Using blogging as a tool for reflection and learning

Today, I have been exploring the use of blogs in education. This is something I have been pondering for a while – can I ask my students to reflect on the work they are doing through blogs? I really enjoy blogging myself, and I think it’s really a excellent (and fun) tool that helps me verbalize some of all the thoughts and ideas that run through my head on an average work day that never makes it to a research paper or a project proposal. Blogging for me is a way to test ideas, elaborate on interesting materials and (if I’m lucky) engage in discussions and dialog with people from within and outside of my field of research all over the world. Very rewarding.

In one of the courses I teach, the students work in smaller groups throughout the course to analyze needs and requirements for a health informatics system of their choosing. It is very difficult to gain access to real stakeholders/end users during the 6 weeks the course is running and so the course (albeit being hands-on in the use of different analysis and modeling tools) becomes quite abstract and disconnected from reality. An idea I had today was that if the students were to describe their proposed systems and progress continuously on blogs, would it then be possible to get feedback from real stakeholders? By making the blogs public perhaps we could actually get healthcare professionals, patients and other stakeholders to access and comment on the proposed solutions. What do you think?

Other benefits of using the blog continuously throughout the course would be that the students can observe in retrospect the process they went through in working on their project. They would also be able to give each other feedback and reflect on difficulties and benefits of using the methods they do. These experiences were described by Tam Nguyen from The University of New South Wales as she explored the use of blogs in her teaching practice.

Some challenges I can foresee are that it will take time to introduce the concept and make sure that all students are actively blogging. It may be intimidating for some students to publicly publish their learning process. Since the course only lasts 6 weeks, it might not be enough to introduce such a concept. On the other hand, if it works out well in one course it is something we could use for the entire program.

In addition, giving feedback to the students will take time too, commenting on 40 blogs might be quite a task for one person. One solution could be to either let them blog in groups (i.e. one blog/project group), but this may be difficult to manage and could perhaps not be used throughout the program. Another would be to divide the students in peer-feedback-groups or pairs, where they are given the task to actively comment on each others blogs throughout the course.

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My digital teaching practice and opportunities for change

UPDATED 19 OCTOBER 2013

Recently, I’ve spent a lot of time thinking about education, teaching and learning and what I can do as a teacher to help my students in their learning process. Since I myself enjoy learning and collaborating online, I want to provide the same tools for my students. So far, however, I’ve mostly used our online learning platform pingpong to provide structure for the course, share information and documents, and support my communication with the students. Very much from my perspective – how can I use the platform as a tool to get my messages across?

In a sense, I think I continue to have a rather traditional approach in my online teaching practice and perhaps it has to do with process of developing as a teacher described by Kugel [1]. Kugel identifies 6 stages, separated into 2 phases, where the first phase focuses on teaching (i.e. the teacher’s role) and the second phase on learning (i.e. the student’s role). The six stages are;

  1. self; when professors being their teaching careers their main concern is their own role in the classroom,
  2. subject; when they have mastered this role their concern shifts to their understanding of the subject matter they teach,
  3. student; in the third stage focus shifts from the teacher to the student and their “ability to absorb what they have been taught” and how the teacher can help them in this process. This third stage also marks the bridge to the second phase where focus moves from teaching to learning,
  4. student as active; concern then typically shifts to helping students learn to use what they have been taught – to be active, and finally
  5. student as independent; where focus is on helping them to learn on their own. [1]

Probably we all move more or less between these different stages, but I find the idea that becoming a teacher in higher education is not something that happens overnight quite comforting (although pedagogical education will probably help you move more rapidly across this process). My reflection so far, is that while in the classroom, I have moved on to stage 4 (and perhaps touching on stage 5), my use of e-learning tools have remained in the first phase, focusing very much on how I as a teacher can use these tool to communicate knowledge to my students. I believe there is great room for improvement here, finding ways to use e-learning tools to help students becoming more active and independent in their learning.

