Medical Education - Theses
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ItemExploring physiotherapy clinician-educator beliefs about their teaching role and their preferences for their development as educators.( 2018)There is strong professional demand for physiotherapy clinical educators (CEs) to facilitate positive student learning experiences for physiotherapy students and ensure high professional standards of physiotherapy. It is well known that the quality of clinical teaching is determined by the educational rather than the clinical expertise of CEs. Within the public healthcare context, inhouse professional development (PD) programs of teaching, are the primary means of developing CEs’ teaching expertise. However, for PD to effectively motivate changes to teaching practice, it must do more than introduce teaching tips and strategies. It needs to resonate with CEs’ beliefs about their teaching practice. The aims of this research were to explore physiotherapy Clinician-Educator (CE) beliefs about their teaching role and effective teaching practice and to use this understanding to inform inhouse PD programs to develop teaching skills. Grounded in a constructivist and interpretivist approach and using mixed methods forty physiotherapy CEs at St Vincent’s Hospital, Melbourne, (SVHM) completed the Conceptions and Learning Teaching (COLT) questionnaire. The COLT is a reliable and validated tool that was used to explore CE teaching beliefs. Subsequently, CE beliefs of teaching were further explored in two focus groups, comprised of eighteen CEs. The focus groups were allocated according to teaching experience; early career CEs with less than five years of teaching experience and experienced CEs with five or more years of teaching experience. Thematic analysis of focus group transcripts revealed CE teaching beliefs varied significantly between CEs and generally reflected the development of their identities as educators, relative to their identities as clinicians. Three levels of educator identity emerged; weak, intermediate and strong. Each level exposed differences in CE interest, motivation and engagement with learning about teaching. The translation of this research to PD programming at SVHM included the development of a multi-tiered framework for PD. This introduced a range of learning activities that accommodated for different CE learning needs and levels of identity as educator. The implications of this research when combined with the broader education literature, are that developing an improved understanding of CE beliefs about teaching within PD has the potential to improve PD program design in the preparation and implementation phases. There appear to be benefits for CEs in re-aligning PD content to better match CE learning needs, motivation levels and learning preferences. In addition, acknowledging differences in levels of identity as an educator, discussing CE concerns and supporting them to negotiate contextual barriers to implementing new teaching strategies may improve translation of learning to practice. Future research may focus on specific PD techniques to facilitate changes in identity level as an educator. This research contributes to the understanding of CE identity and teaching beliefs in the development of further teaching expertise.
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ItemNarrative windows into student writer identities( 2014)The purpose of this study was to explore the identities and possibilities of identities constructed by a group of Year Five students in their stories. These stories were originally published in ‘Pigeons: Stories in the Post Volume II’ in 2010. This case study focused on three stories from this publication which were analysed using the new Identity Discourse Analysis Tool (adapted from Gee’s (2005) Discourse Analysis Approach); Thematic Analysis (Braun & Clarke, 2006) and the Three Dimensions of Viewing (Callow, 2005) model. The aim of the analysis was to reveal the identities (primary building task of language) and to consider the role language segments (secondary building tasks of language) and thematic contexts played in the identity construction process. The identities created by the student writers in their imagined storyworlds were a product of a complex interaction between narrative thematic contexts and secondary building tasks of language.
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ItemReady to work?: Does a simulation education program improve the competence of final year medical students to perform common invasive procedures?( 2014)Ready to work? Does a simulation education program improve the competence of final year medical students to perform common invasive procedures? From the day they commence work new medical interns must be ready to perform common invasive procedures. In contrast to this requirement from employing health services, medical schools in Australia have not been required to demonstrate that a graduating student is competent at the appropriate procedural skills. This project investigated the effect of an immersive simulation Educational Intervention (EI) on the competence of final year medical students to perform four common and important procedural skills. A Competency-Based Assessment (CBA) implemented in the simulated environment was developed to measure the students’ performance of the four procedural skills; Intravenous Cannulation, Venepuncture, Male Indwelling Catheter Insertion and Basic Life Support. The prospective, quasi-experimental study enrolled a cohort of final year medical students who were undertaking their final semester of education between two metropolitan hospital-based Clinical Schools. The students were allocated by convenience into one of three Streams of the study, where they undertook either the usual curriculum or the Educational Intervention. All Streams undertook the internal CBA and their final external university examinations. Results indicated that, compared to the usual procedural skills curriculum, the EI, especially in combination with the CBA, improved competence. Students’ results improved when the CBA was used for formative feedback before summative assessment. Both the EI and the CBA programs have been adopted into a metropolitan medical school curriculum.