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Contextual activity sampling: a method to develop clinical interprofessional education
Sophiahemmet University. Karolinska Institutet.ORCID iD: 0000-0001-9435-5950
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Higher health care education in interprofessional settings is evaluated and developed continuously. The aim of clinical interprofessional education is to provide healthcare students opportunities to develop their professional roles, and understanding of other professions, as well as to develop their teamwork and communication skills. However, there is still a need to improve understanding of how students experience their learning. Most often, post-course questionnaires and interviews are used to investigate students’ experiences of their learning activities. When using such approaches the respondents generalize about their experiences in retrospect instead of reporting on learning as it occurs. The Contextual Activity Sampling System (CASS) is a methodology inspired by ideas from the Experience Sampling Method (ESM). CASS was designed to collect frequent data from the participants’ ongoing learning activities by using mobile phones, which was the main methodology used in this thesis.The overall aim of this thesis was to investigate the potential of contextual activity sampling as an approach for studying students’ experiences connected to learning activities during clinical interprofessional education.Eighty-one students from six interprofessional training ward courses conducted during 2009 agreed to participate. For each course, students from two teams of three were randomly assigned to be included in an intervention group (using CASS, n=54) and from one team in a control group (not using CASS, n=27). The students’ learning experiences in the intervention group were collected via CASS and, for both groups, via interviews after the conducted courses and also RIPLS questionnaires both before and after the conducted courses. Study I was a study aiming at investigating the usability of CASS as a methodology in a clinical interprofessional context. Study II focused on the students’ experiences of clinical learning and Study III on the students’ experiences of collaboration. Study IV investigated whether students using CASS experienced their learning activities in different ways compared to students not using CASS.In Study I it was shown that the translated and cross-culturally adapted Swedish version of CASS was usable in a clinical learning environment and that it helped students to structure their study days and reflect on their learning activities. Study II demonstrated that students reported optimal experiences (flow) when they were engaged in knowledge creation activities and collaborated with their fellow students. A significant correlation was identified between positive emotions and how important the activities were considered to be. Study III showed that CASS provided possibilities to identify the student teams’ need of support to attain the intended learning outcomes and highlighted the importance of structure, interaction and insight in clinical interprofessional collaboration. In Study IV differences between the intervention and control groups were noted. The students who had used CASS rated their experience of ‘teamwork and collaboration’ significantly higher after the course than before the course, which was not the case for the control group. On the other hand, students in the control group rated stress higher than those who had used CASS.In conclusion, this thesis showed that the CASS methodology is suitable for collecting contextual data in clinical settings and can help students to structure their days and reflect on their learning activities. When interprofessional collaboration was working well it was associated with knowledge creation and an increased feeling of ‘flow’. CASS is an innovative methodology, which can be useful for stimulating reflection on clinical learning activities and development of clinical interprofessional education.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet , 2013. , 77 p.
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:shh:diva-1474ISBN: 978-91-7549-249-0 (print)OAI: oai:DiVA.org:shh-1474DiVA: diva2:667091
Public defence
2013-12-13, Aulan, Södersjukhuset, Stockholm, 15:33
Opponent
Supervisors
Available from: 2013-11-25 Created: 2013-11-25 Last updated: 2016-06-09Bibliographically approved
List of papers
1. Introducing and adapting a novel method for investigating learning experiences in clinical learning environments
Open this publication in new window or tab >>Introducing and adapting a novel method for investigating learning experiences in clinical learning environments
2012 (English)In: Informatics for Health and Social Care, ISSN 1753-8157, Vol. 37, no 3, 125-140 p.Article in journal (Refereed) Published
Abstract [en]

The Contextual Activity Sampling System (CASS) is a novel methodology designed for collecting data of on-going learning experiences through frequent sampling by using mobile phones. This paper describes how it for the first time has been introduced to clinical learning environments. The purposes of this study were to cross-culturally adapt the CASS tool and questionnaire for use in clinical learning environments, investigate whether the methodology is suitable for collecting data and how it is experienced by students. A study was carried out with 51 students who reported about their activities and experiences five times a day during a 2-week course on an interprofessional training ward. Interviews were conducted after the course. The study showed that CASS provided a range of detailed and interesting qualitative and quantitative data, which we would not have been able to collect using traditional methods such as post-course questionnaires or interviews. Moreover, the participants reported that CASS worked well, was easy to use, helped them structure their days and reflect on their learning activities. This methodology proved to be a fruitful way of collecting information about experiences, which could be useful for not only researchers but also students, teachers and course designers

Keyword
Contextual activity sampling, Reflection, Self-assessment
National Category
Health Sciences
Identifiers
urn:nbn:se:shh:diva-977 (URN)10.3109/17538157.2012.678449 (DOI)22713123 (PubMedID)
Available from: 2012-03-14 Created: 2012-03-14 Last updated: 2014-09-29Bibliographically approved
2. Capturing students' learning experiences and academic emotions at an interprofessional training ward
Open this publication in new window or tab >>Capturing students' learning experiences and academic emotions at an interprofessional training ward
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2013 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 27, no 2, 137-145 p.Article in journal (Refereed) Published
Abstract [en]

