I found this interesting you may too.

May 5th is the International Midwives Day. Here is what theInternational Confederation of Midwives say about this day:

“The International Day of the Midwife is an occasion for every midwife to think about the many others in the profession, to make new contacts within and outside midwifery, and to widen the knowledge of what midwives do for the world. In 2010 and in the years leading up to 2015, ICM will use the overarching theme The World Needs Midwives Now More Than Ever as part of an ongoing campaign to highlight the need for midwives. This reflects the WHO call for midwives and the need to accelerate progress towards the achievement of MDGs 4 & 5.”

How about participating in the Virtual International Day of the Midwife. This is a free conference for midwives. An opportunity to come together from the comfort of your own home or from your workplace. You can access all the sessions online through the links that you will see beside the sessions. Come and join us. You will have an opportunity to ask the presenters questions or to share your own thoughts.

This is a wee presentation I put together with voice over. It is not great and there is no content other than voice on the first slide but it might be useful for some

What feedback models or processes do you prefer?

Nicol (2006) states that good formative feedback provides clear guidance to students about what constitutes good performance while helping students to develop self assessment and reflective practice skills. It involves dialogue between students and lecturers, motivates learning and promotes self-esteem.

While formative feedback is important to guide student learning summative assessment give student the key to what counts for the course (Boud, 2000). Summative assessment suggests that there is an end point in the learning process where the student will have met learning outcomes is then assessed and pronounced competent or otherwise. It does not consider the nature of learning as a life long process which students need to engage with. While summative feedback may suggest ways in which the student can improve performance there is little opportunity for the student to do this unless there is a resit or resubmission opportunity. In my experience these opportunities are usually only given to failing students. Summative feedback therefore may have little influence on continued learning.

Why is feedback important?

Feedback helps students to close the gap between their current and desired performance and provides lecturers with information which can help to structure ongoing teaching. Feedback is of particular importance in formative assessment where the goal is to support student learning by identifying knowledge gaps and creating learning opportunities to bridge those gaps. It is important the feedback is closely related to the learning outcomes for the course and matches those outcomes with the students’ current performance. It is also important that students have an opportunity to consider and reflect on feedback and strategise how to meet their own learning needs.

What are the challenges or issues with assessment feedback?

If the goal of formative feedback is to assist student learning and identify how any further learning needs can be met, how do we know that the feedback we are giving students is effective in this way? It may be relatively easy to respond to areas of weakness for a whole class but how do we do that on an individual level? Do some types of assessment support this type of feedback loop more than others? It is important that feedback is given in a timely fashion and this can be a challenge if there are large numbers of assessments to consider.

How do you balance how much feedback to give?

I find sometimes that I spend a great deal of time giving feedback to students which is probably never really considered in any depth, this may be because much of the feedback I am giving is on summative assessments. It would probably be better to develop the art of skilful inquiry, asking the students to identify themselves where there learning needs are and how they well they feel they have achieved the outcomes. Students then need to have an opportunity to prove that they have met their learning needs and identify further goals. This process is a process well suited to a learning contract process of assessment.

References

Boud, D. (2000). Sustainable assessment: Rethinking assessment for the learning society. Studies in Continuing Education, 22, (2), 151-167

Nicol, D. J., McFarlane-Dick, D. (2006). Formative assessment and self-regulated learning: A model and seven principles of good feedback practice. Studies in higher education. 31, (2), 199-219. Retrieved from the World Wide Web on 15th September 2009 from http://www.reap.ac.uk/public/Papers/DN_SHE_Final.pdf

Introduction / Background

The learning contract, which is the focus of this post, is an assessment in the first year practice skills course in our undergraduate midwifery degree programme.  Although this three year degree has been running for around 16 years this is the first year on the new model of course delivery. I have described this course in detail in previous blog posts. The new undergraduate degree programme is very similar in content to the previous programme however the process of delivery has changed dramatically this year. In this post I discuss the learning contract and explain why we are using this as an assessment in this course I also explain how this assessment is presented to the students and how it is marked.

What assessment in being used in the practice skills course?

One of the main assessment tools that is being used in this course is  a learning contract. The students are required to identify a learning need around a midwifery practice skill. They have to identify the knowledge they already have about this and what it is that they need to learn. Students then explain how they will go about meeting these learning needs, what resources they will access and how they will improve their knowledge and/or experience with the skill. Students thenrecord what they have learned and what, if anything they still need to do to feel confident in their knowledge of the skill.  Finally the student prepares a reflective piece about their experience of undertaking this project. This assessment gives the student 50% of the  mark in the practice skills course.

