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Muster: Global Community Engaged Medical Education 27-30 October 2014
Dr. Josephine Boland
Dr. Margaret McGrath
College of Medicine, Nursing & Health Sciences
Curriculum Development for Community Engagement in Medical and Healthcare Education
Source

2. +
Faculty/Presenter Disclosure Dr. Josephine Boland
•
Relationships with commercial interests:
•
None
•
Employee:
•
School of Medicine, National University of Ireland Galway

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Disclosure of Support Slide 2
Potential for conflict(s) of interest: none Dr. Josephine Boland has received conference funding from
•Community Knowledge Initiative, NUI Galway
•School of Medicine, NUI Galway
•Triennial Conference Travel Fund, NUI Galway

4. +
Dr. Josephine Boland School of Medicine, NUI Galway Campus Engage Mentor Dr. Margaret McGrath School of Health Sciences, NUI Galway
Introductions

5. +
Introductions … on your way in
Who you are?
Write first name and country on a ‘post it’
Level of experience of community engagement
Pin your name on ‘Experience’ chart – from ‘limited’ to ‘lots’!
What would you like to achieve from workshop?
Write on a post it, pin on ‘Wish List’ chart

6. +
Ambitious outcomes for you!

identify opportunities for embedding community engaged learning in medical and healthcare education….

draft some key elements of a community engaged curriculum

explore opportunities, strengths and limitations associated with different models of community-university partnership
……. in the context of medical and healthcare education

7. +
Overview of workshop

Introductions

Key concepts

Curriculum design

Preparing for partnering

Extras …….to take away.

Assessment

Reflection

8. +
Overview of workshop

Introductions

Key concepts

Curriculum design

Preparing for partnering

Extras …….to take away.

Assessment

Reflection
Collaborative Group Work
T o draft some key elements of a community engaged curriculum
All images licensed by Creative Commons or labelled for non-commercial use

9. +
Activity

Select

a music instrument whose characteristics you most identify with

Share (in pairs)

Explain your choice

Listen to their explanation
Reflect
What did you learn?
How did it feel?
http://www.flickr.com/photos/adam_jones/4857938188/ 9
J Boland NUIG 2014

10. +
Debriefing
explanation

Reflection

What did you learn?
How did it feel?
How might you use this activity in the context of
Medical education
Community engaged learning?
http://www.flickr.com/photos/adam_jones/4857938188/ 10
J Boland NUIG 2014

11. +
Community Engagement Community Engaged Learning Community Engaged Research
Some Key Concepts

12. +
Defining community engagement
http://www.campusengage.ie/

13. +
‘Community engagement’
A mutually beneficial knowledge-based collaboration between the higher education institution, its staff and students, with the wider community, through a range of activities
(Campus Engage, 2009)

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‘Community engagement’
A mutually beneficial knowledge-based collaboration between the higher education institution, its staff and students, with the wider community, through a range of activities
Campus Engage (2009)
Such initiatives commonly reflect the norms and values of reciprocity and diversity and are often explicitly linked to social inclusion.
Gonzalez-Perez et al. (2007)

15. +
Teaching
Research
Service
Community Engagement
Community engagement as a way of doing higher education

16. +
Teaching
Research
Service
Community
engaged
research
Community Engagement
Community engaged learning
Public
engagement
Boland (2012)

17. +
Rationale?

18. +
Rationale?
In Medical Education?

Social Accountability

Greater Equity in Health

Patient Involvement

Professionalism

Global Health

Regulatory Bodies

19. What motivates us?
Civic
Higher Education
Student learning
Personal
Local
Broad
Community
Democracy
Employability
Applied learning
Disadvantage
Citizenship
Beliefs and values
Experience
Mission
Social accountability
Boland (2014)
Orientations to
Civic Engagement

20. +
http://www.campusengage.ie/

21. +
Teaching
Research
Service
Community
engaged
research
Community Engagement
Embedded in the Curriculum
Community
engaged
learning
Adapted from Boland (2012)

22. +
Community Engaged Learning

experiential learning

embedded in the curriculum

academic credit for learning

global/local citizenship as core value

not-for-profit/voluntary sector/community

integration of theory and practice

application of knowledge and skills

reflection as a central element

23. +
Community Engaged Research

A collaborative approach to research that equitably involves all partners in the research process and recognised the strengths that each can bring
Israel et al, 1998, p. 177
Undertaken by students with/for community partner
Embedded in the curriculum
Academic credit

