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"New Learning": How Might it Look in Veterinary Education?

Anyone who is interested in a body of work on the future of education should follow the work of Professors Mary Kalantzis and Bill Cope at the University of Illinois College of Education. They have just released their new website which summarizes their expansive and groundbreaking efforts:

https://newlearningonline.com

Dr. Kalantzis is also the previous Dean of that College and Dr. Cope is also the founder of Common Ground Scholar, a multimedia writing, social media, peer review, and learning analytics learning management platform. I have had the pleasure of collaborating with them to evaluate this platform for use in medical case analyses as part of our efforts to engage first-year veterinary students in critical clinical thinking (more later).

From this experience, I have been struck by how solidly veterinary education appears stuck in what they call “old learning.” Obviously, if other elements of general education were not stuck there as well (isn’t that where we get our students?), they wouldn’t be talking about what “new learning” be.  It is worth reviewing their “5 theses on the future of learning” in entirety at the following link. 

https://newlearningonline.com/e-learning/five-theses-on-the-future-of-learning

I hope to now summarize them below, with some specific ideas about how veterinary medical education might adjust to recognize the realities and possibilities of this approach.  As a preface to these veterinary-specific comments, it is worth mentioning that medical information is now doubling every 70 days…less than a semester!  This reality highlights both the challenges for the student but also the instructor.  Those of us trained 40 years ago could count on 7 YEARS before that information doubled!

The 5 theses:

1. There will be no pedagogical differences between learning in person and learning online.
2. There will be no distinction between instruction and assessment.
3. Adaptive and personalized learning will not be at the expense of learning community.
4. There will be no class scale.
5. Educators will stop insisting on inequality of outcomes.

On Thesis 1, veterinary medicine started to embrace the online environment, at least for the graduate veterinarian, when continuing education (CE) began to be offered almost 30 years ago by Veterinary Information Network (VIN).  As the director of CE for VIN at the time, I noticed the huge motivation for the “distance” learner to learn “in situ” and apply almost instantly what they learned, getting within-course feedback about how best to apply it in their practices. The experience changed my thoughts and approach to “face-to-face” teaching from that time forward. Concepts wrapped in practical relevance seemed to have a better chance of engendering long-term learning.

But what Cope and Kalantzis say goes beyond “e-learning,” which, even when framed as flipped learning, still has the potential to look like “the teacher still mostly talks and the student mostly listens.” You might wonder why VetMedAcademy.org is trying to facilitate such a “half-way” measure. Largely because we believe that the comfort, traditions, and reward systems for teaching within veterinary academia still lie largely with the content-filled lectures presented in the bricks-and-mortar classroom (the teaching artifacts are largely Powerpoints).  By capturing or recapitulating this content in video format, and surrounding it by suggestions for more active learning like case analyses on CG Scholar (see below), we hope to prevent “reinvented wheels,” while demonstrating that there are more crucial roles for the in-class instructor than delivering the content.  

But how would the “new school” approach impact veterinary medicine if we could get there? Kalantzis and Cope have identified seven affordances: 1) ubiquitous learning, 2) active knowledge making, 3) multimodal knowledge representations, 4) recursive feedback, 5)collaborative intelligence, 6) metacognitive reflection and 7) differentiated learning (1,2). In veterinary medicine, particularly in light of our 70-day extinction halflife of content (and shorter student memory extinction halflives!), these affordances sound some of our profession’s proposed “Entrustable Professional Activities” (EPAs) (2). Let’s see how by adding references to these affordances [#] as we examine EPA 5 entitled “Formulate relevant questions and retrieve evidence to advance care.” The note accompanying EPA 5 states:

“The use of evidence-based practices [#3] and self-awareness [#6] are essential to identify [#2] and remedy/correct [#4] knowledge gaps [#4,6]. Life-long learning [#1,7] is an essential professional practice [#5] to promote quality patient and population care.” 

Old SchoolMoving to Thesis 2, veterinary medicine probably has a bit farther to go, as we still look a lot like their description of “old school."  As Cope and Kalantzis say about “old school,” “To learn was to memorize; assessment is to find out what had been remembered. Learning came first; assessment followed. The relation of learning to assessment was linear: first learning, then assessment (then move on to something else).”  

Let’s imagine veterinary medicine moving to “new school” where there is “no distinction between learning and assessment.” The closest we get to this is in the clinical year rotations and practicums, but I’d argue that, at that time, it might be too late, at least for some students.  What about “new school” before the clinical experience?…what would it look like?  Within the integrated first-year curriculum at the University of Illinois College of Veterinary Medicine, we tried a once-weekly exercise/assignment that, if expanded to a more comprehensive instructional approach, might get close.  Students were assigned clinical cases about which to write a multimedia analysis of about 2000 words within the CG Scholar platform (https://cgscholar.com) (4). We tried to design the cases to reinforce content in contemporaneous lectures by the faculty (yes, mostly Powerpoints).  Students were provided with guiding “critical clinical thinking” questions, but asked not to respond like a simple Q and A. They also were provided the rubric by which 3 of their peers would anonymously provide feedback about their first draft.  Although we did have offline group discussions, these could have been transferred to Scholar’s blog-like discussion where everyone was expected to contribute. 

