Apprenticeships in England: recent trends

I’ve noticed a lot of excitement around degree level apprenticeships lately. Perhaps this is fuelled by the relentless rise in university tuition fees in England. I decided to look into some of the figures and came up with this infographic. I hope you like it!

apprenticeship-trends

Prototyping for eHealth

I have never used eHealth apps myself. However I am in the middle of a course on Futurelearn that is all about developing eHealth. This means I am able to participate in discussions with people who do have experience of using eHealth apps. The course is great for me. I’ve always been curious about the processes involved in developing apps for mobile phones, and now is my chance to have a go.

Currently, I am at the stage of designing a ‘lo-fi’ prototype for an eHealth app. Prototypes of this sort don’t need to be technical in any way. In fact, we are being encouraged to make them on paper or on a computer screen. At the same time as taking this course, I am also working on a literature review about diabetes prevention. So what better topic for my first design than a Type 2 diabetes prevention app?

Developing the concept

Actually, I decided it might be more realistic to create a diabetes manager app. At least there is a clear target audience. After all, I am finding from the literature review that it can be very challenging to engage people to look after their health “just in case” they develop a preventable disease.

So far, I am discovering that an important key to a good design is to make the app visually appealing. The information needs to be concise, and people need to be enticed in with simple images, videos and clear navigation. Underneath all of that, the needs and requirements of the target audience need to be established. People need a very good reason to use it.

Understanding user requirements

Why would someone with diabetes want an app? I can only guess that people who use apps are already committed in some way. They are motivated to take good care of themselves and their condition. And, they are probably the kind of people who are interested in making technology work for them. I will have to leave to another day the problem of how to reach people who do not fit into these two categories.

I’m interested in how healthcare professionals and service users can work together to manage long-term conditions. There’s a huge scope for technology to play a supporting role here. I like the idea of technology levelling out the playing field between clinician and patient. People need to be empowered to take control.

For instance, when you attend a consultation with a clinician, they will have all the data about you available at their fingertips. But you don’t have the data in front of you in the same way. As a patient, you are aware of the time pressures, and you’ve been thinking for weeks about all the things you wanted to talk about. If you’re anything like me you come armed with the set of questions, but don’t ask them all because as you get the end of the list, it all starts to feel a little trivial. Perhaps those last two questions aren’t really very important. You feel you are already taking up too much of their time. That’s my reality, anyway.

When I first started to design my diabetes manager app, I had these experiences in mind. I was also considering a case study in which a clinician had to input a lot of patient self-report data by hand during a consultation. The challenge was to design an eHealth solution that would solve some of the problems for both clinician and patient.

Prototyping

At first, I felt completely overwhelmed by the task. But then I thought I should really just have a go. I tried to analyse the situation from both perspectives. I tried to apply the design principles. I also decided to have a go at using Balsamiq software .

Balsamiq is a software environment that allows you to do rapid mockups. It claims to reproduce the experience of sketching on a whiteboard. I always find a little bit of technology helps me to be creative and overcome the inertia of getting started on something that feels difficult.

Imagine Ravi who has type II diabetes. He’s really keen to manage it better, and would like to have a better relationship with the diabetic nurse specialist who he sees about once every couple of months.

So I thought, what if Ravi has a really clever glucose meter that will transmit data to a phone app, and the app will transmit this data to a central patient record. Then, I thought well, what if everything else like the exercise diary, food diary and weight measurements could also be sent by the app to the central record? Ravi could agree with the nurse specialist the kind of things to keep a record of.

I started to sketch out the home screen of the app. I majored on using photographs for visual appeal and interest. I had very little text on this screen. Alongside the exercise diary and food diary, I decided that Ravi might want some information as an aide memoire of exercises or types of physical activity he can do as well as the kind of foods he should be encouraged to eat or avoid.

Here is a screenshot of the prototype I came up with after about an hour fiddling around with Balsamiq. This of course is only the first step. Each link on the homepage opens up a range of possibilities. How will we exercise and food tips be presented? Should I use video and how much? How can I produce a blood glucose graph? And so on.

