Learning in vivo

Pondering about shadowing on an examination bed

Shadowing entails following someone else while they are at work to learn about that person's job. Often shadowing takes place during orientation (onboarding) at a new place of work, or new job by initially shadowing a more experienced employee.

While undergoing an abdominal ultrasound examination, I pondered shadowing. The sonographer gave several instructions while operating the ultrasonic imaging device to produce diagnostic images. While lying on my back or either side with my hands above my head, I have been asked to breathe in deeply and holding my breath during scanning. I was also asked to pinch my nose, puff my cheeks, and hold my breath during scanning; and to engage in starting sit-ups, and to hold my abdominal muscles tight while scanning. These are the various techniques to acquire the best possible three-dimensional diagnostic images for the ultrasound report. If a student-sonographer that is undergoing clinical training, were to only receive the images, there would not be much learning opportunity. However, if the individual were introduced to me, my consent requested, actions explained while observing—being told what is done and why, then significant training would probably be derived from such shadowing.

Time spent shadowing intellectual work seems to require telepathy. Often shadowing is advocated as a means for existing employees who are aspiring to advancement, to gain experience laterally. However, unless the future role-taker is entrusted aspects of work to intellectually engage with on their own, while under supervision and guidance, little learning could be expected. Merely being kept in the loop through email traffic does not allow for shadowing of the intellectual processes involved.

Different forms, types or modalities of work-integrated learning (WIL)

The Higher Education Qualifications Sub-Framework (HEQSF) (South African Government, 2014) differentiates five forms work-integrated learning (WIL), and the imbedded WIL template, under section D (p. 8) of the Council on Higher Education (CHE, 2021), Higher Education Quality Committee (HEQC) offline version of the online ‘Application for programme accreditation and qualification registration’, two more:

1. virtual or simulated learning,
2. work-directed theoretical learning (WDTL),
3. problem-based learning (PBL),
4. project-based learning (PjBL),
5. workplace-based learning (WPBL),
6. practicum placements,
7. service-learning, and so on.

The CHE’s Good Practice Guide (2011) advocates four distinct WIL curricular modalities, namely WDTL, PBL, PjBL and WPBL above. The eight definitions below were composed through consultation of several sources.

Practicum (plural practicums) placements	is a course/programme module, or part thereof, that involves involving activities emphasising the practical/clinical application of theory, knowledge and skills of the qualification curriculum; gaining on-the-job/vocation/professional experience; putting into practice; clinical/practical training; actual working in the area/field of study
Problem-based learning (PBL)	is a radical form of teaching which entail that ‘problems’, rather than academic subjects, as organising structure of the curriculum, with the main objective the acquisition of an extensive, integrated knowledge base. Problem-oriented learning is more commonly used and involves the inclusion of real-world scenarios for problem-based activities, assignments, and projects. Ill-structured problems stimulate the generation of multiple hypotheses or potential solutions. Ill-structured problems further allow students to observe, interview, and review records or documents to obtain needed information.
Project-based learning (PjBL)	involves learning through projects. Projects are either ‘real’ projects located in the world of work; or simulated with input from workplaces. Projects generally involve elements of research and supervision by both a university lecturer and workplace supervisor or mentor. PJBL enables the acquisition of an extensive, integrated knowledge base that students can draw on and apply to the analysis and solution of problems.
Service-learning	generally entails voluntary activities directed at specific community needs, applied learning and engaging in reflection to deepen understanding of what is being taught. It could be credit-bearing, if integrated into the curriculum of an academic programme and assessed as such., It may take place with an agency (usually a non-profit or social service group).
Simulated (or virtual) learning	means the learning and teaching technologies used to create artificial learning environments to enhance or replace a student’s actual experience with the world of work through simulations. For example, live projects, case studies, employer talks, role play, mentoring, and e-simulations.
Work-directed theoretical learning (WDTL)	enables the alignment of theoretical understanding with the practical or practice-based components and enabling students to apply such in the workplace. Presentations by workplace and/or professional practice may be used.
Work-integrated learning (WIL)	is used as an umbrella term to describe curricular, pedagogic and assessment practices, across a range of academic disciplines that integrate formal learning and workplace concerns. The International Journal of Work-Integrated Learning (IJWIL) defines WIL as "an educational approach that uses relevant work-based experiences to allow students to integrate theory with the meaningful practice of work as an intentional component of the curriculum. Defining elements of this educational approach require that students engage in authentic and meaningful work-related tasks, and must involve three stakeholders; the student, the university, and the workplace/community." (www.ijwil.org)
Workplace-based learning (WPBL)	happens when students are placed in work environments for the purposes of learning, which provides students with real life work experiences, in order internalise knowledge, skills and competencies, and gain insights through exposure to work by achieving specific outcomes. Both the HEQSF & CHE (2014) specify criteria for work(place)-based learning.

The Regulations (South African Government, 2018) for WPBL Agreements, lists nine forms of WPBL, requiring selection:

1. Apprenticeship
2. Learnership
3. Internship for the ‘N’ Diploma
4. Candidacy (postgrad for professional)
5. Student internship. Category A (for certificates & diplomas in HEQSF)
6. Student internship: Category B (requirement professional registration)
7. Student internship: Category C (for QCTO qualifications)
8. Student internship (SAQA qualification & vacation work)
9. Graduate internship (got qualification, to gain workplace experience)

Council on Higher Education (2011). Work-Integrated Learning: Good Practice Guide. HE Monitor No. 12, August 2011. Pretoria: IeCommunications. Electronically accessible from https://www.che.ac.za/sites/default/files/publications/Higher_Education_Monitor_12.pdf

Council on Higher Education (2014). Distance Higher Education Programmes in a Digital Era: Programme Accreditation Criteria, pp. 81 – 107. In Distance Higher Education Programmes in a Digital Era: Good Practice Guide. Electronically accessible from https://www.saide.org.za/documents/CHE_-_Distance_Higher_Education.pdf

Council on Higher Education (2021). Higher Education Quality Committee (HEQC) offline version of the online ‘Application for programme accreditation and qualification registration’. https://www.che.ac.za/publications/submissions/heqc-offline-application

South African Government. (2014), Department of Higher Education and Training, Government Notice No 819. Higher Education Qualifications Sub-Framework. Government Gazette No. 38116, 17 October 2014. Electronically accessible from https://www.gov.za/sites/default/files/gcis_document/201410/38116gon819.pdf

South African Government. (2018). Sector Education and Training Authorities (SETAs) workplace based learning programme agreement regulations. Department of Higher Education and Training. Government Gazette No 42037, 16 November 2018. Skills Development Act (Act 97 of 1998). https://www.gov.za/sites/default/files/gcis_document/201811/42037gon1241.pdf

Graduate internships distinguished from work placements or other curricular activities

Graduate internships are “employment experiences of finite duration, normally assumed to have a learning component to them, undertaken in the early stages following graduation” say Hunt & Scott (2020: 465), who emphasise delimitation, “because there is no agreed definition of an internship”. Conflating graduate internships with work placements is not helpful, because the latter are normally undertaken whilst studying. Although ‘internship’ opportunities are widely advertised, no such employment status, for example, exists in UK law.

Academic literature recognises the importance of a ‘clinical placements’ (medical terminology for work-integrated learning) in graduate nursing programs. During clinical placement students may, for example, choose the nature of placement based on clinical interest. The objective of clinical placement is the acquisition of advanced practice nursing (APN) skills, increased understanding of the APN role, and development APN competencies, which “include direct comprehensive care, optimizing health system, education, research, leadership, consultation, and collaboration” indicate Cretu and Stilos. (2021: 494). During placement post-graduate students could further “build networks, advance their personal and professional development, and validate their motivation and desire to pursue a particular professional area of” APN. Preceptorship, a nursing education term for supervision and mentoring, plays a significant role with a learner-centred teaching approach and philosophy, incorporating “scientific knowledge, evidence-based practice, reflection and knowledge transformation, communication engagement, and possession of a respectful and responsible attitude” say Cretu and Stilos. (2021: 495). Such preceptoring provides ongoing encouragement and support. Students learn “by doing, questioning, reflecting, and engaging in discussions with patients and healthcare professionals, capturing the APN competencies whereby a fusion of knowledge and clinical skills happened in real-time”.

“Internships and field placements are a critical component of public health education in that they help ensure that future public health workers are able to apply theory and concepts to practice” say Dreyzehner; Williams and Harkness (2017: 10S), who indicate that collaboration between academic institutions and public health agencies is required to identify successfully develop competencies required in the field of practice. They caution that considerable time and resources from public health departments are needed to make these practice-based field experiences successful.

