Student Engagement During the Clinical Experience [Learner Engagement Summit]

Brianna Bannach 0:05
Thank you everyone for joining, I am excited to introduce you to Dr. Andrew Baldwin. He is the co director of clinical education education at Mary Baldwin University's Murphy Demin College of Health Sciences, he will be talking about student engagement during the clinical experience. Thank you for joining us, Andrew.

Andrew Baldwin 0:23
Thanks for having me. Hello, everyone, just be here. So hopefully, I can kind of give everyone a great learning experience and kind of see some of the tools that we use to kind of supplement the clinical experience. So I am co director for the doctor physical therapy program, we also utilize Yellowdig, four factor of occupational therapy program as well. So hopefully give you some things to work on and see what things worked for us and what you may be able to carry over into your programs, in even beyond clinical education as well. So I want to show you different strategies to engage students who may be off campus, how they can get them to collaborate, be more interactive, on a platform, such as Yellowdig also share some real experiences of how our students have achieved success and be able to utilize this and be more engaged with one another can give you some examples, and how we utilize this data for our accreditation process as well, for the doctor physical therapy or occupational therapy program, we have to meet certain standards. So it's always good to have that data to back that up and reflect, you know, how students are learning taking what they learned from the didactic portion of the courses and then carrying over into their real world clinical experience. And then I'll also share specific feedback from students that have really had great successes with this. So when students are on clinical rotation, they're often away from their support structures. So they may go to an area geographically significantly, away from their family away from professors. Sometimes they're staying with complete strangers. They also, maybe there aren't any clinic where they don't know their colleagues as well. And at the start of the rotation, that can be quite stressful. So and they basically want to know, am I the only one experiencing these issues? And oftentimes, the answer, of course, is no. But this allows them an opportunity to interact with one another and be involved in different way beyond just a simple discussion boards. So different means that we use, and we still do use some discussion boards for shorter rotations. But you know, as we use JL Yellowdig, we also try to engage students in doing site visits or site calls. Where as a Clinical Directors will either visit them or do like a Google meet or a zoom call. Now, there's various assignments that we also utilize to try to engage students with one another as well. And then you'll find the students also are involved in more informal communication with one another, maybe they have text groups or email chains, or they're meeting up together as well to kind of provide that support. So discussion boards, in general, my opinion of them, you know, is that they tend to be a little maybe too structured, kind of like a top down. So we're giving them a topic to discuss, they comment on someone may comment on, on that, and so forth. Whereas, you know, with Yellowdig, we found it to be a little more interactive. So the scope of, of discussion on the discussion boards are typically more narrow. Now, you might get a have a topic like they haven't practiced, and you know, one student response, maybe another student responds differently, and then they get a comment, so forth. So it's kind of that top down flow, not much incentive. Obviously, they're graded on that, but they don't have as much incentive to really participate. And there's often, you know, quick end to that conversation moving forward. So we try to engage them in different ways. So, you know, as we go through with Yellowdig, here's an example of how students interact on elevate. Looks a little messy right there, of course, but this is actually an image that we pulled out from Yellowdig from our actual students as they interact. So we cleaned that up a little bit. This is, I think, a better picture of how our students are able to interact on an online platform such as this. So this is kind of a neat thing to play around with. But as you can see a lot more interconnectedness going on there. Then there's me kind of the outlier, who's not interacting, which kind of for a reason, which I'll get into here shortly. So this kind of reminds me of this image here, which this was actually a study that was done do clinical education. But when I kind of we created that web of interaction with our students, this was kind of what I feel like represents it best. So in the lab, kind of like discussion board is really limited. But on the right with Yellowdig, we've been able to kind of map more interaction. So they're more integrated. They're linked more often with one another as students, and just increased connectivity. Now, those terms on the right to describe this interaction is actually straight from this study that use pictures come from, interestingly enough, a little bit outside my scope of practice. But these images are from a study on magic mushrooms and the amount of neuronal connections and networking that occurs on magic mushrooms. So again, outside my scope of practice, that's a different presentation, I believe. But um, but basically, the same is just completely so unrelated study, but the image is, is, is perfect for how our students are interacting. So what we do for our coursework, coordination with our student rotation, is we give them specific topics, topics that relate to requirements of the program, whether it's accreditation, and just development of our students. So the didactic portion. We also allow for other general questions or undefined posts, which I'll get into shortly as well. So that it really allows some, you know, off topic conversations the students can connect, I don't think anyone would argue that, for students to have kind of started with sidebar conversations and discuss their interests with one another that are off topic, I don't think anyone would say that that's not a good thing for their mental health as well, to be able to kind of branch out a little bit and really just, you know, kept communication with one another. So that, I think it's important to still allow that freedom for students to connect on other in other ways. Without feeling like we had to nitpick and bring them back on track. The students usually, or they do a good job without any oversight, kind of bringing it in when it needs to when they need to rent. But, but I really think that those two topics, allow students to just kind of expand on their learning experience. Besides the topics, everything else is student led, we take a hands off approach. That's why that image before my little picture was small, but it was off to the side. And I didn't have any connection. But it lets the students that have the conversation, less pressure that they're being graded. So this is an example of, I just have a couple of students there just so you can see kind of what the interaction themes. So if you hover over their image, you can see what are the connections mean. So for example, on the last student a, they responded to 72% of their colleagues, and received responses from 69 69%. That's a pretty good level of interaction there, they, meaning they're commenting on a big chunk of their classmates posts. And they're also receiving comments from the student of being on the right, they responded to 63%, a little bit less, but almost everyone in the class responded to one of their posts. So they're obviously doing a great job of gauging their classmates and creating conversation based on what they're posting. And at the bottom, there is just an example of how we score students, they're told us in the syllabus, they know what to expect. So it's 1000 points a week, they get a big chunk of points if they post something with a certain amount of words. And if someone comments on their posts to get points, if someone gives them a thumbs up or an accolade they get points as well. So you also get points for other classmates reacting and commenting. So and these may be a little hard to see on this PowerPoint. But these are just examples of the kinds of data we can pull that we've found useful. So you can see the topics on the left, and the number of posts. So right there at the top that the two most commented on posts, where the general questions and then define, which again, isn't a bad thing, to see some of the conversations that do engage them, but they also were making posts with these topics that we have, such as practice mental relationships, interview health disparity, and we can break that down by students. So I obviously hit the student names there, but the percentages there reflect what percentage of activity each student has, in those, each of those topic areas that we that we have, and again, those topic areas. This description is in the syllabus, but beyond that, they click on that topic area. They don't need to go in and read through that every time but they can actually see just the general topic and then expand on that.