Why is this assessment being used in this course?

This assessment forms part of the students Midwifery Practice Portfolio. The Portfolio is a structured document outlining all the practice experiences a student has during the three year degree programme. Students also reflect on their learning and experiences within the portfolio.  They maintain a record of the skills practiced and competence achieved with these skills.  The portfolio also provides a mechanism for reflection on midwifery practice and professional relationships with women and colleagues.  Portfolios have been identified as a useful tool to assess learning and competence amongst health professionals and are commonly used in nursing (Joyce, 2005; McMullan, Endacott et al, 2003; Scholes, Webb et al, 2004). The professional portfolio has been identified as a useful tool to develop critical thinking, promote adult learning and is geared to the individual needs of the learner (ibid). Portfolios are a required component of the recertification programme for midwives in New Zealand (http://www.midwiferycouncil.org.nz/main/Recertification/)

As a component of the portfolio, learning contracts also fit within the pedagogical framework of adult learning. Anderson and Boud (1996) suggest that learning contracts are useful assessment tools for flexible learning courses. Learning contracts support and encourage student autonomy and responsibility with regards to learning. Anderson and Boud recommend that  learning contracts should be used across the course and should not be a single isolated assessment tool within a course. Within the learning contract students  identify when, what, how and why they will learn a particular skill, they perform a self assessment of their own learning and provide evidence to corroborate this, they also identify their future learning goals.  This prepares the student well for the reality of midwifery practice where lifelong learning is essential (Boud, 2000). It will give the student a model to follow as they progress from undergraduate midwifery education to midwifery practice. It is an important aspect of practice, for students and midwives, to identify learning needs and how these learning needs can be met.

How this assessment is is being implemented

Students have been encouraged to use the learning contract process to identify their learning goals, learning activities and learning achievements within the portfolio and are being asked to identify one skill which they will submit for assessment and marking within the practice skills course. They have been given a table, within the portfolio, as a guide to help identify the process they need to follow to do this.  Students have been asked to keep their topic focused on the skills which they are learning  in the first year of the programme and will record their learning experience and reflections on this experience. The learning outcomes for the practice skills course are

1. demonstrate an ability to use communication skills to develop effective professional relationships with their peers and colleagues.
2. utilise an awareness of effective communication to enhance the quality of the childbearing experience for women and their families.
3. safely perform a range of selected practice skills and be able to outline their underlying theories and rationale.
4. accurately perform drug calculations and demonstrate skill of medication administration.

This assignment is designed to meet outcomes 1, 2, and 3.

In the course outline students have been asked to identify a situation in practice where a midwifery assessment has been carried out and write a reflective account of this experience. Students then develop a learning contract relating to this subject area. The student reviews her existing knowledge around the subject area and identifies her learning goals. She then reviews how these goals will be met and verify that they have achieved these goals. Students have also been given guidance within the portfolio to demonstrate how they can prepare and present this learning contract.

As the assignment date approaches students have been asking questions about this assignment. While I believe this is a good assignment technique in this course I am not sure that we have clearly articulated how this relates to the learning outcomes. I think this assessment will develop, change and grow for subsequent years.  I am interested to see how the students work with this assignment.

Is this assessment appropriate?

As described above there is a rationale for this assessment. Student are only now engaging with the process for submission of their learning contract. This may be because I am only getting my head around it too at the moment. I welcome your thoughts on this. If you are an educator of undergraduate health students do you think this would be a good way for your students to learn or be assessed? Are their any suggestions you have where this process could be better? I welcome any feedback on this. Please leave your comments in the comments tab below this post. Many thanks for coming to my blog and reading this post.

Conclusion

This post has outlined the learning contract which the most significant piece of assessment in the practice skills course in the first year of the undergraduate midwifery programme at Otago Polytechnic. Learning contract has been identified as a useful assessment tool for flexible learning, supports adult learners and gives the student skills which support lifelong learning. This is further described within the learning outcomes of the course, information in the course outline and within the portfolio document.

References

Anderson, G. & Boud, D. (1996). Introducing learning contracts: a flexible way to learn. Innovations in Education and Training International, 33, (4). 221-227.

Boud, D. (2000). Sustainable assessment: rethinking assessment for the learning society. Studies in Continuing Education, 22, (2). 151-167.