Diabetes_app5

Learning with others and making connections

Learning as part of a large group has its benefits here. I’m able to pick up ideas from my peers. For example, wouldn’t it be great to incorporate reminders to exercise, measure blood glucose, or take medication? One of my fellow students included mood snapshots – how am I feeling now? What a great idea! Sending alerts to the clinician if things are going a bit haywire would also be very useful.

Then, I remember from my work on the literature review that waist measurement can be very significant in people with diabetes. Again, someone on the course had included this in their app. Aiming to reduce your waist measurement can have a huge impact on your metabolism. Controlling weight and waist size can even mean that a person no longer needs further interventions to control diabetes.

Once I have finished work on the literature review, and once I have moved on to usability testing on the course, I may have more to say. If you would like some help to manage your diabetes, would you use this sort of thing? What apps are you already using?

Ten Layers of expertise in developing distance learning

Photo of mountains-woodland-scrubWell-written and well-designed distance learning materials aim to provide learners with an interesting and seamless experience. If they are composed well, they seem to capture the audience effortlessly. Slips in coherence, even small ones, can draw attention to the material itself, rather than keep the learner engaged and absorbed in the narrative.

A major problem for authors, especially those new to this genre, is that it looks much easier than it actually is. Even for seasoned Open University academics, distance-learning materials undergo a multitude of iterations. Here, I explain about ten layers of expertise involved in developing these materials.

1.       Curriculum knowledge

2.       Knowledge of academic levels

3.       Knowledge of assessment

4.       Knowledge of the audience and all stakeholders

5.       Subject knowledge

6.       Skills knowledge

7.       Pedagogical knowledge

8.       Design knowledge

9.       Knowledge about online and print formats

10.   Knowledge about correct use of written English

1 Curriculum knowledge

As a consultant, one of the first things I do is to locate a set of learning outcomes, along with a broad outline of the intended subject content and skills development. It also helps if the assessment points are mapped against the intended content and skills. I like to get my ducks lined up ready! Seeing how a course or module fits within the broader offering of a qualification is also a helpful grounding exercise. What has already been taught, and what is to come next?

2. Knowledge of academic levels

The academic level of a course will guide the demands placed upon learners. Elements such as the complexity of ideas, length and difficulty of readings, expectations for originality of learning outputs, ability to collaborate, maturity of approach and learner autonomy, will depend on the level. Achieving this knowledge requires reference to national levels frameworks.

3. Knowledge of assessment

Assessment has close links with curriculum and levels. Are you applying the right method of assessment depending on the desired learning outcome? Distance learning can mean some limitations on mode of assessment – giving a presentation may not be practical, for example. Skills in writing assessments can stretch from writing essay questions and guidance, interactive computer marked assessments, project assignments, and exam questions. Knowledge of how to minimise plagiarism is also important here.

4. Knowledge of the audience and all stakeholders

Who are your students? Are they going to be putting their new knowledge into practice straight away? Will they be supported by a tutor? How much time will the tutor contract involve? Who else has stakes in your course? For this last question, consider professional groups and employers, and even service users. Think globally if appropriate. Consider asking for feedback from all potential stakeholders at the development stage.

5. Subject knowledge

Many academic authors focus on their subject expertise, and so they should. Finding ways of presenting your expert knowledge to ‘invisible’ learners can be greatly challenging. Any of the content needs to be relevant to the wider narrative of a course, so paying attention to the sequence is vitally important.  You also need to ensure that you support any claims you make with robust evidence – after all, you expect your students to do this!

6. Skills knowledge

How are your students going to engage with the subject? What skills do they need? How can you help them develop practical and academic skills? Thinking about these questions can guide your writing and assist you in constructing your students’ learning activity. All too often, academics tend to overlook the skills required for reading academic texts, navigating online databases, using search engines, engaging with audio-visual resources, engaging in social media, and writing in your own words.

7. Pedagogical knowledge

How can you teach an invisible audience who will be interacting with the learning materials at some point in the future? How can you engage their curiosity? The magic of learning occurs at the intersection between the distance learning materials and the engaged learner. If you get all the ingredients right, students will follow your instructions – read/watch/discuss/find/make notes – and bring their own life experience to bear on making this process and it outputs meaningful.

