Module 4 Reflective Commentary

Learning Activities (LA) with further Insights on Theory.

CDD - Reflective commentary
The LA's relate to components of work undertaken by Hospice Community Palliative Care Nurses (HCPCN). The e-learning module is an Orientation to this work. Each task is designed to engage the learner in a "walk through" of situations and work they will be undertaking either in the weeks running up to or as they begin their Orientation to Community teamwork (1-3).

There are 5 LA's (not fully described here) Student Learning Hours
Assessment Skills in a New Environment

1.5 hours
Self Care/Resilience

2 hours
Recognising when to ask for help in Complex Environments

2 hours
Confidence with IT Technology /
Telephone and Navigation Skills

2 hours
Understanding Your Community

.5 (1/2hr)

The work will be contained within their own e-portfolio and provide them with reference material, reflective practice and resources. The e-Portfolio also provides evidence of learning and competence which is useful submission to Nursing Council for an Annual Competency Based Practising Certificate (which requires evidence of at least 60 hrs education in 3 years).
The technology LA could encroach on the 8-10 hours allowed for the entire module. Reflecting on the learning hours involved with this paper I think I will revise and reduce the tasks. The technology knowledge acquired completing the tasks is transferable and confidence building -described by Bates and Poole as Interactivity (1).

LA's will articulate, justify, collaborate to create meaningful products,
Using vignettes comprising past and present cases students will be provided will work together to produce a plan of care. Students will be asked to provide evidence for decisions made in their care plan. The expectations of content and evidence will be transparent in the marking criteria or rubric. Varying levels will be accepted as some will have no understanding of APA referencing.
They will be expected to quote their source and be given examples of how to do this. This will include consulting a more senior colleague.
As work is collaborative learning about referencing can be learner to learner described by Kaufman as Constructivism (4).
This is an area where I need to align my dominant TPI scores of Apprenticeship and Nurturing with setting high standards (5). However my primary focus is to reduce not increase stress on the participants as they are undertaking major change in their work environment.
The predominant theory is constructivist using the experience based method to incorporate the seven learning principles of Chickering and Erhman (5). Incorporating Leah and Sanya's tips on increasing effective e-learning added to my principles which did not include how that learning would be formed.

The technology LA that requires producing and teaching using a power point presentation would serve as a resource to other team members. Their increased skills from the e-learning would enable them to act as super users and actively support the move towards electronic records about to be adopted by the entire team. Bandura (4) describes self-efficacy as requiring verbal persuasion, this would be provided as feedback and cues towards completing tasks.

The learning activity centered on navigation across the city requires discussion on-line. New and smarter routes can be shared with the team by creating a navigation site the wider team to use. Developing contact telephone directory, working records/journals could be used by many other teams as well as our own.

Technologies Resources, Perspectives and Suitable Mediums.

Mercy Hospice Auckland is about to undergo transition from hand written records to Electronic Records. Many of the existing team is computer literate and all the team will undergo training for the new system.
Using e-portfolio to undergo Orientation to the Community Team will build on existing knowledge. Nurses move to the Community when they have good grounding to Hospice Palliative Care work, this usually involves working in the Inpatient Unit where they have basic grounding in computer skills. Many have undertaken and completed Masters Degrees which involve research and keyboard skills at least.

All have some form of computer access at home but this will be available at work and the programme is intended to be used in the workplace primarily. They may choose a distance option also. Use of online videos and Skype will be limited by cost and experience of use, these technologies may be employed voluntarily or for nurses who are more confident with the technology.

Introducing accessible learning tools through the creative commons will add many more resources in developing the care plan. Wikipedia, Medline Plus MIT's Pharmacy Course which offers manageable sections on Pharmacokinetics, Opioids, MRI, Radiation and Chemotherapy. These resources will continue to support the HCPCN on completion of the module as will continuing use of the e-portfolio. Learning objects will include text, electronic mail,discussion board(blackboard), chat facilities, synchronous and asynchronous messaging, interactive activities and self grading activities (6).

Offering free safe easy to access Dictionaries and papers online at MIT Open Courseware will help them complete their LA's and continue to provide them resource in their day to day work, self directed and life-long learning habits.

Finally I have reflected on my reluctance to engage closely with Theories, perspectives and teaching methods. The TPI reminded me of Myers Briggs and Horoscopes where you are "labelled". Reading and re-reading has bought some clarity and I align the self-knowledge /epistemology as important in teaching as it is to research, nurse or be a parent. Combining that self discovery with "what is out there" over the last 4 weeks has increased the possibilities for developing real e-learning education 100%.

References
1. Bates AWP, G. Effective Teaching with Technology in Higher Education. San Francisco: Jossey-Bass; 2003.
2. Dent JAH, R.M., editor. A Practical Guide fo Medical Teachers. Second ed. Edinburgh: Elsevier Churchill Livingstone; 2005.
3. Stuart CC. Assessment, Supervision and Support in Clinical Practice. A Guide for Nurses, Midwives and other Health Professionals. Second ed. Edinburgh: Churchill Livingstone, Elsevier; 2007.
4. Kaufman D, M. Applying educational theory in practice. BMJ. 2003 25 January;326:213-6.
5. Chickering A, W. and Ehrmann, Stephen,C. Implementing the Seven Principles:Technology as a Lever. AAHE Bulletin. 1996(October):3-6.
6. Anderson TE, F., editor. Theory and Practice of Online Learning. Athabasca: Athabasca University; 2004.