Joyce, P. (2005). A framework for portfolio development in postgraduate nursing practice. Journal of clinical nursing. 14, (4). 456-463

McMullan, M.,  Endacott, R.,  Gray, M. A.,  Jasper, M.,  Miller, C.,  Scholes, J.,  Webb, C. (2003). Portfolios and assessment of competence: a review of the literature. Journal of Advanced Nursing. 41, (3). 283-294

Scholes, J.  Webb, C.  Gray, M.  Endacott, R.  Miller, C. Jasper, M. McMullan, M. (2004). Making portfolios work in practice. Journal of advanced Nursing. 46, (6). 595-603

Last evening I spoke with my buddy and colleague Sarah Stewart about the development work I have been doing and my ideas around flexibility in courses. Sarah recorded this interview and has posted it on her own blog linked here. Sarah has loaded this interview onto Slideshare.  At the time I thought I may not have come across very clearly however when I listened to this I realised that it does articulate a lot of my ideas around flexible course delivery and how we have gone about this so have decided to put this inteview on here as well. So here you are.

By the way we do not usually wear hats like that (just in case you thought otherwise). It was an afternoon tea party, at the Savoy in Dunedin,   where we had the opportunity to pick a hat out of a box. I loved them, mine looked just like something my Aunty Nettie would have worn when I was a wee girl.

It has been an incredibly busy couple of months since I returned from a brief summer break to finish preparations on the midwifery practice skills course for the start of our new programme. There were some last minute adjustments to make and I completed work on the documentation section of the communication module. All of the other learning resources required for the start of the programme were ready but required proof  reading and correction. A couple of resources, not required until later in the year, will be developed as time allows. I will not discuss here the other teaching and administrative duties that are part of my workload however it is worth noting that they exist and required some of my time initially. I have had to put all of these to one side as the start of the new programme neared.

2nd February 2009.

Start of the new combined Bachelor of Midwifery programme with OP and CPIT.

We welcomed our new class on the 2nd of February, much earlier than any of the other programmes begin and well before our other students returned. This is because our new programme has an extended academic year, allowing increased practice hours for the students. This increase in practice hours is a new requirment from our Midwifery Council and is part of the reason for changing our programme of study. Orientation week began with a welcome to otago Polytechnic  lead by Kaitohutohu Dr Khyla Russell. The rest of the day was an introduction to the institution and the programme. When I had a chance I mentioned the facebook group I had established to keep the students connected to each other and was happily surprised by how many were existing facebook users. The requests for membership of the group came thick and fast after that.  The next day we went off to Whare Flat scout camp and spent the next couple of days there. Staff from the sport institute came along and did a great job in with some team activities. We also ran a couple of workshops on communication. In the evening we did some belly dancing, very novice but fun, we all got involved. We have a staff member and one of our new students who are instructors in this art. We also went for a hike, needless to say I was the tail end Charlie, but I made it. We all seemed to find these two days very worthwhile for getting to know each other.  On Thursday students had another day full of polytechnic information, I had to cover things such as fire safety, harassment and bullying prevention etc. This was the end of the week as it was the Waitangi weekend holiday.

I had the students all day on Monday and introduced the concept of professional portfolios then went on to introduce the practice skills course. We then started the skills with standard precautions, infection control and handwashing. Tuesday we were introducing the students to recording vital signs, one of my colleagues gave a brief lecture to outline key aspects before they got down to looking at equipment and doing this skill. All the learning resources around these topics are online for the student and we have linked to excellent freely available resources such as:

• The CDC hand hygiene interactive training resource
• The Nottingham University hand hygiene training resource
• The British Hypertensive society

Unfortunately I came down with a horrid bug on Tuesday and was forced to come home where I have been moaning a groaning ever since. Today I am feeling almost Ok so thought I might use a little of my time to record this.

I am aware of the huge amount of work I still have to do in organising the midwifery practice placements and finding women willing to have students involved and share their experience of childbirth. If you happen to be a pregnant woman in Otago or Southland and are willing to have a student please drop me a line to cardacs@gmail.com. There is still the small amount of development work to do and we may need to fine tune some of our existing resources in response to student feedback if this is necessary. Of course all the other things I have had to put to one side are urgently calling for attention.

My reflections on the start of the programme.

It is a shame I was not around for the whole week. My sense was that the students have gelled quite well and that is has been a positive start.  The Scout camp was fun but was also a good team building opportunity. I was dubious about conducting the communication workshops there but it actually did work quite well.

It is a  hassle that we have to organise MRSA screening and Mantoux for the students, just another little job amongst so many. It would be much easier if the students came with this already competed.

We have the portfolio, which is an over-arching programme document positioned in the first year practice skills course. I think this is a mistake as it makes this course appear overly complex where in fact it is simpler with fewer assessment components than we had in the old programme. There are components of the practice skills which fit within the portfolio and there are components of other courses that fit here too. I believe it needs a separate  but linked place in the overall programme interface. We need to come together as a team to decide how to do this and how to present it to the students in the future.

