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  • Making Sense of the PCA Model: Turning Problem Cases into Learning Opportunities

    Clinical learning rarely follows a neat script. More often it emerges from the difficult cases – the ones that unsettle us, challenge our assumptions, and force us to rethink how we practise. Years ago, we developed a Problem Case Analysis (PCA) model during a GP Trainers ‘retreat’ in Germany. It provided a structured approach to making sense of these experiences. It works by using the case itself as the “curriculum,” guiding the learner through a reflective cycle that fosters deeper understanding and future growth.

    The model is built around five domains, each tapping into key principles of adult learning theory:

    1. Define Needs/Wants: Clarify

    Key questions: “Why is this a problem for you?” “What about this bothers you?”

    This domain gets to the heart of the learner’s agenda. In adult learning, relevance is king – adults are motivated to learn when they can see immediate value (Knowles, 1980). By identifying why the case matters to the learner, the educator ensures the encounter feels personal and worthwhile. Sometimes the need is technical (e.g. uncertainty about investigations), sometimes emotional (e.g. frustration with a demanding patient), and sometimes relational (e.g. difficulty negotiating with colleagues). Surfacing these concerns clarifies where the learner’s energy lies.

    2. Explore Understanding

    Key questions: “What do you think is going on?” “Have you seen something like this before?”

    Here, the learner’s existing knowledge structures come into play. From an adult learning perspective, this step draws on:

    Constructivism: adults build new knowledge upon prior experience. Cognitive load theory: if a case is rare but important (a “high-affinity, low-occurrence” scenario, like recognising temporal arteritis or meningitis), learners may struggle because their schemas are underdeveloped. By revisiting similar past encounters, they reduce intrinsic load and strengthen memory traces. Kolb’s experiential cycle: reflection on prior experience (“Have you met this before?”) feeds directly into abstract conceptualisation and future action.

    In practice, this step often reveals biases (“I always worry about missing cancer”) or blind spots, which become fertile ground for learning.

    3. Define Options: Challenge to Look at New Dimensions

    Key questions: “What other ways are there of dealing with this problem?” “This is what I think… how would you feel about using this?”

    This is where the educator encourages cognitive flexibility. The learner may be anchored in one way of managing the case, but by introducing alternatives – diagnostic, therapeutic, or communicative – we widen their repertoire.

    Here, transformative learning theory is relevant: disorienting dilemmas (such as a case that “doesn’t fit”) can trigger perspective shifts when the learner is guided to explore new frames of reference (Mezirow, 1991). Encouraging multiple options fosters resilience in the face of complexity, and mitigates the “tunnel vision” that can occur under stress or cognitive overload.

    4. Summarise & Confirm Understanding

    Key questions: “What will you do now?” “How will you handle this type of problem next time?”

    This step consolidates learning. The act of summarising is more than repetition – it represents schema reorganisation, where the learner integrates new perspectives into their existing mental models.

    Feedback here is vital. Adults value feedback that is specific, respectful, and actionable. Drawing on Vygotsky’s “zone of proximal development,” the educator scaffolds the learner’s performance just enough to push them beyond their current level without overwhelming them. This also reduces extraneous cognitive load, as the learner leaves with a clarified plan and less mental clutter.

    5. Future Learning

    Key questions: “What have you learnt from this?” “What else do you need to know?” “How will you handle this in future when I’m not here?”

    This final domain turns the case into a springboard for lifelong learning. It encourages:

    Self-direction: adults prefer autonomy in setting their learning goals (Knowles). Metacognition: thinking about how they learn, not just what they’ve learnt. Forward transfer: preparing to apply insights in new, unpredictable contexts.

    A Clinical Example

    Take a GP trainee wrestling with a patient who repeatedly attends with vague chest pain.

    Define Needs/Wants: The trainee admits they are worried about “missing a heart attack” but also feels the patient is becoming dependent.

