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Healthcare settings – Work Based Learning

The ‘rites of passage’ according to Manokore et al.(2019) & Levett- Jones et al (2009) identified WBL HCA Nurse progress towards workplace competence and service delivery for a far more expanded and beneficial health care service (Baskerville, Liddy, & Hogg, 2012; Grumbach et al., 2012).

According to Thor et al. (2004) WBL Assessors can support critical reflection on practice and identify patterns that adopt alternate thinking strategies and behaviours. Assessor- learner working relationship supports Watling (2015) position that HCA staff are observed as person centred who develop new skills and knowledge.

This context for a recognised need for improvement identifies a progression towards the development on health and social care teams as discussed by Smith et al.(2018) & Manley and McCormick (2004). At the beginning of COVID 19 Kessler et.al (2019) identified there is a lack of research evidence to support the successful implementation of new training initiatives.

Furthering the discussion, Costley & Pizzolato (2018) knowledge in the context of WBL is often described as being ‘transdisciplinary’ however, the HCA experience within the workplace as a learning environment will need to demonstrate how they can actively participate in the creation of a new learning environment. This proposal sets out to identify if HSC learning is informed by theory and occurs as a by-product of work-based learning or from experience as highlighted by Eraut (2007) & Williams (2010). Experiences and collaboration of learning development and interaction and exchange of these experiences may identify tensions as Nevalainen et al. (2018: p27) highlights effectiveness towards staff development can be viewed as the ‘essential paradox of work-based learning’.

 

HSC staff may require a need for space, time and reflection for mutual interactions and exchange of experiences due to COVID 19 while recognising the impact on WBL outcomes.

Nevalainen et al’s (2018) & Christensen et al. (2017) qualitative review reporting on WBL in health care settings and highlighted the opportunities provided by WBL compared to the classroom setting. (practical competence, i.e. handling safe medication) Acknowledging Christensen et al. (2017) & Thurgate (2018) discussions, WBL learning practitioners identified effective and positive learning outcomes:

 

  • A culture of the workplace, learner behaviours- positive/negative
  • A workspace and how it is organised to promote (or inhibit) learning;
  • Managers – How effective they were in enabling and promoting WBL
  • How the Interpersonal relationships between the staff in the workplace are viewed.
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Understanding student learning

Piaget (1950) and Bruner (1960, 1966) are two of the twentieth century’s most eminent educationalists, with views that are largely congruent with constructivism. For example, Bruner’s ideas relating to inducting students into the modes of thinking in individual disciplines and his notion of revisiting knowledge at ever higher levels of understanding, leading to the idea of a spiral curriculum, have been very influential. In the discipline of history, for instance, Bruner is often cited as the inspiration for changing the focus of history teaching in schools in England. This shifted the balance from regurgitation of factual information to understanding. Some of the ways in which this was done were to encourage learners to understand how the past is reconstructed and understood, for example by learning how to empathise and to work from primary sources. Constructivism tells us that we learn by fitting new understanding and knowledge into and with, extending and supplanting, old understanding and knowledge. As teachers, we need to be aware that we are rarely if ever ‘writing on a blank slate’, even if prior understanding is rudimentary, or wrong. Without changes or additions to pre-existing knowledge and understanding, little learning will occur. Very frequently learning is thought of in terms only of adding more knowledge, whereas teachers should be considering also how to bring about change or transformation to the pre-existing knowledge of their learners (Mezirow, 1991). Additions to knowledge, in the sense of accumulated ‘facts’, may sometimes be possible without substantial transformation, but any learning of a higher order, involving understanding or creativity, for example, can usually only happen when the underlying schemata are themselves changed to incorporate new, more refined understanding and linkages.

 

Andragogy is considered to have five principles:

As a person matures he or she becomes more self-directed.

Adults have accumulated experiences that can be a rich resource for learning.

Adults become ready to learn when they experience a need to know something.

Adults tend to be less subject-centred than children; they are increasingly problem centred. For adults the most potent motivators are internal.

