Interventions to Support Student Wellbeing to Improve Retention and Learning

by Alyssa Hooter, PharmD, PGY1 Pharmacy Practice Resident, University of Mississippi Medical Center

Burnout, a term to describe a state of exhaustion from working excessively, was first used in 1974.¹ Burnout can also be used to describe the depleted mental state and mental exhaustion students develop toward their studies. This is often seen in students pursuing professional degrees in the health professions, including medicine, pharmacy, dentistry, and others.  Students need to recharge so that their long-term performance and success is not hindered. To combat student burnout, many institutions have implemented a variety of interventions to help students build up the stamina needed to pursue a career in healthcare.

Health professional students commonly experience burnout due to exhaustion and the gradual loss of excitement to pursue their career. Sometimes burnout can lead to physical manifestations, such as diseases like hypertension, and negative psychological states, like depression, and behavioral problems, like substance use or suicidal thoughts.¹ A meta-analysis of 39 learning burnout intervention studies, including 3,400 students, evaluated the effects of different interventions that were most effective in decreasing burnout.¹ The interventions were divided by type: individual, organizational, matching interventions, and learning engagement. The interventions most commonly studied were exercise (an individual intervention) and group counseling (an organizational intervention).

Physical activity has been shown to promote positive moods and decreases the risk of depression and reduces tension associate with prolonged learning activities.¹ Group counseling sessions involve providing students a safe group atmosphere and a process that facilitates respectful interactions between students.  Group counseling has been shown to improve students’ self-efficacy in learning behavior and the selection of positive coping strategies.

Healthcare workers are at particularly high risk for burnout, including medical students. Reducing the risk of student burnout can be done by individual faculty and the institution.  The American Medical Association (AMA) released an AMA STEPS Forward^TM initiative that describes the measures medical schools can take to promote well-being.² The first step is to recognize shared responsibility by assigning a faculty member with the obligation to oversee student well-being and evaluate resources to make school-level changes. Often, this person is deemed the Director of Student Well-Being.  The second step involves measuring student well-being regularly by using a standardized instrument to compare progress as the institution implements changes. Third, the AMA emphasizes the importance of optimizing the curriculum. Research has found that pass-fail grading is associated with a reduced risk of burnout. Even if pass-fail grading is not practical for every course, it can be beneficial in non-clinical courses. Moreover, changing to pass-fail has not had a detrimental impact on learning as measured by the United States Medical Licensing Examination Step tests. Fourth, the AMA report also acknowledges that student debt is a major factor that contributes to burnout.

Another strategy to decrease burnout is to optimize the institution’s learning environment and cultivate a supportive community. This can be done through displays of support from faculty and empowering students in the clinical setting to build confidence and inspiration within themselves. Step 6 is to promote self-care and resiliency. Why is this step 6?  This is intentional. A student can only progress and excel in an environment that supports and nourishes growth. Trying to have discussions about self-care to students who do not feel supported by their institutions or who feel discouraged during their clinical experiences will not go far. Once empowered and given appropriate resources to prevent burnout, students may begin to understand their self-doubt and how their thoughts may be a source of discouragement.  It is imperative that students are given time to reshape their thoughts and work through these feelings without added pressure from their institutions. This can be accomplished through designated well-being days, specific quiet areas, and free counseling services. Step 7 is to provide adequate services for students are already affected by burnout or distress. Lastly, the AMA report encourages the funding of studies that measure the impact of organizational changes on student well-being.

Pharmacy students also experience burnout.  The American Association of Colleges of Pharmacy (AACP) has a Community for Wellness and Resiliency with the goal of providing “quality resources and ideas to infuse well-being science into pharmacy education.”  This is a great start for pharmacy schools — addressing mental health in students “has been on the back burner for several years.”² Given the added stress of the COVID-19 pandemic, it is imperative that programs not only be developed, but enforced.  I believe an individualized student-specific approach will result in improved mental resilience that will carry the student from the classroom throughout their career.