    Explore Understanding: They recall a previous case of ACS but admit they struggle to balance reassurance with risk.

    Define Options: Together, you explore structured risk assessment tools, shared decision-making, and safety-netting approaches.

    Summarise & Confirm: The trainee outlines a plan to use the QRISK tool, document carefully, and agree a follow-up strategy.

    Future Learning: They commit to reading about “frequent attender” management and plan to discuss psychosocial factors in their next tutorial.

    Through the PCA lens, the case is transformed from an anxiety-provoking encounter into a structured learning opportunity, reducing cognitive load and increasing confidence for future practice.

    In summary: The PCA model works because it respects the principles of adult learning – relevance, experience, self-direction, and reflection – while providing a clear framework to process difficult cases. It helps learners move from discomfort (“Why does this unsettle me?”) to capability (“How will I manage this better next time?”).

    Adult Learning Theories in Action:

    • Knowles’ Andragogy (1980):
      Adults learn best when the material is relevant, problem-centred, and connected to their own goals. The PCA model starts with the learner’s agenda, ensuring alignment with this principle.
    • Kolb’s Experiential Learning Cycle (1984):
      Learning arises from cycling through concrete experience → reflective observation → abstract conceptualisation → active experimentation. PCA mirrors this cycle by encouraging learners to reflect on past cases, integrate new ideas, and plan for next time.
    • Cognitive Load Theory (Sweller, 1988):
      Working memory is limited; learners struggle with high intrinsic load (rare, complex cases) and unnecessary extraneous load (poor explanations, irrelevant detail). PCA reduces this by structuring reflection, linking to prior knowledge, and clarifying next steps.
    • Transformative Learning (Mezirow, 1991):
      Disorienting dilemmas – like challenging cases – can trigger a shift in perspective. By exploring alternative options, PCA helps learners reframe their thinking and grow professionally.
    • Desirable Difficulties (Bjork & Bjork, 2011):
      Effortful, challenging learning (e.g. grappling with difficult cases) enhances long-term retention and adaptability. PCA encourages learners to lean into discomfort and use it productively.

  • Smartphone and Social Media use for CPD in Wessex

    I have finally written up a brief survey I did last year looking at how a selected group of Wessex GPs were using the Internet, Web 2.0 tools and smartphones for their CPD. The link to the document is here.

    I had the privilege of presenting a poster of the key findings at the Wessex Educational Fellows 2017 conference. I also learnt a number of things. Firstly, printing on linen is far easier than heavy duty paper. Secondly there’s a fair amount we can share educationally between primary and secondary care. Lastly, there are some very bright & dedicated educationalists around in medicine. The two Keynote speeches were very powerful.

    Anyway, back to the paper. You can read it in all its glory but I just wanted to comment on what I feel are a couple of important points.

    The population surveyed was only small but I suspect can be generalised to the wider GP population. As GPs, we have a suspicion of Social Media for education. It is not without its flaws but I fear we are missing out on the benefits. In order to increase the uptake, there needs to be training for GPs in how to actually use Social Media, Blogs and Podcasts. Once GPs are using it, we need to grow a Professional Network so we can share best practice, ideas, guidelines etc. For this to happen, GPs need to be convinced of the reliability & educational rigour of the material being disseminated as well as be confident in the security of any on-line discussions.

    I would like to extend my huge thanks to those who partook in the survey. I hope to do some further work in the future to explore some of the issues, day job permitting…

  • Mobile Learning and Smartphone use amongst Wessex GPs

    I have finally got around to disseminating a questionnaire to the good GPs and GPSTs of Wessex to assess the use of smartphones and their use for M-learning and CPD.  More to come but I have drafted an abstract of my findings below.

    Background and Aims

    There is an increasing use of smart phones for both under and postgraduate medical education. Despite this, uptake amongst general practitioners is poor. This survey examined the current use of smartphones for medical education amongst a cohort of Wessex GPs and GPSTs. Also explored was the use of social media for medical education.