24. Community Based Medical Education
CBME
Community Engaged Learning/Research
Volunteering
Student is main beneficiary
Academic credit
Goal in student learning
Reflection not essential
Community and student are mutual beneficiaries
Meets community need
Goals in authentic partnership
Academic credit
Reflection is core
Community is main beneficiary Goal is involvement with community No academic credit Reflection is rarely an element Muster PEARLs session_ NUIG
Continuum
Adapted from Campus Engage Guide (2014)

25. Community Based Medical Education
CBME
Community Engaged Learning/Research
Volunteering
Student is main beneficiary
Academic credit
Goal in student learning
Reflection not essential
Community and student are mutual beneficiaries Meets community need Goals in authentic partnership Academic credit Reflection is core
Community is main beneficiary
Goal is involvement with community
No academic credit
Reflection is rarely an element Muster PEARLs session_ NUIG
Adapted from Campus Engage Guide (2014)

26. A Continuum of Intentions
‘Transactional’

community as recipient/subject

academic credit for learning/findings
‘Transformative’ (for learners)

leads to deeper understanding or empathy

develop civic skills and sense of agency
‘Transformative’ (for community/society)
question and/or change the circumstances, conditions, values or beliefs at the root of community’s/society’s need.
Adapted from Jacoby (2003) and Welch (2006) 26

27. 1: Community
identifies issue
3: Preparation and briefing
4: Learning agreement
5: Activity
Integration & application
6: Assessment
Reflection on experience
Community Engaged
Adapted from Campus Engage Mentor Programme 2014

28. 1: Community
identifies issue
2: Modify/adapt/develop curriculum
3: Preparation and briefing
4: Collaborative research design
5: Research project
Integration & application
6: Report
Reflection on experience
Community Engaged
Adapted from Campus Engage Mentor Programme 2014

29. 1: Community
identifies issue
2: Embed in curriculum
3: Preparation
4: Agreement
5: Integration/Application
6: Reflection
Evaluation
Community Engagement
Adapted from Campus Engage Mentor Programme 2014

31. +
Which Communities? Issues? Interests?

32. +
Global or local

33. +
Community Engaged Learning

experiential learning

embedded in the curriculum

academic credit for learning

global/local citizenship as core value

not-for-profit/voluntary sector/community

integration of theory and practice

application of knowledge and skills

reflection as a central element

34. +
Knowledge, skills, theory and practice in medical education?

35. +
Some Educational Outcomes (Medical Council, Ireland)
Medical graduates will be able to

understand the biological, social and psychological basis of health and disease

communicate effectively and compassionately with patients, carers, colleagues

work as part of a multidisciplinary patient care

apply a knowledge of the ethical, regulatory and legal framework

recognise the roles and contributions of other healthcare professionals

provide the highest levels of ethical, rational, holistic and humane care

manage resources available to them effectively

apply principles of health promotion and disease prevention

contribute effectively to the teaching of others

And lots more besides……

36. +
Some examples from NUI Galway

Teaching CPR to School Children

Nutrition Education

Teanga an Leighis

End of Life Enhancement

Preventive Cardiology

Adolescent Mental Health

Care of the Drug User

Care of the Dialysis Patient

Sign Language

Emerging areas in Occupational Therapy Practice

Aphasia Outreach

International Nursing in the Developed and Developing Worlds
See: http://cki.nuigalway.ie/ for details

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Activity:

Identify:

a potential community partner

an issue which your students could

learn from

contribute to

What do you think students might do?

What do you think they might achieve?

What makes it community engaged?

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Curriculum
Design Options

39. Platform
Conceptions, beliefs, values, theories
Make choices
Deliberation
Generate alternatives, consider opportunities, benefits, risks, costs
Beginning
Process
End
Curriculum Design
Adapted from Walker’s Naturalistic (Deliberative) Model of Curriculum Development (1971) 39
J Boland. NUI Galway.

