REALISING EXEMPLARY PRACTICE-BASED EDUCATION

PRACTICE-BASED EDUCATION REALISATIONS

 Higgs, Joy, et al.

REALISING EXEMPLARY PRACTICE-BASED EDUCATION

 In this chapter we address the two key questions posed by this book: How can we realize, understand and conceptualize what is exemplary practice-based education (PBE)? How can our understanding of PBE be realized, enacted or put into practice? Broadly the authors of this book have been addressing one or both of these questions. In reality they have asked and answered a number of related questions that lead us in this chapter to a set of answers and interpretations that help us realize and provide the collective authors’ guidance for implementing exemplary practice-based education. Figure 30.1 provides a framework of inquiry that shapes our response. Indented quotes throughout are extracts from previous chapters.

 What is Practice-Based Education (PBE) and where does it fit in and shape higher education? What is the purpose of higher education? What is the purpose of professional education? What is professional practice as the goal and context for PBE? How does PBE contribute to the goal of preparation for professional practice? What educational theories underpin PBE? What is exemplary PBE? What do PBE stakeholders expect of PBE? How does ‘exemplary’ relate to standards of good practice? What do PBE programs that people consider or experience to be exemplary tell us about what constitutes exemplary PBE? How can exemplary PBE be realiszed/ enacted?

Realizing Exemplary Practice-Based Education,

As discussed in this book occurs within two key contexts

a)       higher or university education a

b)      professional education.

Higher Education

higher education through universities is presented as aiming to: − go beyond the development of knowledge and skills to develop (for/with students) “a life of rich significance

 provide education for an economically viable workforce and education that develops ethically engaged citizens –

 consider professional education within the totality of a lived life

− educate for the greater/common good as well as for individual benefit and development. Professional Education