I have provided the students with areas where they could (in theory) collaborate in their respective groups, but so far they haven’t used these facilities much. Today I’m pondering why… so far I’ve come up with a number of reasons:

  1. the courses I teach are not exclusively online, and students do not have to use the online facilities to complete their group work assignments
  2. pingpong is not the most easy-to-use and accessible tool – many students are more comfortable communication through e.g. facebook – perhaps they are using online tools to collaborate and I just don’t know about it! Not necessarily because other tools are easier to use than pingpong, but because they are more familiar with them?
  3. pingpong provides opportunity for us as teachers to monitor activity and follow discussions – perhaps this is a reason why students prefer to use other tools? Autonomy is an important part of work and if you feel constantly watched it may decrease your motivation. On the other hand, having support and facilitation from teachers would probably be considered very positive by most students – so perhaps this should rather be emphasized as a benefit.

So, in the future – how could I support my students in using online collaboration and communication tools? First of all – is it necessary? Well, I actually think that many of the students would appreciate being able to collaborate when and where they want to – even if it’s not a distance course. Every year there is some conflict about some students not contributing enough – and perhaps by enabling more flexible ways of collaborating some of these issues could be resolved.

Secondly, do I need to monitor their work? This is a trickier question. I don’t think I necessarily need to monitor everything they do – I don’t have the time anyway… but I need to be accessible as a facilitator. So perhaps different fora/platforms are needed. Some room where they can actively collaborate without me watching over their shoulder, and a common area where issues can be raised and results presented.

Many of the issues discussed above relates to the different roles of the teacher as described by Harden and Crosby [2];

  1. the information provider in the lecture, and in the
    clinical context;
  2. the role model on-the-job, and in more formal
    teaching settings;
  3. the facilitator as a mentor and learning
    facilitator;
  4. the student assessor and curriculum evaluator;
  5. the curriculum and course planner; and
  6. the resource developer, both of resource materials, and study guide producer.

So far, I’ve mostly used the e-learning tools to support my activities as an information provider, planner and resource developer, but not as much to develop my activities as a role model, facilitator and assessor. We do have some discussions online (acting as a facilitator) and they do submit assignments and are given feedback online (acting as an assessor), but I do think these aspects of my teaching practices could be strengthened. This I hope to explore more in the future.

[1] Kugel “How professors develop as teachers” Studies in Higher Education Volume 18, Issue 3 1993 , pages 315 – 328

[2] Harden & Crosby, “The good teacher is more than a lecturer – the twelve roles of the teacher”, Medical teacher, 2000, vol 22, nr 4, pages 334-347

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I’m writing this online, on a flight to London (thank you for the WiFi, Norwegian!) as the first assignment to a course I’m taking on flexible, distance and online learning (FDOL)! The topic is “The digital me – past, present and future”. I really appreciate being able to go online on a flight – which probably gives a hint to just how digital the current me is. I’ve tweeted a couple of times today (it’s 8.00 AM when I draft this post), checked my facebook, the google+ community (which to be honest is quite new to me, but I quickly got drawn in by the FDOL course), and sent a few messages to a friend I’m meeting in London. So, as you might have guessed, I handle a lot of my social interactions online, and I love it! As an example of the “digital private me”, I’m a member of a book club and we meet (in real life) roughly once a month. It’s great to meet up with friends (some old, some new) over a nice dinner discussing both a good book and life in general. That really is good enough, right? However, between meetings we communicate online – everything from deciding on a time/place for the next meeting and keeping track of books we want to read, to looking up reviews and researching authors we’re currently reading. It enriches the social interaction tremendously, without taking away from the “real” meetings we have on a regular basis.