40. 1: Community organisation identifies issue
2: Modify/adapt/develop curriculum
3: Preparation and briefing
4: Learning agreement
5: Activity
Integration & Application
6: Assessment Reflection on experience
Community Engaged Learning
Adapted from Campus Engage Mentor Programme 2014

41. 1. Adapt existing module
Curriculum design options
Elective modules

Adopt a new way of teaching

Redesign existing assessment strategy

Include criteria to reward ‘civic’ outcomes
41
Boland, J (2013)

42. 2. Add an elective module for the course
1. Adapt existing module
Curriculum design options 42
Boland, J (2013)

43. 2. Add an elective module for the course
3. Develop new mandatory module
Curriculum design options
A choice to be made: Optional or Mandatory
43
Boland, J (2013)

44. 2. Add to elective modules for course
4. Develop generic standalone (elective/core) module
Curriculum design options 44
Boland, J (2013)

45. 3. Add to elective modules for course
1. Adapt existing module
2. Develop new mandatory module
4. Develop generic standalone (elective/core) module
Curriculum design options 45
Boland, J (2013)

46. Curriculum design options – integrated approach
Programme A
5. Integrated across two or more modules 46
Boland, J (2013)

47. Curriculum design options – integrated approach
Programme B
Programme A
6. Integrated across two or more programme
47
Boland, J (2013)

48. Curriculum design options
Programme A
7. Infused across the curriculum
48
Boland, J (2013)

49. +
Choices to be made

Optional or mandatory

Integrated or standalone
Other choices
Sourcing of ‘site/project’
by students or by medical school
Inolvement of community partners
in design, teaching, learning and assessment

50. +
Choices to be made

Optional or mandatory

Integrated or standalone
Other choices

Sourcing of ‘site/project’

by students or by medical school

Involvement of community partners

in design, teaching, learning and assessment Boland, J. (2008)

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Writing Learning Outcomes
For Engagement

52. +
Learning Outcomes
Learning outcomes are statements of what a learner is expected to know, understand and/or be able to demonstrate after completion of a process of learning
(ECTS Users Guide, p.47)

achievable, observable, measurable and assessable

cognitive, psychomotor and/or affective

academic, vocational, personal, civic

content, product and/or process focussed.

53. +
Examples of Learning Outcomes

Academic

design a menu with a local school with due regard to health promotion, cultural context and resources

Professional

apply clinical knowledge and skills appropriately in an unfamiliar setting characterised by diversity or disadvantage

Civic

collaborate with a youth group in the development of a sexual health promotion initiative

Personal

reflect on their own professional sense of identity and personal values

54. +
Teaching CPR to School Children
At the end of the module the medical student will be able to:

Perform CPR competently and safely

Collaborate with peers in the design of a session to instruct others in the performance of CPR

Engage with young children and teachers appropriately and professionally

Deliver the session through the medium of Irish in Irish speaking schools

Detail what they learned from their experience of planning, liaising, organising, managing a teaching session

Reflect on how their understanding of civic responsibility and community participation has been affected by the experience

Give a presentation / poster/ video log detailing the experience. 54
School of Medicine, NUI Galway

55. +
Partnering
For Engagement

56. +
Community Engaged Learning

experiential learning

embedded in the curriculum

academic credit for learning

global/local citizenship as core value

not-for-profit/voluntary sector/community

integration of theory and practice

application of knowledge and skills

reflection as a central element

57. +
Learning Agreements
Elements e.g.

Information on student, partner, academic/s

Contact details

Intended Learning Outcomes

Responsibilities and requirements

Commitment – times, hours

Supervision, evaluation

58. +
Ethical Considerations

Students

Code of conduct

Students responsibilities to community

Physical/psychological risk for students
University / academics
Responsibility to the community
Is the student/university a risk to the community
Balancing academic requirements and community outcomes
Community Partners
Informed consent
Understanding the limits of student projects
Student learning needs v partner needs

59. Ethical Principles Ethical Practice

Respect

Collaborative Autonomy

Transparency

Consent

Benefit

Fairness

Accountability

60. +
Core Principles of Partnership for Community Engaged Learning
Equity
•Respect
Transparency
•Trust
Mutual Benefit
•Sustainability

61. Nature of Partnership
Students
Academics
Community
61
Adapted from Boland, J. and McIlrath, L (2005)

62. All About the Students
Students
Academics
Community
62

63. Community as a Site of Learning
Students
Academics
Community
63

64. Minimal Oversight
Students
Academics
Community
64

65. Partnerships: the ideal scenario
Students
Academics
Community
65
Adapted from Boland, J. and McIlrath, L (2005)

66. An outline of phases in a partnership
Copyright: The Partnering Initiative

67. +
Assessment of Community Engaged
Learning

68. Teaching and
learning
(What will the students do?)
Assessment
(How will we know?)
Learning outcomes
(What do we want them to achieve)
Constructive Alignment
Biggs (1999)
68
J Boland. NUI Galway.