 A key theme in this book is the way PBE provides a relevant and effective means of realizing professional education, meaning the education of university students for their professional practice or educating professional practitioners. The focus is on professional entry education, however, the place of PBE in continuing and postgraduate professional education is recognized and valued. Shulman (2004) summarized well … the challenges of professional education in preparing graduates who know, apply, think, render judgement and are able to manage the uncertainty of practice. … It is learning for practice and learning from experience that makes all the difference in professional education. PBE Practice-based education (PBE) is a broad term, referring in this book to tertiary education that prepares graduates for their practice occupations, and the work, roles, identities and worlds they will inhabit in these occupations. In practice as in theory, PBE operates at curriculum level and through particular teaching and learning strategies. A PBE curriculum is one that frames goals, strategies and assessment around engagement with and preparation for practice; it values both learning for and learning in practice and occupational contexts. PBE teaching and learning strategies include explicit activities, such as workplace learning placements, practical classes and simulations where students learn occupational skills and become oriented to their occupational roles, lectures where visions of their occupational contributions are presented, and assignments and online learning where they can work on practical problems they will encounter in their future work roles. Across these strategies lie the goals of developing the novice practitioner’s professional identity and key profession-specific as well as generic capabilities needed in their future occupations, and the requirement for critique and appraisal of processes and outcomes occurring through assessment of students’ learning and evaluation of programs. (Sheehan & Higgs, Chapter 2) … effective, desirable or good-quality PBE is higher education for practice that (a) is fit for the purpose of educating high-quality university graduates for society, (b) is relevant to the given occupation’s practice, (c) is appropriately situated in the context of the course and the graduates’ work destinations (both locally and globally if relevant), (d) is grounded in and engaged with practice communities, and (e) that satisfies the needs, interests and expectations of relevant stakeholders.  realiszedAs a pedagogic practice, we can understand PBE as comprising normative and relational elements and, as such, teacher learning fits well within a PBE paradigm. We assert that teachers’ professional learning is complex and sophisticated. (Kidd & Czerniawski, Chapter 27) STAKEHOLDERS AND EXPECTATIONS In each layered context – in university education generally, in professional education, and in curricula based on PBE – stakeholders set considerable expectations of what curricula should deliver and what graduates should achieve. This position is exemplified in the following extract. Good PBE, … (is) education that meets the needs of practitioners (future graduates), practice worlds (including clients, employers, colleagues), occupational groups and society (as funders, setters of standards and regulations, and the collection of consumers of graduates’ services).  realiszedUniversity graduates are expected to be knowledgeable, reflective and competent in their disciplinary fields and to demonstrate a range of generic attributes including communication and interpersonal abilities, thinking and problem solving skills, attitudes and capabilities around critical self-appraisal and the pursuit of ongoing currency and quality in their practices. Recognising the needs of society: A vital group of stakeholders is represented both conceptually and in reality by the term “society”. The following quote emphasises the importance of professional education having the goal of contributing to the wellbeing and advancement of society. Nations in the 21st century are becoming increasingly multiethnic and multicultural, with a high degree of mobility and aging populations. for instance, has the highest proportion of old people in the world. These trends carry implications for the organisation, delivery and cost of health and social care, thereby putting practising professionals under increasing pressure to respond to more complex problems. It requires interprofessional competence to respond effectively and to realise the ideals of holistic care and treatment. Taking a holistic approach to patients necessitates the use of such tools as problem solving and critical thinking. This means that professions in health and social care need to define new roles and create new cultural patterns to ensure patient/client-centred care and to strengthen the clinical pathway. Collaboration between professions is especially important in rural and remote areas, where the available health care resources are often relatively scarcer than in urban areas (Faresjö, 2006). (Wilhelmsson, Chapter 13) Professionalism and professional capabilities are key dimensions of professional and practice-based education and are portrayed through the notion and commitment towards service and duty of care towards others seen in the following extracts. PBE aims to realise the goals of developing students’ occupationally-relevant social, technical and professional capabilities, forming their occupational identities, and supporting their development as positively contributing global citizens.  realiszedPreparation for practice: Stakeholders have expectations of curricula as well as of the graduates. This includes providing relevant preparation for the practice roles and worlds the graduates will enter. We see this in the words of Jensen and Purtilo (in Chapter 7) who pose the challenging question “How can educators prepare learners for such human circumstances?” to recognise how much is demanded of professional graduates providing human services and also how much is demanded of the educators whose role it is to ensure students’ preparation for practice. Practice-based learning must offer experiences that equip learners with the capacity to cope with the complex and diverse nature of practice with its many, often conflicting priorities and unpredictable outcomes. (Baldry Currens & Coyle, Chapter 8) PBE supports the development of sensitive, flexible and client-centred professionals who are able to apply metacognitive strategies across the rich tapestry of clinical challenges. (Baldry Currens & Coyle, Chapter 8) Since the core goal of PBE is to prepare graduates for practice, its foundation goal is to enable students to develop the capabilities and professional identity relevant to their profession. It is important to note here that we are emphasising capability not just knowledge and technical competencies. This includes the capacity to make decisions and act both professionally and soundly in situations of complexity, uncertainty and unfamiliarity. Professional capability requires confidence, self-evaluation, skilled judgement and recognition of when help is needed. Technical ability and scientific knowledge is the starting point not the epitome of capability. A key part of capability is also the recognition of the need for and the active career-long pursuit of ongoing self-evaluation and learning. Thus, PBE needs to help learners become capable and active self-directed learners as well as practitioners in their field. We would want this lifelong learning to be both a conscious and committed choice as well as a habitual, almost unconscious practice. When it comes to facilitating the development of clinical reasoning abilities in our students we need to remember that this ability needs development across one’s professional career. … When one asks therapists what draws them into clinical residency programs they often express frustration about entry-level training and short continuing education courses that focus more on technical skills, and express a desire for development of stronger reasoning and decision-making abilities. (Christensen et al., Chapter 14) As a profession, we are also challenged by thinking that is too often focused on the analytical – the dominant pattern – where thinking, things, and events are somewhat detached from everyday life as we look only for general patterns of cause and effect. We know that understanding the context and lived experience of the patient (“reading” the patient) is critical in designing successful physical therapy interventions. This understanding of context relies not only on analytical skills but also on the development of the narrative, where significance is found in understanding the context of meaningful interaction (Bruner, 1990). … The continuing ability to build new clinical knowledge and develop deeper understandings of practice needs to be intentional and lifelong. (Christensen et al., Chapter 14) The notion of professional identity has clear expectations that the graduate will understand and relate to what it means to be a member of their profession. But they also need to realise and deliver on what it means to be a professional. This term recognises the role of professions in service of society; on top of our previous discussion of university graduates being expected to be global citizens contributing to their society, professionals need to act professionally towards their clients and embody ethical principles such as duty of care. Previous chapters have articulated how PBE provides spaces for the exploration and development of students’ professional identity, a key part of which is the evolution of self, alongside the process of becoming a professional. Exemplary PBE probes at and facilitates the formation of professional identity through: – fostering human characteristics that are lifewide (such as wisdom, dignity, courage and humanity) – engaging students in a journey of becoming – coming to realise the responsibilities and inherent complexities that constitute ethical, professional practice