    Method

    An online questionnaire invite was sent out via email. The questions included closed demographic questions and open free text responses. The survey population was composed of GPSTs and GPs on the Wessex PBSGL database. Responses were analysed using a grounded theory approach to identify themes.

    Results

    There were 61 respondents from 253 invitees. 98% had smartphones, 77% used smartphones for medical apps, 65% used smartphones for medical education, 69% used smartphones for social media and 20% used social media for medical education.  Thematic analysis of free text responses identified 58 nodes which were grouped into 21 minor themes in 8 categories.  These were: Accessing learning; Educational impact of online and m-learning; Educational networking; Learning involves social interaction with peers and mentor; Physical constraints of mobile devices; Signposting to guidelines and learning via the Internet; Technical challenges of online and m-learning; Work life balance

    Conclusions

    This is a snapshot of a small population but does raise some important key messages.  There is a training requirement for GPs in how to use social media for education.  GPs valued the networking between colleagues at courses and conferences.  However, most respondents recognised the future benefits of mobile learning platforms and wanted to engage more.

  • A Meta-Analysis of Continuing Medical Education Effectiveness (Mansouri and Lockyer 2007)

    Free text from here.

    In trying to justify why I think PBSGL is a good way of learning, I have done a lot of literature searching and reading about how different CME interventions can change what we do as physicians. The more recent research on PBSGL has demonstrated that Small Group Learning (SGL) is associated with several positive outcomes. For example, implementing guidelines into practice, an activity that is often associated with many difficulties (Macvicar, Cunningham et al. 2006). If only patients would do what they’re told, it would be so much easier! Clearly primary care is not about the sapiental ‘all knowing’ doctor. It is about empowering patients to make decisions. This generates uncertainties. Sharing these uncertainties in a SGL group with a trained facilitator frees up the physician to say what they think with reduced fear. I have often wanted to ask questions in a GP update lecture but am embarrassed to ask simple things about chronic disease management, something we are not always good at working for the MOD with a young population.

    I have also found lectures a mixed bag of usefulness. I write furiously in my learning journal, coming up with all sorts of ideas for audits and interventions only to reflect on them (usually just prior to my appraisal) wondering where has all that enthusiasm gone? This is why I have been such an advocate of SGL and what it can do to enhance our learning and improve patient care. Hence my review of this article for both my professional project and for general interest.

    This meta-analysis is not a new article but is a solid piece of work where the authors undertakes a literature review of CME interventions and looks at outcomes. The main type of interventions examined are active (workshops & individual training), passive (conferences and lectures) and mixed (SGL and post-course feedback). Three types of outcomes are looked at: physician knowledge, physician performance and patient outcome. There were 31 studies which actually generated 61 interventions (as some studies had multiple outcomes). The interventions were entered separately into the meta-analysis. All outcomes had positive & significant effect although the size was generally small. The data was also grouped and analysed for various types of CME. No surprises for guessing the results (summarised in table 3). Interactive SGL, case discussions, multi-faceted programmes and longitudinal workshops all had the largest effect.

    What was interesting was the small number of studies looking at patient outcomes. I decided to look in detail at one of these. Gask et al used role playing actors with videotaped consultations to look at consultation behaviour pre- and post educational intervention (Gask, Usherwood et al. 1998). The subject was depression. In what seems to be a nicely constructed but probably expensive study, ratings of the consultations with the role players were carried out in the context of assessment and management of depression. The intervention involved small group work in five 2 hour sessions. It included intensive training, review of videoed consults, role playing etc. In other words, a very intensive package and probably impractical for a busy GP nowadays.

    It would be a fair conclusion to draw that the least effective methods of delivering education (e.g lectures) are probably the most popular as they are cheaper to provide. More intensive training eg with SGL is associated with better outcomes, but with increased number of hours of intervention so the cost of delivery is probably more. I would argue that case based training can be cost effective and in the one relevant study included in this meta-analysis, physician knowledge improved considerably (Doucet, Purdy et al. 1998).