A valuable starting place to support the well-being of a student is to show them that they are not just a generic student, but rather, an individual who has needs. One way we can do that is by allowing the student to have at least one day per month that they can use, similar to how a full-time employee would use paid time off. Explanations would not need to be given and the day can be used however the student needs. Other methods of demonstrating respect and understanding for students is for professors to talk about personal and professional hardships, during class sessions or advising meetings, and what they did to overcome or learn from those experiences.  This can help students realize they are not alone as all of us have experienced difficulties and hardships. It takes both an institutional approach and an individual willingness to reach out and truly assist learners to reduce the risk of burnout. Addressing these issues while students are in school can help ensure that their future patients’ lives are in confident and competent hands.

References

1. Tang L, Zhang F, Yin R, Fan Z. Effect of interventions on learning burnout: A systematic review and meta-analysis. Front Psychol 2021; 12: Article 645662.
2. Rooney J. A Renewed Focus on Resilience. Academic Pharmacy Now 2020: https://www.aacp.org/article/renewed-focus-resilience
3. Brook J, Aitken L, MacLaren J, Salmon D. An Intervention to Decrease burnout and Increase Retention of Early Career Nurses: A Mixed Methods Study of Acceptability and Feasibility. BMC Nursing 2021; 20(1):19.
4. Harris R. Embracing Your Demons: An Overview of Acceptance and Commitment Therapy. Psychother Austr 2006; 4:1-7.

Should TBL Readiness Assurance Tests Be Graded?

by Kaylee Hall, PGY1 Pharmacy Practice Resident, University of Mississippi Medical Center

Team-based learning (TBL) is a learning strategy that requires students to prepare for topics prior to class and be ready to apply that knowledge to solve problems in a group setting. In professional schools, this is typically done by working through patient cases and clinical questions as a team. TBL is structured so the class starts with an Individual Readiness Assurance Test (iRAT), typically consisting of multiple-choice questions designed to test if the student is prepared to work through the cases/questions during that class. Following the iRAT, students then complete the group Readiness Assurance Test (gRAT), which consists of the same questions from the iRAT; however students work together in groups to answer the questions, facilitating group discussion and problem-solving. Students typically receive immediate feedback on the gRATs to promote conversations within the group and a deeper understanding of the subject matter. While the RATs are an important part of the learning process, controversy exists on whether the RATs scores should be counted towards students’ grades or counted as participation (i.e., the student is awarded full credit for being present and completing both the iRAT and gRAT).¹

A recent study conducted at the University of Tennessee College of Pharmacy assessed student performance when RATs were graded versus ungraded in a TBL course. They compared results from an elective course offered in the spring of 2020 and 2021. RAT scores were graded in 2020 and not graded in 2021. After the 2021 course, students were asked to take a survey to assess class preparation and perceived team accountability. The investigators found no significant difference in student exam performance when comparing the ungraded versus graded cohorts and concluded that ungraded RATs did not adversely impact students' examination performance.²

Pros to counting RAT scores

Assessment drives learning. Having RAT scores count towards the students' grades may provide them with extrinsic motivation to complete the pre-class materials which are essential for TBL. Previous investigations have looked at how grading iRATs affected class preparation and performance. They found that when iRATs were graded, students were more likely to download pre-class materials and performed significantly better on iRATs. When they compared the download frequency of preclass materials, it dropped by about 30% for Year 1 and by nearly 50% in Year 2 courses when iRATs were ungraded compared to graded.³

Cons to counting RAT scores

An assessment focus rather than a mastery focus. Assessments may promote cramming of material and superficial learning of the subject in order to pass the quiz or examination without truly understanding the concepts.⁴ Grading RATs may also encourage students to use a performance or performance-avoidance approach to learning, where students focus on the assessment with the goal to perform well or outperform their peers. This orientation toward learning promotes superficial learning of the material without encouraging students to master the subject.⁵

Negative effects on group cohesion. Grading RATs may push students to focus on individual efforts instead of working as a team. Poor group cohesion may promote social loafing where students give less effort because they can rely on other members of the team to do the work.⁶ In contrast, not grading RATs may encourage students to work together to achieve mastery of the subject. Without the need to achieve a grade, group assessments encourage students to prepare for the materials based on their intrinsic motivation and the desire to contribute their ideas. When students are intrinsically motivated, they tend to be more engaged and stay engaged longer than students who are extrinsically motivated.