recognising that the formation of professional identity extends beyond university education and providing scaffolding (through the development of lifelong learning aspirations and abilities for ongoing professional identity and capability development. Through reflection, experience and dialogue in education, students can develop an awareness of who they are and of their individual strengths and abilities, cares and concerns, sensitivities and fears. A professional identity, a particular way of being a professional, is never fixed; it changes through professional life in a dialectic interchange with lifeworld experience (Dall’Alba, 2009). Despite postmodern doubt, this fluid self is anchored by some core sense of “who I am”: a self-sameness that infuses becoming with continuity over time to develop a narrative sense of one’s self Institutions and communities have the potential to help or hinder student professionals’ moral progress and to facilitate or compromise the development of ethical practice and professional virtues or moral dispositions … The context of learning for ethical practice is multi-faceted and complex, comprising early socialisation and both formal and informal learning activities. It is not, therefore, the responsibility of lecturers or teachers only; preparation for ethical practice is everybody’s business. The haphazard and context-bound nature of learning situations is characteristic of work-based learning, and can also be perceived positively as manifesting the richness of practice-based learning. Seeing and experiencing authentic working life developed the residents’ professional identity and their ability to respond to the challenges encountered in working-life situations Lifelong and lifewide learning both contribute to the development of graduate and professional capabilities. As students are educated for practice, they progress along a journey of becoming. This becoming is related to the formation of professional identity but in becoming professionals they are also becoming themselves. For young school leavers, they are simultaneously becoming adults but this (professional) identity formation is more than a developmental coincidence because it occurs in different forms with mature age and postgraduate students as well. In terms of becoming, as the student forms a professional identity, the emerging professional identity merges with and moulds the formation of self identity, reflecting the process of lifewide, transformative personal development. The need to support lifelong learning has become firmly established in higher education over the past 30 years. …

The notion of learning from life in a broader sense is not so widely established in higher education. … (this concept has) been embraced within professional education to refer to the value of extra-curricular activities as well as the involvement in activities integrated into the curriculum that support students’ individual interests, such as service-oriented or creative ventures  In this chapter we step through and then beyond professional entry education and the preparation of beginning practitioners to examine the way lifelong practice-based education can enable individuals to become wise practitioners and help educators and mentors to foster practice wisdom in their students and colleagues. We believe that wisdom has been overlooked and undervalued within higher education for some time. Within the university wisdom has lost territory to knowledge and, because of its nature as individualistic, situational and personal, it has been in the “too hard basket” with university educators. We consider that research on practice wisdom from a variety of disciplines would benefit from a return to its roots in the scholarship of wisdom more broadly. Practice-based education (PBE), when it extends to lifelong and lifewide learning, is conceptualised as a bridge to wise becoming.) Plato, Aristotle and others introduced the notion of courage as a virtue or character trait that protects the other virtues at their testing point, equating courage with bravery or fortitude. This inner resource stands ready to come into play on behalf of learners, each of whom will need to learn new areas of competence and to learn what care/service, compassion or fairness really requires in the individual situation. The idea that successful professionals must have the courage to learn – and continue to learn – throughout their lifetime must be instilled early in the educational process.  7) University curricula and standards go hand in hand. Expectations for curricula, staff and graduates to achieve standards come from the graduates themselves, professions, employers, universities, accrediting bodies, regulatory agencies and society in general. Professional schools are generally found in university settings where emphasis is on professional preparation led by faculty who must function and adhere to the standards of a university academic setting. A dimension that needs to permeate all aspects of curricula and pedagogies is the concept and practice of standards: standards as reflective of practice expectations and professionalism and professional codes of conduct or industry standards that are part of practice and professional socialisation,. Realising Exemplary Practice-Based Education, standards as accepted pedagogies across the discipline and standards of higher education.  Realiszed