It is self-evident that experience gained through life, education and work should play a central role in learning; this, constructivist, perspective on learning is called experiential learning. The most widespread theory of learning from experience is associated with David Kolb (1984), who developed ideas from earlier models of experiential learning; the Kolb model appears most frequently in the literature. An appreciation of experiential learning is a necessary underpinning to many of the different types of teaching and learning activity discussed elsewhere in this book, including work-based (or placement) learning, action learning, teaching laboratory work and reflective practice. The provision of vicarious experience, such as by using case studies or role play, and many types of small group use experiential learning as an underlying rationale. Experiential learning is based on the notion that understanding is not a fixed or unchangeable element of thought and that experiences can contribute to its forming and re-forming. Experiential learning is a continuous process and implies that we all bring to learning situations our own knowledge, ideas, beliefs and practices at different levels of elaboration that should in turn be amended or shaped by the experience – if we learn from it.

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Covid 19 Service delivery- Good Practice

During the Covid-19 lockdown regulations, all assessors at KYP Training have contacted every learner at least once a month by phone and also by regular email contact. Learners have been given one-to-one support and guidance for each unit completed and thorough feedback to help their journey and increase knowledge and understanding.

According to DG Allo (2020) the purpose of the study was to investigate the learners’ perception on Online Learning System in the midst of a COVID-19 pandemic. Pedagogically, before the pandemic occurred, lecturers provides lectures through face to face. Lecture material is explained by the lecturer in front of the class, then followed by interaction by giving the student feedback, and usually there is a task at the end.

‘students agree and like to study with group discussions, but awareness of this pandemic will suggest giving task in the form of individual duties. According to the learner, with individual assignments will make them more focus work and pour ideas on their task’(DG Allo, P5 2020).

In the case of KYP service delivery, with the aid of an e-portfolio One file system, telephone calls, what’s app messaging and email, KYP have encouraged reflective practice. This has provided an opportunity to support individual Home Managers to engage in the learning process enabling learners to develop skills and knowledge which they put into practice in the workplace. Learners and Managers have been supported to provide the required Expert Witness Testimonies under the guidance of the Assessor. This has been used to confirm their work practice and competence when working in the home over a set period of time. Popovici and Mironov (2014) discussed that students are deeply aware of the changes brought over by the digital technologies, by their impact on the learning process.

Due to this increased contact, Managers who work with KYP are now more understanding of the Diploma and Apprenticeship process and are gaining knowledge themselves about the knowledge, skills, and behaviours that learners require to meet the criteria of the Standards. Managers are more involved and are able to work with the learners to provide the performance evidence and recognise any gaps in knowledge. The ADKAR organisational change model (Hiatt, 2006) is focused on the needs of the individuals: Awareness of the need for change (easier in response to the COVID reality); have the Desire to participate in and support the change (such as motivated by self-directed life-long learning); have the Knowledge necessary for change (including where and how to find a suitable technology platform and learning to use appropriate tools for delivery and assessment); Ability to implement required skills and behaviours (including practice with both giving and receiving feedback); Reinforcement to sustain the change (such as program evaluation). The ADKAR model needs to be addressed from the perspective of both learners and educators. As an example, Delgaty (2015) described an action research project where they implemented a distance education module consisting of many of the elements that we will describe in this article, including independent activities, wikis and discussion forums enabling both individual and group tasks. They identified a diverse set of roles that were required for effective implementation, including administrator, manager, content expert and online facilitator. KYP post COVID -19 will continue to provide our revised service delivery to learners and managers. It has demonstrated macro groups learners may become lost in the fog of continuous information discussed without a learner intervention towards understanding or reflection. (Anseel, F., & Ong, M. (2020) ) Regular contact and involvement with each individual Manager has proved very successful and motivating for the learners and has made for more robust assessments. Skills, knowledge and behaviours are more interlinked throughout the process leading to more confidence when working with individuals.