Indeed, student surveys have found that ungraded cohorts feel more responsible for the team and have a greater desire to contribute to the group’s work. Students also report that they felt their contributions were important, indicating good group involvement and cohesion. Additionally, the majority of students reported that class preparation is necessary to perform well in the course.²

Increased pressure to perform. The pressure to perform well on assessments may encourage academic dishonesty and promote unneeded stress. Without the pressure to perform, students are able to focus on a deeper understanding of the material and are less likely to engage in superficial learning simply to perform well on examinations.

Conclusion

Few studies have looked at student performance when RATs are graded versus ungraded in the Team-Based Learning model.  Professional opinions differ on which approach is best. Historically, we know that assessment drives learning, but graded assessments may not be the most appropriate approach to the team-based learning strategy and may have unintended consequences. Grading readiness assurance tests may promote superficial learning of the material, lead to poor group cohesion and inflict unnecessary stress on students.  At least one study suggests that ungraded RATS does not harm student grades. Removing grades may diminish extrinsic motivation for students to prepare for readiness assessments but allows students to foster their intrinsic motivation — to be motivated more by the desire to contribute to the group and to master the material. More evidence is needed to truly assess the pros and cons of graded versus ungraded readiness assurance tests in professional schools.

Resources:

1. Hrynchak P, Batty H. The educational theory basis of team-based learning. Med Teach. 2012;34(10):796-801.
2. Eudaley ST, Farland MZ, Melton T, et al. Student Performance on Graded Versus Ungraded Readiness Assurance Tests in a Team-Based Learning Elective. Am J Pharm Educ. 2022;86(9): 8851.
3. Koh YYJ, Rotgans JI, Rajalingam P, et al. Effects of graded versus ungraded individual readiness assurance scores in team-based learning: a quasi-experimental study. Adv Health Sci Educ Theory Pract. 2019;24(3):477-488.
4. Epstein RM. Assessment in medical education. N Engl J Med. 2007;356(4):387-96.
5. Meece JL, Anderman EM, Anderman LH. Classroom goal structure, student motivation, and academic achievement. Annu Rev Psychol. 2006;57:487-503.
6. Karau SJ, Williams KD. Social loafing: A meta-analytic review and theoretical integration. Journal of Personality and Social Psychology. 1993;65(4):681–706.

Leading Future Leaders? Developing a Curriculum to Enhance Leadership Skills

by Blake Mangum, PharmD, PGY1 Pharmacy Practice Resident, University of Mississippi Medical Center

When enrolling in a professional health program such as medicine, pharmacy, or nursing, many students must adjust to the demands of their program. The material is complex, the workload is demanding, and there are often co-curricular organizations and responsibilities to make time management even more complicated. Didactic instruction is critical in career development to understand the core material needed, but it's equally important to develop the professional and leadership skills required to excel. We often focus on helping students develop as future clinicians and instill the requisite foundational knowledge for their chosen professional field. But it is easy to overlook the importance of helping students develop as future leaders. Organizations that accredit professional programs, such as the Accreditation Council for Pharmacy Education (ACPE), require the curricula to address professional development and leadership.  However, the method and material to be covered are left to the individual program. This introduces some variability between programs as institutions have various philosophies on the optimal method to deliver this material and may even define leadership differently. Do you structure the leadership curriculum by delivering a series of lectures, a couple of exams, and a final project?  Or do you divide students into teams and have small-group discussions?  Or do you send students out on their clinical rotations to develop their leadership skills in the "real world"? This essay will reflect on methods currently used in leadership development education and the outcomes reported by those using these methods.