8. Design knowledge

Bringing together all the elements of a distance-learning course can require complex design skills. Visual design (logos, icons, images, page layout online navigation) and learning design (e.g. combining assimilative, productive, cooperative, interactive activities) are both important here. Good assessment design is also crucial for helping learners make sense of the learning journey.

9. Knowledge about online and print formats

You need to adapt your approach, depending on whether you are writing for print or writing for the computer or smartphone screen. Attention spans will be shorter on-screen, so limit long expanses of text to print resources. Of course, the boundaries are blurring with the burgeoning of tablets designed for reading books and long documents. Methods of annotating have also expanded with the introduction of new technologies. Keep up to date! In online formats, the reader can easily follow an embedded hyperlink, whereas in print it will be difficult for the reader to move seamlessly to a website. If your online materials are easy to update, make sure that any time-sensitive content is presented in this format rather than in print.

10. Knowledge about correct use of written English

You want your learners to develop good writing habits, so make sure you are modelling a good example. Paying attention to clear, plain language will also mean that learners are more likely to understand what you are saying, and reduce the risk of excluding people who are non-native English speakers. Correct use of English is also about ensuring you use non-discriminatory language. The input of skilled editors is invaluable! If you are writing your materials in any other language, the principles still apply!

No wonder great quality distance learning is highly valued and sometimes envied. It is not something to be rattled out over a weekend!

Unravelling digital health literacy

When I come across the phrase ‘Digital health literacy’, I feel uneasy. There seems to be ambiguity here and I often wonder if I’m the only one who senses it.

Finally, I have decided to explore whether there is a distinction between the potentially three meanings of the phrase:

  1. Is it about ‘digital information literacy’ in the world of health?
  2. Or perhaps we are talking about health literacy in the digital age (digital ‘health literacy’)
  3. Or is it about people’s ability to engage with digital health (‘digital health’ literacy)?

Or are they the same phenomena? To understand the knot I’ve created for myself, I’ll begin by disentangling these terms.

What is Literacy?

Literacy word cloud
Image source: http://dpcdsb-literacy.wikispaces.com/

‘Literacy’ is a widely-used term, especially amongst educators. From nurseries to universities, literacy looms as a set of skills and competencies that need mastering.

UNESCO recognises the complexity of meanings the word represents. At a basic level, literacy is about simply being able to read and write. But it is also about being educated and knowledgeable, including knowing how to access, engage with, and share knowledge. Amongst academics, the main buzzword is ‘information literacy’. In this context, people develop the skills to interpret information sources, making ‘informed judgments’. They also learn how to produce information in their own right. Armed with these skills, people are empowered to make critical decisions about key aspects of their lives, including their own health.

Temporarily discarding the ‘digital’ label, this seems a good point at which to consider ‘health literacy’. According to the World Health Organisation (2015), health literacy refers to ‘the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health.’ This definition of health literacy is very close to the idea of information literacy (as defined above), applied to health domain.

And so, to digital ‘health literacy’. The European Commission’s definition of ‘digital health literacy’ looks very much like a ‘digital’ extension of ‘health literacy’: ‘the ability to seek, find, understand and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem’. A scan of publically available literature on digital health literacy reveals a common, almost exclusive, focus on using the internet to search for health-related information. This observation is unnerving because it seems to be side-stepping the elephant in my room, which is the one obsessed with digital health.

Image of elephant in roomm labelled with 'digital health'

Digital health involves the application of digital tools (e.g. smartphones, wireless sensors, apps, and social networking) to monitor and help to maintain health. It draws on advances in genomics and mobile technologies to individualise healthcare interventions as well as to understand population health. Self-monitoring becomes a central feature of digital health tools.

In this world of digital health, consumers have access to raw data about their own bodies and they need to develop a new set of literacies around reading and interpreting this information. I was encouraged to see that a summary of ‘digital ambitions’ for healthcare in Wales included developing capability in both staff and patients to engage with smartphones and wearable devices, as well as online records. Engaging with digital health helps to meet the ambitions of providing increasingly personalised care.

