We want to ensure that the teaching and assessment practices in health professions education align well with their originating paradigms. This means that one should be able to trace what you are doing practically back to a particular “paradigm of education” (Baker et al, 2019) in a relatively linear fashion.

Consider these two cases which outline the teaching and assessment approaches used to teach about the same general topic. Pay attention to the purposes of education, the role(s) of the teacher and learner, the desired outcomes of education/learning, and the teaching and assessment approaches and concepts. Notice the consistent alignment of all of these considerations within each case. This alignment contributes to quality, to achieving the intended purposes and outcomes, and a sense of cohesiveness for the learner.

Please note: Alignment can occur at the level of an individual class, between a class and a course, and between a course and an overarching curriculum. In the cases below, we are featuring alignment within an individual class.

• Course name: Introduction to Professional Practice
  Session/Lesson topic: Professionalism
  Students: 125 first year, first-term, physiotherapy students
  Class length: 2 hours
  Classroom type: Traditional lecture hall

Purpose of lesson and desired outcome of learning

The educator is aiming to give students experience and knowledge with concepts and methods relevant to professionalism. The educator is looking to assess both outcomes (what would the student do with a particular case) and process (how did they arrive at that conclusion) and to see that the learning can transfer to novel cases with similar contexts, and novel cases with different contexts.

The lesson

To begin the lesson, a cognitivist educator would split the class into groups of 5 or 6 and provide them with 4 clinical cases in which various concerns related to professionalism arise. Learners read each case thoroughly, and then as a group identify instances of questionable professional behaviour, think about the reasons why they are issues of professionalism, and brainstorm how to react in those situations. The educator carefully designed/selected these cases to introduce learners to the nuances and complexity of professionalism not yet discussed in class. The purpose of this activity isn’t for learners to get the correct answer, but rather to provide experience with the concepts and methods the educator will elaborate upon after the activity. Following the activity, the educator provides direct instruction about professionalism, and various strategies for addressing challenges in practice. The educator also highlights underlying commonalities and differences across the cases and provides learners a chance to ask questions for clarification.

Assessment of learning

To initially assess learning, learners identify professionalism issues in novel cases with similar contextual variables (e.g. similar patient population or team makeup). They will be asked to discuss their reasoning and describe how they would resolve it. A final transfer assessment would assess if they can transfer their learning when contextual variables are changed in novel cases.

Purpose of lesson and desired outcome of learning

To create a safe, reflective, theory-informed space for the consideration of complex challenges related to professionalism and to offer guidance for practice.

The lesson

Before class learners read an article about a breach of professionalism experienced by OT students. To start class, learners think about professionalism concerns they have experienced personally. In small groups, they work through the concerns they have identified. They have the following guiding prompts:

Reflect and discuss your initial reactions:

• How did you discern it was in fact an issue of professionalism?
• Identify the types of professionalism breaches that were involved
• What or who might you draw on to guide your deliberation and decision making about how to proceed?
• What actions might be taken to seek resolution?
• If applicable, what did you do and would you do anything differently?

Bringing it back to the large group the educator then shares a personal story of a breach of professionalism experienced in practice. She chooses to do this to demonstrate vulnerability as the “teacher,” which disrupts the traditional teacher-learner hierarchy and supports learner safety within the learning experience. As a group the class then engages in a dialogue about the nuances and complexity of professionalism. For the most part this section is conversational, although there are parts that are more didactic where terminology and constructs relating to professionalism are explored.

Assessment of learning

coming soon