Optimal Structure of a Leadership Curriculum

During my time as a pharmacy student, I took several professional and leadership development courses that were required in my program. I had assumed the structure and methods used would be similar at every health professions program. My classes started by taking a strengths finder analysis and discussing the impacts that various skills could have on team dynamics and performance. While researching what goes into making a leadership development course, I found that some programs take a similar approach, but others are very different. A recent scoping review examined fourteen published reports on leadership education in PharmD programs.¹ Of those, only six employed traditional didactic lectures in the required curriculum. Others relied on co-curricular activities, elective courses, and leadership retreats. Even didactic lectures had variable content and schedules. Another systematic review provides insight into what components give us the most return on investment.² The review used Kirkpatrick levels of evaluation to determine the effectiveness of each intervention or approach. They found that leadership interventions that combined didactic lectures with projects, lab activities, and small groups were more effective than didactic lectures alone.² Both papers report that students prefer a multimodal approach. The course structure is not the only variable to consider.

Optimal Duration of a Leadership Curriculum

We have all heard that practice makes perfect. It is important to consider how long it takes to conduct a program aimed at leadership development and how often the participants should meet. The literature is quite variable in this regard.  Some programs met once monthly for a semester or entire academic year, while others consisted of a 5-module series over multiple years, and others were a single-day leadership retreat.^1,2 The exact length of a program and how often to meet will depend on several institution-specific factors, such as the availability of professors to deliver lectures, the schedules of students' other classes, physical facilities, and more. Based on a review of the literature, longitudinal courses have greater efficacy than shorter program durations; however, programs that lasted half a day were compared to programs that lasted the entire four-year curriculum.² The answer to how long to teach and how often to meet is debatable, but a good starting point would be a standard semester-long course.

Optimal Class Size

The literature reviews report cohorts ranging from 6 to over 200 students.^1,2 Smaller cohorts scored higher on efficacy rankings than large cohorts. This area is a little harder to navigate as not much can be done about a class size if you require the entire student body to complete the program. One possible method of ensuring smaller cohorts would be to divide classes into sections, with some sitting in a lecture for one week while the other section is involved in a skills lab, and perhaps dividing up the cohort into even smaller groups for discussion sessions. This method would provide students with a multimodal learning experience and more direct learning opportunities.

Optimal Course Development

The University of Massachusetts Medical School recently created a course to enhance medical students' leadership and teamwork skills.³ The course objectives included leadership style, communication within the health care team, giving and receiving feedback, delegating responsibilities, and setting direction for a team. These leadership skills were identified as core competencies in a previous needs assessment survey. The course involved six 90-minute sessions.  A portion of each session was a didactic lecture, plus there were interactive activities to reinforce the material, post-session questionnaires, and individual reflections. Similar to previous studies, the authors used pre- and post-course surveys to gauge course impact. Students completed a survey eight months after the course conclusion to assess the long-term skill use and effects of the course. The authors documented increased student confidence related to each course objective and the key skills learned during the course were still being used in everyday life eight months later. This model indicates that surveying students about impact is a best practice to assess the effectiveness of a course. Of note, the creators of this course were students themselves! This underscores the fact that students actively seek to strengthen their leadership skills and, in this case, help others develop them as well. Healthcare is a team sport, and having the ability to lead the team in your area of expertise is an essential skill.

Leadership skill development is not routinely considered when entering a clinical profession. However, these skills are critically important and need to be considered when developing a curriculum. The optimal methods will vary between institutions, but using a multimodal approach with lectures, longitudinal projects, and having smaller cohorts in classes are factors that can improve the effectiveness of a leadership course.

References

1. DeVolld T, DiPietro Mager N, et al. Management, entrepreneurship, continuing professional development, and leadership education in United States doctor of pharmacy curricula: A scoping review. Curr Pharm Teach Learn 2022;14(6):798–808
2. Evans MA, James EJ, Misa Mi. Leadership training in undergraduate medical education: A systematic review. Int J Med Students 2023;11(1):58–66.
3. Richard K, Noujaim M, Thorndyke L, Fischer MA. Preparing medical students to be physician leaders: A leadership training program for students designed and led by students.. Med Ed Portal. 2019; 15: 10863

Biases, Microaggressions, and Stereotype Threat and Their Impact on Learning

by La’Kendra Bell, PharmD, PGY1 Community Pharmacy Practice Resident, University of Mississippi School of Pharmacy