Hunt & Scott (2020: 465) remark that “graduates are increasingly called upon to exhibit additional markers of employability over and above educational qualifications” and that work placements, internships and other extra-curricular activities (ECAs) are various means to setting oneself apart and enhanced employability. However, they cite Perlin’s (2012) publication ‘How to earn nothing and learn little in the brave new economy’ and remark that evidence exists “that some internships amount to little more than exploitation with unpaid interns carrying out routine tasks that would otherwise have fallen to paid members of staff”. They mention that research “point to significant differences between paid and unpaid internships in terms of perceived development, with unpaid internships viewed as less developmental”. Furthermore, that “unpaid internships generally do not appear to confer long-term career advantages in the same way that HE work placements do” and caution against “those resorting to unpaid internships becoming ghettoised in relatively precarious employment paths”.

Cretu, E. & Stilos, K. (2021). The value of a post-graduate clinical placement for nursing students. Reflections in education, in Canadian Oncology Nursing Journal, 31(4), 494 – 499. Electronically accessible from http://canadianoncologynursingjournal.com/index.php/conj/article/view/1233

Dreyzehner,  J.; Williams, C. & Harkness, E. (2017). More than just an intern: utilizing the post-graduate medical education model to increase the value of field placement experiences for public health program graduates. Pedagogy in Health Promotion, 3(1_suppl), 10S-12S. Electronically accessible from doi:10.1177/2373379917698698

Hunt, W. & Scott, P. (2020). Paid and unpaid graduate internships: prevalence, quality and motivations at six months after graduation. Studies in Higher Education, 45(2), 464-476, Electronically accessible from https://doi.org/10.1080/03075079.2018.1541450

Perlin, R. 2012. Intern Nation: How to earn nothing and learn little in the brave new economy. New York: Verso.

Internships, valuable CV-polishing learning or exploitation?

“No universally accepted definition of an internship” exists, indicates Stewart (2021: 17-18), and citing The Economist (2014), saying it is “a spell of CV-burnishing work experience”. The terminology (internship), in use for more than a century, originated in medical education, where it denotes a postgraduate period of clinical training of doctors under supervision, but also spread across many other professions and occupational fields to provide knowledge and skills in the workplace. Internships may serve “to satisfy the requirements of education or training courses”; or offered by employment service providers to job seekers as part a labour-market programme; or by established business to offer a taste of the nature of work in a particular profession, or to test out applicants. However, job seekers may further initiate internships in order to supplement résumés, or to gain contacts. Both known as ‘open-market’ internships. Maake-Malatji (2021: 137) indicate that in “South Africa ‘low- or no-pay “creative internships” are proliferating at an astonishing rate”.

Maake-Malatji (2021: 132) indicates that the terms ‘intern’ and ‘internship’ are defined in various ways, frequently depending on the field. A person “employed at an entry-level position in an organisation in a structured programme to gain practical experience in a particular occupation or profession” is usually deemed an ‘intern’ he says, and cites Stellenbosch University’s guidelines “which describe an internship as a planned, structured and managed programme that provides work experience for an agreed period of time”. An alternative description of an internship, he says, is a “career specific work experience that one undertakes during/after one’s studies in order to gain the practical experience required to operate and make a positive contribution with respect to the career path one eventually pursues”.

Stewart, Owens, O'Higgins and Hewitt (2021: 2) cites Ross Perlin (2012), who published ‘Intern nation: how to earn nothing and learn little in the brave new economy’ and who stated “a global fact of life [is that] internships are … a significant source of cheap, flexible white-collar labor and a major steppingstone to affluence and professional success. They grant access to those who can afford them, and block further progress for those who cannot”. Maake-Malatji (2021: 141) says that in South African context are several higher education institutions, “based on their recognition within the national and international spheres, gain leverage for their graduates in the world of work”, contributing to inequality and exclusion for students from an underprivileged institutions. The struggle for resources by underprivileged institutions is prevalent, and says “for black graduates, education is a tool to do away with poverty”.

Stewart et al. (2021: 2) observe that little has changed during the past decade; that “internships have become even more firmly entrenched in the transition from education to work”; and that it “is still not attracting the attention it deserves” as forms of ‘work-based learning’ (p. 5). Stewart et al. (2021: 3) qualify what they mean by the term ‘internship’, or ‘traineeship’ as sometimes called in Europe, “to be any arrangement for the performance of work within a business or organization which is primarily intended to provide experience, skills and/or contacts that will help the worker obtain employment or other work opportunities in the future”. They caution that the definition is far from exact and that “it does not matter whether the internship is undertaken during, after or as part of a formal scheme of education, training or government assistance”. They, however, “distinguish an internship from an apprenticeship, on the basis that the latter seeks in a more structured (if not always formal) way to provide all the skills needed to practise a particular trade or profession”.

Whereas the traditional apprenticeship model “has always been premised on the idea of learning a particular trade or craft, while performing [paid] work to practise what has been learnt and to hone the skills involved”, in recent decades there “has been the steady decoupling of training from paid employment” observe Stewart et al. (2021: 3-4). Furthermore, the prevailing modern form of apprenticeship (and the contemporary ‘learnership’ in South Africa) “typically requires time release from work to attend classes at an educational institution”, “however, on-the-job instruction still remains an integral element of these schemes” explain Stewart et al. (2021: 3). Regardless of what called, “licensing or accreditation schemes often require a period of time to be spent working under the supervision of experienced practitioners” (p. 4).

Several drivers and pressures are causing the disconnecting of training from paid employment, say Stewart et al. (2021: 5). The volatility of global markets on the one hand, and pressure on enterprises to accomplish adequate returns to shareholders on the other, result in reduced long-term investment in training. ‘Grow your own timber’ in-house entry-level training programmes are far less prevalent. It is evident that the costs of training significantly shifted from business to the job seeker, the employee and the state. Often funds for training and education are limited to recovery of Skills Development Levy expenditure.

The pedagogical belief of further and higher education institutions that certain knowledge, and in particular skills, are best acquired through real-life experiences, is contributing to growth of need for internships, alternatively termed ‘work-integrated (or experiential) learning’, opportunities. There is further increasingly a demand for graduates who are ‘work ready’, say Stewart et al. (2021: 5). These two drivers towards, however, are impeded by limited paid-learning opportunities and constraints with regard to state funding made available through Sectoral Education & Training Authorities (SETAs) by means of discretionary grants.

Maake-Malatji, M.I. (2021). The law and regulation of internships in South Africa. . In Stewart, A., Owens, R., O'Higgins, N. & Hewitt, A. (2021). Internships, Employability and the Search for Decent Work Experience, Ch. 8, 130-144. Electronically accessible from https://doi.org/10.4337/9781800885042

Stewart, A. (2021). The nature and prevalence of internships. In Stewart, A., Owens, R., O'Higgins, N. & Hewitt, A. (2021). Internships, Employability and the Search for Decent Work Experience, Ch. 2, 17-33. Electronically accessible from https://doi.org/10.4337/9781800885042

Stewart, A., Owens, R., O'Higgins, N. & Hewitt, A. (2021). Internships: A policy and regulatory challenge. In Stewart, A., Owens, R., O'Higgins, N. & Hewitt, A. (2021). Internships, Employability and the Search for Decent Work Experience, Ch. 1, 2-16. Electronically accessible from https://doi.org/10.4337/9781800885042

Part of an active disaster management team as learning experience

Because competence in coping with natural and fabricated disasters is of increasing importance, disaster management became an integral part of the curriculum of, for example, nursing education. Often “first responders in the most acute phases of disaster to the long-term aftermath addressing loss, grief and posttraumatic stress disorders” include nurses, say Sickora et al. (2020: 30). Apart from “disaster preparedness theory and frameworks for intervention”, it is deemed essential to provide clinical “experiential learning opportunities”, which “often includes simulation experiences that range from mass casualty to active shooter”. Although less common, for students to become part of an active disaster management team, has been experienced as invaluable with remarks such as “I felt like a real nurse” and “This is the best experience I have had since I decided to become a nurse”. In this regard Strimel (2014) remark that natural disasters happen at the intersection between humans and nature, and having to face a current real-life issue, students are challenged with the issues at hand.