This wider application of the term ‘digital health literacy’ can encompass a diverse range of electronic information sources. Greater use of technology-based health tools would open the way for the Internet of Things, as well as the pre-digested information found on the internet. The burgeoning of digital health technologies is no less a challenge for healthcare staff as it is for the general public.

Returning to the puzzle I set for myself, it seems that the first two meanings are practically the same. Most common understandings of ‘digital health literacy’ are about digital ‘health information literacy’, where the focus is mainly on the ability to engage with health-related texts on the internet. This is different to the third meaning, in which the focus is on ‘digital health’ interventions. I would like to see ‘digital health literacy’ represent the broadest range of digital tools, data and information, to keep pace with advances in technology.

 

Dickens’s ‘A Christmas Carol’ and mentorship

Image representing 'A Christmas Carol'

Turn on the television this time of year, and you can guarantee that it won’t be long before Ebenezer Scrooge appears on the screen. He is cold natured and miserly, with no charitable bones in his body. He shuns Christmas celebrations and prefers his own company. In the story ‘A Christmas Carol’, his intransigence seems absolute – he is thoroughly mean. It becomes clear at an early stage that if Scrooge is to learn a different approach to life, it will take much effort and he will not do it alone.

As the respective ghosts visit him, they operate as catalysts for change. In many respects, they act like mentors. One exception to this is that a mentoring relationship is usually a mutual one, where both parties agree to work together in a climate of trust and respect. However, by the time the Ghost of Christmas Future arrives, Scrooge is much more willing to engage and accept guidance from his ‘mentor’.

Change is an outcome of learning. For Scrooge, nothing would change if his ‘mentors’ do not engage his emotions first of all. The Ghost of Christmas Past begins by reminding Scrooge of deep-seated, repressed emotions linked to his childhood and earlier adulthood. Scrooge tries to fight against re-connecting with the painful memories. But this re-connection seems to be essential for Scrooge to see the need for change.

Mentoring is frequently portrayed as a role most people can do, with a little help and training. The benefits of being a mentor usually outweigh any drawbacks, but there can be risks, especially when deep-seated beliefs and feelings are involved. Mentees may not always want to adapt in a certain way, or address difficult emotional issues, to make real progress. Mentors have to respect this of course, but it can get messy without clear boundaries. Mentors also can be confronted with their own difficult feelings about their past when helping someone.

If we accept that digging up the past was an essential first step in Scrooge’s learning journey, the next stage is where Scrooge learns to ‘see’ what is happening around him. He can no longer shut himself off from others, and is suddenly painfully aware of the misery for which he is partly responsible. Learning to view the present through a new lens is another step towards change. When training for professional roles, this lens can take the form of principles of practice (e.g. client confidentiality) or theoretical frameworks (e.g. social construction of ageing, or materials science). A mentor can support their mentee to understand how these lenses relate to their own situation.

At this point, Scrooge recognises the need for change and starts to find new ways of seeing the world. Now, he needs a mentor more than ever to help him overcome his inertia. The Ghost of Christmas Future achieves this by showing him what a sad, lonely death Scrooge would have if he didn’t change. Seeing into this dark future is the tipping point. With the help of the three ghosts, Scrooge is able to work out what he needs to do. In any mentoring relationship, the mentee must be able to take the guidance and decide on their own path.

Scrooge’s dramatic transformation is symbolic of the kind of outcomes mentoring can achieve. Few would be so extreme, but nevertheless A Christmas Carol provides us with a vehicle for understanding a little more about how a timely intervention can make all the difference.

 

Buzzwords galore, but what about the learning?

I’ve always had a problem with the term ‘e-learning’. Learning doesn’t take place electronically, but in people and communities of practice.

Cartoon of an e-learning course

There are many different words and phrases bandied about these days to describe 21st Century modes of teaching and learning. Here are some: e-learning, blended learning, technology enhanced learning, flipped classroom, social learning, mobile learning, gamification, cloud based learning, synchronous classroom, distance learning, agile learning, rhizomatic learning.