Now, the digital me is not only part of my private life – as much as we take on different roles in our daily lives, we take on different online roles. I’ve already given an example from my private life, so onwards to the professional. The reason I’m flying to London today is that I’m attending a conference called Medicine 2.0, according to the organizers “the leading academic conference series for Internet, Social Media, and mobile apps in health”. This is where my field of research is and it’s fascinating! I’m currently working on a project where we are developing national services for patients/citizens to support their interactions with health- and social care and enable them (us!) to follow care processes and activities online. I’m very excited about this work. One key issue though, is ensuring that we work together with people that are not all as enthusiastic as I am to make sure we develop solutions and services that work for everyone. But returning to the reason I’m in London; during the conference I will most likely be live-tweeting. In august, I was part of a team organizing a workshop at another medical informatics conference, Medinfo, and we actually decided to try to engage with a wider public before and during the conference. As a first experiment it was a great experience – and I hope to be able to continue doing similar things in the future. Overall, for me using social media in my professional life has been a very important learning experience. So, when I use facebook mostly for private interactions, I use twitter almost exclusively for professional tasks. Although the line between private and professional is often quite blurry for me, so far it works quite well. I especially like twitter as a personal learning tool. It enables me to keep up to date on most of my work, and it’s a lot of fun.

Teaching is of course another big part of my working me, and I try to combine digital and real meetings in my courses there as well. Much as in my personal life, I don’t think that online interactions will necessarily replace f2f meetings, however it enriches and expands the opportunities for learning and connecting with other people far beyond traditional meetings. I teach at the international master program in health informatics at KI, and we use the online learning platform PingPong for communication with students. I publish all materials there, use it to communicate with students and encourage them to use the platform for their group work. I feel however that I’m not quite at the level of usage on online tools in teaching as in other parts of my life. So I hope that the FDOL course will give me the tools to take my “digital teaching me” to the next level.

In summary, the digital me is a very big part of me. It hasn’t always been… I vaguely remember life before email, self-tracking devices, and twitter – but I would never go back. For me, online communication does not compete with f2f communication – instead it adds value and enriches the interactions. So, I hope this post will be inspirational to someone out there a bit uncertain about taking the plunge into the digital world – jump in!

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Flexible, Distance and Online Learning – FDOL

I have signed up for an online course on Flexible, Distance and Online Learning (FDOL) that will run throughout the fall. We’re just getting started and throughout the course we will be writing posts on different topics related to the course and post these to our own “portfolios”. I plan to use this blog as my portfolio, so prepare to hear many more reflections on online learning and education from me!

The 5 posts will be:

  1. The digital me: past, present, future
  2. My digital teaching practice and opportunities for change
  3. Extending collaborative learning using digital technologies
  4. How do I support my students and opportunities for further improvement
  5. Opening up my practice
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Medinfo 2013 – reflections

I want to summarize my experiences of Medinfo2013 – and what’s a better way than doing it in a blog post to share with everyone interested? Naturally the post will reflect on the issues I was most interested in. Since the impressive program had 8 (sometimes even 10!) parallel sessions it was difficult to choose, and impossible to attend to everything interesting. But social media nerds as yours truly could always multitask and get some insight in what was going on in parallel sessions as well (as long as someone was tweeting from them!). I hope that even more tweeps will attend Medinfo2015 in Brazil (considering that they aim to enable more people to follow the conference from a distance by streaming sessions, I have high hopes they will have a good plan for more interactive tools as well)!

For me, the conference had 3 main themes (I’m sure for someone else it had many different, this is what I focused on and took with me).

What is the Patient’s role in e-health/medical informatics?

A major part of Medinfo2013 for me was about patients (and/or citizens? persons? individuals?) and how we study/involve/view/consider them when designing e-health.  This was not only because of my part in a workshop called “Experiences of Novel e-Health Services for Patients – Pros, Cons and Future Challenges” which I live-tweeted and had great fun during – but also because there were vivid discussions ongoing in different fora through out the conference. My stand point on this is fairly clear – I believe that we NEED to actively involve the end-users of any tool/service that we design throughout the development process (not just during testing). This is regardless of whether they are healthcare professionals, patients, or family carers. There is however a tendency to speak for others in this field – we are all patients in some respect, and knowing what the care process looks like from one perspective (that of the healthcare provider) gives us all the information we need. I completely disagree with this – using healthcare professionals as proxy for patients can get you in real trouble!

