PART G. Work plan and work packages
IMPORTANT: Sections G.1 to G.3 should be duplicated and completed together for each work
package.
G.1 Identifcation
Aim: to develop suitable pedagogical solutions for learning about the issues connected with
the three themes.
Objectives:
- to do a literature review on the three core themes and compare findings from this review
with findings from the data collected from stakeholders.
- to develop a didactic framework that matches learning objectives and feasible learning
formats in which the eLearning material can be organized. Input for this will be the inventory
of prioritized central issues, overarching characteristics between the three core themes and
so called transversal skills. The didactic framework will be a grid that will give the learning
materials a recognizable face with fixed recurring learning tasks and methods of knowledge
transfer and exchange (e.g. videoclips, expert interviews, on-line lectures, case scenarios,
etc.).
- to foster critical companionship of eMenthe partners on this didactic framework and
pedagogical options that are derived from the international feedback of experts within the
eMenthe consortium
Priorities that inform our organisation and approach:
The University of Applied Sciences HU, based in Utrecht, The Netherlands, has a key role in
the completion of workpackage 4 as described above.
In line with the Erasmus requirements the University of Applied Science, Utrecht will focus on
the following aspects:
•
the establishment of the Master level eLearning programs should include practice
development impact.
•
the design of sound curricula and modules for continuous education based on
enhancing previous acquired expertise of the Master student.
•
Exploring the potential of ICT options to connect students and lecturers
internationally, meeting universal accreditation criteria.
So, on the one hand we have demands on the pedagogic approach from the content: the
three themes and the knowledge, skills and attitudes to cope with them. On the other hand
there is the urgence to connect with ‘real life’ situations relevant to the student’ own places of
work and existing skills already acquired in professional life. They constitute the pedagogical
principles that we must find consensus on.
In brief: we aim at developing elearning material that facilitates students to apply the
acquired theoretical knowledge in real life practice within the three core knowledge transfer
domains. This is done within a lifelong learning context at Master level. The context of Life
Long Learning means that the eLearning course must facilitate continuing learning. However,
we cannot step too much in the way how the e-learning material will be used to realize
continuous learning. But we can assume that critical reflection is essential to this (this is
certainly the case for the master level). As a critical reflection depends on learning from
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different perspectives, we think that this must be part of the content of the e-learning
material. The discussion can further be to what degree ethical issues must be incorporated
as these are also an integral part of reflective thinking (again keep in mind that we address
the master level).
Learning will be done in a so called virtual learning environment (VLE) that facilitates selfpaced learning in an asynchronous training. A VLE has the potency to create and nurture an
on-line community of students working independently and with each other. However, the role
of an educator functioning as facilitator or tutor is assumed here, but cannot be realized
within the terms of the present project.
Steps
1 The essential issues (underlying the three themes), overlapping common characteristics
and transversal skills that that must be incorporated in the elearning material are identified
in the data collected from stakeholders (workpackage 3) and compared with findings from
a literature review. Timeplan: may 2014-october 2014.
2 The outcome of this investigation will be the content for cells in a matrix that can serve as
input for a didactic framework. Timeplan: october 2014.
The outcome of the literature review can be the input for the first of two articles (for each of
the three core themes) to be submitted to professional journals. The second article will
then focus on the outcome of the matching of findings from our data with literature.
Timeplan: first draft of the manuscript: November 2014.
3 Prioritising content and drafting of an outline in which content is combined with learning
objectives, derived from pedagogical principles (the matrix in figure 2: the pedagogical
principles must still be decided on). Consultation with partners on this outline. Timeplan:
November 2014.
4 All eMenthepartners connect the outcome of step 3 with didactic methods that they think
that may match the content and learning objectives. To this aim they use the matrix in
figure 2 enriched with learning objectives. Results are again collated by the HU.
Followed by consultation with partners on this didactic framework. Timeplan: November
2014-december 2014.
