C4Tech: Blending to Connect the Classroom, Clinician, and Community for Active and Collaborative Learning

Concurrent Session 8

Session Materials

Brief Abstract

Presents research findings regarding the efficacy of a blended course model which connects the classroom, clinic, and community at (C4Tech) large through online communities of inquiry.  Includes details on model design, research methodology, research findings and relevance and potential application of model to other disciplines.

Additional Authors

Debra Herrmann is an Assistant Professor in the Department of Physician Assistant Studies at the George Washington University Physician Assistant Program in Washington, DC. As the Associate Director of the Clinical Education at the GWU PA Program, Ms. Herrmann is involved in teaching, curricular design/implementation/evaluation/improvement as well as clinical site placement and recruitment. Ms. Herrmann received the 2011 Physician Assistant Education Association’s Faculty Rising Star Award for exemplary work in PA education. Ms. Herrmann graduated from The George Washington University Physician Assistant Program as a National Health Service Corp Scholar in 2001 and has practiced clinically in Outpatient Community Medicine, Emergency Medicine, and Urgent Care. She was appointed Chair of the PA Advisory Committee to the DC BOM in 2010 and continues to serve in this role today. Ms. Herrmann is currently a doctoral candidate at the A.T. Stills University Doctor of Health Sciences program.
Karen Schlumpf is an epidemiologist and biostatistician within the Department of Clinical and Translational Research at the George Washington University. She is the director of research curriculum within the School of Health Sciences. Prior to becoming full-time faculty in 2013, she served as an adjunct professor for 10 years. Ms Schlumpf's research experience include transfusion medicine, neurogenetic linkage and gene mapping, infantile feeding disorders, and health service utilization. She is currently working on her dissertation, exploring the sensemaking process of families experiencing terminal illness.

Extended Abstract

Problem and Background:  New, innovative structures are required in health professions education which can bridge classroom and clinical experiences to provide the authentic learning experiences students require for higher levels of learning. Failing to adopt innovative delivery models will inhibit the ability of future clinicians to fully participate in collaborative problem-solving as members of healthcare teams working to improve patient care (Costello et al., 2014, p. 15).

Skill in collaborative problem-solving can be acquired by participating in online communities of inquiry (Garrison, Anderson, & Archer, 2003) which facilitate higher level of learning through online collaboration with more knowledgeable peers or instructors.  In these communities, students and faculty can safely negotiate the meaning of controversial issues in relation to future practice, such as health disparities, leading to reflection, critical thinking, and the generation of new knowledge. Online collaborative inquiry facilitates active learning (Kolb, 1984) when discussion and collaboration builds on: (1) authentic, concrete experiences that allow reflection upon the experiences from different perspectives; (2) opportunity to interpret the experience in relation to concepts presented in a course/program; and (3) active experimentation with novel conceptualizations in new and differing situations (Kolb, 1984). Collaborating with practicing clinicians to address first-hand problems encountered in clinical practice during the didactic year would better prepare future clinicians to deliver care which improves patient outcomes during the clinical training year and in future practice.

In this presentation, we review our model for connecting the classroom to the clinic in order to create online communities of inquiry in an introductory Physician Assistant course: Health, Justice and Society (HSJ).  HJS is a two course sequence offered in the fall and spring semesters of the PA program that introduces students to social determinants of health. The model we will discuss builds on research conducted on previous attempts at "blending" the course.  The integration of technology in the first semester of the course has led to higher levels of student learning (McDonald, Straker, Schlumpf & Plack, 2014). However, some students consider topics presented in the course sequence as "soft" in part because a lack of clinical experience makes it difficult to imagine the manifestations of social determinants in clinical settings or to anticipate how the social interaction between clinician and patient may be influenced by those determinants. As a result, students do not perceive the courses as offering "clinical" learning experiences which teach skills they readily apply in future practice.  The current model aims toward a more "authentic" learning experience.

The current course model integrates online technology in a way that connects the classroom and clinic to provide students "hands-on" opportunities to work with clinicians to address actual disparities within the clinics' populations while learning about diversity and disparities in the classroom setting. These connections will ground the courses in real-world experiences, even if at a physical distance, and allow students and clinicians to experience the value of technically mediated communication in professional collaboration and problem-solving.

Research Questions: How does connecting the classroom and clinic through online technology influence 1) student awareness of the impact of the social determinants of health, 2) students' and clinicians' perceptions of their ability to use online technology for collaboration and problem-solving, and 3) the creation of student/clinician team projects integrating classroom and clinical knowledge to address social determinants of health and healthcare disparities.

Methodology: To study the adoption of this model, we implemented a case study approach (Yin, 2009). The case was bound by the two semester course sequence of HJS in which student/clinician teams will collaborate. Multiple forms of data were collected to facilitate triangulation across data sources including online reflection journals, Blackboard Collaborate recordings, online discussion board postings, student-clinician projects, and student and clinician perception surveys.

Findings:  While data analysis is ongoing, preliminary findings indicate that the model did facilitate achievement of higher levels of learning (integration, application and creation of knowledge) as related to social determinants of health and health disparities. It also enabled the creation of PI-CME (Performance Improvement Clinical Medical Education Projects)aligned with the specific needs of participating clinics and clinicians, allowing students to apply their knowledge to actual current problems in clinics related to social determinants of health in the first year of coursework. Findings also indicate student awareness of the distinction between collaboration and coordination with regard to team process and knowledge generation and of factors influencing the “default” to coordination.   

Discussion:  In the presentation, we will discuss the relevance of our findings to the adoption of our model in other disciplines.  We will also discuss lessons-learned based upon our application of the model. Finally, we will review adaption to the model in subsequent courses based upon student and clinician feedback.   

Session Objectives

  • Review a blended learning model which promotes active and collaborative learning
  • Explore how technology can be used to create authentic learning experiences which connect the classroom, clinic, and communit
  • Review a method for researching the effectiveness of a blended model
  • Discuss research findings and application to other disciplines