EXPERIENCING EXEMPLARY PBE: EDUCATORS AND LEARNERS

 In Section Two of the book we asked educators to write about their experiences and their colleagues’ and students’ experiences of exemplary PBE. This was in pursuit of three goals a) to bring PBE alive through real practice examples, b) to ask the authors to reflect on what made their PBE exemplary and c) to consider how they dealt with the challenges they faced. In essence, we were asking them to do with their teaching, the same thing we ask our students to do in PBE: to understand their practice through doing, reflecting upon and articulating it. Each of these Section Two accounts and reflections on exemplary PBE practice were organised around a template for showcasing innovation and capturing critical reflection. The authors considered the setting, the focus, the strategy and the challenges faced in relation to their PBE programs. The guidelines for these chapters provided a structural framework for author’s critical reflection. When these case studies are read side by side and considered not as individual beacons of exemplary practice but rather as a collective wisdom, we derive an opportunity to interrogate the collectiveness of these diverse experiences. Learners’ Experiences Royeen presents a “triangle of experience”, predicated upon mentorship, interaction with practice, coupled with reflection and reflexivity as the critical, intervening set of `experiences that address the integration and synthesis essential for the habit of the art (of practice) called for by Sullivan and Rosin (2008). That is, we may not know exactly how to foster and develop integration of all three metaphorical habits (of the mind, of the hand and of the art), but we have a pretty good idea that it is the triangle of experience that allows it to grow and develop, from the student level to the expert level, over time and engagement in the activity of the practice of the profession. How much do our current academic programs truly address learning in the triangle of experience? Is that another venue for assessment of how we develop practitioners? (Royeen & Kramer, Chapter 3) The majority of trainees reported that participating in the Virtual Schools activities generated a lot of evidence against the professional standards (for gaining qualified teacher status in England) and also gave them an opportunity to demonstrate leadership and effective team work as we had shifted ‘teacher education from a curriculum organized by knowledge domains to a curriculum organized around practices of the

The students work in small groups or pairs, sometimes with each other and sometimes with aged care centre staff, depending upon the circumstances. The nurse educator facilitates appropriate selection of residents and care activities to support student learning from experience, and plans learning or debriefing sessions on most days. These can be quite lively later in the semester, when up to 18 students can be in one of the two larger facilities on a single day (usually in two shifts). (Grealish & Trede, Chapter 9) In watching the videos, students see how they move and manage equipment: “When I wear the clothes, I start to think that I am a nurse and I am going to do this; if I was wearing normal clothes it might seem less serious”. They find that the images of patients’ faces in different scenarios provide a sense of a real situation: “It provides an image of a real patient.” (Johannesson et al., Chapter 20) Educators’ Experiences Seeing our work as engagement with colleagues in a professional learning community also affects the ways we work with and consult with the profession. (Letts, Chapter 11) We were particularly interested in creating an intentional opportunity for faculty in health professions programs to meet and discuss topics and pedagogies unique to teaching and learning in health professions, such as teaching and assessing clinical skills. In particular, we recognised that health professions faculty share a common, signature pedagogy, “learning in the practice settings of the workplace” (Harris, 2011, p. 43). Signature pedagogies are important because they are pervasive and define how knowledge is transmitted, analysed, criticised, accepted or discarded (Shulman, 2005, p. 54). We determined that an intensive, multi-day workshop or retreat, open to novice teachers from all of the health professions programs, would best accomplish this goal. The program we envisioned would complement existing school and program sponsored activities, draw upon the resources of the university, and enlarge our individual school efforts. In 2006, Creighton University Schools of Medicine, Nursing, and Pharmacy and Health Professions introduced the Summer Initiative for Teaching Excellence in the Health Professions, known informally as the SITE program. (Huggett & Jensen, Chapter 12) First, the professionals brought together to teach in this innovative program share a deep commitment to issues of human rights, equity and social inclusion. This is manifest in how and what we teach, and in our professional lives and scholarship beyond the classroom.