Disaster relief intervention, as experiential learning opportunity, is deemed to serve a dual purpose, namely (a) “meeting the needs of a community in real-time crisis”, and (b) providing “students with boots-on-the-ground disaster relief experiences”, say Sickora et al. (2020: 31). Similar to Buschlen, Warner and Goffnett (2015: 40), Sickora et al. (2020: 31) emphasise preparation of students before, and debriefing after their disaster intervention. Many students made requests to return, because of deeply affirming experiences, share Sickora et al. (2020).

Sickora et al. (2020: 32) caution that “organization is crucial throughout an effective disaster relief intervention and that initial logistics are challenging and time consuming”, as well as that all stakeholders need to be identified, and resources secured. “Coordination and collaboration with indigenous health care providers and other resources, such as charities and nongovernment organizations” are essential. Long-range preplanning is important, as is effective administration to “ensure proper tracking of disaster relief execution, patient medications, nurse and staff log-ins and log-outs, and patient contact information are also key factors in the effort”. “Keeping a cool head and rolling with the punches” while rendering disaster relief is vital. Practicalities, such as, translators make a significant difference. On-site, fellow relief “workers, such as those providing assistance in construction, debris removal, or road repair, are also in need of care for a variety of maladies, ranging from heat exhaustion to insect bites and wound care”, which suggest a need for multi-disciplinary collaboration.

Buschlen, E., Warner, C. & Goffnett, S. (2015). Leadership education and service: Exploring transformational learning following a tornado. Journal of Leadership Education, 14(1), 33-54. https://journalofleadershiped.org/wp-content/uploads/2019/02/14_1_buschlen.pdf

Sickora, C., Salt, R.J., Page, T.S., Lee, W., Cantu, A.G., Lee, M., Schwab, K.W., Martinez, M.L., Byrd, D. (2020). Evolution of experiential learning opportunities for nursing students after natural disaster. Journal of Nursing Education, 59(1), 30-33. Electronically accessible from https://doi.org/10.3928/01484834-20191223-07.

Strimel, G. (2014). Authentic education by providing a situation for student-selected problem-based learning. Technology and Engineering Teacher, 73 (7), 8-18. Abstract accessible from https://eric.ed.gov/?id=EJ1049199

Work integrated learning is a bridge for students between academic present and professional future

Work integrated learning (WIL) “is a bridge for the student between the academic present and their professional future”, say Martin, Rees, and Edwards (2011: 7). It “is a structured educational strategy, which aims to merge theoretical knowledge gained in academic studies to workplace experiences”, seeking “to provide graduates with a comprehensive industry skill set desired by potential employers”.

Chilvers, Hay, Maidment, and Tudor (2021: 436) cite Martin et al. (2011) who derived through research, from retrospective feedback and documentation, a template of good WIL practice, comprising six key factors, namely (1) organization set up, (2) student preparation, (3) supervision, (4) competencies, (5) pedagogies, and (6) assessment. Chilvers et al. (2021) explore the alignment of social work field education and work-integrated learning (WIL) pedagogy, and made three improvement contributions with regard to the WIL best practice framework, namely (a) preplacement preparation of both students and the field; (b) professional supervision approaches; and (c) ‘inclusion of service user feedback within student assessment processes’. There is much to be gained from more active dialogue and closer relationship between field education and WIL practices they recommend.

Chilvers et al. (2021: 433) indicate that both “social work education and work-integrated learning share a long history of helping students connect with authentic work-related learning opportunities in the context of engagement and partnership with organizations outside of the educational institution, using onsite mentoring”. Chilvers et al. (2021: 436) use the metaphor of a family tree, with different branches, portraying the origins and lines of theory development, of field education in Social Work, and work-integrated learning (WIL) in several other disciplines. Field education and WIL have clearly developed along different lines of the same family tree, only recently beginning to integrate, they observe. However, there are further several other branches to the tree, such as clinical training in Medicine; internships in Psychology; articles in Law; etc. Knud Illeris (2002) sketch numerous contributors to the learning theoretical field in the form of a triangle, between the three dimensions of content, incentive, and interaction. The three sides respectively represent (a) developmental psychology—this side also depicts institutional learning, (b) activity theory, between cognition and society the learning organisation and practice learning, and (c) socialisation theory illustrated between society and emotion, also reflecting collective learning.

Chilvers et al. (2021: 433) examine the tensions associated with aligning social work and WIL. They explore the pedagogical similarities. They discuss key tools and processes for strengthening the quality of field education in social work pertaining student supervision and assessment. Chilvers et al. (2021: 437) offer the following contributions from field education with regard to WIL:

Preparation of students similar to the requirement set by the Social Workers Registration Board (SWRB)—"the regulatory body, which sets parameters around admission, governance, graduate attributes, staffing, stakeholder collaboration and field education”—that academic institutions must assess the professional suitability of applicants upon enrolment, which is generally repeated prior to each placement. The checks include criminal records, assessment of suitability to work with children and vulnerable adults, character references and health. A portfolio of evidence is accumulated to demonstrate the professional suitability of each graduate. Those students that do not meet the requirements are suitably counselled. In addition to checks, intentional preparation of students prior to placement is deemed an important component to clarify expectations of what might be encountered and to reduce anxiety. This includes clear articulation of the roles and responsibilities, and role playing. Attention is given to matching the fit between student and field educator.

Field educator preparation aims to provide clarity around four domains, namely placement administration; teaching and learning; assessment; and quality (p. 438). Relationships between institutions and field educators are dependent upon reciprocity and understanding of the roles and responsibilities. It is firmly believed that those who facilitate field education require specialist preparation and training

Professional supervision is deemed under-explored and inadequately-theorised in the body of literature pertaining WIL. In contrast, it is regarded a key contributor in social work education where students are supported during placement to engage in knowledge and skill development. Chilvers et al. (2021: 439) indicate that “development occurs through exposure to genuine practice opportunities with service users, by fostering critical reflection, providing feedback, and facilitating a broad range of experiential learning activities in a safe environment”. Students are socialised into a professional group by their field supervisors.

Student assessment with the view of demonstrating to the SWRB (the regulatory body) that core competencies were acquired during field placements. A broad range of forms evidence collection could be considered for WIL, such as direct observation of student practice, team meetings, consultations with agencies, written appraisals, case notes, client assessment reports, email communications, referral letters, and documentation associated with conducting research and policy or procedural development. Other ways of teaching, learning and assessment include “the use of process recordings to provide students with an opportunity for a detailed ‘think aloud’ about a particular interchange with a client or team member” (Chilvers et al. 2021: 441); the writing or presenting of a deconstruction of an event or interaction that happened; and compilation of a digital learning portfolio.

Chilvers, D., Hay, K., Maidment, J., & Tudor, R: Contribution of social work field education to WIL. International Journal of Work-Integrated Learning, 2021, 22(4), 433-444. Electronically accessible from https://www.ijwil.org/files/IJWIL_22_4_433_444.pdf

Illeris, K. 2002. The three dimensions of learning. Malabar, Fla: Krieger

Martin, A., Rees, M., & Edwards, M. (2011a). Work integrated learning, a template for good practice: supervisors’ reflections. An Ako Aotearoa publication. Electronically accessible from: https://ako.ac.nz/assets/Knowledge-centre/RHPF-c43-Work-Integrated-Learning/RESEARCH-REPORT-Work-Integrated-Learning-A-Template-for-Good-Practice-Supervisors-Reflections.pdf

The acronym ‘PBL’ represents a significant range of problem based learning practices

“The label ‘PBL’ covers an amazing diversity of educational practices”, say Ryberg and Nørgaard (2013: V); citing Kolmos and Graaff (2003: 657), who observe the use of the acronym “ranging from problem-oriented lectures to completely open experiential learning environments”; as well as Barrows (1986: 485) who states it “addresses different objectives to varying degrees”; and recommends “any PBL method must be analysed in terms of the type of problem used, the teaching learning sequences, the responsibility given to students for learning and the student assessment method used”.