References Anseel, F., & Ong, M. (2020). Reflection: Behavioral Strategies to Structure and Accelerate Learning from Experience. Allo, M. D. (2020). Is the online learning good in the midst of Covid-19 Pandemic? The case of EFL learners. Jurnal Sinestesia, 10(1), 1-10. Sandars, J., Correia, R., Dankbaar, M., de Jong, P., Goh, P. S., Hege, I., … & Pusic, M. (2020). Twelve tips for rapidly migrating to online learning during the COVID-19 pandemic. MedEdPublish, 9.
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Effective assessment of individual student learning

There should be an emphasis and a need for curricular development towards learner attributes promoted by providers. Predicated upon preparation, learners for work place strategies aimed at the development of career competence and underpinning knowledge skills: that is, how an individual might personally manage the exigencies of life, learning and work throughout his/her lifetime.

The content of career development learning in essence represents learning about self and learning about the world of work. Process learning represents the development of the skills necessary to navigate a successful and satisfying life/career (McMahon, Patton, & Tatham, 2003, p. 6).

There are a number of career development learning frameworks which may usefully inform the conceptualisation and the delivery of work-integrated learning in higher education. The career development learning framework which clearly and simply captured student-related issues pertaining to the world of-work, self-reflection, and transferability across learning and employment settings was the DOTS model of career development (Watts, 2006). The dimensions and elements of the DOTS model (viz. Self-Awareness, Opportunity Awareness, Decision-Making Learning, and Transition Learning). Self-Awareness refers to an individual’s understanding of his/her career identity; Opportunity Awareness refers to an individual’s knowledge of opportunities within the world-of-work; Decision-Making Learning refers to the skills of making choices with regard to securing opportunities in the world-of-work; and Transitional Learning refers to the knowledge and skills considered necessary for entry into the workforce.

The evidence presented for the correspondence between work-integrated learning and the theoretical elements of career development learning may not surprise career development practitioners whose profession has been involved in the delivery of work-integrated learning under the aegis of career education.

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Learning environment- Health and Social Care

Learning is an individual process where new knowledge, skills and attitudes gives each individual a unique understanding of thinking and action. A good learning environment creates motivation, activity, context with reality, and provides an atmosphere for learning (Alvarstein & Johannesen, 2001). Delivery of learning was achieved by lessons in schools and lectures in universities, together with practical on-the-job work experience or apprenticeships to acquire skills and reading to acquire knowledge.

 

Employees in Health and Social Care settings; must now be able to identify problems, analyze and finally solve them. (Alvarstein & Johannesen, 2001) Change has also taken place in the educational sector at an accelerating rate. Many factors have contributed to this change but those primarily responsible are (Race, 1998):

  • A knowledge explosion.
  • A communications revolution.
  • Rapidly increasing awareness of the processes where effective learning is achieved.
  • The empowerment of learners.

With the changes taking place, teachers and tutors have been disempowered and many learners are now increasingly paying for their own training and with that comes an expectation of change from teachers and tutors in terms of what they should be delivering. This has resulted in the conceptualization of ‘student centred learning’. Race (1998) argues that learning has always been student centred, but that teaching, and training have not.

 

According to Race (1998) there are five factors that underpin successful learning:

  • wanting to learn (or intrinsic motivation);
  • needing to learn (or extrinsic motivation);
  • learning-by-doing (practice, trial and error, experiential learning);
  • learning through feedback (other people’s reactions, praise, criticism);

 making sense of what has been learned (‘digesting’, reflecting, getting one’s head around it)

 

PBL could be able to be applied across all industries and professions because in the application there is a diversification away from the pedagogical model toward an andragogical model that makes the student more responsible for the process of learning and the provision of a solution or solutions. Intrinsic in this model is the ability of the student to cooperate and learn in a group environment, as they would in the workplace, and together, apply creativity to formulate the solutions to designated problems. The student effectively changes from a passive to an active role (Chen-Jung, 2003)

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Work based learning – Learning needs

In order to meet the learning needs of adults, many of the fundamental assumptions of traditional education and delivery models have had to be rethought. These include assumptions about the nature of knowledge and the mechanisms for learning. In addition to these academic issues have come a series of institutional, administrative and cultural challenges. In this paper, the rationale for change and the means for achieving it are described. Many of the theories of learning discussed here are widely understood to provide the basis for alternative forms of provision (recent examples include theories by Malloch, Cairns, Evans & O’Connor [2011] and Illeris [2011]), but there has been less translation of these ideas into practical programs for delivery.