through the experiences of learners and educators, permits a more embodied understanding of PBE. Viewed in this light, exemplary PBE is seen to be social, relational and experiential. THE SOCIAL ASPECTS OF EXEMPLARY PBE A core theme identified in reviewing the chapters in this book was the critical place of the social aspects of learning that parallel professional practice. In this conceptualisation of ‘exemplary’ we see that this term refers to the notion of exemplifying or typifying good PBE practice. The social aspects of learning and practice refer to the understanding that exemplary PBE incorporates and privileges the social aspects of learning and professional practice. We also see that learning through university education can be viewed as practice and a set of practices in the same way that professional practice is understood. Schatzki (2011) identifies a key argument in practice theory: that practice can be viewed as an organised constellation of diverse people’s activities. A practice can be thought of as a social phenomenon in the sense that it involves multiple people; their interests, activities and consequences. The term professional practice refers to “the enactment of the role of a profession or occupational group in serving or contributing to society”). In participating as learners at university and as novices becoming members of their profession, university students are developing their capabilities as learners and novice professionals and gaining an understanding of, and identify as, university graduates and members of their professions. The book has explored numerous social dimensions of learning. These include the following. Recognising and engaging students as social learners is a key aspect of PBE, particularly in workplace learning settings. Scaffolding to authenticate IPL experiences may be used with other strategies to develop a student-centred approach to learning. This has been associated with enhanced learning outcomes (Lea, Stephenson, & Troy, 2003). However, student-centred approaches require care as they can add a destabilising layer of complexity (Geelan, 1999), important in the complex IPL context where students are already reframing their professional identities. (Baldry Currens & Coyle, Chapter 8) Within this tentative democratic model, teachers and trainee teachers – professional learners – are conceived as active, as are the learners they work with. To engage the Student Voice within any PBE pedagogy, we maintain that it is vital to see teachers (in training or established) as work-based learners who are in need of developing successful mutual cooperation. Authentic Student Voice enables a true PBE, based upon mutual support and understanding. Teachers need to work with each other; but they need to with learners too. Only by engaging with the Student Voice can PBE be fully situated and realiszed. (Kidd & Czerniawski, Chapter 27) Understanding practice and knowledge as social constructs is an important aspect of PBE for both educators and learners. To see both of these learning outcomes as socially constructed rather than absolute or received is a key driver for the way PBE is conceptualized. Eraut (2000) argued that knowledge can be conceptualized as a social rather than an individual attribute. His argument draws on the concept of distributed cognition (which involves individuals distributing their knowledge into the environment and depending on or utilising the knowledge of others to act effectively) and the idea that learning is embedded in a set of social relations and may be socially rather than individually constructed. This approach draws on Vygotskian developmental theories. (Sheehan & Higgs, Chapter 2) Communities of practice (and learning communities) are widely supported as ways of understanding professional and learning practices (Egan & Jaye, 2009; Sheehan, 2011) and as ways of fostering learning and professional development. The term communities of practice was coined by Lave and Wenger (1991) to describe a theory of social learning, one that places “learning in the context of our lived experience of participation in the world” (Wenger, 1998, p. 3) (see further discussions in Chapter 4). Underpinning this theory are four articulated premises: (i) that people are social beings, (ii) that knowledge occurs in relation to valued enterprises, (iii) that knowing results from participating and pursuing ability in these enterprises, and (iv) that learning produces meaningful knowledge. Although these premises have been critiqued and expanded they make a firm connection between social practice and learning by framing learning as social and relational participation (Hughes, Jewson, & Unwin, 2007). In acknowledging the ubiquitous nature of communities of practice, Wenger (1998) sought to overcome the “forgotten familiarity of obviousness” (p. 7) that can lead us to overlook the ongoing learning we do while working with others. (Croker et al., Chapter 6) Explicitly preparing and supporting students to join and participate in interprofessional communities of practice and to reflect on their learning from these experiences can help them to optimise practice-bazed education and workplace learning experiences. When viewed through a lens of communities of practice our workplaces are replete with opportunities for learning through shared practice. Some communities of practice (such as informal work and study groups) may be self-initiated; others (such as long-term formal work groups) are well established and students join them “on the run,” like cyclists entering a moving peloton. … Practice-based education that focuses on realising the capability to see and join communities of practice will enhance opportunities for lifelong learning. (Baldry Currens & Coyle, Chapter 8) Higgs, Joy, et al. Realising Exemplary Practice-Based Education, . Peer learning has numerous benefits in PBE. Increased interactions with peers may facilitate knowledge production in socially constructed learning environments. The aspects of inferencing strategy instruction should include not only explanations of the strategies and their functions, but also modelling the use of strategies by the instructor, and guided practice of strategies matched to tasks and contexts. Learners must be made aware that to convey their ideas clearly and effectively they must use varied sentence structures and choose appropriate vocabulary for an academic audience. University students need to learn the metalanguage (rules of language) as well as vocabulary and basic communication to be effective and successful using the second language in work and practice environments. (Giridharan, Chapter 19) Interprofessional learning exposes students to different frames of reference and experiences early in their professional career. When a theatre director is setting up a production, what happens if he or she decides to let the actors rehearse their roles separately and then meet one another for the first time on stage on opening night? Unfortunately, in Sweden, as in many other countries, students who are going to work together in health and social care organisations have not, for the most part, “met” one another during their education/training “rehearsals”, even though they are going to act every day in the same arena with the same patients and clients. Thus, rather than having accumulated interest or gains, they, and more importantly their patients, are disadvantaged by the lack of opportunities to be educated collaboratively, interprofessionally. (Wilhelmsson Chapter 13) Incorporating others into learning is a key aspect of PBE and preparing students for professional practice which involves, typically, working with others: clients, team members within and across different disciplines, professional peers and members of the community. The concept of “others” in PBE commonly – includes peer learning and interprofessional learners situated together. (Baldry Currens & Coyle, Chapter 8) The Student Nurse Led Ward model provides for students from third, second and first year to work collaboratively in a service unit. Senior students mentor junior students, enabling skill development in peer learning and leadership. The students work closely with clinical staff members who provide mentoring and feedback. An on-site nurse educator develops staff capacity for supervision and supports student learning through reflection and discussion. (Grealish & Trede, Chapter 9) Partnerships were identified as key aspects of a number of the programs. Higgs, Joy, et al. Realising Exemplary Practice-Based Education, REALISING EXEMPLARY PBE 289 Framing school-based practicums as a reciprocal act of learning – both ways learning, as opposed to the more traditionally conceptualized unidirectional learning from school or Associate Teacher to the student teacher/teacher candidate – foregrounds that learning happens in dialogue and acknowledges that we hope associate teachers and the schools they work in also benefit from the practicum placement. We view the associate teachers and site coordinators as school-based teacher educators, valuable partners in the important work of teacher education that happens in both school and university classrooms [and beyond them]. (Letts, Chapter 11) Teaching and learning strategies that creatively and richly used the opportunities provided by real workplaces, classrooms, educational technology and blends of these were evident throughout the cases. This project was initiated and developed whilst I was Director of Initial Teacher Education at the university. A workspace (wiki) hosted by the US company ‘pbworks,’ was the online platform used as part of a blended learning approach to promote problem-based learning on the professional studies element of the programs. The project involved student teachers, academic tutors and also secondary school teachers who worked within partnership schools. … with this initiative, we wanted to test whether collaborative problem-based learning was enhanced in the online environment and in the context of the Virtual Schools project, and whether this context, an ‘approximation of practice’ (Grossman, Hammerness, & McDonald, 2009), can help lead to accelerated professional learning and induction into their role as a teacher. (Wright, Chapter 29) CHALLENGES IN IMPLEMENTING PBE Educators and learners faced a number of challenges in PBE related to the culture and norms of their university and workplace settings, developing good partnerships, reconciling diverse interests and values, learning relationships, different learner levels of success, dealing with change, logistics (particularly timetabling and timing), workload, and learning to use new teaching tools and strategies. Professional schools are generally found in university settings where emphasis is on professional preparation led by faculty who must function and adhere to the standards of a university academic setting. Professions are well known for their focused, specialized education that is a required portal to the profession and for the tight linkages that exist between education, accreditation and licensure.  7) Despite limited preparation to teach and serve as educational leaders, health sciences faculty must address unique structural challenges compared to other higher education settings: faculty time available for teaching is limited; Higgs, Joy, et al. Realising Exemplary Practice-Based Education, faculty preparation models emphasise research; curricula are typically integrated; multiple settings are used for teaching and learning; teaching often occurs in a clinical practice setting with actual patients; and evaluation of learning often requires performance-based assessment. (Huggett & Jensen, Chapter 12) Establishing the model was time-intense. Collaboration requires listening, negotiating, and at times even giving in to others in order to achieve higher order aims (Trede & McEwen, 2012). Reconciling university and aged care facilities’ interests was not entirely straightforward. It required many meetings and rigorous discussions. However, these led to stronger partnerships and the sustainability of this model. (Grealish & Trede, Chapter 9) (Challenges faced in using simulations in police education include:) (i) the personal safety issues inherent in the nature of policing create restraints in the design and implementation of learning experiences for policing students, and (ii) consideration of the needs of students who choose to undertake their Session 1 studies by distance education. These students who study remotely (except for 20 days of residential on-campus classes across 6 months), while the on-campus students are exposed to simulated policing situations on a daily basis, are expected to attain similar standards of learning achievement at entry into Session 2 as their on-campus Session 1 colleagues. … simulations are employed to provide a PBE approach to the distance education study programme, the on-campus learning programme and the workplace-based study component of the ADPP. (Davies, Chapter 26) … with this initiative, we wanted to test whether collaborative problem-based learning was enhanced in the online environment and in the context of the Virtual Schools project, and whether this context, an ‘approximation of), can help lead to accelerated professional learning and induction into their role as a teacher.