    Two other findings piqued my interest. The first was that when the assessment was done was important.  This is not surprising. If the assessment is performed 52 weeks later, the impact is likely to be less. The other finding was that mixed disciplines fared less well than single group disciplines. Details were patchy but it is something to consider if planning some interdisciplinary education. It may be that with increased specialisation and training of practice nurses, plus delegation of management to them by GPs, this effect will be less in 2016 than it was in 2007. An adjunct to this was that increased participants had a negative correlation although it is not clear if this this was related. One would expect increased numbers at passive interventions so it may be a secondary effect.

    Doucet, M., et al. (1998). “Comparison of problem-based learning and lecture format in continuing medical education on headache diagnosis and management.” MEDICAL EDUCATION-OXFORD- 32: 590-596.

    Gask, L., et al. (1998). “Evaluation of a training package in the assessment and management of depression in primary care.” Medical Education 32(2): 190-198.

    Macvicar, R., et al. (2006). “Applying evidence in practice through small group learning: a Scottish pilot of a Canadian programme.” Education for Primary Care 17(5): 465-472.

    Mansouri, M. and J. Lockyer (2007). “A meta‐analysis of continuing medical education effectiveness.” Journal of continuing education in the health professions 27(1): 6-15.

  • Potential Research Project: Web 2.0 technologies in Primary Care Education. What is the current level of knowledge and utilisation of Web 2.0 technologies in Primary Care Education.

    Any thoughts?

  • Tweeting For Learning

    Tweeting for learning: A critical analysis of research on microblogging in education published in 2008–2011

    F Gao, T Luo, K Zhang – British Journal of Educational Technology 43.5 (2012): 783-801.

    I came across this article when searching for microblogging papers. It is a useful article in that it summarises the research done between 2008 and 2011 on microblogging, or more succinctly, microblogging in education (MIE). It is worth a read due to the design of the study. What the authors did was to try and look specifically at evidence for the benefit of MIE whilst excluding opinion pieces and review articles. During my various searches, I have come across a lot of opinion pieces which although relevant, do not always provide the evidence for benefit. This paper is essentially a systematic review. Due to the variety of the included studies, it isn’t a meta analysis but it does provide a nice summary. One can delve further into the individual studies if one wants to and I hope the title above links to a free text version of the paper.

    The article attempted to answer 4 research questions:

    1. What types of research were conducted on MIE?
    2. How was microblogging used for teaching and learning in these studies?
    3. What educational benefits did MIE have on teaching and learning as identified in these studies?
    4. What are the suggestions and implications for future MIE research?

    The method involved is one of the clearer descriptions I have read in a paper for a while and I would recommend reading this part of the paper. Four rounds of searches identified a total of 21 papers which met the criteria for inclusion. They were then analysed. Reassuringly some of the papers I have already reviewed plus ones which are pending were included in the datasets so I did feel a bit smug. It rated the paper by Ebner et Al as having greater validity (sample size, duration etc). Another rated highly is by Kop et Al available here which I haven’t read yet. The submission date in October is getting closer and every time I scratch the surface, another paper pops up.

    RESULTS

    The article described the papers included. These varied in several ways. For example a couple explored microblogging in the context of a conference and the positive effect of real time feedback and questions to the lecturer/presenter. Most were set in higher education. The sample size varied greatly. My own view is that this is less important as these tend not to be quantitative studies. The duration varied as well. A conference or lecture may only last a few hours yet some of the interventions extended to 2 semesters. Ebner’s study lasted 6 weeks yet was very labour intensive & meticulous. It also drew some very balanced conclusions.

    The areas further identified and explored by the authors are: Who is participating? When to learn? What to learn? How to learn? Participation and Engagement; Reflective thinking; Collaborative learning.

