Conversations for Learning – Kay McAlinden

This case study concerns the current module Psychosocial Issues in Cancer and Palliative care (ONC8006) as it is taught in 2020-21 academic year. This module is part of the Cancer and Palliative care programme and as such deals with emotionally challenging topics, including breaking bad news, loss, responding with empathy, screening for distress, anxiety and depression, families and carers, body image issues, survivorship, and interventions such as Cognitive Behavioural Therapy and Mindfulness. It is currently a small module with less than 20 students.

Next year it will be merging with another module, Handling Loss Grief and Bereavement (ONC 8010) and will become Psychosocial issues in Advanced Disease (ONC8030). Several elements of professional development, including a session run by Manchester University, and the FMS TEL Humanising the Online Experience webinar, helped to inspire and implement a few new ways of working which will be carried forward.

Choosing Priorities

Clear themes emerged from the sessions attended, showing what students want from their online courses. Prompt feedback from tutors is clearly valued, as well as ease of access and clear information about assignments. Students want to feel the tutor’s presence in their course and want to be able to give feedback afterwards.

Given that the online environment can be stark and unemotional, and people do not always want to discuss these topics – even in classrooms, teaching this content online was always going to be a challenge. It was important to try and model the communication skills, behaviours and support that students would be learning about, allowing this to stand as an example of good practice.

Zoom Tutorials

The stress and emotional load on students this year has been particularly high both personally and professionally given the impact of COVID on service delivery and home life.  Students often mentioned the difficulties of delivering bad news by phone and trying to support patients and families when there was minimal access to psychosocial services. This prompted the decision to offer Zoom appointments or phone calls to anyone who wanted them. These were offered rather than being compulsory, and not all students took up the offer. These were offered via Canvas announcements.

This year most chats only lasted 10-15 minutes but allowed students to consider how they would approach their essay. Spending this one-to-one time with students, even on the phone or via Zoom, has meant that getting to know them has been a lot easier, and students feel more supported. In some cases, a chat over email was enough, but sometimes it was much more time-effective just to call the student and have a quick chat, rather than spending time drafting and re-drafting a long or complex email.

Many of these chats took the form of one-to-one tutorials on assignments, explaining what was expected and how to do a good job of the assignment, as well as offering reassurance. Careful monitoring of the discussion boards has also allowed issues to be picked up and addressed.

Use of Discussion Boards

This module has always made good use of discussion boards. Participation in the discussion boards has been good, and regular and swift responses to students’ posts have helped further this. Questions such as ‘If you were diagnosed with cancer, who would be around to support you? What if they weren’t there?’ push students to think very deeply about their own personal situations, and to connect compassionately with what they are learning.

Some tasks had options which are less emotive, but most students chose to answer the most emotive task – naturally tutor feedback for this was very rich. This meant it was time-consuming, but also extremely valuable. Adding a simple ‘like’ or a quick remark would have been far too dispassionate for a module like this! Other students were also able to respond in a way that supported each other, thanking one another for their stories.

Further discussion board use included the choice for students to respond in their own private journal area rather than more publicly. This setup can help to engage students when topics are personal or reflective in nature.

Advice and Support from FMS TEL

The advice and support about what is possible, and how to implement things technically has been invaluable. This has allowed for modernisation, development and innovations in the methods used, as well as some experimentation within the module. When trying new things, make sure you set yourself up to succeed by starting small, and starting with what you’re comfortable with, adding more new elements as your confidence grows.

Feedback and Next Steps

This year the use of regular Canvas announcements has been a good way of keeping things on track. The participation in discussion boards and tutorials has been great, and students have said they feel supported. As the module will look very different next year, more adaptations will need to be made. For example, in future it might be useful to offer assignment guidance as a small group tutorial, especially if more students are taking the module. This way it can be scaled up and students can still feel supported.

Now it feels easier to interact with students online than it did at the beginning. Getting to know them as people beyond their studies has been very rewarding for everyone. Small things like being confident enough to use humour, or to share a funny cartoon about the subject, have become easier to judge as time has gone on. This can be tricky to judge if you can’t see faces or are worried about cultural faux pas, but once again, getting to know your class by building community really helps with this.

Resources

Newcastle University Digital Learning – Technology Guides

Enrol in the FMS TEL Canvas Community for access to materials and Canvas notifications of new resources and blog posts.

Humanising the Online Experience Webinar Materials (watch, listen or read)

Discussion Boards Webinar Materials (watch, listen or read) – including examples from this module

Discussion Boards Guides – how to implement different types of boards for different purposes in Canvas and Padlet (for MLE users)

Building Community

I recently spoke to Laura Leonardo about how she and her colleagues build community online. The case study is available to view on the LTDS Case Studies website.

You may find this particularly useful reading if you are working with PGR students who are off-campus or still abroad.

