Using online chat to enhance peer learning while on fieldwork placementsSharynne McLeod
Speech pathology program, School of Community Health, Charles Sturt University, Albury, NSW 2640, Australia
Shane Dawson and Louise Berg
Centre for Enhancing Learning and Teaching, Charles Sturt University, Albury, NSW 2640, Australia
Students in applied science disciplines in the School of Community Health at Charles Sturt University undertake fieldwork in urban, rural and remote areas throughout Australia and overseas (e.g. Vietnam) in each of the four years of their course. As students are situated in a diversity of locations, the ability to offer academic support is greatly reduced, whilst the opportunity for peer support is non-existent. Online chat facilities are introduced to the students in first year and are available each time students are on fieldwork placements. During a specified time each week, students and their lecturer logon to discuss issues of importance to students. Peer learning and collegial support are significant outcomes of these sessions. Since its inception in 1999, the use of online chat for fieldwork support has been adopted by other programs such as occupational therapy, physiotherapy and social work in Australia and overseas.
The retention of rural and remote allied health workers is a chronic problem (National Rural Health Policy Forum and National Rural Health Alliance 1999). An important aspect of the preparation of applied science students for working in rural and remote areas is to provide them with the tools necessary to decrease the degree of professional isolation. Students first experience professional isolation when they are on fieldwork placements.
Each year, almost every student involved in applied science disciplines (such as medicine, nursing, speech pathology, physiotherapy, etc.) completes at least one fieldwork placement often for extended periods of time. Students are not only sent to far-flung places across Australia, but also undertake fieldwork in locations across the world. Even if the university budget allowed for it, it is logistically impossible for every student to be visited by a university staff member. Usually, a phone-call to the clinical educator/supervising practitioner is all that is available; a few universities also attempt to contact their students while on placement.
One of the most common ways health science professionals learn is through peer interactions at formal and informal levels. Peer interactions provide opportunities for mutual problem solving, brain storming, joint analysis as well as facilitating reorganisation and reanalysis of thoughts (Lincoln, Stockhausen and Maloney 1997). Furthermore, interactions among students in similar learning situations are likely to facilitate the expression of negative and positive emotions about a clinical placement because there may be more empathy and less risk of judgment. Hart (1990) also reported that nurses involved in teleconferences with peers experienced reduced feelings of isolation, were able to gain a different perspective on professional issues, and were provided with reassurance. Peer learning is difficult if students are isolated from their peers while on fieldwork placements. The notion of peer support between fellow classmates and regular contact with students' lecturers while on fieldwork placements seems impossible to orchestrate. This has been status quo across many applied science disciplines until recently.
The speech pathology program at Charles Sturt University (CSU) is a program set in and emphasising practice in rural and remote areas. The six other speech pathology programs within Australia are located in a major metropolitan centre. CSU students undertake fieldwork placement for between 2 and 20 weeks of the year to places scattered across Australia and the world (see Figure 1). One of the major goals of the speech pathology program at CSU is to provide students with strategies for working in rural and remote settings. Online chat is an important strategy.
Figure 1. Field work placement sites for CSU speech pathology students during 2001
What is online chat?
Online chat is an electronic communications technology that allows people to 'talk' to each other in 'real time' via their computers. Messages appear on all participants' computer screens, resembling a verbal conversation. Online chat offers the opportunity for students and academics to question, clarify, and re-clarify issues within a very short period of time (see Figure 2).
While students are on their fieldwork placements they log into their secure online chat room for one hour each week (e.g. each Thursday from 4-5pm) in order to communicate with their peers and lecturer about their placement. In order to provide free and open discussion amongst students, fieldwork supervisors are not involved in the online chat. However, in order to further develop and enhance communication across practitioners in rural and remote areas, students are required to inform and perhaps demonstrate current IT resources such as online chat to their fieldwork supervisors. The topics discussed were not pre-planned, but due to the friendly and supportive environment generated they evolved to cater for the immediate and specific requirements/needs of the group.