    The ‘who’ and ‘when’ are fairly straightforward. Examples of who given include delegates at conferences and the when is essentially at anytime. The concept of education when & where you want it. MIE has been used for informal communication outside of the classroom sustaining engagement by posting updates and relevant links.

    A lot of the positive benefits of MIE have already been described when looking at collaboration and these are all positive effects in the studies looked at. The remaining ‘how’ is a bit more interesting. ‘Fostering interactive activities’ and ‘encouraging informal learning’ are known strengths of MIE. The main educational effect from the review was the development of learning communities, promoting interaction between conversations between students as well as students and teachers. MIE is not meant to be a conversation tool but using the @ prefix achieved this. My own experience is that this is not the case but by flagging with a #, response and conversations are more likely. Apart from all these, there was no objective evidence on the educational impact of MIE. For example better scores in assessments. This is discussed in their future research suggestions. Only one of the studies was experimental, the rest being descriptive. This is what I am finding. Whilst these studies are important, it would be good to find an experimental study which perhaps compared marks with & without a Web 2.0 tool. This would be dependant on students being without their smartphones for a period or not using SNS, something which may prove more challenging.

  • MICROBLOGS IN HIGHER EDUCATION – A CHANCE TO FACILITATE INFORMAL AND PROCESS-ORIENTATED LEARNING?

    Ebner, Martin, et al. “Microblogs in Higher Education–A chance to facilitate informal and process-oriented learning?.” Computers & Education 55.1 (2010): 92-100.

    Free text available here if you register with Researchgate.net which I did.

    The study

    This is an interesting study if only as an attempt to provide objective evidence of the educational impact of microblogging in two areas of learning. It analysed the microblogging entries of a group of business students (full time & part time) at an Austrian University. The students undertook a ‘New Media and Multi-Channel Management’ module as part of the research. This was undertaken as an additional item of study at a busy time during a semester when the students were taking up to 5 parallel course subjects. Students had to use two type of new media – microblogging (MBlog) and Wiki (MediaWiki) – in order to collaborate, communicate and produce business plans. A bit like big brother, the entries on the blog & Wiki were analysed weekly over a 6 week period and categorised into 8 different subtypes (for example, including a hyperlink, content reflects a discussion about the topics of the course subject). In total, 11214 posts from 21 full time and 13 part time students were analysed. To support the extra workload of the students engaging with the module, more of the credit points for this module were awarded on the process, less on the actual business case presentations. The students were told of this.

    Theoretical Background

    I had come across informal learning before in my studies. One of the best examples I used with a previous student was the informal learning that takes place in the medical centre when a new doctor is posted in. The new doctor will be fresh with ideas, certainly up to date with medical knowledge and keen to make a mark. However, what they may not know certainly in a military context is how a job may affect a soldier’s medical condition and vice versa. Therefore time spent either with the medics or with the soldiers will allow them to learn about occupational aspects of their patients’ role through social interactions. The formal curriculum may teach them about PTSD; the informal curriculum may give insight into the horrific experiences of young soldiers especially in Afghanistan by talking and working with them.

    I knew roughly what process orientated learning was but sought clarification. From Wikipedia: Process Orientated learning is a pedagogical method in which students are encouraged to use process skills such as collaboration and written expression. Whilst reading this, I came across the term Positive Interdependence . This is where ‘members of a group who share common goals perceive that working together is individually and collectively beneficial, and success depends on the participation of all the members’. Negative interdependence is the opposite and reminded me of the McLaren Mercedes F1 ‘Team’ of Louis Hamilton and Nico Rosberg (‘individuals can only achieve their goal via the failure of a competitor’).