Are there. So here's some examples. And this is big in the in the PT and OT world is being able to share research. So students can post about their experiences with a specific patient, obviously following HIPAA regulations. But yeah, the students shared an article about clinical prediction rules for patients with neck pain who may benefit from the breast population so that engaged some classmates, you may be in a similar situation, and they can pull up that article and click on that link. And you get points for clicking on the links to actually open up. So that was an evidence of practice topic area that we had. For the interview process, we encourage students to interview a colleague in the in their office for their work. And it could be another PT, it could be another health care professional, it can be some at the front desk. So they would share their experience with with interviewing and asking questions to their colleagues. And this, the student chose to post about different codes that they use when they bill for care. And, you know, they were able to engage in more conversations to see how their classmates are doing, what code did they come up with. Another example is mental relationships. We try to encourage students engaging with their clinical instructors and using them as mentors. And that's also as part of the accreditation process for PTSD. So you know, they can share that information, whether Kali or whether five spaces see how did they handle those situations of how are they interacting with their with their clinical instructors? Another top period health disparity, you know, what are students experience, you may be in an area where there's lack of care, or it's more challenging for patients to have access to care. This is something that we want our students to be exposed to be proactive with the kind of as a profession to develop, so they can share these stories with one another. You know, so going back to the platform, and how we use the data and how we can analyze it, if you're a numbers person, this is this is for you, there's a lot of things you can determine here. So and there's some things that are, you know, a little more in depth that may go above and beyond the scope of what you're interested in sharing or knowing about but but we can see the amount of connection that students have with one another. You know, what percentage of the, of the members or your classmates responded them here to tell them how many incoming connections, how many outgoing connections, how many times they respond to posts, who who responded, and how much. And then how recently they've been posting. So on the last year, again, lots of numbers. So study well, but basically, on the left is a breakdown by weeks. for a specific student, how many points they're accumulating each way, you can see on this one, we created 12 weeks, 12 to 16 weeks, this student did not post anything. So they had zero point, goals to get 1000 a week, but they made up for it. So they know they had extra points other weeks. So we can look at that. We can pull up total points for the semester ongoing. And then it gets converted to Canvas, so that the students log in through Canvas. And it leaves their their posts and creates the grade. So for example, our goal was 16,000 points that that student achieved enough of their grade was 100%. The students just missed it. So their grade was 98%. So the points are converted, that's a nice thing to have, they just log in through Canvas and can have that link. So that's been, you know, easy to easy to use and visualize, and the students can see it updated week to week as well on campus. So this is just a general area of information that I think is interesting. So looking at Community Health, I think that was a good term to use, you know, how well is the community doing how well are the students interacting with one another as a whole, you can look at total posts or comments reaction was called conversation ratio. But you can see this was actually the end of the semester, but you can look at it week by week as well. So you can see you can kind of analyze when we're students from around posting. And we've got a number of posts here. You know, sometimes it started to taper off and then they bounce back up again. So it was you can look for trends there. If you look like the numbers and the things you can see definitely trends. So you know, breaking it down further this is another thing I found interesting to utilize was, you know these different scores sharing for listings for racquet sport. So on the left there is just some different metrics you can look at. And kind of rate how the fact that doing. So how many links were shared, you can see with our class didn't do quite as well as the typical Yellowdig community with regards to, you know, how many links they were sharing. But you can look at average number of posts. How many multimedia images were shared, every