Figure 2. The online chat screen used by CSU speech pathology students
The use of online chat and the development of cyber-communities have been documented for a number of years (e.g. Paulsen 1995; Thompsen, Straubhaar and Bolyard 1998). What is unique about this use of online chat for fieldwork support is that a cyber-community is not generated for people who are skilled at using the Internet. Instead, an existing community of university students are taught to use the Internet (our questionnaire data shows that many found this a challenge; 25% actually could not logon, often due to problems with firewalls at the hospital site). We encouraged students to seek alternative sites such as city libraries, schools, and Internet cafes. Although access to the Internet was seen as problematic by a number of students, this was anticipated from the outset and was presented to the students as a part of the learning experience. Many practising speech pathologists do not have access to computers, let alone the Internet; and others are not aware of the potential for Internet access to enhance the work of a speech pathologist. One of the goals of hosting the online chat sessions was to demonstrate both to the speech pathologists and students that the Internet is a tool which can reduce professional isolation and enhance peer support.
To date, no one has explored ways for students to collectively support one another on fieldwork. The notion of peer support in fieldwork has been discussed for a number of years (e.g. Lincoln and McAllister 1993); however, never before has there been a means for collegial support to be offered amongst all students on fieldwork placements at differing sites. The use of online chat has enabled this important forum for peer support to be a reality. Consequently, students can compare experiences across sites and are empowered to negotiate their learning experiences with their fieldwork supervisors by using real-time examples from their peers.
Use of online chat in the CSU speech pathology program
In 1999 an online chat room was created for speech pathology clinical education subjects. The pilot phase included support and training for both the lecturers and students from CSU educational designers, help desk support during the online chat, administration of questionnaires to the students and debriefing after the trial had ended. Upon completion of their fieldwork placement the students completed a confidential questionnaire that asked them to reflect on the online chat trial and to propose a list of teaching and learning benefits and disadvantages of the online chat environment. After the initial trial, a report was written and presented (McLeod 2000). The overall outcome deriving from the University wide evaluation was that chat was seen to be an effective communicative tool offering opportunities for diverse and innovative teaching strategies whilst enhancing peer and staff support. As a result of the success of the trial, all students in the speech pathology program at CSU use online chat while on fieldwork. Anecdotal evidence suggests, the use of online chat with internal students on fieldwork placements has become one of the major uses of this technology within CSU.
After completing their fieldwork placements speech pathology students completed questionnaires about the use of online chat. Feedback from year 2 students in 1999 (n=16) and year 1 and 2 students in 2001 (n=48) will be presented.
In the evaluation questionnaires, students were asked to recall the topics covered during the online chat. The list of topics included: what happened on placement; clients of interest (e.g. those with autism, neurofibromitosos, developmental disabilities); number of clients seen; service delivery models (e.g. home visits, lunch breaks); specific issues that students had faced (e.g. what to do when clients cried); comparison of favourite resources used for assessment and intervention; questions to their lecturer about their assignment; and social topics. One discussion initiated by a student commenced with the question "Who would work in the city rather than the good ol' outback after what we have seen this week?" Their responses affirmed the realisation of the goal of the CSU speech pathology program, to promote the desire for our students to work as health professionals in rural and remote practices (Wilson et al. 1991).
Benefits of online chat
The students were asked in an open-ended question to list the advantages of online chat. The majority of students indicated the major benefit of online chat was peer support (1999 - 94%; 2001 - 67%) (e.g. "To feel that you are not alone and to bridge the gap of distance as phone calls were too expensive." "It was fantastic to be able to touch base with people you know and to share experiences and get ideas of what was available at the clinics you mightened (sic) have realised" "Provided a link with the familiar in an unfamiliar setting." "Good just to chat with people we know, it makes the distance and how far away from each other we are feel alot less").
Other advantages included: * to gain immediate advice regarding problem areas (31%; 17%) (e.g. "Discussing issues and problems, allowing you to implement any suggestions/strategies in 2nd week"); * contact with the lecturer (25%; 15%) (e.g. "It is a good time to ask the lecturer questions and receive quick feedback"); and * to gain computer/internet skills (6%).
