Transcript StupansPresentation_ACEN2011

Enhancing learning in clinical
placements: self assessment, rubrics
and scaffolding (a case study)
Ieva Stupans
University of New England
Geoff March &Susanne Owen
University of South Australia
Australian UG pharmacy programs
 4 years, include clinical placements , at graduation not




competent , require one year intern period and assessments
etc in order to be registered.
Therefore program endpoint is not specified.
However program must enable student to commence intern
period.
Assessments of clinical placements in pharmacy generally
based on assessment of individual activities not assessment of
competency as such.
These activities may be based around competencies
Competency Standards for Pharmacists in
Australia
 Eight domains
 Standard 1.5, element 1:importance of life-long
learning, self assessment, reflective
learning
Learning activity based around
counselling
 Each student required to undertake counselling
throughout the placement
 Write a reflective piece regarding their improvements
in counselling between the early and late stages of the
placement
Learning activity based around
counselling
 Each student required to undertake counselling
throughout the placement
 Three iterations of the activity developed A, B,C
 Evaluation
 scoring of various facets
 determining types of reflection demonstrated in the
writing
How would you scaffold this activity?
 Write a reflective piece regarding their
improvements in counselling between the early
and late stages of the placement
Scoring: Understanding of role and function of Competencies - uses
competency developmental criteria language, refers to relevant performance
criteria
16
14
12
C
10
B
A
8
6
4
2
0
1
2
3
4
5
6
Marks
7
8
9
10
Scoring: Clear thoughtful analysis – makes connections between
experiences, course material and other relevant events (Reflection)
16
14
12
10
B
C
8
6
4
A
2
0
1
2
3
4
5
Marks
6
7
8
9
10
Examples from the qualitative
analysis for reflective writing
Reflective observation involving explaining actions:
 “I became better at identifying a particular patient’s
information needs. I was able to tailor the type and extent of
information provided to the patient depending on the
number of other medications and also the patient’s cognitive
level”
Examples from the qualitative
analysis for reflective writing
Abstract conceptualisation involving linking to other
experiences:
 “ the level of support from my preceptor needed.... the time
taken for me to provide..... degree of client focus also
improved”
Abstract experimentation/theory confirmation involving
discussing future action
 “I would look up tertiary references (such as the Australian
Medicines Handbook) for important counselling points”
What were the differences between
the 3 iterations?
 A-Write a reflective piece regarding your improvements in
counselling between the early and late stages of the placement
 B-Write a reflective piece regarding your improvements in
counselling between the early and late stages of the placement
Plus description of reflection
Plus graduated descriptors around competencies
 C-Write a reflective piece regarding your improvements in
counselling between the early and late stages of the placement
Plus description of reflection
Plus graduated descriptors around competencies
Plus rubric and specific scaffolding
RO-reflective observation; AC-abstract conceptualisation;
AE-active experimentation; CE- concrete experience
1. Setting of
professional
goals
Reflectionfor- action
4. Active change
by experimentation
and practice
5. Developing
Supportive
Networks
3.
Planning
Learning
Agenda
Reflecting and Goal Setting
Reflectionfor-action
2. Evaluating
strengths
& needs
Rubric: Explain
(1) what the most significant changes are,
(2) why changes in competency skill development are
occurring
(3) describe the evidence for this change
(4) describe the change you have observed in terms of the links
to pre-placement and during placement support/learning
materials and
(5) your action for the future in further developing your
proficiency in this skill.
Journey to competency
Criteria
 Level of support
 Time taken for preparing for the task
 Time taken for doing the task
 Clinical problem solving
 Degree of client focus
Journey to Competency
Example
 Focussed on self
 Partly client focussed
 Mostly client focussed
 Sufficient process skills for client focus
Reflection- in, on, for action- Placement period B
16
14
12
in
on
10
8
6
4
2
0
for
Reflection in, on, for action- Placement period C
16
14
12
on
10
in
8
6
4
2
0
for
Summary
Reflective observation
involving explaining
actions
Abstract conceptualisation
involving linking to other
experiences
Abstract
experimentation/theory
confirmation involving
discussing future action
B
53%
C
37%
42%
42%
5%
21%
 Reflection is an essential element of lifelong learning and
professional development
 Self assessment in itself is meaningless unless it leads to
planning
Conclusion
 Students with appropriate scaffolding can plan for future
personal development i.e. Reflection for action
Scaffolding or Assessment ???
“from our students’ point of view, assessment always defines the actual
curriculum” (Ramsden)
“Assessment defines what students regard as important [and] how they
spend their time… If you want to change student learning then
change the methods of assessment” (Brown)
“Assessment systems dominate what students are oriented towards in
their learning” (Gibbs)
Zone of Proximal Development
Learning
What ideas could you incorporate into
students’ activities?
How do you prepare students to go on
placement?