single comment, so forth? Now the listening for was more, how much? Are they assuming content? So how many links are they clicking how many posts and then the conversation ratio, which the conversation ratio. And you have to take a statistics course before you use this, but not really feel that way. But But anyways, get information, the conversation ratio is the total number of comments in the course divided by the total number of posts to kind of get some more data. Again, if you're a numbers person, that's definitely helpful. The interacting for you know has to do with, you know, how connected, we got various tools and images to kind of see, yeah, they're definitely connecting. But here's some specific data, you know, how many users were connected, we want that to be 100%. But I think in this case, it was 97%, because I was a member and did not interact. I also started partway through here, so but you can see you know, how many reactions were given on average, better with this class compared to the typical community? And same with the average number of connections? So you can look at? What does that mean? What is the average number of connections, the total number of comments reactions mentioned, divided by the number of members, so you can kind of break it down in a lot of different ways, which is really helpful. So now I'm going to go through how to track Community Health and special boards. So this is gonna take about 20 minutes to kind of go over just a little bit. But if everyone just looks at this chalkboard here, you can figure it out. Perfect, okay, a little more difficult to really determine in a discussion, you know, old fashioned discussion board, how do you determine community health? I don't know. I mean, again, even if you're not a numbers person, or you are a numbers person that's still hard to track. So what So what I want to touch on now is related to accreditation, there's this could carry over to any program, I believe, as far as how you utilize this data and information to show that your students are prepared for the professional you're getting into. So we looked at different outcome measures, curricular standards, and just in general, how we relate that so with the DPT and the OCD programs, you know, we're looking at how we can relate the didactic portion of the courses to the clinical experience with MPT the clinical experiences are interspersed throughout the didactic, but the two last clinical rotations that are sticking with the piece are at the end. So we want to show that they have integrated what they've learnt. So we have different accrediting body cavity of the Accreditation Council for occupational therapy education. And I'd hold these standards from the website just to kind of draw it in specifically to county for therapy. But here's an example some of the topics we use. And I mentioned, we use general questions and undefined. But you know, some of these other topics like the mental relations, job, search, interprofessional practice, these are all important for the students to achieve their goals and become quality physiotherapist, but also for the program, to meet accreditation standards, we need to reflect that students are competent in their lives. So now, I won't take a ton of time I need to go through but these at the top here just showing some of the actual standards from Kathy. So for the physiotherapy accreditation body, I just kind of cherry pick some some different things that we need to show that we'd meet. So in this example, you know, is the program, the clinical education component organized to basically build off the didactic portion? So how do we demonstrate that well, with some of our Yellowdig conversation, evidence into practice, we're having students post specifically on evidence into practice. And basically, that's an example we could say, hey, look, these are what our students are doing, we can pull that information that's archives, another area and then you're gonna see a lot of different categories that we use for our topics that could be kind of fall under the umbrella here. This standard has to do with intra and inter professionalism and also communication. You know, knowing our professional roles and responsibilities. and working as a team. So here's some of the topics that we specifically have students come at them, again, on Yellowdig. That's all they know is that's the category. And then they know, there's a very brief description of the syllabus that says, here's what we want you to focus on. But some of them speak for themselves, but it kind of allows them freedom to kind of get left with that. So interprofessional practice, you know, mentor relationships, the interview process, and there's a lot of different areas that we have have, that students can then utilize and will reflect that, hey, we're providing these resources, all the students are actually building off of what they've learned.