Disadvantages of online chat
The majority of students indicated the major disadvantage/problem of online chat was access (50%). Others stated that a problem was that they missed out on seeing clients (13%); others stated that there were no disadvantages (6%); and the rest did not respond.
Online chat is generally seen as a positive experience by speech pathology students; however, a few students did not find the experience beneficial. The differing students' responses highlight the different learning styles of students in speech pathology (McLeod et al. 1995) and suggest the need to accommodate these. Online chat is not compulsory and is not attached to an assessment task, and the differing attitudes to the experience of online chat support this educational stance based on a model of adult learning (Knowles 1980; McAllister 1997).
Figure 3 shows responses to the following questions: * Would you like to have online chat available for your next fieldwork placement? * Do you think you would use chat groups when you start working as a clinician?
Figure 3. Responses to the following questions: Would you like to have online chat available for your next fieldwork placement? Do you think you would use chat groups when you start working as a clinician?
It is obvious from this chart that students value the use of online chat. 90% of students in 2001 would like to use online chat on their next fieldwork placement and 60% would like to use online chat when they are working as a clinician. These data demonstrate that the use of online chat not only provides a supportive framework for students but offers a continued network of communication to reduce the degree of professional isolation often experienced by rural and remote practitioners.
Impact and outcomes
Online chat provided an unexpected insight into the issues and problems faced by students on clinical placement. The fact that topics were not pre-determined generally enabled students to direct the flow of the conversation. Topics such as whether or not their clinical educators ate lunch and other work practice issues not traditionally addressed in clinical education subjects were identified during online chat; and were important for students developing their own professional identity. The ability of information technology to empower students in the educational setting is highlighted in the literature. It is said that information technology "alters the collaborative interaction and shared dialogue between students and teachers" (Rowe 1996, p. 1). "The most active person in the environment is the learner and often the teacher is a spectator of learning shouting advice from the sidelines." (Oliver 1999, p. 3). The experience of online chat facilitated a different learning interaction from that experienced with students in the on-campus setting.
A poignant discussion was held on September 12, 2001, the day after the terrorist attacks in America. All of year 1 and 2 were scattered across Australia on placement, away from their homes, family and social networks. It was reaffirming for all students to have support and a safe place to discuss their fears and concerns about world events. For example, one student 'whispered' to me during the online chat session: "Sharynne, I have been having trouble focusing on my placement all day today. I am worried because I have a good friend in Los Angeles. Is LA involved in the terrorist attacks?" Another was so moved by the events that she typed "Pray for the deceased and dying in America and pray that nothing so horrid should ever happen in this great nation". Had online chat not been scheduled, these students would not have had the opportunity to discuss their fears and concerns in an open supportive environment. Too often teaching staff focus merely on the provision of subject content and support relating only to that content. The opportunity to reduce fears and concerns through peer and academic support provided students with greater clarity and purpose and the ability to re-focus on the opportunities presented to them on their fieldwork placements.
Since the initial use of online chat as a tool for facilitating learning for students on fieldwork placements in 1999, numerous other university courses both national and international and professional associations have adopted our procedures in an attempt to emulate the support and increased communicative functionality offered by online chat for use in their contexts (e.g. Barbara, Walker and Whiteford 2001; Schwartz 2001).
Through the incorporation of online chat into clinical field placements the tyranny of distance and the associated feeling of isolation has been negated, whilst providing an avenue for promotion and support for health professionals in rural and remote areas. The use of online chat is seen to be beneficial for encouraging peer learning and collegial support while on clinical placements. As a direct result of this trial, and the perceived benefits, online chat has been established for off-campus fieldwork education placements at many other sites and institutions. The use of online chat has increased peer and staff support, alleviated student concerns pertaining to field placement and provided enhanced communicative opportunities for health professionals in rural and remote areas.
Portions of this paper were presented in McLeod, S., Barbara, A. and Wilson, L. (2002) Reducing professional isolation via online chat. Fifth World Organisation of Family Doctors (WONCA) World Conference on Rural Health, 30 April - 3 May 2002, Melbourne.
Shane Dawson and Louise Berg
CAL-laborate Volume 8 June 2002
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