I attended a thought provoking workshop where the topic was “Moving beyond eHealth Systems for ‘People like us'” where the authors (Paul Turner, Andre Kushniruk, Pernille Bertelsen, Luis Falcon and Chris Showell) questioned whether we are designing services/e-health for PLUs (people like us) or DDDs (Disempowered, Disengaged and Disconnected). They certainly caught my attention – is it ok to talk about people as DDDs (was my first reaction)? I thought about the elderly and stroke survivors I have worked with – a group of people who are often seen as not very interested or able to use e-health and I felt almost offended on their behalf. But of course this is what the authors wanted – and we got a good discussion out of it. Who will be able to use the services we develop? Are we excluding those who need the most support? For me, yet another proof that we need to engage and involve the real end-users throughout the development process. But also that we need to consider those who will NEVER be users of e-health but very important users of health services…

Elderly – Seniors – Ageing

One group of patients/people remains very important to me, ever since I wrote my PhD thesis in the field, and that is our elderly, seniors, older persons – whatever you want to call them. I was happy to see a few presentations on the topic (did not attend all of them at the conference) and even more happy to talk to many fellow researchers in Australia working with elderly care, e.g. Andrew Georgiou and Elin Lehnbom from UNSW . It was a real inspiration – hope to work more in this field in the future!

Social media – danger or opportunity?

Since I have become quite the twitter-addict lately and have seen many examples of how social media can be used in a positive way (both for research, information sharing and support) I attended a few sessions on the topic. To my surprise, many had a very warning touch to them… for example, a panel entitled “Social Media for More Patient-Centered, Cost-Effective Healthcare Delivery” almost exclusively discussed legal issues and what you can and cannot say and do on social media as a healthcare provider or professional. Interesting, but not really what I was looking for… I realize that these issues are important – but I would have liked to hear more about opportunities – especially from a health informatics point of view! There were however many other sessions on social media that I missed out on, so I will go through the proceedings and see if I can get a more diverse perspective.

For me personally, I had great fun tweeting throughout the conference, and I think that this is a great way to create a discussion with the “world outside research”. Health (or medical) informatics is a field that interest so many diverse stakeholders and only a very limited number attend these types of conferences. So it’s been great sharing some of my reflections and thoughts with a greater audience!

Education – a changing field for health informatics?

Finally, I attended a few sessions on education. Since I spend a lot of my time teaching at the international Master program in Health Informatics here at KI, I really looked forward to being inspired on how to improve. There were a lot more sessions on eduction than I have seen before at Medinfo, and I only attended a few – so again, a browse through the proceedings will be great. I was however inspired both by talks on MOOCs (Massive Open Online Courses) and I will definitely take a look at the materials on Health Informatics out there (e.g. at the Health Informatis Forum). I was also inspired by how others have used blogs for students to reflect on their learning throughout practical work, and the idea of the “flipped classroom” – something I have been considering for one of my courses… we’ll see.

That will have to be all for now – back to writing papers, grading exams, and involving end-users!

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The #EHR4U chat – a summary

I wrote a blog post a couple of days ago called An invitation to participate describing our decision to use twitter to try to engage with a broader public before, during and hopefully after our workshop at Medinfo2013. The workshop is called “Experiences of Novel e-Health Services for Patients – Pros, Cons and Future Challenges” and naturally the twitter chat hoped to gather opinions on getting online access to electronic health records (EHR) – hence the hashtag #EHR4U.

Monday the 19th of August we held a one hour twitter chat. Me and my two colleagues Isabella Scandurra (@isadurra) and Rose-Mharie Åhlfeldt (RoseMharie2) took active parts in the discussion. 3 more persons were actively engaged in the discussion, but we hope to raise the number to participants as we continue live-tweeting from the workshop tomorrow. Here I will give a brief summary of the contents of the discussion.

All participants clearly expressed that they wanted access – in fact the participants considered it a patient right!

  1. #EHR4U Q 1 yes we should have access, same as banking they don’t hid most of your bank detail

  2. @MariaHagglund I want access to my medical records. Also believe that it is the patient’s right! #EHR4U
  3. @Isadurra @MariaHagglund Yes I would like to have access for self-management and easy access to my nxt caregivers on my consent #EHR4U
  4. Some concerns however, was that even if you gained access your data
    it would probably be scattered throughout different systems and
    difficult to get an overview of. This is of course an important issue
    when providing patients access to their health information – how can it
    be integrated into one consistent view?