Another area that's in the accreditation process is that we're students are going to have a learning experience related to diversity, equity and inclusion. Also, looking at personal finance, clinical reasoning, was a different regulation. So we have a cultural competence topics, job search topic, so looking at personal finance, mental relationships, communicating with mentors in the clinic, to see how they succeed and how they how they progress with a professional, again, evidence practice, interview process, a lot of different topics fall under that was definitely though. This is another example of an area that we have to show that we need to engage in a professional development leadership. Also looking at health care disparities, health inequities. So, you know, we saw that as an example, there was a student that discussed health disparities. Also, again, go make better relationships with people overlap here, the interview process, a lot lots of overlap. So that, you know, that's just a kind of a quick snippet of some of the topics we use, but that can be tailored to whatever. So. So in general, these kind of more interactive platforms in higher ed, I think, are clickable, definitely an online situation, which is more or less what the students are in when they're on clinical rotation. But also with hybrid programs, I think it would be a good supplement for in person programs as well. That's a dog with an alligator head catching a Frisbee. So if anyone needs clarification that's related to hybrid. Okay, just want to make sure I made that clear. So, now, this is the most important part. And what did the students feel about this experience with Yellowdig. Because these keep in mind, these students in the fall, who are who are using Yellowdig, they use regular discussion for before, and I'm sure they did an undergrad as well. So they did a lot of the feedback they give is important. So I'll show you a couple quick examples. And I'll get into more, you know, the actual feedback, but we talked about, you know, wellness and mental health and students being able to engage with one another, in beyond just sticking to the script of it has to be directly related to PT or OT, during the World Cup, someone posted about, you know, a the Masters Washington World Cup, they could do that if they engage in conversation. So there were comments on this. Another student mentioned, you know, hey, what's their wonder for Thanksgiving? You know, keep in mind, some of these students are out on rotation again, away from family and friends. They may have to work the day before and the day after Thanksgiving. So maybe they're kind of they're isolated. So the student asked, Hey, What's everyone's favorite Thanksgiving dish? Now, in this case, if anyone said cranberry sauce, they lost points, because I don't quite understand that, but. But it really kind of get some good conversations going well. Here's an example of just someone checking in, you know, this student just said, Hey, how's everyone doing? And it's fun to see. You know, what's it been like working in this rotation with each other? Like, we saw a lot of that. In this one, they asked about, what's that one dressing up for Halloween? So yeah, having those other conversations. So, you know, and I could screen show you some of those examples in conversations, but I thought those reports. So now, how did students? Yeah, how did they like the experience? You know, and these are terms that they use, and weirdly enough, that kind of the topic of this presentation. Now, engagement, clinical experience, and you'll see engaging was used by multiple students without any prompting, ask them Hey, what do you think of it? So creative craft platform, it was more interesting to participate in. compared to regular discussion boards. The student said, you know, hey, we were able to speak more freely. It felt like we could learn from it, but also speak freely and talk about more things than just what they were prompted to talk about. So yeah, just encourage them to have more conversation. So that was good. Again, they engage in some thought it was more like social media and less like an assignment. So they were able to, you know, they were kind of connecting to that generation that maybe they learned better in that in that scenario. And yeah, this student mentioned, hey, we've just responded to post about unrelated things, movies, events, things going on. Again, it builds those connections. The student mentioned, hey, it's mainly a platform for students, they knew we were there as directors of plein air, but they were in control, you know, our level of commenting on it was very minimal, we kind of let them take the lead. And then they were able to share their own experiences and maybe mistakes that they encountered. Also, just being able to see other people's experiences was important. They mentioned that they could be more authentic. And that was, they'd have to focus as much on requirements and fitting into that, that mold of a discussion for this more like top down. Again, flexibility discussion, able to kind of branch off and not feel that pressure, much more fun, easier to view the photos, in your mind a lot of repeats, you're basically saying the same thing, but freedom to post topics that may be unrelated, but also learn from the class. Being able to share and review research articles, that's important. And again, they're able to relate it with their classmates to specific samples that they encountered clinic. Again, he's an already engaging, which was interesting. And just like to see that other people are going through the same thing. So some of the students that I didn't feel as alone. And I wrote that on the first slide like, students really question Am I the only one in this situation? This allows them to say to just say, hey, you know, I'm not the only one and I have support. So that's, that's super important. Now, from the clean Ed, Director perspective, I mean, I could add much more to this, I kept it simple here, because we're kind of covering the benefits now as far as things we've been able to engage in. But, you know, here's an example of an OT student who highlighted a piece of adaptive equipment that was not common, and most students probably would not encounter in their clinical experience. But that student could share that. And their classmates got to learn about it as well. Others other times, students will collaborate, how to improve work life balance, they brainstorm treatment ideas, you'll see that pretty commonly. And again, from an accreditation perspective, we're able to use those examples, such discussions and conversations, it's archived there to use to kind of support the accreditation process. So it really might have I think it was like it allows us to observe from afar without interfering. So it's, I mean, that's like the definition of facilitation, we give them something to talk about. And they just run with it. So I feel like we follow those things are captured. So I know there's been some chats going on. And that's all I really have for now. But if there's any questions or anything, we have, like a couple minutes here. And if anyone wants any more feedback on the staff, we're just like now. Now I can, in the planning of my experience with this is very limited today. But I've learned a whole lot just by looking at all the different tools that are available out there. So now when the next time they ask you, what was your favorite presentation? Now you know what the answer if you go on to the other presentations today? Love it. Thank