This is a process that could, potentially, create a number of difficult issues. Most importantly, it implies equality in the relationship between the mentor, tutor and student teacher as dissonant practice is brought into focus. In fact, however, mentors, students and tutors have different and more or less powerful roles in relation to each other, and the extent to which participants would feel able to expose their thinking to dissonant enquiry in this context remains to be seen. Will the participants be able to establish what Cassidy et al. (2008, p. 224) saw as a requirement for joint educational enquiry, “a deepened sense of trust which facilitates critical debate”, or will the current relationship imbalance prove to be an intractable problem? The marae is turangawaewae – literally a place to stand. Delivering a course on the marae is a powerful endorsement of Māori custom and Māori worldviews. When this happens, Māori expect that local customs and values and traditions will be upheld and practiced. The importance of aligning course philosophy with delivery methods and of teaching generic skills to enable graduates to practice in vocational environments has long been recognized. There has been widespread acceptance of integrated curricula (e.g. integrating content from anatomy, physiology and pathology) and of problem-based curricula (presenting clinical scenarios, real-life problems, problem-solving tasks). Such curricula challenge the way content is organized, how it is delivered, and how learning is assessed. There has been much less attempt to date to deliver a Māori curriculum in health. As this case study illustrates, ongoing initiatives to deliver such a curriculum must acknowledge that the underlying teaching content, processes and values, and, most importantly, the place where that curriculum is delivered, have to be different from much that has gone before. (Jansen & Jansen, Chapter 28) A common issue for secondary initial teacher education providers is that secondary trainees value their specialist subject sessions highly, sometimes viewing the professional studies sessions as a less important and relevant part of their training. Trainee evaluations in the years preceding the introduction of the project routinely revealed that subject sessions are more highly rated than professional studies ones, despite all efforts to quality assure the professional studies programme and entrust delivery of the sessions to experienced and effective teacher educators or to external speakers, usually from schools with expertise in specific aspects of the curriculum. The mixing of subject groups into teams or schools seems to have successfully addressed this problem as cross-curricular learning, communication and friendships grew through the initiative. (Wright, Chapter 29) “What are the sources and nature of learning for new professionals during their early years of practice? What forces or factors influence the nature and trajectory of professional development during this time? What facilitates and constrains learning? What experiences shape the formation of professional identity for novice clinicians? How do novices change over time? Why do some therapists grow toward expertise and not others?” (Black et al., 2010, p. 1761). (Mostrom & Black, Chapter 16) With innovation comes change and not all change is welcome. Baines and Chiarelott (2010) raised potentially problematic issues of professional partnerships that can be detrimental to program quality, institutional reputation and faculty autonomy. In the aged care setting, there is a temptation to use nursing students as extra staff, focused on service delivery rather than treating them as learners. The nurse educators were able to set up clear