Barrows (1996: 3) summarises the “factors that motivated the need for curricular change”, the introduction of problem-based learning (PBL) in 1969, and developments that followed. Countless “approaches to problem-based learning”, representing a significant “variety of methods”, resulted in a notion with “far less precision than might be assumed” observes Barrows (1996: 5). Scholkmann (2020) reaffirms that “Variations in PBL implementation need to be seen as the norm rather than the exception, since local PBL practice will always diverge from the ‘original model’”. Despite “the many variations of PBL that have evolved”, Barrows (1996: 5-6) argues that “a core model or basic definition with which others can be compared is needed”, and outlines (paraphrased below) the original method developed for the medical school of McMaster University, Faculty of Health Sciences:

• Learning is student-centred, in that students must take responsibility for their own learning, identify what they need to know to better understand and manage the problem on which they are working and determining where they will get that information.
• Learning occurs in small student groups of five to nine students randomly assigned with a tutor for each curricular unit, giving students practice in working intensely and effectively with a variety of different people.
• Teachers/lecturers/tutors are group facilitators or guides, asking students the kinds of questions that they should be asking themselves to better understand and manage the problem. Tutors are not content experts and discouraged from falling back on old teaching reflexes and giving the students direct information and guidance
• Problems form the organizing focus and stimulus for learning, presented as a written case, case vignette, standardized (also called simulated) patient, computer simulation, videotape. The problems represent challenges students would face in practice, and provides the relevance and motivation for learning. The problems give students foci for integrating information from basic sciences and various disciplines.
• Problems are vehicles for the development of clinical problem-solving skills (professional practice) presented in a format similar to the real world. Students are permitted ask the patient questions, carry out physical examinations, and order laboratory tests.
• New information is acquired through self-directed learning, in that students are expected to learn from the bodies of knowledge and accumulated expertise by virtue of their own study and research, just as real practitioners do. Students work together, discussing, comparing, reviewing, and debating what they have learned.

Moust et al. (2005: 668) illustrate (Figure 1 below) the problem-based learning (PBL) process “connected with the various underlying learning principles in each phase of students’ learning”. They remark that “PBL can be seen as an example of a learning environment that fosters active, constructive, contextual, cooperative, and goal-directed learning”, and that research “has shown that implementation of these principles has a positive effect on students’ learning processes”.

Barrows, H. S. (1986). A taxonomy of problem-based learning methods. Medical Education, 20(6), 481–486. doi:10.1111/j.1365-2923.1986.tb01386.x

Barrows, H. S. (1996). Problem-based learning in medicine and beyond. In L. Wilkerson & W. H. Gijselaers (Eds.), New directions for teaching and learning, 68, 3–13. Jossey-Bass. Electronically accessible from https://doi.org/10.1002/tl.37219966804

Kolmos, A., & Graaff, E. D. (2003). Characteristics of Problem-Based Learning. International Journal of Engineering Education, 2003(19), 657–662.

Moust, J. H. C., Berkel, H. J. M. Van., & Schmidt, H. G. (2005). Signs of erosion: Reflections on three decades of problem-based learning at Maastricht University. Higher Education, 50(4), 665–683. Electronically accessible from https://doi.org/10.1007/s10734-004-6371-z

Ryberg, T. & Nørgaard, B. (2013). Introducing Problem Based Learning in Higher Education. Journal of Problem Based Learning in Higher Education, 1(1), I-VI. https://journals.aau.dk/index.php/pbl/article/view/274/201

Scholkmann, A. (2020). Why don't we all just do the same? Understanding variation in PBL implementation from the perspective of translation theory. The Interdisciplinary Journal of Problem-based Learning, 14 (2), Special Issue: PBLing the unPBLable. Electronically accessible from https://scholarworks.iu.edu/journals/index.php/ijpbl/article/view/28800/35707

What competences; which experiences; and feasibility?

For teaching and learning, the central—“constituting something from which other related things proceed or upon which they depend”—issue, is the expected/stated outcomes (such as knowledge, skills, and attitudes), and/or competencies.

Once the expected outcomes and/or competencies are known, careful consideration must be given to which learning experiences are most likely to accomplish those; and the feasibility of providing such.

Certain learning is best acquired (or accomplished) through contextual experience/s, application, and reflection. A number of conditions are of significance pertaining contextual experiences, such as:

• The degree of authenticity (or genuineness) for learning that is provided
• The degree of fidelity (or proximity) with regard to reality
• The extent of interactivity (and immersivity) made feasible

The extent to which the occupational-field/the profession/the community-of-practice/vocational representatives were involved in determining the learning outcomes; and in particular the expression of willingness to support the teaching, by providing real-life learning opportunities, is a major deciding factor. Without adequate support, and the provision of access to contextual learning experiences, the options are reduced; and workplace-learning placements become a substantial challenge.

Workplace/clinical-field/professional/vocational realities, however, do not always permit actual exposure. This could be due to for example security/confidentiality/safety/sensitivity. In such circumstances, the realities could be simulated in a variety of ways in order to provide alternative experiences with the objective of achieving the stated learning outcomes.

The aforesaid highlight some of the teaching-design considerations, however, there are many other issues to consider, and a range of options and possibilities. Some of the potential modes of teaching include:

• Work-integrated/workplace/work-based learning, clinical training/professional practice/placement
• Project- and problem-based learning, work-based project, and live projects
• Case-based learning, case studies, case methods, life course/experience, and story telling
• Studio-based learning, studio-work, studios, and problem solving
• Service learning, community engagement, and role plays
• Virtual learning environments, virtual reality, and a range of potential simulations
• Non-placement work-integrated learning
• Work-directed theoretical learning, and projects

Core values of a medical residency programme

‘Residency’ refers to “the period during which a physician gets specialized clinical training”. The Northeast Georgia Medical Center (NGMC) Graduate Medical Education offers an Emergency Medicine Residency, “a three-year program designed to provide residents with top-notch clinical training”, a term used in the field of medicine for work-integrated learning, meaning among others ‘related to the bedside of a patient, the observation and treatment’.

‘NGMC Emergency Medicine Residency’ tweeted 24 September 2021: “We believe that any major endeavor -- like starting a new residency -- should be mission-driven and purposeful. We spent a lot of time developing our 6 official (and 1 unofficial) core values that impact and drive everything we do in our residency. Here are our core values:”

• Core value 1: Clinical education and becoming a good EM doctor is foundational -- the bedrock of any career in emergency medicine. If you want to be a leader, administrator, researcher, advocate, or teacher, you first have to be a good doctor and take good care of patients
• Core value 2: We serve our patients best by actively cultivating an environment of respect for diversity. A diversity of ideas, backgrounds, and experiences, makes us all better and helps us provide better medical care for our patients
• Core value 3: We have a firm expectation of honesty, integrity, and transparency at all levels of leadership. We hold ourselves to a high standard and we will hold our residents to a high standard
• Core value 4: We will always push ourselves and challenge ourselves to be better. We want to exist outside our comfort zone in order to continually grow, improve, and be resilient
• Core value 5: We recognize that residents and physicians perform their best when they have ownership of their work environment and educational environment. We want to recruit high achievers and give them the means and opportunity to develop their own path in medicine
• Core value 6: We believe the best learning comes from unofficial mentorship and we will cultivate a collegial and family feel amongst our residents and faculty
• Unofficial core value 7: Food is love. We will feed our residents, their families, and their children and welcome them into our homes and prepare meals for them

We are looking for residents who are similarly mission-driven, who want to push themselves, who want to be challenged, who are innovative, and who want to impact future generations of emergency medicine!”

The programme webpage states “Training in the fast-paced, high-volume emergency departments and learning from passionate, experienced educators at Northeast Georgia Emergency Medicine Residency will prepare graduates to work in any environment world-wide and will be a springboard for a long and satisfying career in emergency medicine.”

Source

Placement and non-placement work-integrated learning (NPWIL)

Through this blogpost I attempt to provide some guidance regarding the scope of placement and non-placement forms of work-integrated learning (WIL).

Work-integrated learning (WIL) is generally associated with placements, whereby students spend periods of time in the workplace. However, in recent years, many innovations–without placement time–with regard to integrating work practices into teaching and learning occurred. There has been “evidence to suggest universities were exploring and experimenting with new ways” and an uptake of non-placement WIL activities, “to include a range of simulated, virtual, authentic and industry-based activities” say Dean, Eady and Yanamandram (2020: 1-2). The global Coronavirus (COVID-19) pandemic escalated experiments, which were further leveraged through technological platforms, and described by some as a learning revolution. It most certainly served as impetus for questioning the dominant modes of WIL, and extending interest into alternative WIL models. Examples of non-placement WIL (NPWIL) “may include (but not limited to) authentic industry projects, simulations, field work, creative studio work, digitally enabled or virtual WIL and other NPWIL experiences”.

