Nurse Education in Practice (2006) 6, 106–111

Nurse

www.elsevierhealth.com/journals/nepr

Educationin Practice

An online learning community forclinical educators

Margaret McAllister *, Wendy Moyle

Research Centre for Clinical Practice Innovation, School of Nursing and Midwifery,Griffith University, Kessels Road, Nathan, Qld. 4111, Australia

Accepted 12 October 2005

Summary This paper describes a curriculum innovation that responds to the needfor a clinical education course to prepare Australian clinical educators for their rolein supporting students of nursing to develop clinical skills and gain confidence in thepractice of nursing. The course is underpinned by two major theoretical approaches:learning community and transformative education. This paper reviews the literatureon the strengths and challenges of online learning and describes the teaching andlearning strategies, assessment, and online presentations that were designed to pro-mote transformative learning and solidarity amongst participants.

�c 2005 Elsevier Ltd. All rights reserved.

KEYWORDSClinical education;Information andcommunicationtechnologies;On line learning;Learning community

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Introduction

Clinical learning for health students is an impor-tant, though problematic, part of education andhealth service functioning (Seabrook, 2003; Pri-deaux et al., 2000). Whilst clinical teachers havea strong influence on the quality of learning nursingstudents achieve (Clare et al., 2002), they are alsoin short supply, and in Australia they lack role clar-ity and uniformity. There is no unifying professionalbody for clinical teachers, which is needed to setstandards, guide research, offer support and pro-mote quality. Without quality clinical education,

471-5953/$ - see front matter �c 2005 Elsevier Ltd. All rights reseroi:10.1016/j.nepr.2005.10.002

* Corresponding author. Tel.: +61 7 3875 6460; fax: +61 7 3875984.E-mail address: m.mcallister@griffith.edu.au.

students are unlikely to thrive in the health contextand their risk of leaving the profession is high.

An accredited postgraduate university-basedelective course was therefore designed. The aimof this paper is to explain the process for curricu-lum development and the teaching and learningstrategies within the course. Apart from includingcontent on learning theories and clinical educa-tional strategies, the course was particularly de-signed to build an online ‘‘learning community’’.Learning communities, whilst still in their infancy,are proving successful in higher education, becausethey emphasise collaborative learning, generatedialogue and build solidarity, so that people ex-change ideas and have the chance to self-correcterrors (Barber, 2001; Buckingham, 2003). The ideatoo has been understood as a reaction against the

ved.

An online learning community for clinical educators 107

tendency for education to be preoccupied withindividual rights rather than social responsibility(Noddings, 1996). A successful learning communityis one that is engaging, creates and shares newknowledge and builds communal competencies,not just individual capabilities (Wenger, 1998).For clinical education, a learning community haspotential to change the culture from its presentstate of fragmentation, to fostering connection be-tween isolated clinical teachers. People who feelownership or a sense of belonging in their commu-nity may develop a strong sense of cultural identityand this may help to establish a new profession,one that is characterised by its own uniqueknowledge and research base. At present inAustralia, very little clinical educational researchis undertaken, perhaps because clinical teachersand their knowledge base are not sufficientlyvalued or developed. Developing community willbe an important way to enhance their visibilityand influence.

Some cautions for curriculum design

A review of the literature on online learning andlearning communities highlights risks as well aspotentials for learning in a predominantly onlineenvironment. Whilst some authors embrace the po-tential for online learning to promote democracy(Boyd, 1987), giving diverse groups greater accessto knowledge and education (Lelliott et al.,2000), reducing barriers, such as gender and cul-ture and thus promoting the visibility of differencesand liberation and reducing the likelihood of dom-ination (Standish, 2002), others are more sceptical.Without confidence in using technology, studentanxiety and dissatisfaction is increased and thuslearning is decreased (Lee et al., 2001). Papasteph-anou (2005) suggests that online learning may actu-ally promote social disconnection because of thedepersonalisation experienced. Mann (2005) sug-gests that, in the desire to build community andbelonging, there might be too much homogeneityfostered and people may feel inhibited fromexpressing differences required for learning. Stillothers have suggested that in an online environ-ment, anonymity can promote insensitivity (Drey-fus, 2002) and there is a tendency for people toignore social rules, to be more blunt, more criticaland less tolerant of expressed differences (Bau-man, 1998; Paloff and Pratt, 1999). Even so, theinternet also offers advantages to the shy or tenta-tive person, it gives voice to more, it promotes asense of proximity, freeing students who aretime-poor from the constraints of scheduled clas-

ses, and with attention to enhancing democraticpractices between students and teacher, it canencourage people to be more thoughtful in theexpression of ideas (Hodgson and Reynolds, 2005).