Work-based learning has been described as the linkage of learning to a work role. Levy et al. (1989, p. 4) identify three components to work-based learning which they claim provides an essential contribution to the learning, by:

● identifying and providing relevant off-the-job learning opportunities;

● structuring learning in the workplace;

● providing appropriate on-job training/learning opportunities.

The use of a structured model of reflective practice used with students from two different courses of study, each undertaking work-based learning in quite different contexts, with an aim to assess the usefulness of a structured model of reflection for general use in work-based learning. To promote deep learning; learning where change in fundamental ideas and attitudes could be effected through work-based activity. It was anticipated that the questions that underpin the model would enable such learning.

Finding appropriate assessment strategies is a significant factor in ensuring the sustainability of experience-based education in universities. Davidge-Johnston (2007) observes, however, that using traditional assessment models can be problematic because it is ‚difficult to validly measure learning in one learning model with tools designed for a completely different model‛ (p. 140). Many traditional methods do not address or adequately measure the new kinds of learning that this type of education seeks to engender, such as the so-called soft skills, graduate capabilities/attributes or personal development and transformation. These aspects of learning do not fit neatly into ‚proscribed and specific learning outcomes‛ (Hodges, 2008, p.11).

Hodges et al. (2004) argue ‚the multiple variables that affect both the design and subsequent implementation of assessment practices, particularly in cooperative education, will inhibit attempts to produce absolute instrument validity and assessor impartiality‛ (p. 50). It is not, however, an impossible task and may require inventive thinking, which presents opportunities‚ that are not ‘boxed in’ by traditional assessment methods‛ (Woolf & Yorke, 2010, p. 35)

 
 
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Pre-COVID-19 Apprenticeships

The new apprenticeship regulations (ESFA, 2019a) and, in particular, the stipulation that all funded training must be off-the-job, was designed to address past abuses of the system, whereby on-the-job training amounted to no more than assessment of (existing) skills without necessarily constituting any learning or training. Instead, these regulations focus on off-the-job training as the only fundable (and thus regulated) element, whilst on-the-job training is defined as ‘practising’ in the work environment the knowledge and skills acquired through the off-thejob element. There is no requirement on employers to provide on-the-job training.

All employers provided (and focused first and foremost) on their own in-house training programmes, which was the training designed to prepare staff for certain job roles, regardless of any apprenticeship training. This included off-the-job training for all staff, through both, initial induction and staff development, in the form of in-house training events and/or access to external provision. As a result, there was little difference in the training provided for apprenticed and non-apprenticed new recruits. Indeed, the main difference was the underpinning knowledge gained through the off-the-job element of apprenticeship.

Drawing on Fuller and Unwin’s (2003) Expansive-Restrictive Framework, the ten employers in our sample fell into two groups: those adopting an expansive approach to apprenticeship and on-the-job training (Engineering, Construction and IT); and those whose approach was more restrictive (Retail and Social Care). Employers utilising an expansive approach provided their own comprehensive training programmes. Whilst these included off-the-job provision (both internal, and access to external training) the focus was on extensive on-the-job training. This was carefully planned and part of a strategy of workforce development. It was designed to develop occupational competence of iv rounded employees, who had an understanding of the organisations as a whole and their positions within them. Many employers had developed their own in-house training plans against which they monitored the apprentices’ progress in a range of skill areas. Whilst the apprenticeship criteria were covered by the companies’ on-the-job training, the latter was commonly far broader and in-depth than what was required by the frameworks or standards.