Brianna Bannach 28:34
you, Andrew, Andrew, sorry, since we do have about five minutes. If you have a question, feel free to pop it in the chat. I'll announce the raffle winner now to give you a second to type in your questions. And then I can ask Andrew a question I have if no one asks anything. So I am excited to congratulate the raffle winner, which is Jenny Harper told I will be following up with you via email, I have your email, you have one, a pilot of Yellowdig for for six months, you'll get to try out Yellowdig for free. So we'll be excited to connect with you about that. Do I see any new questions in the chat?

Andrew Baldwin 29:15
I saw that was about under the undefined topic. That was like an actual heading we have so they just put if they had an off topic thing they didn't know where to attach it to they could they could choose that option. So that was their actual post was it says undefined. The topic. That's awesome. I

Brianna Bannach 29:38
see another one from Ray. She wants to know How do you facilitate Yellowdig discussions.

Andrew Baldwin 29:42
So surprisingly, we really let the students take over pretty much right away. So our The only thing we have beyond just the topic so like for evidence and practice is the topic you In the syllabus is where we write a very brief description of what they should be including. So it might say, you know, describe how you are using your research and evidence to determine what kind of treatment you're doing in the clinic for a specific patient. So that literally like one or two sentences of, hey, this is what we want to do. So we had one for a job interview, so that it was interviewer a colleague, and determine, you know, what they did for the job interview process and how they questions they want to have or facilitation.

Brianna Bannach 30:39
Awesome. It looks like Kay has another as a question she wants to know. Do you have a word word limit? Between, for example, 50 and 100. Words, feel free to jump in. I also can answer Camila to give you like,

Andrew Baldwin 30:51
Yeah, I think well, and you may know better, like, hey, what's the best practice? We have like a minimum word requirement to receive points? It's only like 40 words. I don't think we have a max. But usually students keep it reasonable. Yes, that's exactly

Brianna Bannach 31:06
it, we have a a minimum word limit, it's a little bit different for posting comments. And then we don't have a max. But the thought is, if someone's putting in a whole novel, no one's probably going to read it. So students will learn pretty quickly how long their posts should be

Andrew Baldwin 31:21
being about. Yeah, we've I haven't encountered that where there's been like, super length, I mean, usually the students liked it. So they're pretty good at that.

Brianna Bannach 31:32
Awesome. And a fun fact is that, by default, the point system, you earn more points per word for the comments. And the reason we have it set that way, is to encourage conversations from to actually start instead of everyone just throwing their ideas out in posts, and no one actually interacting. Okay, well, I think we have three more minutes. And I see another question in the chat. Ray would like to know, do you create example posts in Yellowdig community for your class and use accolades?

Andrew Baldwin 32:00
So yes, and no. So I kind of there's like a generic default posts to start that kind of gives instructions again, and files and put them in the syllabus. So I surprisingly haven't, like we just started up the semester with students go ahead and rotation on the second of January, and they kind of just float right into it. So I use the accolades, but I'm still getting use that myself to see like, if they think like, if they're a community builder, they post something that really generates a lot of comments, but I'll give them a little ball accolade and they think they get points for that as well. I don't use it a whole lot. Again, I try to stay somewhat hands off, but we're if I will say if a post is really I think is a great post and not garnering a lot of conversation I've been in that case, I might jump in and make a comment and ask a question, which even at least that student would generate more conversation. So yeah, definitely

Brianna Bannach 32:58
commenting is a great strategy to not be too aggressive in your presence, but But bringing to light the really good posts. Thank you so much, Andrew, I really enjoyed learning from you today. I think your use cases really interesting and I loved getting to see all the data that you you get to dive into. I hope you have a great rest of your day and see you soon