This is the presentation I gave as a progress report on my PhD, at the UWC "Innovations in Teaching and Learning" colloquium.

1. blended learning
in clinical education
michael rowe
department of physiotherapy
university of the western cape

2. background: blended learning
a systematic combination of face-to-face and
technology mediated interactions between students,
teachers and learning resources (bliuc, goodyear & ellis, 2007)
allows for greater flexibility and responsiveness in
teaching and learning (lewin, singh, bateman & glover, 2009)

3. background: blended learning (2)
true potential is in enhancing communication and
promoting reflection
blended learning is highly context dependent, so it
cannot be generalised from other domains (harris, connolly
& feeney, 2009)
the medium is less important than the way in which
learning is approached (laurillard; cited in ennew & fernandez-young,
2005)

4. background: reflection
reflection and reasoning both emphasise the
connection between action and thinking (aars, 2008)
focused reflection is a significant factor in developing
clinical practice through clinical reasoning (murphy, 2004)
making meaning through reflection is more important
than memorising content

5. 1 establish global context
aim: how have others used blended learning in clinical
education?
method: systematic literature review
outcomes:
- few well designed studies evaluating blended learning
- some studies demonstrate positive clinical outcomes
Rowe, M., Frantz, J. & Bozalek, V. (2012). The role of blended learning in the clinical education of
healthcare students: A systematic review. Medical Teacher, 34:e216-221

6. 2 establish local context
aim: what are students' experiences and perceptions of
emerging technology in learning?
method: survey of students
outcomes:
- students use technology, but don't understand it
- studying is not part of social
- internet access is a concern
Rowe, M., Frantz, J. & Bozalek, V. (2012). Physiotherapy students’ use of online technology as
part of their learning practices: a case study. South African Journal of Physiotherapy, 68(1):
29-34

7. 3(a) pilot intervention
aim: how can we use wikis effectively for
collaborative content creation?
method: wiki-based assignment and survey
outcomes:
- students are able to collaboratively develop content
- groupwork is more of a problem than technology
- wikis are difficult to facilitate
Rowe, M., Frantz, J. & Bozalek, V. (2012). The use of a wiki to facilitate collaborative learning
in a South African physiotherapy department. South African Journal of Physiotherapy
(accepted for publication)

10. 3(b) pilot intervention
aim: how can we use a social network for reflection in
clinical education?
method: reflective blogging around clinical experiences
outcomes:
- students need significant facilitation
- social networks provide useful platforms
Rowe, M., Frantz, J. & Bozalek, V. (2012). The use of assisted performance within an online social
network to develop reflective reasoning in undergraduate physiotherapy students. Medical
Teacher, e1-e7

13. 4 intervention design
aim: how will we integrate technology into teaching in
order to develop personal & professional attributes?
method: delphi study with 3 different panels
outcomes:
- values and attributes are essential for clinical practice
- process is more important than product
- technology affordances before platforms & services
Rowe, M., Frantz, J. & Bozalek, V. Beyond knowledge and skills: The use of a Delphi study to
develop innovative teaching practices in a blended learning module. BMC Medical Education
(submitted and under review)

14. 5 explore theoretical perspectives
aim: what theories of learning and instructional
frameworks are appropriate?
method: review of relevant theory
outcomes:
- socio-cultural theories fit clinical education
- instructional frameworks are rarely used
- authentic learning tasks model the clinical context
Rowe, M., Bozalek, V. & Frantz, J. A theoretical approach to technology-mediated teaching and
learning in medical education. Medical Education (submitted and under review)

15. 6 implementation
classroom context:
- case-based learning in small groups
- collaborative content development with facilitation
- online environment for support
clinical context:
- integrated with classroom context
- emphasis on solving problems, not knowing facts

24. 7 evaluation
aim: how are we evaluating and adapting the module?
method: developmental evaluation & focus groups
outcomes:
- frequent changes based on feedback
- students want the certainty of knowing the answer
- initially resistant, but moving towards appreciation
- acknowledgement of benefits e.g. enhanced reasoning
- technology is grudgingly accepted

25. conclusions
this approach is resource intensive (time, energy,
facilitators)
technology is good for moving content out of the
classroom
case-based learning (i.e. classroom context) must be
integrated with practice (i.e. clinical context)
students demonstrating enhanced:
- clinical reasoning
- reflective skills
- evidence-based practice

26. moving forward
introduce teaching approach from 1st year, emphasising:
- authentic learning tasks for students
- technology integration early and throughout
- understanding concepts, not memorising facts
- move conceptually between modules
- develop modules that are flexible and adaptable
- iterate rapidly based on feedback

27. thank you