Whereas my employer opted about a decade ago to use experiential learning as umbrella term, differentiating WIL and simulated work experiences (SWEs), others broadened the range of WIL to include forms of non-placement. Dean, Yanamandram, Eady, Moroney, O'Donnell, and Glover-Chambers (2020) indicate that over the last decade WIL has moved away from the narrow conception of ‘work placements’ to a much broader and widening lens. An earlier typology of WIL entails three models, namely professional programmes, service learning and cooperative education; where students reside in different ‘workplaces’. Another typology delineates different types of WIL experiences, based on ‘on-site’ activities, namely systematic training (e.g., apprenticeships); the structured work experience (e.g., field experience, mandatory professional practice, co-op and internships); and institutional partnerships (e.g., applied projects, service learning). Dean, et al. (2020) indicate that boundaries with regard to WIL are often unclear because of complexities of multiple variables and understandings. They convey five innovative models that are growing, given the advancements in technology, globalisation and creativity, including micro-placements, online projects or placements, competitions such as hackathons, incubators or start-ups and consulting.

Dean, Yanamandram et al. (2020) caution against the use of WIL ‘type’ nomenclature for categorisation, because of variations in terminology, yet relatively similar definitions. They support the notion of classification based on the defining features of WIL rather than specific modes or models of WIL. Dean, Yanamandram et al. (2020) cite a typology by Kaider, Hains-Wesson and Young (2017: 158), comprising a two dimensional grid, namely authenticity vertically and proximity horizontally, depicted in my blogpost ‘Evolving work-integrated learning typologies and frameworks’.

The authenticity axis portrays the learning activity, and the assessment thereof, with regard to the extend students work on problems, processes and projects that they may encounter in the future workplace, and to what extend artefacts that students need to produce would reflect the practice. The proximity axis represents the degree of closeness of learning experiences to real workplaces or practice contexts, and the degree of direct interaction with industry practitioners or community members on work related activities. Kaider et al. (2017) overlaid their grid with exemplars of activities that could take place across three different stages of university education. However Dean, Yanamandram et al. (2020) find this problematic and present both the Universities Australia typology based on the delivery of WIL activities, and the University of Wollongong, Australia, university-wide approach of a WIL Curriculum Classification (WILCC) Framework. Informed by all these, I propose a three-dimensional-kind of typology (or framework), based on Kaider et al. (2017: 159) authenticity-proximity axes, but overlaid by my three broad categories I propose, namely: (a) foundational, (b) applied, and (c) comprehensive, depicted in the diagram below.

Kaider et al. (2017) do not include a grouping for both low-authenticity and low-proximity, because they do not regard such means of teaching and learning as WIL.

Foundational WIL as ‘category’

The four groupings serve as examples of credit-bearing WIL which require of students to observe, explore, analyse or reflect on the application of theory in practice. Activities should be purposefully designed to provide for career development learning, developing of identities, and to guide the learning and reflection of students about the discipline, concepts, skills, ethics and aptitudes. Foundational relates to groundwork or laying the basis for future practice.

Applied WIL as ‘category’

These three groupings also serve as examples of credit-bearing WIL which generally require of students, or provide students opportunities to practise, while also critically reflect while directly engaging in work practices. Applied WIL activities compliment theoretical learning and should be purposefully designed with practical purpose in mind, involving engagement with the actual phenomena.

Comprehensive WIL as ‘category’

This category includes examples of large scope or extensive coverage generally of substantial credit-bearing WIL. However, in some cases internships may involve postgraduate work under supervision with the aim of professional registration. Such WIL should be purposefully designed to provide students opportunities to practise and reflect on actual work with supervisory guidance and feedback. University staff generally provide briefing/debriefing, reflection and support sessions, monitoring and assessment. Students may further be required to participate in activities to share, reflect on and integrate their learning experiences. Comprehensive WIL displays both high levels of authenticity, and high levels of proximity to future work practice.

References

Dean, B., Eady, M.J. and Yanamandram, V. 2020. Editorial: Advancing Non-placement Work-integrated Learning Across the Degree. Journal of University Teaching & Learning Practice, 17(4), Available at: https://ro.uow.edu.au/jutlp/vol17/iss4/1

Dean, B., Yanamandram, V., Eady, M.J., Moroney, T., O'Donnell, N., & Glover-Chambers, T. 2020. An institutional framework for scaffolding work-integrated learning across a degree. Journal of University Teaching & Learning Practice, 17(4). Available at: https://ro.uow.edu.au/jutlp/vol17/iss4/6

Kaider, F., Hains-Wesson, R., & Young, K. 2017. Typology of authentic WIL activities and assessment, Asia-Pacific Journal of Cooperative Education, 18(2), 153-165. Available at: https://www.ijwil.org/files/APJCE_18_2_153_165.pdf

Virtual learning environments (VLEs) could potentially accelerate a significant increase in knowledge

Cunha, Terreri and Len (2020) report on research with regard to the success of a virtual learning programme with regard to paediatric rheumatology in Brazil. They start off by sketching the background and scope of the need for training of resident medical practitioners, who are responsible for the first care of children as it would cause delays in referral, diagnosis and treatment if inadequately trained. Medical educators have since the 1960s developed computerized education and virtual learning environments (VLEs), which “stand out as a safe and potential tool in the literature, supporting the teaching-learning process”, Cunha, Terreri and Len (2020: 2) remark. They outline the approach to the training:

• teachers of reference services in paediatric rheumatology and paediatricians were invited to each suggest ten topics considered of utmost practical significance to the training
• after all the submissions were accrued, the original participants were sent a Survey Monkey assessment and asked to rate the 36 topics suggested in the first request using a Likert scale from 1 to 7 (1 = strongly disagree and 7 = strongly agree)
• after statistical analysis six themes emerged:
  • History and physical examination in rheumatology
  • Warning signs that may indicate rheumatic disease
  • Musculoskeletal pain in childhood
  • Differential diagnosis of acute arthritis
  • Vasculitis: Kawasaki disease and Henoch-Schonlein purpura
  • Juvenile idiopathic arthritis
• a specialized system analyst used ASP.NET 4 associated with the Bootstrap framework to build the web system, making use of a Microsoft SQL Server 2012 database
• a trained and qualified in paediatric rheumatologist created video lessons and interactive clinical case sessions, which were reviewed by professors in the field
• freely accessible scientific articles were selected to complement the teaching
• the virtual learning environment, of each module, comprised a ten to 25 minutes of video lecture, an interactive case study and the mentioned scientific articles
• residents in training could only change modules after watching each video class in full and having answered the entire interactive case report

Cunha, Terreri and Len (2020: 7) observed Paediatric Rheumatology VLE to be an effective tool that brought about a significant increase in knowledge. They conclude that the internet has ushered in a new era, allowing for “students to quickly access information and virtual learning environments”, but remark that “not all educational sites are equally effective”.

Cunha, A.L.C., Terreri, M.T., & Len, C.A. 2020. Virtual learning environment in pediatric rheumatology for pediatric residents. Revista Paulista de Pediatria, 38. Accessed electronically from http://dx.doi.org/10.1590/1984-0462/2020/38/2018189

Value of simulated clinical training

With regard to simulated work-integrated learning (WIL), Rahm, Wieser, Bauer, Waibel, Meyer, Gerber and Fucentese (2018) report that most studies demonstrate virtual reality based simulator training does result in improvement of technical skills. They tested the efficacy of a standardized, competency based training protocol for arthroscopy—also called arthroscopic or keyhole surgery, which is a minimally invasive surgical examination, and sometimes treatment of damage, of a joint. Clinical training (work-integrated learning in the medical field) of medical residents is both a demanding and time consuming job in teaching hospitals. Arthroscopy skills cannot be acquired by observation and assisting alone. Virtual reality competency based simulator training has been found to be at least of equal value as direct observation, animal and/or cadaver models or videotape learning tools. Although the initial investment of a simulator is high, as is service expenses, the benefit of a potentially 24/7 availability of a training tool is deemed increasingly important because hands-on operation time is getting less for residents.

https://images.app.goo.gl/uYDcizXHbA1HDo5u8

Rahm, S., Wieser, K., Bauer, D.E., Waibel, F.W.A., Meyer, D.C., Gerber, C, & Fucentese, S.F. 2018. Efficacy of standardized training on a virtual reality simulator to advance knee and shoulder arthroscopic motor skills. BMC Musculoskeletal Disorders, 19. Accessed electronically from https://doi.org/10.1186/s12891-018-2072-0

Key component of experiential education is reflection, not activity

Snow, Wardley, Carter and Maher (2019: 80) state that the term experiential education “is often misunderstood or misapplied through reductionist thinking to any learning that involves activity”; on the contrary, it is defined as “a pedagogical approach that encourages collective and personal critical reflection and development”. They engaged in seeking to answer questions about the feasibility of designing online experiential learning opportunities and how this can contribute to deepening professional practice in Nursing, Education, Business and Community Studies. They remark that “The key component of experiential education documented in the literature is action on the part of the student that promotes learning through reflection” (emphasis added). However, experience itself is not necessarily educative, especially when reflection is omitted. Experiential learning comprises, as per Kolb’s cycle of four stages, namely: concrete experience (CE), reflective observation (RO), abstract conceptualization (AC), and active experimentation (AE). Snow, Wardley, Carter and Maher (2019) report that collaborative activities through online synchronous and asynchronous technologies have been found to support the development of competence. They share lived experiences about four undergraduate-level professional programmes that involve experiential learning to varying degrees.