5 Handing over the results to the eMenthe partner that is responsible for workpackage 5.
2
Themes
What knowledge, skills and attitudes are What is needed from the didactic or
needed from the thematic perspective as learner’s
perspective/Life
Long
prioritized in step 3
Learning
Pedagogical principles
Attitudes
Real life How
to Critical
Other
Essential issues Transversal
skills
situations connect
aspects
and Common
reflection
with
characteristics
(multiple
Existing
perspectives
skills
and ethical
issues)
Recoverysocial
inclusion
Mental
health
promotion
and
prevention
Family
and
caregivers
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Learning
objectives:
Didactic
methods
Priorities
Figure 1: a matrix suggested in step 4: combining two different perspectives: cells in the
same line represent corresponding or related issues.
Activities
Step 1:
-Dublin meeting: -
deliberation and finding consensus on type of literature review, keywords
to be used, limits and filters, which databases and the use of other
languages beside English.
- discussion and agreement on how to compare findings from the
literature review with the collated findings from data from stakeholders.
This will be translated in instructions to guarantee an uniform way of
working.
- Discussion and preliminary decision on pedagogical principles
-The literature search is done in the three workgroups (Recovery/social inclusion led by
Theo; Mental health promotion and prevention by Louise; Family and
caregivers by Ingela Timespan: june-september 2014.
-Results are collected and sent to the HU. Deadline: 10 October 10 2014.
Step 2:
-The HU collates the results in a matrix as mentioned (figure 2: see page 6).
Deadline definite concept: 24 october. Collated results can be used as common framework
for articles that are in the process of being written.
Step 3:
-(the HU:) Drafting of an outline with listed content (topics prioritized by the work groups) and
learning objectives, overall and per deliminated section. Deadline: 7 november 2014.
-Consultation with partners on this outline: 7 november-14 november 2014 (online meeting?)
-Consultation on the first draft of the articles for professional journals to assure coherence
between them and agreement with a common framework: November 2014 (online
meeting?).
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Step 4:
-all eMenthepartners collect didactic solutions (they may already have come forward when
collecting data in an earlier stage), matching them with the learning objectives in the
common framework (matrix in figure 2). Timespan: 14 November- 10 december 2014.
-(the HU) Collecting didactic solutions from eMenthepartners and collating them in a finalised
didactic framework, combining now content, learning objectives with didactic methods.
Deadline: 20 december 2014
-Consultation with TAMK about the technical solutions.
-Consultation on this didactic framework: december 2014.
-Handing over results to next eMenthe partner: january 2015.
Proposal how to go about these issues:
Step 1:
Literature review: a critical realist review
Type of literature review: the review aims not at finding evidence for the effectivity of
interventions, but rather at exploring necessary knowledge, skills and attitudes (seen as
elements in a competence framework) that professionals need to know and master in order
to cope proficiently with the three themes. This will be done in a critical realist review. The
focus will be on issues that are formulated in an theoretical orientation that will precede the
literature review.
The theoretical orientation will take the form of a critical appraisal of Nursing theories on what
makes a competent nurse in relation to the three core themes. From this evaluation a
distinctive argument must be built in which we take position by prioritizing certain issues. The
connection with the three themes will at this stage be tentative and may be refined in the
literature review and comparative analysis. The argument will be anchored in a normative
evaluation of values and will (ultimately) take into account how innovative concepts related to
them can be translated into nurses’ competences. This will steer us in our search for relevant
literature in journals (and other publications) that combine the topical (thematic) perspective
with the professional perspective. Other than in a systematic review there will be no
keywords and search terms that direct the literature search. There will be a tentative question
that guides us in the literature search, but the process will be emergent. The tentative
question that we begin with will be honed and developed iteratively. The initial question may
be framed in PICO terms, but in recognition of the Critical Realist methodological approach it
may be expanded with the M=mechanism and the C of Context. The expanded PI(C)O fits
our purpose to identify (input for elearning material matching) pathways for competences.