An important goal for interprofessional education (IPE) in clinical settings is to support healthcare students in collaboratively developing their understanding of interprofessional teamwork. The aim of this study was to investigate students' learning experiences and academic emotions as they occur in actual context in relation to collaborative and trialogical activities during a clinical IPE course. The contextual activity sampling system methodology was used to collect data via mobile phones. Thirty-seven healthcare students (medical, nursing, physiotherapy and occupational therapy) reported their experiences, learning activities and academic emotions several times a day via their mobile phones during their 2-week course at an interprofessional training ward (IPTW). The results provided understanding of the students' experiences of their academic emotions and how they created new knowledge collaboratively. These collaborative knowledge creation activities occurred mostly when students from different professions were collaborating as a team (e.g. discussing patient care or participating in a ward round) and were also significantly related to optimal experiences, i.e. "flow" (high challenge in combination with high competence). In conclusion, these results emphasize the importance of collaboration among students during IPTW courses. Our results might help to optimize the design of IPE learning activities in clinical healthcare contexts

Keyword
Interprofessional collaboration, Interprofessional education, Interprofessional learning, Collaboration, Collaborative outcomes, Team-based practice, Work-based learning
National Category
Health Sciences
Identifiers
urn:nbn:se:shh:diva-979 (URN)10.3109/13561820.2012.724124 (DOI)23043548 (PubMedID)
Available from: 2012-03-14 Created: 2012-03-14 Last updated: 2015-01-22Bibliographically approved
3. Students' experiences of collaboration during and after an interprofessional training ward course: a mixed methods study
Open this publication in new window or tab >>Students' experiences of collaboration during and after an interprofessional training ward course: a mixed methods study
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2013 (English)In: International Journal of Medical Education, ISSN 2042-6372, Vol. 4, 170-179 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: The objective of this study was to obtain a deeper understanding of how students experience and perceive interprofessional collaboration connected to their learning activities during and after an interprofessional clinical course.

Methods:

A sample of 15 healthcare students participating on a two-week interprofessional clinical course was used. A mixed method approach was used for data collection. The students’ perceptions were gathered several times a day via mobile phones by using the Contextual Activity Sampling System (CASS) and they were also interviewed after the course.

Results:

The data revealed an interesting discrepancy between the students’ learning experiences reported during the course compared to their perceptions after the course. The students were generally more critical during the course, i.e., they tended to report things that did not work well. In the post-course interviews, the students reported that difficulties had been solved during the course. The students emphasized also the importance of structure, interaction, and insights into one’s own and other professions’ tasks as a base for fruitful interprofessional collaboration. Further-more, they underlined the benefits of interprofessional team learning with opportunities to contribute to and to acquire new knowledge.

Conclusions:

The CASS methodology provides possibilities to identify students’ and student teams’ needs of support to reach the intended learning outcomes of a specific course. Our results might be useful when developing clinical education with a special focus on supporting students in their collaborative practices.

Keyword
Interprofessional clinical education, Interprofessional collaboration, mixed methods, Student's experiences of interprofessional collaboration, Trialogical learning
National Category
Health Sciences
Identifiers
urn:nbn:se:shh:diva-1407 (URN)10.5116/ijme.51fc.c412 (DOI)
Available from: 2013-08-27 Created: 2013-08-27 Last updated: 2014-12-01Bibliographically approved
4. Promoting reflection by using contextual activity sampling: a study on students' interprofessional learning
Open this publication in new window or tab >>Promoting reflection by using contextual activity sampling: a study on students' interprofessional learning
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2014 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 28, no 5, 400-406 p.Article in journal (Refereed) Published
Abstract [en]

Abstract Students' engagement and reflection on learning activities are important during interprofessional clinical practice. The contextual activity sampling system (CASS) is a methodology designed for collecting data on experiences of ongoing activities by frequent distribution of questionnaires via mobile phones. The aim of this study was to investigate if the use of the CASS methodology affected students' experiences of their learning activities, readiness for interprofessional learning, academic emotions and experiences of interprofessional team collaboration. Student teams, consisting of 33 students in total from four different healthcare programs, were randomized into an intervention group that used CASS or into a control group that did not use CASS. Both quantitative (questionnaires) and qualitative (interviews) data were collected. The results showed that students in the intervention group rated teamwork and collaboration significantly higher after than before the course, which was not the case in the control group. On the other hand, the control group reported experiencing more stress than the intervention group. The qualitative data showed that CASS seemed to support reflection and also have a positive impact on students' experiences of ongoing learning activities and interprofessional collaboration. In conclusion, the CASS methodology provides support for students in their understanding of interprofessional teamwork.

Keyword
Collaboration, Content analysis, Interprofessional education, Interprofessional practice, Interviews, Mixed methods, Team-based practice
National Category
Learning Health Sciences
Identifiers
urn:nbn:se:shh:diva-1566 (URN)10.3109/13561820.2014.907777 (DOI)24754545 (PubMedID)
Available from: 2014-04-29 Created: 2014-04-29 Last updated: 2014-12-01Bibliographically approved

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