The first scenario pertains to a part-time blended learning programme from Registered Practical Nurse (RPN) to a Bachelor of Science in Nursing (BScN) degree. The RPN to BScN programme comprises theory courses delivered online and clinical (experiential) courses occurring in clinical practice settings. Each clinical module includes an online course site, which houses resources and “serves as an environment where students are required to reflect and think critically on their learning with their clinical instructor and other students”. The reflection principally through writing, with tools such as discussion boards, blogs, and course-specific email. This “blend of clinical learning with carefully designed online writing activities is a powerful combination”. Case studies and problem-based learning activities in the theory modules further serve as a form of experiential learning. The clinical or experiential, on the other hand are “enhanced through online activities and assignments that require critical thinking through reflection”.

The table below summarises the other three scenarios:

Scenario	Reflective Observation	Abstract Conceptualization	Active Experimentation	Concrete Experience
2.    Typical blended learning cycle, teacher education, science	The first lesson of each unit face-to-face, in which the previous experience deconstructed and explored and a new cycle established.	Asynchronous online activities were used to engage with theory related to learning objectives.	Each lesson design was unique to the student and specific community context.	Students did online video presenta-tions of their lessons & received feedback from their classmates.
3.    Typical learning cycle, occupational health & safety	Interactive learning based on content of module	Research paper	Discussion posts, blog entries & case studies	Community-based marketing outreach message
	Simulations and videos posted by professor with questions to address in blogs	Conceptualizing workforce-relevant knowledge related to the group topic	Reflecting, applying knowledge, and evaluating peers	Content presented online; three-tiered monitoring and measurement systems (peers, professor, and community members)
4.    Typical learning cycle, work place-ment courses	Discussion posts and a final reflective essay for each course	Developing a career plan (COMS 2101); information interview (COMS 3101)	Discussion posts, journal summaries, & self/supervisor evaluations	Placements with a community partner (100 hours for COMS 2101, 100 hours for COMS 3101)

It is the experience of the authors that “the practical realities of experiential education in higher education are challenging, and faculty interested in developing experiential learning opportunities for students must negotiate institutional policies, external regulatory bodies, and, at times, even concerns about legitimacy within their departments”.

Snow, K., Wardley, L., Carter, L. & Maher, P. 2019. Lived Experiences of Online and Experiential Learning Programs in Four Undergraduate Professional Programs. Collected Essays on Learning & Teaching: Pedagogical Innovation: Adapting Practice to Evolving Cultures, Section II, Vol. 12, p79-93. DOI: https://doi.org/10.22329/celt.v12i0.5388

A comprehensive framework for assuring the quality of work-integrated learning

Much emphasis is placed on the notion of ‘quality’, on quality assurance measures and initiatives, and on improvement plans (or frameworks), state McRae, Pretti and Church (2019: 1-2). Quality could be described as a desired end-state, a striving for excellence.

There are a number of frameworks of quality standards deemed relevant:

• Smith’s (2012) framework for evaluation of the work-integrated learning (WIL) curriculum proposes six measures of specific domains, namely authenticity, integrated learning support, alignment, supervisor access, and induction (or preparation processes)
• The Council on Higher Education (2014) criteria for the coordination of work-based learning programmes presented by distance higher education institutions.
• The McRae, Pretti and Church (2019) triple-A star (AAA★) framework below, comprising five main sections, namely (1) the foundation, concepts, terminology and five stakeholder groups (students, host organisations/employers, the educators, academic institutions, and governments—in each of the stakeholder groups there are potentially “advocates”, which are bodies representing the interests of and/or supporting the group); (2) the participation aims of each of the stakeholders; (3) the actions by each of the stakeholders that is critical for quality; (4) the expected achievements (or outcomes, impacts, measures, and key performance indicators) for each of the stakeholders; and (5) finally a synthesis of four sections, as well as an outline of a continuous improvement process.

Figure: Triple-A star (AAA★) framework (McRae, Pretti & Church, 2019: 1)

Whereas the Council on Higher Education (2014) reiterates the 2004 accreditation criteria; Smith (2012: 250) presents a new evaluation framework which structurally and conceptually divides the WIL curriculum into six domains or constructs:

1. Authenticity
2. Alignment of teaching and learning activities with integrative learning objectives (Align-TLA)
3. Alignment of assessment with integrative learning objectives (Align-Asst)
4. Integrated Learning Support (across the two university and workplace sites) (ILS)
5. Supervisor Access (Sup. Access)
6. Induction and Preparation Processes (IPP)

The Council on Higher Education (2014) furthermore persists with the use of the term work-based learning (and the coordination thereof), whereas Smith (2012: 250) asserts that authenticity “is at the heart of all workplace-situated learning”. Smith (2012: 247) asserts that work-integrated learning (WIL) entails students spending time “in professional, work or other practice settings relevant to their degrees of study and to their occupational futures”; but points out that “WIL is not the same as work experience or work-based learning, neither of which require students to specifically learn, apply or integrate canonical disciplinary knowledge”. Both physical authenticity (providing students with real work environments) and cognitive authenticity (where students personally engage in, encounter, and participate in meaningful and relevant learning within the specified disciplinary framework) of curricula are deemed important. The authenticity is assessed with regard to what extent the environment would expose students to the real work settings and to which students can observe, interact and respond to that particular context. Projects should be meaningful and consequential. Freestone, Williams, Thompson and Trembath (2007) illustrate the application of a variant of the Course Experience Questionnaire (CEQ), namely the Work Experience Questionnaire (WEQ), as measure of the workplace learning experiences of students. The WEQ had been designed to explore the perceptions of students about their learning environment. The WEQ requires students to respond on a conventional five-point scale, ranging from strong disagreement (1), through to strong agreement/concurrence (5), with the intermediate points not labelled. The dimensions of ‘clear goals’ and ‘support for learning’ have been found to correlate highly with student learning. The WEQ questionnaire consisting of 33 items (questions), with items bundled into scales, namely:

• Clear Goals Scale (3 items)
• Support for Learning Scale (5 items)
• Generic Skills Scale (5 items)
• Menial Tasks Scale (3 items)
• Overall Satisfaction (1 item)
• Ungrouped individual questions (7 items)
• Additional Generic Skills (9 items).

Conceptually, there is a substantial difference between what is deemed quality. Whereas the Council on Higher Education (2014) focusses on various elements of coordination; Smith (2012) focusses on what constitutes good teaching and learning. He (p. 248) argues that WIL “focuses attention on the integration of discipline learning and workplace practice or application”. Smith (2012: 251) advances the “notion of the constructive alignment of learning objectives with teaching and learning activities (TLAs) and assessments”. He alludes to the fact that during WIL placements students are not at their host universities, but at workplaces, and therefore urges curriculum design deliberately integrated support services in the delivery, in order to improve the individual learning by alleviating stress. This up with the management of pedagogical aspects through induction and preparing students, both pedagogically and practically. Smith (2012: 252) recognises that such present an extra burden on academics, which is compounded by the need for maintaining contact “between the academic convenor (or appropriate others – e.g. tutors) and students in situ” (notion of supervisor access).