    Results

    By analysing the types of posts after they had been sub-divided, the authors attempted to assess what sort of learning had gone on. Positive outcomes were that students chatted a lot & communication levels went up through the 6 week observation period. This causally demonstrated informal learning and collaboration. The use of hyperlinks went down suggesting students were sharing factual information initially but less so as the period went on. Coursework discussion also increased suggesting positive interdependence. However, and it is a big however, the authors noted when they analysed the posts for evidence of process orientated learning, the students tended to use microblogging as an alternative medium for collaboration because they had to. With the number of posts being so high, the authors were suspicious the students were playing the game. There was no reflection on how the medium itself was changing the way they were working. I am really not surprised here as when a student is told the majority of the marks would be awarded for process, of course they will use the medium. The authors acknowledged this but possibly missed a trick but not blinding the marking system. However this in itself may have been on ethically dodgy ground.

    I also wonder what outcomes the students were told about. Were they asked to reflect on the use of the media itself or were they asked to use the media as method of collaboration. To be honest I have read the article several times and am still none the wiser. In their summary they quote McLuhan’s focus of ‘The Medium is the Message’ which I take to mean the research was about the medium of microblogging itself. They commented that the students did not reflect on the impact of microblogging on the way they were working. I have some sympathy with the students here. They are not educationalists interested in the deeper understanding of why microblogging might help. I tried reading McLuhan’s article but got to a bit about light bulbs having no message when my own light failed, late last night (or was it the red wine). I will try again this weekend & post any nuggets of educational wisdom as comments.

    What does this mean? The authors come up with valid conclusions that microblogging has potential to increase informal learning and that the collaboration which has taken place suggests it can be a catalyst for process-orientated learning. It does need more research however. It would have been interesting for example to have compared the outcomes (the business plans) from two groups, one using microblogging and one not then marked these with the assessors being blinded to which ones they were assessing. This would not have measured processes though, just outcomes. There is also an assumption made that lots of communicative posts indicated collaboration. It may just have been students gossiping although to their credit, the authors spent a large amount of time analysing the posts.

    This article made me think what am I try to achieve by blogging my critical appraisals and my article reviews? I am essentially making public the processes I am going through whilst writing my assignment (alongside the PBSGL). I reflected on this last night & came to the conclusion that I am really just throwing things into the mixer and seeing what comes out. This may all end with nothing (bar me being a bit wiser) but I suppose ultimately I am laying the foundation for my dissertation in 18 months time when I put SNS to the test in the context of peer review of teaching. Should I be looking at process orientated learning where a group of GP Trainers peer reviews the video of a tutorial? Or should I be looking at an outcome where the reviewee has a formative teaching plan based on the group feedback (as opposed to an individual reviewer). To be honest, I don’t know and I’m sure by the time I am writing my dissertation there may well be a new SNS which is the next best thing in education. Certainly exciting times in post graduate education and the thought makes the educationalist (or geek) in me tingle with excitement…

  • HOW BLOGGING CAN FACILITATE CPD AND LEARNING

    Bodell, S., et al. (2009). “Creating a learning community in today’s world: how blogging can facilitate continuing professional development and international learning.” The British Journal of Occupational Therapy 72(6): 279-281.

    Unfortunately I do not have the full text of this opinion piece to share which I had to get hold of via the Warwick University library. It is a shame as I have two by the same author both exploring how social media can assist with education. The other one I will eventually appraise (it is about professional Face booking) but I will start with this article from June 2009. One thing I have learnt in critically appraising a generic educational subject is that the first thing I look at – relevance – is less important. I am a primary care physician; the author of this article is an occupational therapist. Yet the principles of SNS and healthcare education are still the same.

    A blog (web log) is an example of a Web 2.0 use. I was always under the assumption Web 2.0 was a type of HTML or application. Actually Web 2.0 is a term used to describe second generation Internet capability. It is not specific. The benefits of Web 2.0 (and specifically blogging) in healthcare education are not widely known. Indeed one of the future considerations for research is to look at Web 2.0 and its educational impact in postgraduate education.

    The author describes 3 areas where a blog may be helpful.

    As a Tool for Reflection. Blogging is a useful way of reflecting both as an individual physician as well as in group reflection. The latter is my aim with writing a blog linked to the Salisbury Plain PBSGL.