Nevertheless, these employers valued apprenticeship as a model of learning. The off-the-job element provided vital theoretical knowledge and understanding to underpin occupational practice. The frameworks or standards also constituted a useful structure, and employers sought to organise the apprentices’ on-the-job training in line with the off-the-job element of the apprenticeship (delivered in day-release classroom education) so as to facilitate the integration of theory and practice. In these organisations, mentoring and shadowing were crucial elements of on-the-job training, the aim of which was to develop apprentices’ expertise and to gradually initiate them into a community of practice. Apprentices would be working alongside a senior worker or trainer for much of the entire duration of the apprenticeship, whilst gradually taking on more responsibility. They therefore held the dual status of learner and employee throughout the apprenticeship. 8. In the case of the employers under the restrictive approach (Retail and Social Care), the main focus was also on the in-house training for specific job roles.

However, these were relatively narrow when compared with the occupational roles in the companies adopting an expansive approach. The training was delivered predominantly off-the-job and, whilst staff development programmes were in place, much training was front-loaded (delivered through an induction).

This was particularly critical in social care, where all staff attended training based on the Care Certificate before they started working with vulnerable adults. The apprenticeship closely matched this training. 9. In sharp contrast to employers in the expansive approach, apprentices in the retail and social care organisations of our sample were first and foremost productive workers (rather than learners), who completed an apprenticeship within the designated 20% of their working time. What is more, this time allocation was not always protected. Indeed, all four employers indicated that they perceived the 20% off-the-job rule as the greatest challenge they were facing, arguing they could scarcely afford ‘losing’ a member of staff from the production process.

The apprenticeship was therefore quite separate from, rather than an integral part of, the apprentices’ workplace practice (i.e. the job roles they carried out). In these organisations, responsibility for the apprenticeship was firmly with the training provider, while employers were generally passive. The employer role was primarily to ‘line-manage’ apprentices, for example, by ensuring apprentices were given time to complete the off-the-job element, and to provide a point of contact for general support and feedback. During the apprentices’ time on the shop floor (80% of their working time), there was little or no on-the-job training provided by the employer (beyond the initial training for all staff, which in any case was limited). Indeed, when asked about on-the-job training, managers and trainers of all four organisations highlighted the importance of workplace learning as occurring naturally as a result of day-to-day practice. Apprentices were encouraged to apply the knowledge and skills they had gained through the off-the-job element, but they did not receive any structured support.

 

‘’apprentices would definitely learn more. For example, legal and governance – with somebody that we’d just recruit into the business… we wouldn’t necessarily educate them on the ins and outs of [for example] trading standards. Because that’s just not necessarily in their role…. Whereas, somebody that we’re investing in, that we want to be a future store manager, we would want to expose them to as much of that that is relevant and at some point in their life they might need that information’’

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‘How do we assess’

Introduction

Assessment is a critical endeavour with implications for students, universities, industry and the wider community. The measurement of student learning, however, presents many challenges, particularly in the context of cooperative education, work-integrated learning, work-based learning, service learning and other models of learning through participation (LTP).

 

Finding appropriate assessment strategies is a significant factor in ensuring the sustainability of experience-based education. Davidge-Johnston (2007) observes, however, that using traditional assessment models can be problematic because it is‚ difficult to validly measure learning in one learning model with tools designed for a completely different model‛ (p. 140). Many traditional methods do not address or adequately measure the new kinds of learning that this type of education seeks to engender, such as the so-called soft skills, graduate capabilities/attributes or personal development and transformation. These aspects of learning do not fit neatly into ‚proscribed and specific learning outcomes‛ (Hodges, 2008, p.11).

 

  1. Determine the aspect/s of learning to be assessed (e.g., application of theory to practice and discipline-specific soft skills) and what kind of evidence of learning can be used.
  2. Decide what students need to achieve and be clear about what will be measured, taking into account any accreditation or certification requirements.
  3. Agree on who is involved in the assessment process and clarify roles in terms of how stakeholders will be involved, whether this be in only some aspects of assessment (i.e., host supervisor involved in formative assessment only) or all of the assessment (i.e., the academic supervisor);
  4. Provide support and training for anyone involved in assessment as stakeholders may be unfamiliar with the aspect of learning, situation of learning and/or some of the methods used for assessment.
  5. Consider the situation/context of learning which will vary between students and ensure the assessment package is flexible and realistic enough to account for variations while also being equitable to all students.