Zoom and MBBS at NUMed with Fiona Clarke

This case study concerns the MBBS programme at NUMed, and the different ways interactive tools and humanising teaching techniques on Zoom has helped facilitate learning during lockdowns. Zoom tools have been used in many different ways, and tools and tips from colleagues, internet searches, and the FMS TEL Humanising the Online Experience webinar have helped enhance these sessions.

From Beginner to Teacher

The prospect of teaching online can be quite daunting, especially if you don’t already have a lot of interest in or experience with the technology. Initially Paul Hubbard offered a help session for Zoom, which was a great help and provided inspiration on how to use the different tools in teaching. With practice, a lot of skills were developed and put into practice with students. After hearing about how Zoom is used in these MBBS sessions, colleagues now come to ask for advice based on the techniques and tools that have been used, and it’s great to be able to provide that for them now.

Humanising the Online Experience in Practice

Turn off Self-View

Some students are very shy, and a range of techniques can help them build their confidence. One among these is turning off self-view in Zoom, which only takes a couple of clicks. This is useful when teaching as well, as your own image can get a little distracting. At first you might worry that you are fidgeting without being aware, but it soon becomes easy to remember that you are still on camera. Students who had initially struggled with presentations or speaking in front of others did become more confident after these interventions, and after getting more comfortable with the Zoom environment.

Encouragement to Switch on Cameras

One thing that has worked very well is giving a lot of deliberate positive feedback to students about switching on their cameras. At the start of sessions students are greeted warmly and the benefits of having the camera on are shared. More importantly, efforts are made to share how lovely it is to see their faces when they do turn the camera on. Even saying something like ‘it’s so nice to see you’ or ‘I’ve missed seeing you all’ as cameras come on encourages others. Since making this deliberate extra effort, a lot more students turn on their cameras during sessions, which helps lift the atmosphere.

Teaching Ethics

Teaching concepts like ethics can be tricky, as they don’t lend themselves to a practical format. To help bring the subject material to life, the ethics segment of the Medicine, Acute Care and Surgery course was previously presented in a very interactive format in person. Students used flipcharts to collate information, moved around the room, worked in groups, did card sorting activities… initially this seemed difficult to replicate online, but it was possible to adapt the sessions using Zoom tools like polling, breakout rooms for group work, and interactive whiteboards.

Approximating In-Hospital Experience

One thing that has been a challenge for the programme is the lack of access to hospitals due to the pandemic, especially for The Hospital-Based Practice course. This is normally case-based, interacting with real patients. The decision was made to create staged patient interactions. These sessions work a bit like branching scenarios in that what the student chooses to do guides the rest of the interaction. A ‘patient’ acts from a script on the Zoom call, and the lecturer can coach the student through the interaction and offer feedback. If the student chooses to, for example, listen to a patient’s breathing, the lecturer provides a sound file of what the student hears when they do so. While this can’t perfectly replicate what it’s like on a ward (patients don’t follow a script!), students still get the chance to practice skills like decision-making and explaining diagnoses.

Advice

The best advice is to try things out and experiment in a Zoom meeting on your own, or with colleagues. Even if you have used a tool before, if it has been a while, just start up an empty Zoom meeting and refresh your memory before it’s time to go live. Google has also been invaluable – it’s possible to fix common issues or refresh your memory by finding software instructions online. Finally, don’t be afraid to try out new tools with students. The interactivity tools such as polls and whiteboards can help bridge the gap and make sessions more engaging.

“Don’t be afraid, just try it out! It’s so worth it, it makes such a difference.”

Fiona Clarke

Resources

Contact

Dr Fiona Clarke, Associate Professor and Senior Lecturer in Medicine, NUMed

Fiona.clarke1@nhs.net

New Zoom Features Released

Some new Zoom features have been pushed today, a few of which have some clear benefits for users in FMS.

Share Multiple Programs at Once allows you to share more than one window with your audience, without having to share the entire desktop. This will be particularly useful if you need to go between a PowerPoint and a webpage, or another piece of software. You can now do this without worrying about accidentally having your emails pop up! The windows are arranged on the participants’ screens exactly as you have them arranged on your desktop, allowing you to rearrange/overlap or change their relative sizes. The image broadcast will update as you do this. To start sharing multiple programs, select the screenshare of one window as usual, then hold Ctrl and click on any additional programs you’d like to include. When you’re ready, click ‘share’.

Suspend Participant Activity acts as a sort of emergency brake in case of serious disruptions. You can disable all microphones, screen sharing and videos at once to stop any disruptive behaviour and give yourself time to remove the unwanted user without the pressure of ongoing interruptions.

Click ‘security’ and then ‘suspend participant activities’ to halt participant input.

To update your Zoom client, click on your profile picture/initials in the top right of the main Zoom window and then click ‘check for updates’. Follow the prompts to complete the update.

The full list of changes can be seen in detail on the Zoom website.

The FMS Community has more detailed walkthroughs relating to security settings and managing disruptions in Zoom, including downloadable guides.