    As a Tool for Peer Discussion. This follows on from using blogging as group reflection. Indeed these two are probably part of the same entity. Certainly receiving my POEMs or reading my journals, my intent is to write my own take on the articles (with a critical hat on) to try & promote discussion. Related to this is dissemination of guidelines and best practice amongst a Network of Practitioners. This sounds great in theory but with two cautions. Firstly it is time consuming. I am trying to work full time, trying to complete my assignment as well as have a home life. The limitations of a blog are it is author orientated so the onus is on me. This can be mitigated by engaging some of my fellow PBSGL members for which I will canvass support at the next meeting. The second area of concern is confidentiality. This I think will limit clinicians engaging and sharing experiences in a public forum.

    As a Tool for extending knowledge. The reverse chronological order of a blog is cited as a way of developing knowledge. I personally cannot see this as a decent search engine will find posts. It can however run alongside the traditional ways of acquiring knowledge to augment it and the author cites a couple of studies reinforcing this. Since starting my blog, and through microblogging (Twitter), I have viewed other blogs and sites and now have numerous tools at my disposal to answer questions that arise from my day to day practice. My most recent literature search involved registering with www.researchgate.net and I have also become reacquainted with CHAIN again ( http://chain.ulcc.ac.uk/chain/index.html ). Indeed if the term ‘tool for extending knowledge’ is defined loosely, through NoPs, informal learning, Web 2.0 applications etc, this is probably the most powerful effect of blogging.

    In summary, this opinion piece summarises nicely the potential of blogging in healthcare education. I am concurrently reading a research article which is attempting to put some meat on the bones; some objective evidence of improved outcomes using microblogging. However I have run out of time and have clinic so I will save that for another time…

  • Teachers & Social Networking part 2

    British Journal of Educational Technology Vol 43 No 5 2012 754-769

    This research in the article aimed to answer 3 research questions.

    Domain: how does the domain (and particularly the way it is approached) impact on group membership?

    Network: does it make sense to distinguish between different types of participatory attitudes and behaviours, involving different levels of engagement in the group?

    Practice: does engagement with a group of professionals sharing practices have an impact on ‘real life’ and professional development?

    It did this by testing several hypotheses. I will not go into details but suffice to say the statistical analyses seem sound although there are some confounders which I will address later. The analysis was based on several sub-groups of the 1107 respondents dividing the groups into generic & themed. An analogous example of the themed group would be a group of doctors interested in ADHD, the generic group our own PBSGL. Divisions were also made on whether the group was open or by application and how long individuals had been members for.

    Domain: There was a distinction here between themed and generic. For themed groups, FB provided emotional support and bonding social capital. Members were likely to have known one another before joining. For the generic group, FB provided a means for sharing information and ideas. It provided bridging social capital converting latent ties into weak ties.

     Network: Senior members demonstrated more active and confident behaviours compared to junior members, as would be expected. However the impact on professional life was similar regardless of length of time of membership. This impact was greater in the generic group reinforcing previous evidence that the motivation behind SNS was sharing ideas & projects.

     Practice: Thematic groups tended to use FB as a social support mechanism as there was already significant off-line co-operation and interaction. The members knew & worked with each other in real life with the SNS providing emotional support away from this. Interestingly the generic group was more likely to start projects in real life after on-line discussion and sharing. This is real evidence that SNS can have an impact in off-line activities.

     Applying the READER critical reading model:

     Relevance: Not primary care, not English. But it did look at a cohort of professionals looking to share information and develop educational ideas.

     Education: The authors make a good argument, it is well referenced and uses terms familiar to most readers. The theoretical background is explored in some detail. There is a logic to it, funnelling the arguments down to the three research questions (relevant to NOPs) being asked. Therefore there was an educational impact.

     Applicability: Highly applicable to the Salisbury Plain PBSGL, albeit with a lot smaller numbers. It is also very relevant to my assignment. The demographics could slightly bias it applicability though with more female members (87.2%).