Whilst new technology may encourage innova-tion of ideas, Laurillard (2002) cautions that on linelearning technologies, far from adding to interac-tivity, have tended to perpetuate a transmissionmodel of teaching and learning – where didacticlectures and passive or even alienated students re-main. If learning communities are to be engagingand activating for students, then students first haveto feel connected with each other (Mann, 2005).

The clinical teaching course

An explicitly democratic pedagogical approach isfound in transformative learning (hooks, 1994;McAllister, 2004) and was used in the develop-ment of the clinical teaching course. The coursedeliberately de-emphasises lecture based mate-rial and foregrounds interactive activities throughthe use of video vignettes, written scenarios,question posing and guided discussion. Assess-ment activities have been designed that invitecritical, creative thinking so that new ways ofrethinking clinical education are stimulated. Inthis way, we believe we have moved beyond atransmission model of teaching to one that iscritical and potentially transformative (Giroux,2000). It is transformative because it aims touncover routine and taken for granted practices,challenge the status quo, articulate criticismsand visions, and tie educational theory to every-day clinical teaching work. Table 1 summarisesrecommended approaches for the course conve-nor. These lifelong learning skills include:research knowledge and capacity, ability to becritical about the use of sources of information,well developed communication skills, respectfulattitudes and ethical values. Wiggins (1989) hasstated that life long learning skills also includeknowing how to listen to someone who knowssomething one does not know; being open andrespectful enough to imagine that a new andstrange idea is worth attending to; and, beinginclined to ask questions about past statements,hidden assumptions or confusions.

Teaching and learning processes

Thus, transformative teaching in this mode of deliv-ery needs to be aware of, and take steps to prevent,the tendency for old social patterns, such as elitism,hierarchy and marginalisation to re-emerge. While

Table 1 Elements of transformative teaching(McAllister, 2004)

Forming the teacher student relationshipAcknowledge and appreciate differenceForm a partnershipExplain the pedagogical approachVoice the studentsModel the benefits and limits of experienceCreate space for dialogueBegin to build community

Building a critical consciousnessSelf-interrogate habits, rituals and routinesMove beyond self-directionRemember the value in knowing one’s historyReveal and subvert the dominant paradigmClaim nursing practiceListen to the voice of consumers of nursingActivate the students

Thinking criticallyReflective practiceDialectical critique

108 M. McAllister, W. Moyle

the course is primarily described as online, face toface contact occurs through workshops. Thisencourages the development of connection andcommunication. Ultimately it may enhance a col-lective potential and shared identity. Direct contactcan also ensure that participants are orientated tothe educational technology, refresh computer nav-igation skills and develop confidence in using the on-line material. In this way, the communicativepotential of online learning is enhanced. During thisgroup-forming stage it is also useful to develop andagree upon shared norms – such as to value open-ness, honesty, confidentiality and respect for differ-ence. In order to set an expectation for interactionearly it may help to outline participants’ roles, andto nominate people to take turns in leading onlinediscussions. It is important to emphasise and explainthe ethical use of information – that is, to gain con-sent before passing on emails from others, to accu-rately acknowledge the ideas of others throughacknowledgement and referencing.

Content and web presence

Participants are assisted to critically reflect ontheir nursing and educational practices, to exploreand understand barriers to change in nursing, edu-cation and healthcare, and to select and imple-ment strategies for developing and enrichingclinical and academic education. Participants alsoengage in the process of becoming part of alearning community to enhance collegiality and

collective potential to produce new evidence forpractice. Six educational themes are addressedand framed around questions that participantsmight ask (see Table 2).

The course gives opportunities for participantsto develop analytical, supportive and empoweringhelping skills to enable them to problem solvevarious challenging interpersonal issues in relationto teaching and learning. Participants will be as-sisted to develop skills required to conduct system-atic enquiry into practice with a view to continuallyimproving clinical education.

