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Students also offered interview through Manchester Access Programme (MAP) plus year zero foundation programme (typically takes 12 students a year) 3 3
Challenge for students to learn and apply science to practice 4 4
integrationThe Manchester Pharmacy School (MPS) MPharm curriculum is based upon an integrated model (Hall et al, 2014), where teaching, learning and assessment are built upon, year-on-year, both horizontally and vertically, in each of the key strands (Medicine, Pharmacist, Patient, Public, Integrated Research Skills, Integrated Project and Integrated Professional Practice – see figure 1), to take the learner towards the higher cognitive domains of Millers triangle (Harden, 2000), whilst integrating the core disciplines to achieve transdisiplinary integration, which is realised for the learner within authentic, work-based practice placements (Harden, 2000). 5 5
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What is TBL? team-based learning comes the United States & has been used to some degree in approximately one third of US pharmacy schools. Of course the difference between studying pharmacy in the US and the UK is that students in the US will have completed at least two years of specific undergraduate college study – but often start pharmacy having already completed a three year BSc course In the UK pharmacy schools have been innovating and looking to using different teaching and learning methods to help students to integrate science and practice – for example, TBL has been introduced into the UK by other pharmacy schools, most noticeably Bradford. It involves a “flipped classroom”, where students are given guides, including written resources, websites, or videos and podcasts, before coming to class. Immediately upon arriving in class, students are asked to complete a short test on the material – which motivates students to prepare for class. From the results of the test it is clear what students have understood and what they haven’t. Once they have completed the individual tests, students break off into groups, which are allocated by academic staff, and complete the same test as a team. They discuss the question, agree on an answer and use a specially designed scratch- card to receive immediate feedback on whether they are correct or not. After the test results are in, staff go over any concepts the class found challenging 7 7
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33/177 overseas (so 144 or 81% are home students); not all home students are domiciled in 128 England (or Wales [n=5]); not all those domiciled in England are of British nationality (n=123) 110 female (62%) Demographically diverse: roughly ¼ are Asian, another ¼ white and almost 1/5 are Chinese –remaining 30% black, Unit-specific material may still be assessed during the semester within a unit. Examples of such assessments include the assessment of practical skills in “the medicine” and “the patient” units, communication skills in objective structured clinical examinations in “the pharmacist” unit, and the production of a health promotion video in “the public” unit. 9 9
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Based on Kolb’s model of experiential learning The way that learners move through the four modes of learning depends on their learning needs, preferences and strategies adopted for optimum learning. For example, in the focus groups it was apparent that some of those taking part in the WhatsApp social learning group were more likely to prefer observing, while others had a preference for active questioning and problem-solving. These differences in preferences are categorised by Kolb (and Austin) in relation to preferences in the way that information is processed – which range between preferences for performing tasks at one end (the active, questioning WhatsApp user) to preferences for watching and reflecting at the other end (the users who never post a question or answer on WhatsApp). In addition to information processing preferences, preferences for either feeling or thinking in how information is taken in. By considering how learners prefer to take in and then process information learners are categorised as divergers, assimilators, convergers or accommodators. Divergers prefer observation to action, enjoy dealing with complex, ambiguous, theoretical situations and viewing a problem from a number of different perspectives. Assimilators prefer to work alone or with a small group of similar people; they also tend towards observing (and learning) from others, and value logic, order and attention to detail. Convergers like to apply ideas to solve problems and perform at their best when there is only one answer. Finally, accommodators prefer to learn through performing tasks and thrive in new and challenging situations. 11 11
The H-PILS is a tool developed by Zubin Austin. It operationalises Kolb’s learning style theory in a standardised self-report questionnaire (Austin, 2004). It consists of 17 items; each item is designed to measure how students prefer to respond to various learning contexts out of a range of alternatives offered. Responses are used to then calculate a score and to identify a dominant learning style As well as providing those who complete it with insight into who they are as learners, what motivates them, frustrates them, inspires them, and disengages them, the H-PILS also enables researchers to categorise learners in terms of the type of learning that may be most motivating and meaningful for them in relation to four different modes of learning: abstract conceptualisation, active experimentation, concrete experience, and reflective observation. These four modes of learning relate to how new experience and information is perceived, and how perception is processed and transformed Our results are consistent with other studies of pharmacists and pharmacy students where it has also been reported that there is a preference for abstract conceptualisation. Given this preference for thinking and reasoning over being directly, actively, involved in a learning situation it is likely that pharmacy students taking part in our study will tend to be more comfortable with learning that emphasises facts, memorising and requires students to pay attention to detail – all of which were evident from the focus group discussion. 12 12
Triangulate with focus group data – see more clearly this preference It also not surprising, based on these learning styles preferences, that the focus group participants found being self-directed difficult and that they preferred clearly defined learning outcomes, and highly structured lectures. 13
What is clear from these narratives is that the speakers recognised that although they might be drawn to learning techniques that had previously guaranteed positive outcomes (that is, the best performance at A-level) they now needed to make different study decisions and learn new ways of learning. Despite this recognition from some students, for many there was an obvious disconnect or dissonance between their learning beliefs and the learning paradigm of the MPharm; and this was particularly noticeable to students when they turned to teaching staff for help, as they would have done prior to entering higher education. When asking for help in this way, students were conceptualising themselves as the objects of instruction; however they often encountered teaching staff who conceptualised students as agents of their own learning, with the result that students were frustrated by the learner-centred reactions they received from staff in response to their questions. For example, students perceived staff as, “V ery reluctant to give you answers.” (FG1) and as rejecting the role of teacher / transmitter of facts: 14 14
recognised that their learning beliefs were challenged by the MPharm’s emphasis on a learning process that focuses on meaning, on making connections between concepts and on understanding, they reported being unable to first of all generate their own learning materials and to then make the connections between different materials and sources when studying – that is, they felt unable to elaborate on their learning, or to develop more complex, emergent understanding of concepts: These discussions between the students attending the focus groups suggest that they have the metacognitive skills to think about learning, and that they have the self-awareness to identify that they lack understanding – but what they lack is skills in addressing how to learn for understanding. Students did, though, acknowledge how important understanding was for the learning paradigm and for their future professional lives: 15 15
Poor learning experiences -Lengthy, crammed power-point driven sessions -Reading verbatim from slides/notes -Staff unfamiliar with material -Staff unwilling to engage with students -Staff giving the impression that teaching was ‘not their priority’ Staff Qualities - Knowledgeable;Enthusiastic; Engaging; Communicative - Approachable; Respectful; Professional; Organised Learning experience - To be stretched and challenged (not spoon-fed) - To be supported - Personalisation of experience - Fairness and equality of opportunity Recommendation: Students almost exclusively spoke of their educational learning experience in terms of their course 16 16
Students expectations of higher education 16
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