RESUMO
Teaching students to 'notice' what is happening around them, to be more attuned to what is going on within themselves, and nurturing self-inquiry into one's practice is desirable yet difficult to achieve. We sought to teach the metacognitive skill of 'noticing' to pre-registration health professions students in the context of interprofessional collaborative practice (IPCP). A three-part curriculum was designed: an e-module focused on 'noticing' in IPCP; a team-based workplace learning observation and interprofessional debrief; and a written reflective assignment. We found that students concentrated on the disciplinary content of IPCP in the assignments, which 'overshadowed' the metacognitive content. We learned that: we had underestimated the challenges of retrofitting new content into existing curricula; that we had not paid enough attention to students' perceptions about what they want to learn; and working with a large and diverse group of educators requires adequate preparation. The next iteration of this program will improve the constructive alignment between learning outcomes and assessments and provide better support for educators. In the future we will temper decisions to act quickly to implement curricular innovations. More broadly, we suggest that educational design that seeks to take account of qualitatively different but intersecting knowledge domains, such as IPCP and 'noticing', is worthy of further study.
RESUMO
BACKGROUND: Electronic medical record (EMR) adoption across healthcare necessitates a purposeful curriculum design to prepare graduates for the delivery of safe and effective patient care in digitally-enabled environments. OBJECTIVE: To describe the design and development of an Interprofessional Electronic Medical Record (iEMR) subject that introduces healthcare students to its utility in clinical settings. METHODS: A six-stage design-based educational research framework (Focus, Formulation, Contextualisation, Definition, Implementation, Evaluation) was used to instigate the iEMR design and development in nursing and five allied health graduate entry to practice (preregistration) degrees at an Australian university. RESULTS: In the Focus process, the concept and interdisciplinary partnerships were developed. The Formulation process secured grant support for subject design and development, including a rapid literature review to accommodate various course and curriculum structures. Discipline-specific subject themes were created through the Contextualisation process. During the Definition process, learning objectives and content resources were built. The Implementation process describes the pilot implementation in the nursing program, where assessment tasks were refined, and interdisciplinary clinical case studies originated. DISCUSSION: The design and development of an iEMR subject is underpinned by internal support for educational innovation and in alignment with digital health strategies in employer organisations. Identified barriers include faculty-level changes in strategic support for teaching innovation, managerial expectations of workload, the scope of work required by academics and learning designers, and the gap between the technology platform required to support online learning and the infrastructure needed to support simulated EMR use. A key discovery was the difficulty of finding EMR software, whether designed for teaching purposes or for clinical use, that could be adapted to meet the needs of this project. CONCLUSION: The lessons learned are relevant to educators and learning designers attempting a similar process. Issues remain surrounding the sustainability of the iEMR subject and maintaining academic responsibility for ongoing curriculum management.