In keeping with the idea of building a close-knitcommunity, the website resembles a virtualvillage. The ‘‘village’’ contains a series of ‘‘cot-tages’’, each with a separate purpose. Tasks, suchas video discussion, quotes, or scenarios functionas triggers for learning and discussion and areaccessed by participants at their own pace andtime. This asynchronous function means that clini-cians working shifts, and probably time-poor, arenot disadvantaged.

When one enters the environment one isdirected to visit the community hall. Likecommunity halls in real life, this is a place thatfunctions as a place for occasional congregation,reflection and ritual. It is designed to be a placefor displays of forthcoming conferences relevantto clinical education, posters of important achieve-ments, messages of support or celebrations ofbirthdays/anniversaries or achievements. A ‘‘foun-dational stone’’ has been laid in this hall toacknowledge how and when the learning commu-nity was first established and the team is namedand thanked. Each time the course is run, we willinvite the student cohort to design their own stoneor plaque to mark and remember their presence,and so contribute to the development of placeand mind, features important to the emergenceof sustainable communities (Sergiovanni, 1994).

The classroom cottage is a space where partici-pants gather to read, download, learn and completetrigger activity relevant to the five educationalthemes. In this environment, the instructors willestablish guidelines for participation so that itis more likely that participants will engage withcolleagues. One of the first challenges forparticipants, relevant to the first educationaltheme, is to clarify their conceptions of the mean-ing of community. We believe that the success ofthe online community hinges upon participants’belief in its purpose. By asking participants toarticulate their thoughts on the benefits, and per-haps barriers to effective community, we hope thatthey will be able to apply such insights to this par-ticular learning experience.

Table 2 Six educational themes

1. What is my role in a learning community? Introduce idea of learning community to enhanceits value and shape its useOutline building blocks for building communityEncourage the expression of values and practicesthat enhance identity in the group, and layfoundations for building a professional communityBuilding a climate of cooperative learning Form

2. What is the theory behind clinical education? Educational Philosophies underpinning programsLearning theories and models of clinical education

3. What are the strategies I can use that will engagenovices and allow them to realizetheir potential as clinicians?

Craft knowledgeThe learner and learningThe teacher and teachingBuilding trusting relationshipsExploring strategies for teaching and learningPlanning learning activitiesTeaching creatively

4. How can I assess novices so that theyremain motivated to learn and to achieve?

The aim of assessmentStrategies for assessing clinical learningGiving constructive feedbackJudging performanceEvaluating learning and teachingProblem solve processes for responding to learnerissues

5. How can I develop professionally as a clinical educator? Distinguishing and rethinking ritual from rationalactionRethinking approaches to reflective practiceFacilitating reflective practiceTransformative learning as change strategySurfacing and challenge dominantways of facilitating clinical educationChallenging novices safelyResearch and clinical education

6. What can I do to enrich the environmentto promote learning and development?

Exploration of elements within the environmentthat contribute to, or challenge, effective learningEngaging clinicians to work with and for novicesTeam work and team building

An online learning community for clinical educators 109

In order to surface and encourage shared expres-sion of meanings of community, participants arerequested to visit the art gallery cottage. Theyare asked to enter the gallery and take a lookaround. Within this cottage are a series of ‘‘artworks’’, actually images that are available free ofcopyright and which have been selected becausein some way they represent notions of community.Participants are then asked to recall what comes tomind when he/she thinks of the meaning of a com-munity, to select an image that evokes some attri-bute about community, and then to participate indiscussion on possible and existing organisationalelements important to clinical education.

The craft shop is perhaps one of the most impor-tant cottages in the village. The vision for this shopis that it functions as a small co-operative, the

symbol for the whole learning community and asustainable place where learning grows, and wis-dom accumulates. It will begin with just a fewresources or wares. Journal papers on creativeteaching strategies provide models for ways ofboth writing about clinical education practice,and approaching the task of teaching participantscreatively. In this way, the ‘‘product’’ being ex-changed is the craft knowledge of clinical educa-tion (Grimmett and MacKinnon, 1992). We intendfor this wisdom to be shared informally as well asformally by refining participants’ contributions sothat they can be published in refereed journalsand so advance the discourse of clinical educationpractice. The products are, however, not limitedto text. They may also comprise images, videos,or power-point presentations. They may be whole

110 M. McAllister, W. Moyle

papers, trigger-teaching strategies, games orreflections.

