Structural Innovation: Blending to Connect the Classroom, Clinic, and Community At Large (C4Tech)

Concurrent Session 7

Brief Abstract

This session reviews an innovative course structure which connects the classroom, clinician and community at large through technology to promote active and authentic learning.


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.

Additional Authors

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

The demand to educate increasing numbers of healthcare practitioners combined with the need to equip future clinicians with the knowledge and skills required to "hit the ground running" when entering the workforce (Costello et al., 2014, p. 15) requires adoption of innovative learning models that challenge the traditional structure of Health Professions education. For example, the current model of PA education separates the clinical and didactic years, which inhibits students' ability to draw upon the authentic environment of the clinic in the generation of new knowledge and in the application of this knowledge in differing situations, particularly students with no clinical experience. New, innovative structures are required 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.

Skill in collaborative problem-solving can be acquired by participating in 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. Health professionals will need to negotiate the social environments in which they work to critically evaluate patient interventions. Promoting communities of inquiry in Health professions education through the blending of online technologies and traditional face-to-face class sessions will provide students with additional opportunities to experience the negotiation and critical thinking vital to future practice.

Online collaborative inquiry can also facilitate active learning when discussion and collaboration build on authentic experiences that challenge learners to view concepts from different perspectives and enable active experimentation with novel concepts in new and differing situations(Kolb, 1984). Collaborating with practicing clinicians to address first-hand problems encountered in clinical practice during the didactic part of the program would promote these types of authentic learning experiences and better prepare future clinicians to deliver care that 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 by creating online communities of inquiry in an introductory Physician Assistant course: Health, Justice and Society (HSJ). HJS is a two course sequence offered in the first year 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 "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 opportunities to work with clinicians to address actual disparities in 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 on this blended model is guided by the following 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.

To study the adoption of this model, we are using a case study approach (Yin, 2009). The case is bound by the two semester course sequence of HJS in which student/clinician teams will collaborate. Multiple forms of data are being collected to facilitate triangulation across data sources. Data collection and analysis are ongoing over the course of two semesters of HSJ. Data sources include reflection journals, webconference recordings, online discussion board postings, student-clinician projects, and student and clinician perception surveys.

Session Objectives
-Review how blended learning can be used to promote an innovative structure in health professions education
-Explore how technology can be used to create authentic learning experiences which connect the classroom, clinic, and community
-Review a method for researching the effectiveness of a blended model

Audience Interaction
The session will include a discussion among participants regarding how the model might be used in other disciplines and professions that emphasize knowledge generation and skill development critical to professional competency.