McRae, Pretti and Church (2019: 7) assert that “WIL is a collaborative endeavour and the perspectives of multiple stakeholders need to be incorporated to ensure the quality of WIL outcomes” and elaborate that “each of these stakeholders has a connection to quality WIL as described by the key aspects identified by P.E.A.R.”:

• P for pedagogy — the curriculum needs to be designed “to allow students and host organizations to make the most of the experience and students need to engage with the curriculum”
• E for experience — “educators need to verify that the opportunity aligns with the educational goals of the course/program, host organizations need to provide opportunities for meaningful and substantial contributions, and WIL students need to fully engage with the host organization to make the experience valuable for both themselves and the organization”
• A for assessment — “designed by the educator with input from the student and host organization”
• R for reflection — the educator must provide prompts “to facilitate reflection on the experience for the student and the host organization ensuring maximum learning gains from the experience”

McRae, Pretti and Church (2019: 4-5) cites the Canadian national association for Co-operative and Work-Integrated Learning (CEWIL) definition of work-integrated learning (WIL), namely “a model and process of curricular experiential education which formally and intentionally integrates a student’s academic studies within a workplace or practice setting. WIL experiences include an engaged partnership of at least: an academic institution, a host organization, and a student. WIL can occur at the course or program level and includes the development of learning outcomes related to employability, personal agency, and life-long learning”. They further differentiate nine different models or forms of curricular WIL that exist in many post-secondary institutional contexts, namely:

• Apprenticeship
• Co-operative Education (co-op alternating and co-op internship models)
• Internship
• Entrepreneurship
• Service Learning
• Applied Research Projects
• Mandatory Professional Practicum/Clinical Placement
• Field Placement
• Work Experience

McRae, Pretti and Church (2019: 17) conclude that a quality framework for work-integrated learning is a critical, because each stakeholder has finite resources that they can be directed towards WIL, and each need to be intentional in how to allocate available resources. Many stakeholders support the positive outcomes of WIL in higher education as well as expansion, however, the outcomes are not guaranteed. Quality must remain in focus. McRae, Pretti and Church (2019: 17) suggest that through articulating the aims; accomplishing the actions; assessing the achievements of the primary stakeholders; and by using the acquired information it is possible to set a continuous improvement process in motion through quality can be assured.

References

Council on Higher Education. 2014. Distance Higher Education Programmes in a Digital Era: Programme Accreditation Criteria (pp 81-107), in Distance Higher Education Programmes in a Digital Era: Good Practice Guide — Criterion 15, p. 104. Electronically accessible from http://www.che.ac.za/sites/default/files/publications/CHE%20-%20Distance%20Higher%20Education.pdf

Freestone, R., Williams, P., Thompson, S. & Trembath, K. 2007. A quantitative approach to assessment of work-based learning outcomes: an urban planning application. Higher Education Research & Development, 26(4), December, 347–361. Electronically accessible from https://tandfonline.com/toc/cher20/26/4?nav=tocList

McRae, N.T., Pretti, J. & Church, D. 2019. Work-Integrated Learning Quality Framework. University of Waterloo, Waterloo Centre for the Advancement of Co-operative Education (WatCACE), Electronically accessible from https://uwaterloo.ca/centre-advancement-co-operative-education/research-publications/wil-quality-framework

Smith, C. 2012. Evaluating the quality of work-integrated learning curricula: a comprehensive framework. Higher Education Research & Development, 31(2), 247–262. Electronically accessible from https://www.tandfonline.com/doi/full/10.1080/07294360.2011.558072

Exclusion of experiential or work-integrated learning from State funding

The November 2014 Ministerial Statement on University Funding in South Africa (Department of Higher Education and Training, 2014a: 6) specifies that the calculation of actual teaching input excludes experiential learning, or work-integrated learning.

The Report of the Ministerial Committee for the Review of the Funding of Universities, differentiated among others clinical training (§7.4, p. 33; §7.5, p. 266) for health professionals; veterinary sciences (§7.5, p. 33; §7.6, p. 269); and teaching practice for pedagogy (§7.4, p. 256). The Ministerial Statement on University Funding affirms this differentiation in Section C (pp. 12-23), which focuses on budgetary provision for specific universities in earmarked fund categories for 2015/16 and 2016/17. Earmarked veterinary sciences grant (§6, p. 20) and clinical training grant (§ 7, pp. 20-21). It is considered important to point out that only certain programmes are eligible for clinical training funding.

Department of Higher Education and Training (South Africa). 2014a. Ministerial Statement on University Funding: 2015/16 and 2016/17, November 2014. Electronically accessible from http://www.dhet.gov.za/Financial%20and%20Physical%20Planning/Ministerial%20Statement%20at%20University%20funding;%202015-16%20and%202016-2017,%20November%202014.pdf

Department of Higher Education and Training (South Africa). 2014b. Report of the Ministerial Committee for the Review of the Funding of Universities, October 2013. Pretoria: DHET. Electronically accessible from http://www.dhet.gov.za/Financial%20and%20Physical%20Planning/Report%20of%20the%20Ministerial%20Committee%20for%20the%20Review%20of%20the%20Funding%20of%20Universities.pdf

Learning of a different kind occurs when opportunity to apply

Bringing life to learning, a report about experiential learning at Ontario universities, states in the Introduction (Council of Ontario Universities, 2014: 12 - Download Council_Ontario_Universities_EL_Report_p12) that when there is no exam to study for, no essay to write, a different kind of learning occurs. An experiential learning opportunity is where curiosity gets tested in the real world, where knowledge and skills that have been learned are applied to a real life project.

The report further addresses experiential learning issues pertaining to:

• When students of work-integrated learning programs land dream jobs (pp. 13-14)  Download Council_Ontario_Universities_EL_Report_p13 &  Download Council_Ontario_Universities_EL_Report_p14
  
• Cultivation of business leadership (pp. 15-16)  Download Council_Ontario_Universities_EL_Report_p15 &  Download Council_Ontario_Universities_EL_Report_p16
• Innovations in technology (p. 17)  Download Council_Ontario_Universities_EL_Report_p17
• Hearing from students and graduates (p. 19)  Download Council_Ontario_Universities_EL_Report_p19 &  Download Council_Ontario_Universities_EL_Report_p20
• Students shaping communities (pp. 21-22) Download Council_Ontario_Universities_EL_Report_p21 &  Download Council_Ontario_Universities_EL_Report_p22
• What students and graduates are saying (p. 23)  Download Council_Ontario_Universities_EL_Report_p23
• Bridging of borders (p. 24)  Download Council_Ontario_Universities_EL_Report_p24
• Students facilitating healthy living (pp. 25-26)  Download Council_Ontario_Universities_EL_Report_p25 &  Download Council_Ontario_Universities_EL_Report_p26
• Students enriching communities with the arts (p. 27)  Download Council_Ontario_Universities_EL_Report_p27
• Universities adding value through experiential learning (p.29)  Download Council_Ontario_Universities_EL_Report_p29

Council of Ontario Universities. 2014. Bringing life to learning, at Ontario universities — Experiential Learning Report. Toronto: Council of Ontario Universities. Electronically accessible from: http://www.cou.on.ca/publications/reports/pdfs/march262014---experiential-learning-report?utm_content=buffer89cdc&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

Cornell system for taking notes of real-experience learning

Deriving learning from experiences does not merely happen. A note-taking system devised at the University of Cornell, by an education professor, Walter Pauk, in the 1950s, could remarkably enhance the learning from experiences. A spiral reporter's notepad (or any of choice) works well. Space of 2-3 cm is left at the top to record the date, setting and circumstances. A line is drawn vertically, about a quarter to a third, from the left, leaving about 4-5 cms at the bottom. The column on the right serves as space to take notes of observations, explanations, facts, descriptions, etc. The column on the left use for key words, questions, etc. The space at the bottom is meant for recording a summary after the experience, for example at the end of the day.

Due to the efficiency of this method it is still being advocated; iPad templates exist for easy note taking; as well as pre-formated Cornell notepaper and guides to create a MS Word template; or PDF-format versions to print for use.

The Dr Walter Pauk Cornell system emphasises the five Rs, namely Record, Reduce, Recite, Reflect and Review.

Workplace and work-integrated learning in the expanded, effective and integrated post-school education and training system in South Africa

The notions workplace learning and work-integrated learning; each appears 13 times in the White Paper (2013). Download White Paper - final for web Please note that emphases were added to quotations below.

“Universities should seek to build strong partnerships with employers in order to promote the expansion of workplace training opportunities, especially in those areas where qualifications or professional registration depends on practical workplace experience. These partnerships can benefit from the inclusion of SETAs.” states the executive summary of the White Paper for Post-School Education and Training (2013, xiv). This statement is repeated on page 41 with elaboration that Sector Education and Training Authorities (SETAs) “which can assist in brokering university-employer collaboration as well as providing advice and resources to facilitate work-integrated learning”. 

