Building a Collaborative Environment

One of the most frequent issues raised by instructors who are trying to move from a teacher-centred to a team-centred classroom is “How do I get students to collaborate effectively?” The answer is not a simple one because most North American students arrive in the medical classroom from a learning environment that encouraged competition and frequently feared collaboration between students was a doorway to cheating. Many of the most successful students in this environment viewed collaborative activities as a plot to improve the grades of poor students at their expense.
So you need to help students learn to collaborate and I suggest you begin that process by familiarizing yourself with Dr. J. Salmons’ Five Levels of Collaboration, which progress from least trust required to unconscious trust.
1. Dialogue
2. Peer Review
3. Parallel Collaboration
4. Sequential Collaboration
5. Synergistic Collaboration
Dialogue
Begin your course with daily opportunities for students to practice speaking and listening to each other in order to build trust. Avoid the traditional instructor asks a question and a single student answers and use a variety of the following:
• Write, pair, share
• Clicker polls
• Clicker quizzes
• Group discussions
Structured Controversy
Integrated Case Learning
Peer Review
The week before the first paper or assignment is due begin the process of orienting them to critiquing each others work. Explain the concept of rubrics to the class and ask them what criteria they would use to evaluate the assignment/paper. If they have an adequate understanding of the concept, get them to create the rubric; otherwise share your rubric with them. Be open with the students that this is a stage in learning to work as a team. Choose one of the following depending on the size of the group and their readiness for the task:
• Partner – give each other feedback on the format/spelling/sentence structure but not on the content before the work is handed in
• Comment – post the assignment online in a Wiki or Blog and expect at least two thoughtful comments from each student on someone else’s work as part of their marks
• Critique someone else’s work using the established rubric and compare it to the instructor’s critique for marks.
Parallel Collaboration
At this stage, participants divide up the group’s assignment and each individual completes a section independently. The final presentation of the assignment may be vetted by one individual who is ideally the best writer/presenter but who may be just the strongest personality. In some cases, students each present their section and no teamwork is involved. To help students move through this individual stage, you might ask them to do some of the following:
• Encourage them to participate in some sort of group editing/review which can be facilitated by using either Google Docs or a Wiki
• Assign group roles such as gatekeeper, task completer, food bringer etc. or help them identify their role
• Ask group to mark each other on participation in the group role while you mark individual contributions
Sequential Collaboration
The students are developing the skills of team and task management and begin to appreciate the importance of both functions, so they need an assignment that can be accomplished in a series of stages, such as research – group writing – presentation of paper. At each stage, a product will be presented to you by a set date and the students are expected to plan, create and critique this product as a group. Marks for this stage are based on expected group performance not individual.
Synergistic Collaboration
The unconsciously competent team collaboration point may not be achievable in a single course.

Twitter in HealthCare

Several articles have recently come to my attention that I wanted to share with you about how Twitter is being used by physicians, hospitals and other healthcare providers.
American Medical News has an article discussing twitter as a tool to increase the web presence of your practice, connect to patients and network with other providers.
Chris Thorman, who normally blogs about electronic medical records at Software Advice explores Twitter as an epidemiology tool for tracking diseases.
Dr. Shock is interested in how Twitter is being used in educational settings by students and lecturers.
Twitter’s reputation as a mundane socializing tool for updating friends has never been my experience and I am pleased to see the creative use of this tool expanding. What ideas do you have for using Twitter in healthcare?