Teaching and learning under COVID-19 public health edicts: the role of household lockdowns and prior technology usage.

Public health edicts necessitated by COVID-19 prompted a rapid pivot to remote online teaching and learning. Two major consequences followed: households became students' main learning space, and technology became the sole medium of instructional delivery. We use the ideas of "digital disconnect" and "digital divide" to examine, for students and faculty, their prior experience with, and proficiency in using, learning technology. We also explore, for students, how household lockdowns and digital capacity impacted learning. Our findings are drawn from 3806 students and 283 faculty instructors from nine higher education institutions across Asia, Australia, Europe, and North America. For instructors, we find little evidence of a digital divide but some evidence of a digital disconnect. However, neither made a difference to self-reported success in transitioning courses. Faculty instructors were impacted in a myriad of diverse ways. For students, we show that closure and confinement measures which created difficult living situations were associated with lower levels of confidence in learning. The digital divide that did exist among students was less influential than were household lockdown measures in undermining student learning.

The hidden labours of designing the Objective Structured Clinical Examination: a Practice Theory study.

Objective Structured Clinical Examinations (OSCEs) have become ubiquitous as a form of assessment in medical education but involve substantial resource demands and considerable local variation. A detailed understanding of the processes by which OSCEs are designed and administered could improve feasibility and sustainability. This exploration of OSCE design is informed by Practice Theory, which suggests assessment design processes are dynamic, social and situated activities. The overall purpose is to provide insights that inform on-the-ground OSCE administration. Fifteen interviews were conducted with OSCE academics and administrators from three medical schools in Australia, the United Kingdom and Canada. Drawing from post-qualitative inquiry, Schatzki's Practice Theory was used both as a sensibility and as an analytic framework. OSCE design was characterised by planning activities, administration activities, negotiation activities and bureaucratic activities; it involves significant and resource-intensive effort in negotiation and coordination. There was considerable local variation but at the same time activities were remarkably consonant across national boundaries. There was a tension between general understandings such as reliability and validity that underpin the OSCE and the improvisational practices associated with design and administration. Our findings highlighted the role of blueprints as a key coordinating artefact but with too many rules and procedures prompting cycles of bureaucracy and complexity. Emphasising coordination rather than standardisation might ease workloads, support adaptation to local environments and prevent an overly reductive approach to this assessment format.

Forensic interviewers' perceptions of the utility of mock interviews with trained actors as a training tool for child interviewing.

BACKGROUND: The use of mock interviews (also known as role play), particularly using trained actors as interviewees, has demonstrated positive effects on communication training but little is known about how learners engage with these practice activities. OBJECTIVE: The current study was conducted to determine what perceptions forensic interviewers hold about mock interviews as a learning exercise for developing skills for child interviewing, and whether there are negative perceptions that could potentially have an impact on the helpfulness of the exercise. PARTICIPANTS: Written reflections were obtained from 35 US forensic interviewing professionals who were enrolled in an online child interviewer training program. METHODS: Common themes were extracted from the reflections to establish forensic interviewers' perceptions of aspects of the mock interview. Extraction of themes assisted in the determination of whether perceptions impacted the manner and degree to which interviewers engaged in the mock interview process. RESULTS: Results suggest that regardless of potential anxiety, learners experience multiple benefits from the mock interview. CONCLUSIONS: Findings from the present study suggests suggest most trainees perceive mock interviews favourably, and they are useful in child interview training programs.

Identifying educator behaviours for high quality verbal feedback in health professions education: literature review and expert refinement.

BACKGROUND: Health professions education is characterised by work-based learning and relies on effective verbal feedback. However the literature reports problems in feedback practice, including lack of both learner engagement and explicit strategies for improving performance. It is not clear what constitutes high quality, learner-centred feedback or how educators can promote it. We hoped to enhance feedback in clinical practice by distinguishing the elements of an educator's role in feedback considered to influence learner outcomes, then develop descriptions of observable educator behaviours that exemplify them. METHODS: An extensive literature review was conducted to identify i) information substantiating specific components of an educator's role in feedback asserted to have an important influence on learner outcomes and ii) verbal feedback instruments in health professions education, that may describe important educator activities in effective feedback. This information was used to construct a list of elements thought to be important in effective feedback. Based on these elements, descriptions of observable educator behaviours that represent effective feedback were developed and refined during three rounds of a Delphi process and a face-to-face meeting with experts across the health professions and education. RESULTS: The review identified more than 170 relevant articles (involving health professions, education, psychology and business literature) and ten verbal feedback instruments in health professions education (plus modified versions). Eighteen distinct elements of an educator's role in effective feedback were delineated. Twenty five descriptions of educator behaviours that align with the elements were ratified by the expert panel. CONCLUSIONS: This research clarifies the distinct elements of an educator's role in feedback considered to enhance learner outcomes. The corresponding set of observable educator behaviours aim to describe how an educator could engage, motivate and enable a learner to improve. This creates the foundation for developing a method to systematically evaluate the impact of verbal feedback on learner performance.

Interprofessional learning at work: what spatial theory can tell us about workplace learning in an acute care ward.

It is widely recognized that every workplace potentially provides a rich source of learning. Studies focusing on health care contexts have shown that social interaction within and between professions is crucial in enabling professionals to learn through work, address problems and cope with challenges of clinical practice. While hospital environments are beginning to be understood in spatial terms, the links between space and interprofessional learning at work have not been explored. This paper draws on Lefebvre's tri-partite theoretical framework of perceived, conceived and lived space to enrich understandings of interprofessional learning on an acute care ward in an Australian teaching hospital. Qualitative analysis was undertaken using data from observations of Registered Nurses at work and semi-structured interviews linked to observed events. The paper focuses on a ward round, the medical workroom and the Registrar's room, comparing and contrasting the intended (conceived), practiced (perceived) and pedagogically experienced (lived) spatial dimensions. The paper concludes that spatial theory has much to offer understandings of interprofessional learning in work, and the features of work environments and daily practices that produce spaces that enable or constrain learning.