Reflection 2: Literature review

Analysis of responses from the two surveys so far:

Survey to find out current use and suggestions about additional tools in the LMS for the 'Occupational Therapy in Physical Health' course

	Lecturers (n=4)	Students (n=4)
Current tools used
Announcements	4	4
Resources	4	3
Calendar	1	0
Assignments	1	0
Course evaluation	1	2
Gradebook	0	3
Suggested tool to support learning during practice learning placements	·        Video resources for students to refer to ·        Submitting written work (client treatment logs, reflective logs and case studies) via Assignment tab à maintain a record of student submissions and turnaround time for supervisor feedback ·        Specific tab for practice learning that includes assessment forms and checklists ·        Chat rooms for teaching staff to assist students as problems arise ·        Tests and quizzes	·        YouTube videos to help practice ·        Resources on the practical implementation of intervention techniques

Of the students who responded, 2 used the LMS 3 times a week, 1 less than 3 times a week and 1 hardly ever. Most accessed announcements from Vula via their cell phones. 

The number of student responses is somewhat disappointing, but not unexpected.

Summary

Students want videos and resources to assist them with practical application of OT intervention methods. Lecturers support this but have made additional practical suggestions for othre tools that could support the students when they are in practice learning, i.e. quizzes, chat rooms, submission of written work online and a resource to access assessment forms.

Literature review to inform the intervention

A search of EBSCO host (ERIC, CINAHL, Health Source: Nursing and Allied Health Edition and Africa-Wide were selected) using the keywords ‘occupational therapy’, ‘clinical reasoning’ ‘e-learning’, ‘learning management systems’ and ‘online learning’, revealed 5 relevant articles of which 2 were not yet available through the UCT library (1 year embargo). This is clearly an under-researched area in occupational therapy.

Main points identified

• A review of the potential of computer-enhanced classroom-based teaching and online professional education showed that students appreciated the increased access, greater variety and convenience offered by online materials and the fact that they could pace their learning but that it required reliable technology (Hollis and Madill, 2006). From the lecturers’ perspectives, online education enabled effective and efficient communication with students but demanded additional preparation time and appropriate training and support (Hollis and Madill, 2006).
• Development of professional expertise requires contextualised learning as well as reflective judgement during and/or after the learning experience so that students can link theory with actions (Schell and Schell, 2008). Reflection in and on action enables students to apply information in real practice situations (Schell and Schell, 2008).
• Written case scenarios and reflective journals can be effective in facilitating the development of clinical reasoning as shown in a group of Masters of Occupational Therapy students in America (Mitchell and Batorski, 2006). It is, however, preferable to have transcripts of actual interviews with clients, family members and/or team members when using paper cases (Mitchell and Batorski, 2006). Students need guidance during learning and should be provided with individual feedback (Mitchell and Batorksi, 2006).
• More research is needed to identify the most effective methods for assisting novices to learn how to make expert decision about their clients (Mitchell and Batorski, 2006).
• An inter-professional course for health sciences students including occupational therapists compared a 100% face-to-face delivery format with a blended learning format  (70% instruction via a synchronous virtual classroom technology (Elluminate) and 30% with an asynchronous technology (WebCT)) and found equivalent effects in team process skills but  a more positive experience of learning in the blended format group (Carbonaro et al, 2008).
• Example of how case studies can be developed into scenarios to encourage clinical reasoning using a 6-step process (Levett-Jones and Hoffmann).

Conclusion

1. A LMS allows students to access course materials when they need it and facilitates communication between lecturers and students.
2. Students in this course already write reflections on practice but perhaps these could be submitted and commented on via the LMS.
3. A LMS can be used to develop clinical reasoning provided the appropriate materials are developed.

References

Carbonaro M, King S, Taylor E, Satzinger F, Snart F, Drummond J (2008). Integration of e-learning technologies in an interprofessional health sciences course. Medical Teacher, 30: 25-33.

Hollis V, Madill H (2006). Online learning : the potential for occupational therapy education. Occupational Therapy International, 13(2): 61-68.

Levett-Jones T, Hoffmann K (no date). Turning case studies into online clinical reasoning scenarios using a set of generic design principles. Australian Learning and Teaching Council project team.

Mitchell A, Batorski R (2009). A study of critical reasoning in online learning: application of the occupational performance process model. Occupational Therapy International, 16(2): 134-153.

Schell B, Schell J (eds) (2008). Clinical and professsional reasoning in occupational therapy. Philadelphia: Lippincott, Williams & Wilkins.