“Learners exiting universities … are not, in general, finding work easily …” state the same white paper on page 64, because “they are often described by employers as lacking the skills needed” to which the “lack of practical workplace experience” is related. It is then concluded that “workplace learning must be seen as integral part of qualification and programme design”. On page 65 it is stated that “in future, universities should engage with industry stakeholders and SETAs to examine how their programmes could be progressively adjusted to fulfil the role”. 

The executive summary states on page xvi that “Universities, especially comprehensive universities and universities of technology, will be encouraged to expand distance higher education for vocationally orientated diploma programmes”. This is elaborated on at the bottom of page 50 and continued on page 51, stating “In the university sector, distance education is served by Unisa, as well as by North West University, the University of Pretoria, the University of KwaZulu–Natal and a handful of other public and private institutions. However, distance higher education for vocationally oriented diploma programmes at comprehensive universities or universities of technology is not as well-developed as that for the purely academic programmes.”

“Simulated workplace experience can be difficult to recreate in a workshop” is stated on page 9 of the white paper. This statement is preceded by the argument that “in many areas of study, useful practical experience can be obtained in an institutional workshop where learning can be easily controlled in line with a curriculum. However, institutional workshops often cannot afford to keep up with the most recent equipment available.” It is further stated that “… it is always beneficial to augment this with practice in an actual workplace where real-life experiences such as working under pressure, dealing with customers, and working as part of a team may be more easily learned”.

Page xvi of the executive summary observes that “the design of training systems, including curricula, requires close collaboration between education and training providers and employers — especially in those programmes providing vocational training”. On page xii this notion is repeated saying “emphasis will be given to strengthening partnerships with employers, both at the system level and that of individual colleges. Such partnerships will assist the colleges to locate opportunities for work-integrated learning”. It is also said that “employers should also be in a position to advise the college system and individual colleges around issues of curriculum, and experts from industry could teach at colleges …”. It is furthermore stated that “SETAs have an important role to play in promoting and facilitating between colleges and employers”. 

It is pointed out on page 5 that “the new configuration of the Department of Higher Education and Training enables tremendous possibilities for cooperation and mutual support among post-school institutions …” It is further pointed out that “SETAs working more closely with public institutions, especially TVET colleges and universities” and (p. 6) that “SETAs are beginning to help establish partnerships between these educational institutions and employers, especially to facilitate various forms of work-integrated learning.” 

The “National Skills Accord, signed in July 2011 by all partners in the National Economic Development and Labour Council (NEDLAC)” is mentioned on page 8. The signatories is said to have agreed to, among others, promote access to training opportunities in workplaces. On page 9 it is stated that the “combination of both theoretical knowledge and practical experience is important, indeed essential”; as well as that “practical experience builds applied knowledge and develops self-confidence in someone’s ability to act effectively”. 

It is deduced on page 9 that “training systems, including curricula, need to be designed around close cooperation between employers and education and training providers”. Teaching hospitals, as well developed models, are recommended. The important role of SETAs is stated in that “SETAs have a crucial role to play in facilitating such workplace learning partnerships between employers and educational institutions”. 

Page 16 elaborates that “it is essential that they [colleges] develop and maintain close relationships with employers in their areas of study”, because “close partnerships between colleges and employers will assist the colleges to locate opportunities for work-integrated learning and help them to place students”. Another benefit is that “colleges may also be in a position to benefit from donations of equipment from particular employers”. The role of SETAs is again mentioned, namely that “SETAs should play a role in forging relationships between colleges and employers, using not only their contacts but also their resources to incentivise employers to take on students for workplace learning opportunities. Partnerships between colleges and SETAs will be facilitated by the establishment of offices representing the SETAs in each college. These offices should represent all the SETAs in that college, and work to promote and facilitate the relationship between the college and individual SETAs in the interests of both. Some SETA offices, representing clusters of SETAs, have already been established in colleges”. 

About workplace learning it is stated on page 64 that often “work placements are unstructured and do not contribute to the outcomes of the qualification; rather, they take the form of compulsory work experience.” However, is said “the possibility exists for the colleges and the SETAs to work together to restructure such programmes as learnerships or apprenticeships, or for the work placement to become a more structured internship.”

Apart from “increasing access to workplaces for students in vocational and higher education, in the form of various of types of work-integrated learning” on page 65; it is remarked that “also essential is improving and updating the industry knowledge of educators by providing appropriate work-exposure opportunities for TVET [Technical and vocational education and training] lecturers”.

In the conclusion (p. 75) it is stated that “this White Paper sees a key role for employers in the integration of education and training. This will include a very significant expansion of work-integrated learning and workplace-based learning”. About SETAs, is stated that “the White Paper also envisages a strategic shift in the role of the SETAs in skills planning and in supporting the provision of education and training”. 

Republic of South Africa. 2013. Government Gazette No 37229. Department of Higher Education and Training. Notice No 11. 15 January 2014. White paper for post-school education and training — building an expanded, effective and integrated post-school system. Pretoria. Electronically available from http://www.che.ac.za/sites/default/files/publications/White%20Paper%20-%20final%20for%20web.pdf / http://www.gov.za/documents/download.php?f=207591

White Paper approved by cabinet 20 November 2013 and released 16 January 2014 by Dr BE Nzimande, Minister of Higher Education and Training.

• http://mg.co.za/article/2014-01-16-blade-launches-dhets-white-paper-to-meet-needs-of-the-neets/
• http://www.che.ac.za/media_and_publications/legislation/white-paper-post-school-education-and-training
• http://www.politicsweb.co.za/politicsweb/view/politicsweb/en/page71654?oid=515605&sn=Detail&pid=71616
• http://www.iol.co.za/business/features/white-paper-prioritises-artisan-training-at-colleges-1.1633531
• http://www.bdlive.co.za/national/education/2014/01/16/post-school-education-policy-could-not-have-come-at-better-time
• http://www.iol.co.za/news/south-africa/kwazulu-natal/varsity-push-for-african-languages-1.1633918#.Ut2DHJoaKvE

The meaning of the acronymn MBChB during clinical training

A popular joke among medical students according to medical doctor and author Rosamund Kendal; on page 9 of her fictional publication The Karma Suture; is that MBChB stand for messenger boy and carrier of human blood.

The title of her book is in itself most interesting:

• suture means to a sewing together or a joining as by sewing; and in medicine specifically, the joining of the edges of a wound through stitches.
• and karma, the notion of bringing something upon yourself.

A book about a young doctor's trials and tribulations practicing medicine, being over worked, seeking love and intimacy, dealing with complicated matters, and several experiential learning vinettes.

Importance of precise observation of skills demonstrated

Kogan et al (2011) emphasise the importance of precise observation of skills demonstrated and of giving first-rate feedback as essential aspects for the development of competence.

In clinical training many tools have been developed and published for the direct observation of the skills of residents with patients (Kogan et al, 2011). Despite this, performance ratings are often subjective and subject to rating errors, such as inaccuracy and unreliability. However, there has not been much investigation into causal factors of rater variability. Explanations by raters themselves for low inter-rater agreement include “differences in observer gender, ethnicity, experience or clinical competence” (p. 1049). In a study by Kogan et al (2011: 1051), four themes were identified to explain
the variability of judgements and ratings, namely:           
(i.)        “the use of variable frames of reference during observation and rating;        
(ii.)         the role of inference;       
(iii.)        the use of variable approaches to synthesising judgements into numerical ratings; and       
(iv.)        factors external to resident performance that influence ratings.”

Kogan et al (2011: 1051) found that many direct observers use their own outlook—how they do things—or what they consider a respected practitioner would, as criteria for making judgements and giving ratings.

Based on the four themes, Kogan et al (2011: 1056) created a descriptive model of the direct observation process. Present within observers are an amalgam of characteristics, values, expertise and emotions that could impact their observations. Observation is done through two lenses, namely the frame of reference as yardstick lens; and the other lens represents inference, which shapes the meaning and interpretation of the observations. The observation is furthermore done within a context of practice. The observations and interpretations are synthesised into a rating. Unfortunately reality is not neatly, foreseeable or straightforward. There are often other influences and complexities present that may sway ratings. Feedback to the observer, further contribute to modify current and future ratings. The model can be supported by situated cognition theory, namely “an individual’s thinking, knowing and processing are uniquely tied to and inextricably situated within (and cannot be completely separated from) the specific social situations within which those thoughts and actions occur” (pp. 1056-7).

Kogan, J.R., Conforti, L., Bernabeo, E. Iobst, W. & Holmboe, E. 2011. Opening the black box of clinical skills assessment via observation: a conceptual model. Medical Education, 45, 1048–1060.