A feature in this environment is an animated im-age of a patchwork quilt which is linked to one oftwo assessment items, later described. The quiltsymbolises how an individual’s contribution, onepatch in a quilt, can be joined with others, so thatthe finished product becomes something larger andmore beautiful. There is pleasure also in the pro-cess of making a quilt. So the quilt is used to high-light the importance of shared productivity in thislearning community. Succinct text is present to ex-plain our beliefs that an individual’s contributionbrought together with others becomes somethingmore significant than a single idea. That is, thewhole is more than the sum of its parts. And wheneach student contributes their own little piece ofcraft wisdom, woven together, they have potentialto extend each student’s capacity to teach clinicalskills more effectively. This illustrates the notionof developing communal competence (Wenger,1998). Moreover acting in this way, participantshave potential to extend the discipline of clinicaleducation. Encouraging participants to contributea piece to a growing quilt, we think contributesto sustainability – past participants contribute topresent and future participants, and people buildupon and share the crafts made by their predeces-sors. Woven together, the strategies have potentialto extend each student’s capacity to teach clinicalskills more effectively. Moreover, they have poten-tial to extend the discipline of clinical education. Itmay be that in the future there will be some sort ofdisplay of this produce, and then a celebration tomark its completion.

Assessment

Participants are set two main tasks: Web-based dis-cussion reflecting on various theories of educationand the practice of clinical education, as well asa critical report on a clinical teaching strategy thatthey have used or intend to use.

Participation in web-based discussion is impor-tant to the success of this online learning commu-nity. We felt that by setting an assessment itemon discussion, it would encourage participants tobe active. We also set clear guidelines for the levelof activity. We advised participants that goodteaching relies on knowledge and informationgathering, motivation of participants, innovativethought, relevant content and pedagogy and on-site problem solving. To do this a teacher must re-flect in and upon action.

That is, participants are to log on to the discus-sion forum on at least three separate occasions and

engage in conversation with other participants andlecturers about relevant teaching and learningmaterial from this first module. The discussion isto be structured along the following lines: partici-pants are to have completed the readings listedand then they are to generate discussion by sum-marising the major issues and eliciting their col-leagues’ views.

Entries need to demonstrate understanding ofthe differing notions of reflection as they relateto clinical teachers’ work, the different levels ofreflection using examples and discussion of prob-lems, issues and challenges posed by the literature.And only short quotes from the literature are to beincluded.

In relation to the clinical teaching strategy, weemphasized with participants the importance of aclinical educator’s role in engaging undergraduatesthroughout clinical placement. Participants are re-quired to reflect on themselves as a teacher, think-ing about the creativity and efforts used to engageand teach undergraduates, and more broadly onteachers’ craft. As is explained, craft knowledgeis a concept widely discussed and debated in edu-cation literature (Jacobs, 1992; Johnston, 1994;McAllister and Rowe, 2003; Schon, 1983; Tanner,1993; Zeichner et al., 1987).

The task for participants is to discuss the impor-tance of the teacher’s craft by applying theirunderstanding of this term to their experiences inteaching. Participants are asked to explain a strat-egy they have used, appraise its merits, and suggestareas for improvement or future development. Anexample of such a critical appraisal is found inthe craft shop. When this activity is completedand marked, and if the student agrees the finalwork is deposited into the craft shop so that itcan be used by future participants of the course.As more strategies are deposited in the craft shop,an animated graphic of the patch work quilt showsthat pieces have been added to symbolise that theircollective achievement, and knowledge capital isgrowing.

Conclusion

While this paper has outlined an innovation specificto the target group of clinical educators, thecourse design and online environment has potentialto be relevant and useful to other groups that seekto develop communal competence, shared identityand aggregated knowledge. We have what we be-lieve to be a knowledge-building community thatsets standards for sound pedagogy in the use oflearning technologies.

An online learning community for clinical educators 111

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