Developing the reflective professional: medical students' use of resources and patterns of learning Project lead: Dr Peter Dangerfield Researcher: Tünde Varga-Atkins Participant student groups: 1st year Abstract This project builds on a previous CEDP Fellowship award (entitled 'Writing and reflecting: exploring the use of wikis and online peers assessment tools to promote the personal and professional development of undergraduate medical students') which explored how students interacted and shared their findings and resources between face-to-face PBL sessions. This presentation reports on project findings which focused on the process of how students research and evaluate their learning objectives. Through the introduction of online tools in the PBL process, the project examined the potential of a social bookmarking tool, Diigo, in supporting the development of students' reflective practice.

1. Developing the reflective
professional:
medical students' use of
resources and patterns of learning
11th May 2010
CETL seminar presentation
Peter Dangerfield
Tünde Varga-Atkins
Ian Ellis
Louis Vitone

2. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Initial project 2007-8
 Current project 2009-10
 Aims
 Methods
 Findings
- Social bookmarking
 Conclusion
Session outline

3. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
Publications – previous project
•Developing professionalism through the use of wikis: a study with first-year
undergraduate medical students. Medical Teacher 32(10), October. 2010
•HEA MEDEV subject centre newsletter. Spring 2010. (Issue 21) Using wikis
to promote the personal and professional development of undergraduate
medical students: a report for the CETL in Developing Professionalism

4. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Introduced use of wikis in PBL context –
enhance learning?
 Students welcomed sharing resources.
 Interacting in (‘formal’) online spaces
contributed to a development of
professionalism.
First project: using wikis in PBL

5. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
Conclusions
5
 Students were less familiar with the
technology than expected.
 Students were not confident posting in a large
group wiki – importance of trust (expressed in
sharing / privacy of technology used).
 Importance of alerts and usability of the tool.

6. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Explain purpose of process – hands on session
 On-line tool must use Web 2 type of alerts etc
 Private / Group / Public areas
 Environment must bring with it the concept of Trust
 If students only tend to share web links:
explore social bookmarking
6
Recommendations

7. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
Rationale for building on first project
People
Techniques
Resources
Research PBL
objectives
Student
Tools
Lifelong learning

8. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 We interpret this here to be:
- Independent learning skills
- Information skills (search, retrieve,
store, evaluate and synthesise
information)
- Building up for medical career
Reflective professional

9. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Can students’ PBL learning be enhanced?
- What tools (techniques, resources) do
students use to research their PBL / develop
their professionalism?
- Introduce an online social bookmarking tool.
 How do students engage with the social
bookmarking tool?
 How do they value such a tool for their PBL
research?
Aims

10. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Small scale study, pilot.
 Focus groups & interviews.
- Piloted ‘walkthrough interview’.
- Also interviewed third years from first project to
compare.
 Online engagement and statistics.
 Email feedback.
 Used activity theory to help interpret and
organise findings.
Methods

11. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Small scale study.
 Interpretative.
 Focus group limitations.
NB Preliminary results
 Analysis is still being refined
Limitations of process

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 Context
 Temporal
 Conflict between direction and self-
directed learning
 Issue of ‘Depth’
 BUT this tension is the source of
learning
Findings

13. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
Support and resources for PBL
People
Techniques
Resources
Research PBL
objectives
Student
Tools

14. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
Learning landscape: 1st years and where
resources come from
People
Techniques
Resources

15. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
Learning landscape: 3rd years
People
Techniques
Resources

16. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
Learning landscape: people
First years
Senior peers
Friends,
ex-school
friends
PBL group
HARC staff Lecturers
Family,
relatives
PBL facilitator

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Learning landscape: people
Third years
Clinical staff
patients
peers
flat mates
Year group
faculty
facilitators
PBL group

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Learning landscape: resources
First years
books
internet
library search
past exam papers
VITAL resources
HARC booklets
lectures
HARC
hands-on

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Learning landscape: resources
Third years
Speciality
booklets
web search
reference
books
journals
Library databases PBL booklet

20. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
Learning landscape: techniques
First & third years
mnemonics
Note-taking
diagrams
drawings
mind maps
cue-cards
quizzes
copying
reflecting

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Techniques
With others
Individual

22. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Specific to the individual (e.g. Note-taking etc.)
eg diagramming creating powerpoint slides for PBL
Individual techniques

23. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
(First and third years)
 Reflection
 Aware of own skills, limitations
 Overcompensating
 Interest (satisfying own interest) ‘indulge’
 Aware of learning styles preference
 (third year) – writing and reflecting
Individual techniques

24. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Discussions – library, at home, on campus
 Sharing – via email, Facebook, during PBL, texting and
phone calls
 Skill exchange
 Role of sharing
- First year:
DEPTH, revision
- Third year :
checking understanding,
sharing resources
Techniques: collaboration with peers

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 Emphasis / importance of people and resources changes
over the years;
 Techniques change from person to person;
 Quality of techniques change (in certain cases);
 Further questions:
- Does the range of techniques change?
- Do students learn expand their techniques over the years?
- What influences their take-up (or no take-up) of a tool?
Preliminary interpretation

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One technique: internet search
First years
 VITAL, HARC, lectures help direct to sources;
 Google search [or quick overview e.g. Wikipedia]
- Senior peers
- Recall lecturers – does site cover the points
mentioned?
- ‘Trusted sites’ e.g. NHS, Direct Gov, university
sites etc
- NOT using ‘social’ element of bookmarking
 Links via email, face to face chats, Facebook

27. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
One technique: internet search
Third years
 Google search or quick overview (e.g. Wikipedia)
- Range of trusted sites: wider
- Author / web publisher’s trustworthiness
- Medical community recommendations, doctors’
recommendations
- NOT using ‘social’ element of bookmarking
 Increasing use of specialised medical databases, journals
etc
 Links via email, face to face chats, Facebook

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 Browse others’
searches
 Snowballing
 Common interests
Social bookmarking
 Portable ‘favourites’
 Toolbar – saving
weblinks quickly

29. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Browse others’
searches
 Snowballing
 Common interests
Social bookmarking
 Portable ‘favourites’
 Toolbar – saving
weblinks quickly
Can it enhance PBL?

30. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Previous project: sharing weblinks useful;
 Current project:
- Physical sharing ie via face to face, FaceBook,
email, text
- First year- main source of information = books >
internet links
 Role of sharing: to help guide students about
DEPTH rather than share a physical resource.
Sharing web links

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Social bookmarking tool not used/useful
 Usability
- Not downloaded toolbar
- ‘Cumbersome’
 Practice
- Shared via face to face discussions
instead or via email.
- Store web links in favourites or in
their PBL notebooks.
How students shared weblinks

32. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Tool fulfils all previous demands
 Useful in theory – but not used in practice:
- Quantity
- Utility vs effort
- ‘social’ element not utilised, recognised
 May be a good tool in the later years when there are more
internet searches
 May be taken up by an individual rather than whole groups.
Social bookmarking

33. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Sharing is perceived to be useful – purpose is about
DEPTH
 Learning styles / different individual strategies are
important
 No ‘blanket tool’ but tool for specific individuals /
purposes
 Bookmarking has potential to enhance learning – but
potential is not recognised by students (eg helping in searches
etc.)
Conclusions

34. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
 Acknowledge support from the CETL
 Interesting area
 Clearly more analysis
 Further work needed
 The Road to the future?
Conclusions

35. DEVELOPING THE REFLECTIVE PROFESSIONAL: MEDICAL STUDENTS’ USE OF RESOURCES AND LEARNING PATTERNS /35
QUESTIONS