – learning styles and differences in supervision style
9. Goal setting with children and the influence of parents in managmenet
10. Questions about practice = what works, what doesn’t work with specific cases
11. Managing classes.
12. Family centered care – paediatrics…how to engage family
13. Difference in practice between facilities eg. ACL?
14. Pain and paediatric treatment…
15. Communication strategies and patient compliance – communication difficulties
16. How decisions are made about use of specific equipment how much EBP drives practice.

• General feeling that the Blog is much better than the Patient Clinical Written Examinaation
• Would be useful to introduce blogging and more expanded opportunities for students to develop reflective practice skills earlier in the curriculum. This would make engagement at fourth year during clinical placements potentially easier. There is some space for this in the second year but it really needs to be examined more broadly across the curriculum.
• It is still difficult to ascertain how fully engaged participants are in the Blog environment because of required elements and the presence of an academic monitor.
• Some participants clearly are better at reflective engagement whereas others need coaching to move from describing events to more reflective practice.
• Moderators find they must refrain themselves from providing too much expert opinion. Need to encourage students to engage in a dialogue and reflection about shared practice. Otherwise students may shift dependence to moderator.

Some greater clarity about the staff role is needed. Some guidelines that were discussed include:

• Encourage learners to apply more of the Experiential Learning Framework to their journaling: Write about their experience, discuss their reflections such as how they felt, what they understood to have happened…make some conclusions based on this thinking and consider how to apply learning in the future….
• Vulnerability - encourage students to self disclose, be more vulnerable, shift away from ‘looking good’ and share questions as this is how professional practice develops.
• Give feedback to others to reduce their blind spots and move out of hidden windows so that others can help with questions.
• Challenge them to make contributions, generate questions to make them think and consider more deeply issues that are raised in the blog
• Dates for placements should be provided by organisers so know when students rotate and whether they are in the first, second, third etc.. week.
• Tracking of student contributions can be made on a simple template.
• Provide positive feedback for good contributions.
• Monitor the quality of contributions as well.
  

There are some great potential research outcomes that will flow from this project. They largely will be qualitiative in nature by examining and coding the documents. Will need student consent and ethics approval. However some outcomes will be to look at the sorts of issues students generate and need help with. Will be great information for curriculum planners and problem based learning cases. Can also look at differences in blogging by gender. Reflective practice and clinical reasoning analysis can also be carried out. Questions on evidence based practice that frequently appear may also be used for curriculum innovations.