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social networks and clinical practice


Summary Clinical practice is a challenging component of physiotherapy education. Communities of practice provide a framework for facilitating clinical reasoning among professionals. Social networks have characteristics that make them potentially useful platforms for developing practice knowledge among undergraduate physiotherapy students.
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Background

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Method

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Thornquist2001a;HiggsRichardsonDahlgren2004 Developing practice knowledge within the context of clinical education is challenging because the student must learn to review problems in an enterprise of active interpretation, using tacit knowledge in a context of meaning that is often intuitive and hidden

The study was conducted in a physiotherapy department in the Western Cape during 2010, among all undergraduate physiotherapy students (n=109). Each class was given an assignment to be completed within the social network, x x which dealt with an aspect of clinical practice associated with clinical or ethical reasoning strategies. Prior to completing the assignment, each class was surveyed to determine their knowledge and experiences using emerging online tools, as well as their perspectives on teaching and learning practices within the department. This poster highlights how features of the network were used to facilitate collaboration and peer learning within the context of social engagement x x within a supportive environment, while the survey results will be presented elsewhere. The project was approved by the UWC Ethics Committee, and permission was obtained from the Head of Department. Each questionnaire was accompanied by an information sheet explaining the background and reason for the survey and students gave written consent following an opportunity to ask questions. Participation was voluntary, and students could withdraw at any time with no negative consequences. Permission was obtained from students to show their avatars, status updates, blog comments and reflective entries within the context of a research project. However, when published, the survey results and x engagement within the the network will be anonymised.

Keywords
Community of practice, Clinical reasoning Ethical reasoning, Reflection, Social networks

Schon1987;Clouder2000 Reflection has been highlighted as an important, yet barely recognised component of clinical education, and integrating it into the formal curriculum is challenging Jacques1991;Mason1998;Hanko1999 On the other hand, practice knowledge can be developed by sharing clinical experiences in a collegial environment that develops critical and reflective thinking Engestrom1987;BrownCollinsDuguid1989 Learning is situated within contexts and relationships, rather than within individuals and it derives from social engagement and collaboration Minocha2009 Social networks have been shown to facilitate collaborative and peer-to-peer learning in online environments GarrisonAndersonArcher2000 And they can also provide the social, cognitive and teacher presence within a Community of Inquiry that supports meaningful online learning, within a Community of Practice

Aim

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To determine if social networks can be used to develop reflective discussion around ethical and clinical reasoning within a South African physiotherapy department

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Results and Discussion
uwcphysio2010 Students demonstrated that they were able to read and reflect on the work of others and then generate a response that was based on evidence, as well as taking into account patient rights and ethical viewpoints that may have an impact on decision-making. JonesGrimmerEdwards2006 like this Evidence-based practice is the process by which a clinician evaluates the quality of evidence before applying it to patient management, taking into account the multi-factorial nature of the problem EdwardsBraunack-mayerJones2005 Ethical reasoning is required in the everyday decision-making of clinical practice, and should be integrated within the clinical reasoning process

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Conclusion
Social networks have the potential to facilitate reflective and supportive

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discussion around ethical and clinical scenarios within the context of clinical uwcphysio2010 Students were found to provide encouragement and useful feedback to each other, as well as share additional resources as part of building a community of practice among peers. The use of evidence was an important component of the feedback in order to differentiate between opinion and fact. practice, but whether or not this leads to enhanced reasoning strategies has yet to be determined. Students did not make extensive use of the multimedia features of the network (i.e. embedding video and images into posts) but found value in linking to external sources. Zimitat2007 likes this A community of practice describes the social interactions by which novices are inducted into expert ways of knowing, thinking and reasoning in their professional circle. x Challenges included issues with physical and epistemological access to technology, as well as resistance to change. Finally, even though the tools for effective facilitation of discussion were available, few facilitators made use of uwcphysio2010 Students shared experiences highlighting some of the challenges they faced, often in distressing environments and situations, and the network provided a platform for supporting each other. TanLadyshewskyGardner2010 likes this Strategies that can be used to provide support to students during clinical practice are important to develop entry level competence and work readiness. them.

Author
Michael Rowe Department of Physiotherapy University of the Western Cape mrowe@uwc.ac.za

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