Experts attempt to differentiate between and define these various terms, which overlap considerably.  I can’t help thinking they all sound very clever, very technical, and slightly mysterious. Certainly, they have their proponents and trailblazers who desperately want others to ‘get it’, adopt the approach and join in the conversation about how it can benefit and transform learning. This all helps to build communities of practice and gather evidence of effectiveness.

Underneath all the buzzwords, there is the tricky concept of LEARNING. Learning is very difficult to pin down. On my bookshelf I have a book edited by Knud Illeris, a Danish professor of lifelong learning, who has gathered contemporary accounts of 16 influential learning theorists. It is a fascinating and inspirational read. But having read it, I still sense that learning itself remains mysterious. Learning is not a spectator sport – you cannot ‘see’ learning happen, although you can witness what emerges the other side of the ‘learning black box’. And you can study the learning context in order to understand how to help people learn.

Learn-small

Behind the inventive terminology and fascinating theories, I can identify five common threads for a successful learning context.

  1. Provide access to information
  2. Promote interaction between the source of information and the learner
  3. Create space for personal reflection and discussion with other learners
  4. Allow learners to test out their newly acquired knowledge/skills and to obtain feedback
  5. Provide learners with means of sensing progress and achievement

Here are some ways these five threads are woven into contemporary education.

  1. Provide access to information

  • Get people into a physical or online (synchronous or asynchronous) classroom and a teacher talks. The talking could be augmented by demonstrating a skill, technique, or practice situation. In an online or face-to-face classroom, the demonstration could be delivered as a pre-recorded video.
  • Supply reading material or a reading list. Formats for reading materials can be print or to suit a range of electronic devices. Some devices are more portable than others. Electronic delivery allows flexibility in meeting the needs of some learners with sensory impairment and learning disabilities – e.g. changing font size and colour, allowing audio conversion.
  • Help learners gain the skills to find appropriate information – e.g. in libraries and on the World Wide Web.
  • In a workplace, allow learners to immerse themselves in the community of practice, observe others, supply them with a buddy or mentor, provide access to libraries and internal documents.
  1. Promote interaction between the source of information and the learner

  • Help learners to make notes, actively interrogate content, organise their thoughts and responses in light of the information. They are not ‘just reading’, or ‘just listening’, or ‘just watching’ – engagement with the information has to be active. Gamification is a very engaging technique for promoting such interaction. In classroom situations, learners commonly achieve active interrogation and organising their thoughts by asking the teacher questions.
  • Help learners to question their information sources. Teach them the skills to judge the provenance, trustworthiness, and so on, of sources.
  • In a workplace, cultivate a climate of trust. Train mentors and buddies to adopt a facilitative, non-judgemental attitude to questions.
  1. Create space for personal reflection and discussion with other learners

  • Create break-out groups in lectures – either virtual or face-to-face. Online classrooms also have the facility for messaging, emoticons and voting buttons – and voting buttons are also available in some lecture halls. Online forums are widespread, a very useful tool for running discussions. Blogging is also becoming increasingly popular for reflection and discussion.
  • Provide prompt questions for reflection. Online, questions can be made interactive so that a learner’s response influences the next question posed.
  • A flipped classroom involves learners accessing the information they need before entering the classroom. This frees up the classroom time for extensive group work and reflection. This is a common model used in distance learning with tutor support.
  • In a workplace, a useful approach is to facilitate learners to form networks or learning sets for reflection, discussion and peer support – ‘social learning‘ springs to mind here.
  1. Allow learners to test out their newly acquired knowledge/skills and to obtain feedback

  • In academic learning, this testing out commonly occurs in formal or informal written assignments.
  • Peer feedback can also be solicited in group work and discussions via a range of electronic media as well as old-fashioned face-to-face.
  • In practice situations, trying things out and obtaining feedback could be almost continuous. If mentors and supervisors accept mistakes as part of the learning process rather than a source of shame, discussion opens up and learning is more likely.
  1. Provide learners with means of sensing progress and achievement

  • Set meaningful and tangible learning outcomes and objectives.
  • Design assessment tasks carefully.
  • Regular quizzes (in any format) can be fun and motivating.
  • Ensure any feedback is carefully formulated to encourage.
  • Emphasise the value of any qualifications to be gained.