The I in the expanded PICO then stands for interventions, which under certain conditions or
in certain structures (Context) can be generated through the competences (generative
Mechanism) to achieve valuable social effects (Outcome). This distinction corresponds
perfectly with the domains in a critical realist approach where researchers recognize that: “To
explore the real is to ask about the structure of some objects as well as their causal powers
[among them competences of professionals], whether or not these causal powers are
exercised […] The actual is concerned with what happens if and when those powers are
activated.”(Edgley et al). We have used this for a further operationalization in the
comparative analysis (see also figure 1).
Proposed Nursing theories on competences: see addendum
Nomination (by work group ‘leaders’) of who is writing the theoretical orientation/evaluation
resulting in 3 tentative initial questions (for each core theme) to be used in the literature
review: 500 words
4
Theo
?
?
?
?
Jan
ESC
Benner
Carper
Bondy
Steinaker and Bell
Person-centred Care
The question can be raised if we must synthesize the evaluations of these 6
theoretical orientations in one overall evaluation. The decision upon this matter will be
adjourned until collation (25 june- 2 july).
Instructions for writing the theoretical orientation/evaluation:
-identify how (according to the selected theory) nurses become competent on master level
and what the foremost dimensions are of this competency.
-then relate this to one or two essential aspect of each of the three core themes. This
essential aspect must be value-based, e.g. self-management for the core theme ‘mental
health promotion and prevention’. Self-management may be considered to be based in
values as individual autonomy and self-direction. Make this value base explicit.
-develop an argument here that shows tensions or unresolved issues that touches on
(aspects of) competences. Finish the argument with the guiding question for a literature
review.
The argument that can be built for the example of self-management (see above) may look
like this:
“Person-centred care puts the lived experiences of patients central. In mental health
promotion there is also a need for a focus on reflection by patients on the lived experiences
of illness and, as we postulate, also on how these relate to a so called “valued life”: a life
that is seen as meaningful by patients. The articulation of this perspective must not be
interfered too much by the professional’s interest in fitting the patient in the existing selfmanagement programs. There must be room and ample time for dialogue and sharing with
professionals and other patients. Only then can a collaborative problem-solving and goal
setting be built. This is our evaluation framework with which we pose the following question:
How can the articulation of the patient perspective facilitated by the care professional and
how is this used to promote motivation for self-management? (example from Sitvast, 2013).
The guiding question in this example has all the elements of the expanded PICO.
Under which conditions or in structures (Context) can the articulation of the patient
perspective be generated (facilitated) through which competences (generative Mechanism)
to achieve motivation for self-management (Outcome). The P must still be further specified.
Proposed critical review titles:
1] A critical review of professional competency frameworks for mental health recovery and
social inclusion and implications for life-long learning
2] A critical review of mental health professional competency frameworks for working with
families and carers in mental health care and implications for life-long learning
3] A critical review of mental health professional competency frameworks for mental health
promotion and prevention and implications for life-long learning
Each of them will examine the relevant literature in each theme and acknowledge the
relevant competency frameworks (Nursing and Essential Shared Capabilities and any others)
and then examine the relevancy or otherwise, the gaps and opportunities for further
development in each of the themes to inform life-long learning.
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Limits and filters: none, other than relevancy for answering the guiding question. Studies and
publications from any source (including policy reports from health organisations and
government agencies), even of older date if they are still considered relevant because of
their conceptual innovative meaning.
The use of other languages beside English: only if the abstracts show some key
studies/articles in other languages, these should be included.
Comparative analysis
The relevancy will further be determined by comparing it with findings from the collated data
collected with stakeholders. The explicitly educational perspective will be considered in step
5.
We propose the following framework with a comparative method for determining relevancy,
with a starting point in literature (using the guiding question from the theoretical orientation)
and then comparing the actual dimension with the real and empirical (found in literature ánd
in the data from stakeholders). Every cell in the matrix contains a double entry of findings
from the two datasets, which are then compared (vice versa across data sources).
The matrix in figure 1 can be used to list findings from the two data sources (stakeholders
and literature) in parallel columns with corresponding content in neighbouring cells on linear
level.