69. +
Assessment
…. in education, assessment occurs whenever one person, in some kind of interaction, direct or indirect, with another, is conscious of obtaining and interpreting information about the knowledge, understanding, or abilities and attitudes of another person.
Adapted from Rowntree 1989:4

70. + 70
Reasons for assessment
a)
Formative
“Assessment for learning”
support learning
provide feedback
motivate learners
diagnose difficulties
quality improvement
b)
Summative
“Assessment of learning”

report on performance

grade students

certification

selection/progression

course/tutor evaluation

71. Probably the main
approach in HE
Where circumstances
permit
Via peer assessment
activities
Over coffee or in
the bar
Problems if assessor
is mentor, supervisor
In work-based
situations
Only if an assessment requirement
Where student is acting self-critically
From Formal Informal
Teachers
Peers
Others
Self
Community Engaged Learning
Trends in assessment in HE

72. + 72
Assessment: Key Principles
Validity
Reliability
Constructive Alignment

73. +
Striking the right balance
Reliability
Validity
Significance of Purpose, Goals and Intentions

74. +
Processes involved

Selecting appropriate technique/s

Designing the technique/s

Setting assessment criteria

Identifying the evidence that would be relevant

Carrying out the assessment

Making a judgement - marking/grading

Responding - feedback

Reporting - certification

75. +
Activity: For your community engaged learning
Decide:
What assessment technique/s
Relative weightings of each one?
Individual or group assessment?
Graded and/or competency based?
Involvement of community partner?

76. + 76
Assessment techniques
Written e.g.

Extended prose

SBA, EMQ, MCQ

Structured Q

Case study

Report

Assignment

Seen/unseen exam

Open/closed book
Performance e.g.

OSCE

Project

Portfolio

Reflective journal

Presentation

Viva/Oral

Observation

Questioning

77. + 77
Assessment techniques
Written e.g.

Extended prose

SBA, EMQ, MCQ

Structured Q

Case study

Report

Assignment

Seen/unseen exam

Open/closed book
Performance e.g.

OSCE

Project

Portfolio

Reflective journal

Presentation

Viva/Oral

Observation

Questioning

78. +
Same principles apply

Be clear about your assessment purposes

Clarify and state learning outcomes

Assess range of outcomes (types and levels)

Set/negotiate clear assessment criteria

Ensure students know the criteria

Provide timely feedback

Evaluate – assessment informs teaching

79. +
Activity: For your assessment

Write the student brief

Devise the marking scheme

80. +
Activity: For your Planned Assessment

Write the student brief/task

Devise the assessment criteria
Finally:

Blueprint against the learning outcomes of the programme

81. +
Reflection in Community Engaged Learning

82. 1: Community organisation identifies issue
2: Modify/adapt/develop curriculum
3: Preparation and briefing
4: Learning agreement
5: Activity Integration & Application
6. Assessment
Reflection on experience
Community Engaged Learning
Adapted from Campus Engage Mentor Programme 2014

83. +
Why reflect
‘It is not sufficient simply to have an experience in order to learn. Without reflecting upon this experience it may quickly be forgotten, or its learning potential lost. It is from the feelings and thoughts emerging from this reflection that generalisations or concepts can be generated. And it is generalisations that allow new situations to be tackled effectively.’
(Gibbs 1988)

84. +
Assessing reflection
Discrimination between different levels

Level 1: Descriptive writing

Level 2 : Descriptive account with some reflection

Level 3: Reflective writing (1)

Level 4: Reflective writing (2)
Source: Jenny Moon
..A Framework for Reflective Writing_Jenny Moon.doc

85. +

86. 1: Community organisation identifies issue
2: Modify/adapt/develop curriculum
3: Preparation and briefing
4: Learning agreement
5: Activity
Integration & Application
6. Assessment
Reflection on experience
Evaluation
Community Engagement
Adapted from Campus Engage Mentor Programme 2014

87. All images licensed by Creative Commons or labelled for non-commercial use

88. +
Finally - on post-its please
What did you like most about the workshop?
What did you like least about it?
What will you do next about community engagement?

89. +
Muster: Global Community Engaged Medical Education 27-30 October 2014
Dr. Josephine Boland
Dr. Margaret McGrath
College of Medicine, Nursing & Health Sciences
Curriculum Development for Community Engagement in Medical and Healthcare Education
Source