Innovative Use of Technology to Teach Clinical Skills to Future Mental Health Counselors

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Brief Abstract

Realistic clinical cases, presented within the teaching platform, aim to increase realism in practical learning (meeting a variety of counseling scenarios). Topics of investigation to include creative acquisition of counseling skills in an online synchronous environment and foreseeable challenges in teaching psychology coursework in a virtual environment.

Extended Abstract

Models of Teaching and Learning

The synchronous model of teaching has gained more momentum in the last decade or two as distance learning becomes more ubiquitous in present-day. While remote education has become more widespread, early teaching methods in an online environment has largely been in the form of isolated independent study  that is characteristic of asynchronous learning. In order to better understand the core ideologies of this paper, the differences between these two models of learning (synchronous and asynchronous) should be clarified, in addition to the benefits and challenges accompanying both. Under the asynchronous model of teaching, learning does not necessarily occur at the same time and space for the instructor or the learner (Scheiderer, 2020). This means that students can engage in learning and completion of coursework in their own time, regardless of time and location. While asynchronous learners have freedom of course completion at a time that is most appropriate for them and their schedule (which is particularly important for adult learners), the dynamic, supportive, and collaborative human component that students might experience in the traditional classroom environment is wholly absent under this model of instruction. 

Unlike the asynchronous model, synchronous learning is learning that happens at the same time for both the instructor and the learner. In a synchronous learning environment, the instructor actively leads each class session and orchestrates learning activities in a “cyber-classroom,” just as they would in a traditional face-to-face classroom environment, without the barrier of distance. The course likely has a dedicated agenda set by the instructor and real-time interaction between all parties is a vital component of this learning model. A variety of major functions are served by real-time interaction in an online synchronous learning environment. These functions include instruction, collaboration, socialization, informal exchange, support, and extended outreach (Finkelstein, 2006). 

Challenges in Online Learning

For decades, whether we realize it or not, we have also been using web-based platforms to deliver educational content. Since the 1990s, thanks to the Internet expansion, we have been able to use learning management systems to facilitate course content in both synchronous and asynchronous models. In present day, distance education is inseparably connected to advancements in asynchronous learning management platforms, such as Blackboard, and synchronous video conferencing technology, like Adobe Connect and Zoom. Given the current circumstances of the COVID-19 pandemic, more and more institutions are positioning themselves to provide synchronous instruction to students. Online learning models, however, are not without their own unique challenges. In fact, there are a variety of different challenges within the synchronous model. This section will review a summary of the main challenges the MA Psychology program has faced at this University in working with students in the online synchronous environment. 

Students are dynamic and diverse and, as a result, the challenges that are encountered within the online environment are likely to be diverse as well. That being said, we will explore how we use synchronous learning in graduate counseling courses and the potential impact this model can have on future practitioners of therapy. This University utilizes a number of synchronous methods to engage students including synchronous role play, live lecture, break out rooms, student-based discussions, and integrated multimedia. While teaching counseling skills in real-time can be tedious, teaching students the art of clinical practice becomes increasingly challenging when remote. That said, there is a significant difference between challenging and impossible. 

The graduate psychology program at this University has utilized the synchronous model for a number of years to prepare future marriage and family therapists and clinical counselors for clinical practice. Although this goes without saying, the first and most difficult hurdle to navigate is our understanding and comfort of teaching clinical techniques in a remote environment. What is clear is that, if the instructor is struggling with the model of treatment, their presentation of the information will not produce the desired effects in their students. As such, we must become comfortable with the software system in which we use to deliver the course material. 

At this University, faculty implemented the use of video communication technology, such as Zoom and Adobe Connect, in graduate-level psychology courses in 2017 to accommodate the needs of a growing and dynamic body of learners. To become comfortable with software used to teach remote learning, faculty and administrative staff met regularly to navigate screen sharing, chat monitoring, breakout room functionality, whiteboard functionality, camera usage, muting and unmuting challenges, and more. As we navigated this terrain, it became clear that, while working with students remotely utilizing the synchronous model, we were indeed visitors of our student’s homes, workspaces, frequented coffee shops, and even in their vehicles. This inexplicably altered the traditional understanding that, once a student walks within a classroom, they are to behave as “students.” 

With this recognition, faculty quickly created guidelines for students in our synchronous courses and used critical thinking to improve the teaching environment for instructors. For example, teaching a synchronous course while utilizing a single screen significantly minimizes the effect an instructor may have on learners. By adding a second, or even a third screen, instructors are able to utilize multiple screens to engage with learners, share presentation content, monitor the chat feature, and even reserve space for lecture notes. Of course, this example is not intended to state that faculty should use multiple screens to effectively teach a synchronous model, authors are simply stating that delivery of educational content can be smoother and more effective when technology and appropriate hardware are utilized to create a different kind of learning environment. 

Future Implications

The ability for students to learn clinical skills and implement interventions is essential to their future responsibility to provide clients with the best care and treatment available. At the core of this assumption is competency: beginning with learned clinical skills.  Student competence is an attribute of the student, not of a treatment, but may be tied to the quality of the clinical treatments administered to future patients. Evaluators must determine if we are effectively evaluating students’ ability to learn clinical skills and implement those to an acceptable standard, which would otherwise be expected in a traditional learning environment. Ideally, clinical cases presented within the teaching platform based on realistic community cases aim to increase realism in practical learning (meeting a variety of clinical and interview scenarios). Using the synchronous model and simulating patient interactions students are able to develop and practice a multitude of therapeutic skills including building rapport, developing clinical interviewing skills, exercise complex thinking and conceptualization about counseling issues, and increase their overall approach to client-centered care. 

One barrier is limited pre-existing knowledge on the topic. Many of the studies, to date, on online synchronous teaching and learning have largely focused on social work. Limited research could be found that addressed content from a marriage and family or clinical counseling perspective. Authors propose future study of measuring learned clinical skills in an online synchronous environment to gain a deeper understanding of the effectiveness of teaching clinical skills in an online environment as compared to campus-based traditional teaching environments. With that, authors will investigate the potential prosocial/positive impact in addition to the challenges that synchronous instructors and learners may face in clinical skill acquisition. 

Evaluators will investigate the creative inclusive delivery of clinical content in online environments, proper training of faculty to teach practical elements to foster competent clinical skills (faculty interaction, sensitivity of learning styles, and proper training in online pedagogy including informal mentoring and non-standardized faculty/instructor training). Learners will be measured on overall satisfaction with technology content, overall content learned (using summative evaluation), and measured on therapeutic competence.

The presenters will present engaging content to participants on the importance of engaging graduate counseling skills in a manner that uses innovative technology and evaluative techniques to measure learning outcomes to evaluate learning of clinical/counseling skills.