Praxis
Literature
Literature
Literature
Literature and praxis
findings on
competences
from dataset
‘stakeholders’
The actual:
The real:
the transfer from the
real to the actual:
Outcomes=
Desirable
developments
Mechanism=
How competences
may help
professionals to
realize
Desirable
outcomes
Context=
Conditions and
Necessities for
actualisation
Gaps and
opportunities,
possibilities or
potentials
In terms of the
initial guiding
question
(knowledge of)
Essential issues
and
Common
characteristics
Transversal
skills
Attitudes
Figure 1: a matrix for determining relevancy.
Leading questions here are:
1 ‘Is that what is found in the questionnaires and interviews confirmed by findings from
literature and vice versa?’
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2 ‘In what way do findings from literature differentiate the picture of professional
competences given by stakeholders?’
3 ‘In what way do findings from practice enrich possible theoretical insights (if any)?’
In the end we answer the question: what are the relevant competences (knowledge, skills
and attitudes) that professionals must master to cope with the three themes in a proficient
way?
This assessment of relevancy must be done for every individual article or publication and in
the end, after pooling findings as an overall assessment. The report that will be sent to the
HU then contains an argumentation of how the initial guiding question from the theoretical
orientation is answered with prioritized and selected items that can be taken forward to the
next step.
Time-planning:
Timespan: may-december 2014
.
1-25 June:
 Nomination of who is writing the theoretical orientation/evaluation by work group
‘leaders’ after consultation (Theo-Louise-Ingela).
 Preparing an evaluation of Nursing theories and ESC by nominated individuals;
 Deadline for preparing the evaluation of Nursing theories and the initial guiding
question for the literature review: 25 june (send it to HU for collation).
 Collation and possible synthesis of evaluations: 25 june-2 july).
2 july-9 july: Dividing reading list among workgroup members. There are two readings for
every title. If there is no agreement on relevance score a third reading by a third member of
the workgroup follows.
July-1 september: reading and analysis.
September-10 October: who is in the lead of the workgroup, collects the analysis of all
included publications, is responsible for pooling all findings and making an overall
assessment He/she will write an overall summary beside a process report before sending
findings to eMenthe partner the HU (deadline: 10 October)
7 november-14 november 2014: Consultation with partners on this outline: (online
meeting?)
November 2014: all eMenthepartners collect didactic solutions (they may already have come
forward when collecting data in an earlier stage), matching them with the learning objectives
in the common framework (matrix in figure 2). Deadline for sending in: I0 december 2014.
December 2014: collation by the HU and consultation with partners
Step 3:
Writing the article:
Tenure of the first article: the article can take the form of a report in which the guiding
question (for the literature review), developed in the critical evaluation of our theoretical
framework on Nursing theories, is answered without using data from the comparative
analysis (across data sources).
Tenure of the second article: a report on the comparative analysis between literature and
findings from the stakeholders dataset. The focus is on competences that professionals need
to have in coping with the three themes in such a way that good care is realized, recovery is
facilitated and the participation of family or carers is engaged.
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Which journal to submit the article to: nursing education journals, rehabilitation journals,
family care journals (see Dublin meeting minutes for publication plan).
Making an overall plan for who does what and when: it is advisable to have the writing
process run parallel to the timeplan of the collation process performed by the HU in order to
achieve congruence across the three articles and agreement with the common didactic
framework that step by step becomes into being.
Consulting other workgroups (via the HU) on common themes, transversal skills and
values/attitudes: this can be done by adhering to the common framework
How to tune text to a common framework: see above.
Addendum
Relevant models and frameworks
1. Benner
Benner's work is the seminal 'novice to expert' book (1983 and updated since) - nicely summarised in
“Quinns' principles and practice of nurse education” (Hughes and Quinn (2013) 6th Edition).
Benner introduced the concept that expert nurses develop skills and understanding of patient care
over time through an educational base as well as a multitude of experiences. She proposed that one
could gain knowledge and skills ("knowing how") without ever learning the theory ("knowing that").