I may have missed something out. Can anyone add anything?

5 indispensable tips for giving feedback to struggling learners

Five tips

One of the most persistent challenges that tutors and workplace mentors face, is how to get learners to respond appropriately to feedback. So often, it seems that the student hasn’t been paying sufficient attention. Repeated enough times, this experience can lead to desperation in which tutors start to sound like a broken record, relaying the same message over and over again, and mentors begin to doubt whether the student is really up to the task. This can easily lead to exasperation and disillusionment for learning facilitators.

Want to hear2
But before you give up on any learner or beat yourself up as a failure, consider whether there are any alternative approaches. Always remember that feedback has to be given AND received.

1. Tell them something they want to hear

No, it’s not a cop-out! But if you want someone to hear you, they need to be receptive. It’s easy if your learner is a real star who you can’t praise enough. Praise for performance can soon feel hollow if it doesn’t fit the situation. Here are some alternative openings your learner might want to hear:

  • You clearly have a passion for [the subject/work]
  • Your personal experience and insights about [the subject/work] really shine through
  • I’m really pleased you managed to submit this work by the deadline, as this shows good time management skills.
  • Just think how far you have come since [the first essay/you first arrived]!
  • I always look forward to [receiving your work/working with you]
  • I was very relieved when your assignment appeared, as I know how difficult things have been for you
  • It is rewarding for me to see the journey you are on.
  • I’m amazed at how resourceful you are.
  • Your resilience/perseverance is impressive!

In other words, the learner may be struggling but you still appreciate them as a person.

2. Focus on observable behaviours

Focusing on observable behaviours avoids falling into the trap of making unwelcome personal comments. You might be thinking that that your student is not really interested in helping the clients. If you tell them this, the defences go up, and any further communication will be hampered. Instead, share exactly what you have seen and heard. The learner stood or sat with folded arms. They missed an opportunity to intervene when a more experienced member of staff would have dived in without thinking. These are then opportunities to talk about body language or to teach ‘helping’ techniques.

Feedback

When students repeatedly make the same mistakes in their written work, it is easy to believe that they are ignoring your feedback. But writing well is hard. Try unpicking the issue. Is it grammar, style, structure, showing understanding, using the appropriate content, using evidence? You might think that correcting grammar is simple, but it can be the hardest thing to do. And grammar mistakes often originate from a poor grasp of the topic or the message. Students who struggle with sentence construction are also struggling to express themselves at all as they grapple with new ideas.

Look for clues in the writing and find alternative ways of helping. Such as:

You used a lot of colloquial/informal language, which made your essay seem less persuasive and less objective

It was sometimes difficult for me to follow your discussion, as you were trying to say too many things at once.

Writing

3. Don’t accuse your learner of not putting the time in

Your learner’s work might appear scrappy, rushed and sloppy. But the chances are, this person has sacrificed their family and social life to study or develop a new career. You will instantly alienate your protégé by suggesting they are not doing enough work (even if this is true).

4. Make clear suggestions for moving forward

This may be obvious, but it’s difficult to do well. The learner who is holding back in the workplace may be lacking confidence and/or skills. Find out which it is and help them to address the issue. Draw on the observable behaviours in your discussions and invite the learner to impart the less observable. How are they feeling? Perhaps there is a clash of values or attitudes that needs unpacking. Whatever it is, make sure you can make concrete suggestions – small things like ‘try smiling more’, or bigger things such as shadowing a more experienced colleague or practising one skill until it is mastered.

Moving forward with written work, again try matching your suggestions with your observations:

Try to adopt a more formal writing style, by bringing in more of the specialist language and the concepts discussed in the course

At the planning stage, have a go at writing one phrase that sums up what each paragraph is about. Does the order of your main points seem about right? If not, change it.

5. Listen. Listen. Listen.

I’ve left this most important one until last. Remind yourself that feedback communication is a two-way process. Find out what your learner is thinking and feeling. Check their understanding of the topics or skills they are learning, as well as the feedback they have received. Ask them for their own ideas of how you can help them learn.

Want to hear