Professional programs within mainstream higher education are traditionally conservative and risk-averse, making it hard to introduce any significant changes into the curriculum. This is not necessarily a bad thing, since educators and program heads are subject to audit by professional regulatory bodies, and institutions are reluctant to expose their professional programs to negative public perception should something go wrong.
All of this creates a climate in which curricular innovation is often difficult to implement. This is right. Mainstream health professional education is generally conservative and slow to change because it must not only contend with concerns about pedagogy, but also ensure that patients are not negatively affected by curricular change. And yet innovation is an essential aspect of professional development, especially in a digital and networked society where our understanding of “teaching” and “learning” must adapt in order to ensure that we graduate students who are capable of thriving in the complex and dynamic systems of the 21st century.
In 2013 I asked what a course might look like that aimed to address some of these concerns, and teamed up with Physiopedia to run the first completely open online course in physiotherapy education. We wanted to develop a course that would see physiotherapy students in a mainstream university curriculum given opportunities to develop a set of competencies associated with learning in digital and online environments. We wanted students to be confronted with the challenges presented by the demand to learn collaboratively in public, as well as expose them to a wide range of perspectives regarding professional ethics and the influence of personal morality on clinical decision-making.
We proposed that the best method of facilitating these outcomes would be to have them do their writing (and therefore their thinking) in public using blogging software: a purpose for which we chose WordPress. Another useful benefit was that they would set up their own blogging environment, which be customizable, and, thus, a reflection of a truly personal learning portfolio. Each student would therefore also develop digital literacy skills , and the capacity to create a personally meaningful online learning space. In addition, since we knew students would be discussing potentially sensitive topics in public, we had to prepare them to ensure that they would respect patient and clinician privacy, for example. Rather than forbidding them to interact online, we wanted to see if we could instead better prepare them for public practice (they are, after all, accountable to the public).
This pilot project provided enormous value in terms of developing a set of implementation guidelines for setting up and running open online professional courses (http://www.mrowe.co.za/blog/2013/09/pht402-final-thoughts-and-moving-forward/), and led to a series of conference presentations and academic publications. The fact that the course was open (free to participate in, freely licensed content, and public) allowed us to invite participants from all over the world. In the first pilot implementation we had 38 qualified physiotherapists from around the world interacting with third year physiotherapy students, as they all moved through the course together. We had students giving each other feedback on their writing, but we also had clinical experts giving them feedback, which had a profound influence on the way that the students’ thought about their own ethical practice. It’s all very well for your lecturer to tell you something but when that that same feedback comes from a physiotherapist in another country, it changes the interaction and perceived value to the student. They learn not only that perhaps their lecturers may know something after all, but also how to interact with future colleagues in professional and ethical contexts.