She further explains that the development of knowledge in applied disciplines such as medicine and
nursing is composed of the extension of practical knowledge (know how) through research and the
characterization and understanding of the "know how" of clinical experience. She conceptualises in
her writing about nursing skills as experience is a prerequisite for becoming an expert.
2. Bondy Assessment Framework
The Bondy Skills Escalator Assessment Framework has four stages with the first stage (1) being the
competency level that the student is believed to be able to achieve at the commencement of their
programme of nursing education. Through the following stages, the student requires less supervision
and acquires competency to work autonomously at the conclusion of the training
Bondy has a poor evidence base and apart from the article attached has not been further published
(as far as I know) and adoption of the skills escalator seems to be emerging without any question of
its use (for our sins, we use it in Nottingham).
3. Carper’s fundamental ways of knowing
The typology identifies four fundamental "patterns of knowing":
1. Empirical: Factual knowledge from science, or other external sources, that can be empirically
verified.
2. Personal: Knowledge and attitudes derived from personal self-understanding and empathy,
including imagining one's self in the patient's position.
3. Ethical: Attitudes and knowledge derived from an ethical framework, including an awareness
of moral questions and choices.
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4. Aesthetic: Awareness of the immediate situation, seated in immediate practical action;
including awareness of the patient and their circumstances as uniquely individual, and of the
combined wholeness of the situation.
Chinn and Kramer’ book “Integrated Theory and Knowledge Development in Nursing” offers a good
context for the model and adds a further concept to the model: “Emancipatory knowing”.
4. Steinaker and Bell (1979) The Experiential Taxonomy
Exposure
The student will have observed a competent practitioner carry out aspects of nursing care, shows a
willingness and ability to relate the practice observed and its underlying theory to own previous
experience. Is able to analyse and discuss with the practitioner why and how certain aspects of care
were carried out, and identifies sources and types of information required to enhance further
application of knowledge to the practice observed.
Identification
The student now shows the ability to participate in the delivery of care under supervision on more
sustained basis with less prompting and greater confidence. Shows greater ability to communicate
effectively. Demonstrates a wish to acquire further information and ability to analyse and interpret
information. Applies problem solving skills and knowledge base to meet different situations.
Internalisation
The student is able to explain the rationale for nursing action. Requires less supervision whilst caring
for a group of patients/clients, is able to transfer knowledge to new situations. Seeks and applies
new knowledge and research findings, demonstrates ability to use problem solving skills, critical
analysis and evaluation.
Participation
The student is able to participate under close supervision of a competent practitioner in carrying out
aspects of care, having demonstrated knowledge by analysis. Questions practitioner on aspects of
care and its rationale, decision-making, practical skills, and means of acquiring further information
and opportunities for practice. Shows ability to perform manipulative skills, operationalises
communication and problem solving skills with guidance.
Dissemination
Plans, implementation and evaluates care for a group/clients under minimal supervision. Advises
others, shows ability to teach junior colleagues identifies personal management style and shows
ability to manage care delivery by junior staff. Critical analysis, evaluation and decision-making skills
demonstrated.
5. The Ten Essential Shared Capabilities
These were developed in the UK specifically for mental health professionals after a consultation with
professionals, service users and other stakeholders:
1.
2.
3.
4.
Working in Partnership.
Respecting Diversity.
Practising Ethically.
Challenging Inequality.
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5.
6.
7.
8.
9.
10.
Promoting Recovery.
Identifying People's Needs and Strengths.
Providing Service User Centred Care.
Making a Difference.
Promoting Safety and Positive Risk Taking.
Personal Development and Learning.
Educational Philosophy
In addition to the specific theories listed above, we could say that as “person-centred care” has
become the standard approach for professional care, “student-centred education” (Humanistic
Educational Theory) has become the umbrella educational philosophy for nurse education.
References
Edgley et al, January 2014. Critical realist Review revisions.
Sitvast J.(2013). Self-management and Representation of Reality in Photo Stories. Advances
in Nursing Science Vol. 36; 4: 1–15.
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