    This fragmentation of information was also brought up as an important reason why patients need to have access – since they are the main information carrier between
    different care providers. If you don’t have access to your information
    you will likely forget important information when repeating it to the
    next healthcare professional.

  5. #EHR4U I see many instances in Healthcare profession that they can only see part of the patients history. Pt always filling in other parts
  6. @TinyTonyH yes, patients often act as information carriers in fragmented healthcare – safety issue? #ehr4u
  7. Another important issue that was brought up was the problem of
    misunderstandings and disagreements between patient and healthcare
    professionals.
  8. @Hanife_Krasniqi have you asked for a paper version of your records? and if so, was it “correct” according to you? #EHR4U
  9. @Isadurra 1. Yes. It was shocking. Misconceptions occurred all too often. my care was negatively affected due to this! #EHR4U #eHealth
  10. @Hanife_Krasniqi @Isadurra #EHR4U I have heard this from many patients misconceptions does lead to negativity from profession

  11. In situations as these, it was also considered a benefit to have
    access to your records online so that you could more easily change to a
    different healthcare provider. So, having access to your data could also
    provide a sense of freedom – I have the same information as my
    healthcare provider, and I can choose to take this information with me
    to a different provider.

  12. @Isadurra #EHR4U If Patient had full control of records, would make it easier to change doctor. We are now in a mobile workforce.

  13. We also discussed that different levels of access and/or functionality could be needed. Some persons may prefer a brief summary in layman terms, whereas others want full access to all data. We need to provide flexible solutions – patients are not a homogeneous group.

    And finally we touched on why it is so difficult to realize these
    changes. Cultural aspects was brought up, difficulties in changes work
    processes, and power balance.

  14. @Isadurra @Hanife_Krasniqi #EHR4U Doctors say its to lessen the risk of sensitive information which might endanger pts health. (1/2)
  15. @Isadurra @Hanife_Krasniqi #EHR4U (2/2) But I believe it is the loss of control over the patient. Needs a radical rethink of culture
  16. So – ending on this perhaps not so positive quote, I hope that the
    discussion will continue at #EHR4U. Tomorrow, Thursday 22nd August, we
    will have our workshop here at Medinfo2013. I will be tweeting
    throughout the event and if you have any interesting comments or input –
    please join the discussion!

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An invitation to participate

In only a few weeks the Medinfo 2013 conference will begin in Copenhagen, Denmark. This is one of the big, international conferences in medical informatics (or health informatics as I prefer to say). This year will be my third time visiting Medinfo (since it’s only been every third year, the opportunities have not been that many). The list of attendants is of course long, and many healthcare professionals gone IT and IT-professionals gone healthcare, all with a research interest of course, meet and exchange ideas and get inspired. Great fun.

This year, I am involved in the organizing of a workshop which will take place on the 22nd of August. The title is “Experiences of Novel e-Health Services for Patients – Pros, Cons and Future Challenges” and we start off by stating that it is crucial to involve the patient in the development of patient accessible eHealth systems. Now, I collaborate a lot with patients in my research, trying my very best to actively involve them in the design and development of new and (fingers crossed) useful ehealth solutions. However, I rarely see patients at these types of conferences. Or for that matter, other end-users of the health information systems discussed. So, we decided to try to extend the scope of our workshop outside the traditional boundaries of the research conference by organizing a pre-workshop twitter chat aiming to engage all those with an interest in these issues who can not actually attend the workshop. The goal is to continue the online discussions during the workshop and hopefully also after. So please, if you feel that this is a topic you are interested in – join! Participate!

More information on how to take part in the twitter chat can be found here. We will be using the hash tag #EHR4U an abbreviation for Electronic Health Records for You. If twitter is not your thing – why not write a comment here – what’s your view on patients online access to their electronic health records?

 

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