I am not sure about having these two weeks combined. I believe it would be better to have one week for orientation, giving the students access to the learning resources. I would  then give them a week away to get to grips with the material followed by another week to come together, brain storm how they are finding the online resources, what questions they have and provide any support they need. The students would also be prepared for the practical skills and we would not need to cover so much additional material with them. I may have a go at drawing up an alternative orientation time table for consideration by the midwifery school team.

The facebook group seems to be working well, nearly all the students are members and they are communicating with each other through this group. I have seen a suggestion in facebook that they also connect through Skype, so I am pleased that this network is becoming established.  Hopefully it will prove supportive for the students. There is another resource being established as a joint project between OP and CPIT called ‘The Midwfery Junction’ which is intended to connect midwives on a wider plane.

Overall I think it has been positive. I remain a little apprehensive about the students experience and would love to hear what they think. So if any of you are reading this please drop me a comment here and let me know, or write something in facebook about how this has all been for you. My particular interest is in the practice skills course but of course this is only part of the whole for the students and their experience will be coloured by the other courses also.

We finally seem to have our Moodle site looking good! It has taken a long time to achieve.

Signing off

Well now I have done this I have to go a tidy up my house a bit if I can find the energy.

As readers of the blog will be aware I am developing course material for a new undergraduate midwifery course using the Moodle learning management system I have been using Exe as a development tool. It is a great programme and really easy to use but it does have some limitations. In particular I have found that the quizzes are cumbersome and slow to create, it is a long a protracted process and I find the results less that satisfactory, particularly for  formative assessments, which  I think should be fun as well as educative.

I have started using free online tools to create these formative assessments. Exe has the ability to link these in as websites so that they open seamlessly directly into  the moodle interface. My favourite is Interactive Games. This plays online and so can be linked directly into the moodle interface without having to follow hyperlinks. I really like to look of some of the resources in Classtools but ahve not yet managed to use any in my course work. I have also used Mystudio and it produces very nice looking multichoice quizzes, however I cannot embed them into Exe on Moodle and so have to hyperlink to them.

One of the many advantages of using web based quizzes is the ability to change the quiz, make alterations, add new material, without actually having to take down the whole Exe file, change and reload. The link to the file remains the same only the content has changed.

Does anyone know of any other webbased resources for creating an  online quiz?

I got an email form my friend Sarah Stewart telling me about an  upcoming online event to do with personal learning environments (PLEs)  and eportfolios. I am posting this here as I want to attend this and I am hoping not to forget, so here is the link to the Elluminate session.

Here is a link to a world clock with the time  of the meeting if you are interested in attending.

I have been very busy creating content for the new midwifery practice skills course that I am co-developing with Lorna Davies. We had developed a clear structure for the content grouping it into modular components to make sense of it and give context to the material but I have been feeling increasingly anxious about how the students will actually interact with the modules and work through the course material. We know what parts we want to deliver face to face in the larger class groups, what content we want to deliver face to face in the smaller tutorial groups and what content we feel can be learned online. Clearly there needs to be a structure to when these various components will be taught.

In the old model we did all skills teaching face to face and students have had access to lecture notes and power point presentations through the blackboard learning management system. In the new course the only face to face teaching that will be done will be actual hands on instruction of the skills. Students will be expected to learn the theory components prior to attending the face to face sessions. Various learning resources are being used. Our online moodle modules are composed of learning units breaking down into individual skills, explanations of why these skills are required for midwifery practice, what context they may be used in and any basic bioscience that is required, to be able to understand the important safety aspects of the skill. The learning units link to youtube videos, interactive learning resources and other freely available online learning resources as well as presentations we have developed ourselves. We are using power point presentations with voice over converted into flash for compression. In this way we can make the most of the face to face sessions for the important hands on components that cannot be learned online. It will be very important that the we have a clear plan of how and when these topics will be covered.

Some students will prefer to follow their own plan for learning the course material and that is fine. However they will need to come to the face to face components having covered the required material. Other students will want a more formal guide about how to work through the course material.

To satisfy these needs I have been working on a framework for the course and a learning guide for students . both of these are still in a draft form. You can see the framework here . Although the formatting did not come through 100% correctly into google docs. The learning guide needs some more work doing and I will post later.

I feel a little happier now that I have this structure for the course which I felt I was lacking previously. I feel now that all we need to do is get the content complete and feel certain that this can now be done within the time frame. Particulalry as we do not need to rush with the resources required for the end of the year.