Analytics DashboardThe comprehensive data analytics tracked student  behavior towards a clearly demarcated standard. In this format, we could see enormous growth of the student within their project, and by automated evaluation of the differences between the draft and final versions, we saw the vast majority of students created high quality case analyses despite their first-year status. In the combined class analytics “asterplot” shown below, average progress on a dozen instructor-chosen parameters and performance targets  is illustrated. Honing in on the yellow/green “petal,” we can learn that some improvement is needed to improve detail provided in case peer reviews.  The student can follow his/her analytics (an individual version of all the categories on the asterplot shown below) as they progress through the project, learning where they might need to increase effort, BEFORE the end of the project. (5).

In this approach,  learning is projectized just like life, veterinary practice, and any scientific publication: in effect, they were working collaboratively with their peer reviewers, even wrote rebuttals and comments for their reviewer, and most importantly, they revised and shared (published) their case analysis with their colleagues.  Along the way, the learning experience could have included timed releases of reading and video content, and ‘knowledge surveys’ (formative or summative quizzes) with with open discussion of what makes certain answers correct and others less correct.  The key to all of this is that learning is an incremental path that each student moves along with the help of “recursive feedback” until mastery is achieved. The goal of a project is achievement of perhaps dozens of smaller standards, not the common arraying of students along a bell-shaped curve.  As we are graduating medical professional students who need to meet minimum professional competency standards, why should we assume that the high stakes end-of-course or end-of-curriculum exam, or the North American Veterinary Licensing Examination (NAVLE), will be the most efficient and meaningful ways to assess what the student understands, can actually do, and if they can adjust their learning strategy in the future.  Cope and Kalantzis indicate that by melding assessment and instruction, you create “reflexive pedagogy.” (4)

On Thesis 3, the “new learning” approach does not negate the “learning community” we are so used to in veterinary medicine…those tight-knit veterinary classes that are used to recounting virtually identical experiences when they attend class reunions years in the future?  By working within a system that is adaptive and personalized, but taking advantage of the power of teaching while learning and vice versa, the learning community not only remains, but has the opportunity to become strengthened by collaborative learning experiences. Cope and Kalantzis note, “Intelligence is collaborative. There is machine feedback too, but the glue that moves learning forward is essentially social, the ‘stickiness’ of reciprocal learning.”  Indeed, the veterinary profession needs to train good collaborating teams by engendering cooperation amongst its professionals and paraprofessionals, as well as between generalists and specialists.

On Thesis 4, for those currently believing in and teaching in wet laboratories and the clinics, the idea that veterinary education should be able to “scale” easily in a new learning environment undoubtedly at first connotes a huge headache associated with overwork. However, shouldn’t we embrace elements of technology that will amplify the reach or improve efficiency of instructors?  The general trend recently in veterinary education has been to push class sizes upward for greater income. Therefore, the potential for scalability of some instructional functions should not be ignored. As they note,“Working closely with three peer reviewers is no different in a class of three than a class of three thousand. But for moments also, the class is indeed three thousand.” OK, perhaps veterinary schools are not considering 3000 students like a MOOC, but even the ability to expand to 250-300 as one already sees in many European schools, would be a paradigm shift.

On Thesis 5, we have written previously in this blog about our tendency to need to focus on the amount of teaching and learning that a large veterinary class (on average) can accomplish within a fixed period of time. But as we mention under Thesis 2, why is it that we cannot have mastery learning in a veterinary curriculum? Many will argue that it will cost too much to develop programs that allow for differentiated learning, including differentiated paces of learning.  But if we actually look at the reality of a class of 100-200 students, can we expect them all to satisfy necessary standards within the same timeframe?  Of those not achieving a passing grade of a particular class, how often do we do more than just tell them to repeat the entire course and/or year? Where is the efficiency in that? And what about those students who just scraped by with a passing grade? Just  the simple financial and time investment required to reach that level of the curriculum would create the imperative to “lift all boats” like this, to say nothing about the fact that we are representing to the public that these boats (students) are seaworthy!    

So, “new learning” overlaid on a veterinary medical education would lead to mastery learning involving consistent training in self-reflective, self-corrective critical clinical thinking.

References

  1. Cope, Bill and Mary Kalantzis. 2017. "Conceptualizing E-Learning." Pp. 1-45 in E-Learning Ecologies, edited by B. Cope and M. Kalantzis. New York: Routledge.

  2. Kalantzis, Mary and Bill Cope. 2012. New Learning: Elements of a Science of Education. Cambridge UK: Cambridge University Press.

  3. Competency-Based Veterinary Education, AAVMC. 2019:

https://www.aavmc.org/competencybasedveterinaryeducation/cbve-epas.aspx

  1. Scholar is a research and development project developed with the support of the Institute of Educational Sciences in the US Department of Education, the Bill and Melinda Gates Foundation and the National Science Foundation. Scholar and made available by Common Ground Research Networks, a not-for-profit, public benefit corporation.

  2. McMichael MA, Ferguson DC, Allender MC, Cope W, Kalantzis M, Haniya S, Searsmith D. 2019: Use of a  Multimodal, Peer-to-Peer Learning Management System for Introduction of Teaching Critical Clinical Thinking to First Year Veterinary Students, J. Vet. Med. Ed., in press.