     Discrimination: The research was amongst Italian teachers. However it could quite easily apply to Primary care. The themes that emerged from the questionnaires are relevant: ‘Feeling less isolated’, ‘sharing ideas and projects’, ‘keep me updated on group topics’.

     Evaluation: Interestingly, the Generic FB groups (sharing school experiences in general) generally had more positive outcomes than the Thematic FB groups (special interest eg ASD). The latter felt the group decreased isolation. The former felt it enabled sharing of ideas.

     Reaction: Once I had worked through the article and digested what they were saying, my reaction was very positive. Here is some evidence that SNS could improve the outcomes in our PBSGL group. Further research is required however, or in my case, more reading. It is a start though…

     

     

  • Teachers & Social Networking

    British Journal of Educational Technology Vol 43 No 5 2012 754-769

    As part of my assignment on learning technologies, I have done some literature searches. My intent is to critically evaluate a series of articles which look at the impact of Social Media on education. I am not starting in any particular order, just in the order in which I found them. I am trying to evaluate the evidence which looks specifically at Social Media and any effect it has on enhancing knowledge & skills. It would be helpful if you could read what I have written and post any comments. These may be questions about the article, experiences you have had or just some good old fashioned advice.

    The first article I looked at was unfortunately quite long but very relevant. It had a particularly good section on the theoretical background. The article is divided into two. A very comprehensive and well referenced technical background followed by the research itself. For this blog entry (and in attempt to keep things brief), I will summarise the background. The research itself may take me a bit more time to digest & appraise but will be published in due course.

    Firstly, some facts & figures (as of 2011). Facebook (FB) has 900 million users. Two thirds of adults use Social Networking Sites. Facebook is the commonest site visited on higher educational college campuses. Professional Facebooking is a relatively new phenomenon (FB for professional reasons) and has not been explored as much. This study attempted to research the professional uses of FB amongst Italian teachers and evaluate its impact.

    Lifelong learning is a fundamental part of life, not just of compulsory education. It can be described as career related continuous learning as a pattern of formal and informal activities that people sustain over time for the benefit of their career development’ (London & Smither 1999). Ultimately it is about continually updating skills & knowledge. Information & Communication technology (ICT) has driven changes in the workforce to adapt to new technologies. However ICT has also been a driver for change: the concept of learning anytime & anywhere. The authors believe it is not the technology but the way it is implemented and used which it is used which can enhance learning & knowledge. I would agree with this.

    Social networks & social capital have introduced the concept of latent ties (the section of the FB interface which has ‘users you may know’). These latent ties can be converted to weak ties, so called bridging. This is important when we consider Networks of Practice (NOPs). The Concept of ‘communities of practice’ (COPs) was first described by Wenger in 1998. He described 3 parts to them: Domain – identity defined by a shared domain of interest. Community – members engage in joint practices to share information. Practice – Shared repertoire of resources. COPs apply to interdependent practitioners who share & co-ordinate practice. NOPs apply to a collective of all practitioners of a particular practice. COPs are therefore a subset of NOPs (Brown & Duguid 2000). NOPs by their nature are wider groups of like minded individuals. An analogy I recently encountered was at a course where I met other GPs with an interest in education. Before, there was possibly an exchange of phone numbers or an e-mail address. However I would argue how many times have you looked at your contacts some time later & deleted those contact details because nothing has come of it. A NOP is an entity which exists but is enhanced by SNS. This study looked at groups which started as Facebook groups and were actively exchanging ideas, sharing knowledge and engaging in online discussion.

    To finish, I think of one of my GP Trainer work colleagues who is soon to be moving to Scotland. He has got a Twitter account & is engaging in both this & my blog. However as a GP, he has joined the PBSGL we have established in Salisbury Plain. I hope he will continue to make contributions and we will all share best practice via the blog. This, to me, is what a NOP should represent.