We have to acknowledge Hodges et al. (2004) who suggests there are dangers in concentrating heavily on performance measurement and reliability that ‚lead assessment designers to focus on more tangible and identifiable technical skills and competencies at the expense of more difficult-to-measure soft generic skills and competencies‛ (p.53). Other authors warn that assessment of valuable professional skills such as ‚tacit knowing, intuition and artistry‛ (Zegwaard et al., 2003) or the ‚poorly defined but essential elements of the graduate attributes‛ (Hungerford, Gilbert, Kellett, McLaren, Molan, & Washington-King, 2010, p.199) can be overlooked by such a narrow focus. These skills fall into the list of ‚wicked competencies‛ defined by Knight (2007) who also identifies graduate attributes and complex achievements in this group. He further contends that a competency such as creativity or critical thinking ‚cannot be precisely defined, takes on different shapes in different contexts and is likely to keep on developing‛ (p.1)

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Adult Training

The adult training project monitors and reviews adult learning trends and policy developments. The focus is on how work-based learning help people develop the skills that give them greater chances of finding jobs and improving their careers.

  • Apprenticeships in work-based learning
  • In recent years the value of apprenticeships in combating youth unemployment has come to the fore. The Centre, in cooperation with the Commission, is helping to create apprenticeship alliances across Europe. It is also preparing country reviews on apprenticeships.

  • Assessing VET’s benefits
  • Cedefop is investigating the benefits of VET at micro (individual, enterprise), meso (sectors, social groups and communities) and macro (economy and society, country and European Union) levels.

  • Early leaving from education and training
  • Lifelong learning begins in youth, and early leaving from education and training has a negative effect on both education and employment. Cedefop is currently reviewing European and national strategies that aim to keep young people in education and training and lower the dropout rate.

  • Lifelong Guidance
  • Guidance and counselling should accompany learners and workers at every transition. The Lifelong guidance project reviews related policy and strategy developments in the Member States. It identifies successful initiatives and makes recommendations for future work in Europe and individual countries.

  • Teachers and Trainers’ professional development
  • The Teachers and Trainers’ professional development project monitors trends affecting the roles, skills and training of teachers and trainers who work in vocational education and training, including adult learning and work-based training. The project promotes knowledge-sharing between practitioners and decision-makers and makes proposals on the professional development of vocational teachers and trainers.

  • Validation of non-formal and informal learning
  • The project reviews trends in Validation of non-formal and informal learning – i.e. of learning that takes place outside formal education and training bodies – and supports the development and implementation of validation systems in Member States.
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    Evaluating COVID on learning

    Evaluation mapping activity, coupled with responses from a learner reflection review, provides the opportunity for training providers to explore the alignment of each apprenticeship intended purpose and learning outcomes within the evaluation objectives and methods to assess success during learning.

    This would enable a review/intervention to identify any gaps in either the way the intended purpose of study is being articulated or the evaluation questions or methods being used to assess whether that purpose (or intended learning / outcomes) were being met.

    Research towards several design shifts to individual apprenticeship learning may occur as a result of mapping activity. For example, an initial exploration of the intended outcomes of the Level 5 LACW reveals an intention to develop leadership skills in adult learners, however current research has suggested the mapping activity revealed there was no aspect of program delivery or evaluation specifically addressing this outcome. This may lead to a focused consideration of whether leadership was is in fact being developed through the apprenticeship standard, or if this was just an incidental development due work-based competence and experience.

    The mapping activity may reveal a substantial amount of qualitative, post program data has to be collected across apprenticeships, however a gap analysis may also provide a clearer picture of a lack of data being collected prior to engagement in IAG and career education interventions.