. Objectives in the context of the organization’s capacity to deliver appropriate learning experiences for the students.) We encountered four challenges to the design and implementation of the SITE program. First, we found it difficult to identify program dates that would not conflict with important events in a single school or program. Each school or program operates on a different academic calendar, including unique variations for clinical, summer school, and faculty development activities. We also found that faculty interest and availability varied by contract type, health sciences faculty being engaged for 9-month, 11-month, or 12-month contract periods. A faculty member on a 12-month contract might prefer to participate in the SITE program during the summer months, whereas a colleague with a 9-month contract would not be available during the summer period. We offered the inaugural SITE program in August, hypothesizing that all faculty would be available at that time and motivated by the upcoming academic year to participate in the program. However, after the initial implementation of the program, we received feedback from current and prospective participants that August was too near the start of the new academic year. In the second and subsequent years, we offered the program in early June. This was received favorably, and participants reported that they completed the program prior to summer vacations or non-contract time. Some participants also noted that it was valuable to have the 3-month period prior to starting the academic year so that they could plan or implement their project in time for the new academic year. (Huggett & Jensen, Chapter 12) In the design of the assessment program three major issues became clear right from the start. The first was that in such an assessment approach no single instrument can be seen as a panacea; no single instrument can do it all. Therefore a program of assessment is needed … In programmatic views on assessment there are no good or bad instruments per se; each has its indications, side-effects and contraindications, and should be fitted into the program where it serves its best purpose. Programmatic assessment also requires considerations at the level of combining the results of different instruments, beyond the often arbitrary decisions (examination A counts for 80% and examination B counts for 20%) made in many assessment programs, in which no clear consideration is given to how those examinations contribute to the overarching goal of the assessment program. … A second issue was that for assessment to really inform at the level of integrated competencies … A final issue was that the assessment must be meaningful and taken seriously, but must also be fair and rigorous. This is not easy to achieve; many of the notions about rigour and fairness of assessment originate from research into assessment of learning, and so new ideas had to be found.

Finally, although student feedback about the seminars has been anecdotally positive for the most part, we have yet to develop specific measures of its overall effectiveness. Part of the problem of finding effective measures is inherent in the very nature of narrative learning, exposing what is not predictable or readily apparent, and contextually based. We continue to debate ways of measuring narrative learning, including the perceptions of clinical instructors about student performance as they transition into the clinic. (

The first challenge related to the teachers’ workload. How could we ensure that busy teachers/doctors allocated time to adequately prepare for their teaching responsibilities? We found that transforming a case for the web was something quite different from just copying a patient history. It was easy enough to get the cases, or rather the patient documentation, but it was challenging to motivate teachers to do the necessary adaptations and to think of multimedia triggers. Most teachers were used to working with linear text and could not see the advantages of hypertext and multimedia material, which had rarely been used before. … To address this problem we ran a series of workshops and seminars about how to create motivating and challenging PBL scenarios using new media. We also prepared a guide and a script for the scenario designers to follow. As well, we decided that the scenario designer’s name would be published with the scenario so that students could ask questions and give feedback directly to the person responsible. This was part of a strategy to make the scenarios more enduring and always up-to-date, which proved to be effective. Students’ feedback on scenarios was also sent to the chairman of the thematic group as well as to the semester coordinator. (Persson, Chapter 18) In Chapter 23 Smith et al., provide the following list of challenges of workplace learning: − Integrating WPL into curricula in the context of traditional university structures − Ensuring sufficient quantity of placements that meet the learning objectives relative to the student numbers − Equity of access to quality workplace experiences − Identifying and ensuring a minimum standard of education in the workplace − Funding the costs to stakeholders of WPL − Adequately preparing students for diverse and complex learning experiences − Coordinating and sustaining partnerships between multiple stakeholders − Meeting competing priorities of providing business services and educating students − Identifying and providing educational development for supervisors to enable them to be skilled in providing WPL placements Higgs, Joy, et al. Realising Exemplary Practice-Based Education, . − Ensuring adequate space and resources for students in the workplace − Provision of support services for students e.g. accommodation − Having sufficient empirical research to guide optimal practice of WPL − Effectively moderating assessment − Brokering expansion into new contexts and with non-traditional providers. The inevitable cross-discipline miscommunication and dialogue on the management of differences that emerged from the range of professional orientations, values and perspectives meant that planning was time-consuming and lengthy, particularly the preparation of five cases to include something of “interest” to each professional. However, feedback indicated this was a positive experience for those involved and the supervisors who designed these cases learned about the other professions on the way. It was very much a capacity building exercise. Disappointingly, from the learner feedback we learned that we did not do as much to enhance their interprofessional understanding as we had hoped. Despite this, we felt the exercise was a success as we did enhance their awareness of the issues that surround this ideal of “collaborative practice” and increased their awareness of the strengths and challenges of interprofessional practice. (Sheehan et al., Chapter 24) The term “exemplary practice” may be contested since decisions regarding authority to judge the exemplary nature of practice, and the basis on which such judgments are made, are open to question. Its use alongside the phrase ‘indigenous perspectives’ becomes even more challenging, especially when the narrative voices are outside the indigenous group of interest. Cognisant of these issues, our intention in this chapter is to describe an evolving set of exemplary practices in developing indigenous perspectives in a practice based, teacher education course.