As an African American woman, I have had a front-row seat to the many microaggressions, biases, and stereotypes that come with being black. I, however, did not let it hinder my growth, as I aspired to be a healthcare professional and make a difference in communities that look like me. This essay focuses on how biases, stereotypes, microaggressions, and stereotype threats can negatively impact learning and the strategies educators could use to prevent and manage them. Let’s first make sure we agree on some definitions:

• Bias: An inclination of temperament or outlook. A personal and sometimes unreasoned judgment¹
• Stereotype: something conforming to a fixed or general pattern.¹
• Microaggression: a comment or action that subtly and often unconsciously or unintentionally expresses a prejudiced attitude toward a member of a marginalized group (such as a racial minority)¹
• Marginalized populations: groups and communities that experience discrimination and exclusion (social, political, and economic) because of unequal power relationships²

Growing up in a mostly separated community, I avoided most of these encounters, as most students went to a school with other students of the same race. Therefore, I did not experience microaggressions, biases, and stereotypes from my peers. However, I had to face them with teachers. Being in a low-income, rural area, many teachers would come to our school for a short period of time and did not stick around to invest in our education and development. For them, it was an opportunity to “pay back their loans.” Feeling unwanted by teachers was the first step in the broken system. From time to time, there were statements that made me feel like I couldn’t make it and that I wasn’t good enough. These were subtle statements and attitudes from people with physical characteristics different from me and sometimes even from those who looked like me.

As I went off to college and then became a pharmacy resident, there were other instances where I felt bias and stereotypes were influencing people’s statements and behaviors; but at this point, I am a professional and must behave appropriately. For recipients, microaggressions can be distracting, exhausting, and painful. One must try to figure out the meaning and intent of the microaggression and then decide whether and how to respond.³

For me, figuring out how to respond is very challenging because I want to avoid coming off as aggressive. When educators and other individuals understand microaggressions, they are in a better position to be sensitive to how a person might perceive comments, create a culture where microaggressions are openly discussed, and support students when they experience them.³

Examples of microaggressions: ⁴

Theme	Microaggression	Hidden Message
Alien in own land. When Asian Americans and Latino Americans are assumed to be foreign born.	“Where are you from?” “Where were you born?” “You speak English?”	You are not American. You are a foreigner.
Ascription of intelligence. Assigning intelligence to a person of color on the basis their race.	“You are a credit to your race.” “I wasn’t expecting you to do so well.” Asking an Asian person to help you with a math problem or science problem. Asking a black person if they played sports. “Are you my nurse?”	It is unusual for someone of color to succeed All Asians are good in math or science All black people play sport or are athletic Assuming a female can only be a nurse and no other healthcare professional
Criminality/ assumption of criminal status	Clinching purses as someone approaches you. A store owner or employee follows you around the store	You are a criminal You are going to steal and assuming you don’t have money
Denial of individual race	“I’m not racist. I have several black friends “I do not see race”	I am immune to racism because I have friends of color Dismissing one's background

Stereotype threat is a disruptive psychological state.³ Underrepresented minority students may be affected by the notion that they are not motivated, capable, and/or academically prepared for higher education. When a student experience stereotype threat, they avoid behaviors that might affirm the stereotype.  For example, a Latino student might not seek help from the Writing Center on campus because it would reinforce the stereotype that they don’t speak or write English well. Or a Black student might not speak up during class for fear they might be perceived as aggressive.  Many studies have demonstrated that stereotype threat can cause hypervigilance, impair working memory, and inhibit academic performance. When stereotype threat is triggered, the energy that could be spent on learning is lost to vigilance, worry, and anxiety. It can lead students to avoid communicating with instructors, studying, or coming to class, ultimately leading to increased student attrition.³

Navigating these stereotypes and biases can be difficult, as they can be based on gender, race, socioeconomic status, religion, and more. Microaggressions negatively impact one's ability to concentrate, solve problems, and learn new material.⁵ Studies suggest that hostile racial climates perpetuated through microaggressions on college campuses disrupt students’ ability to participate in class discussions. Moreover, experiencing microaggressions in the classroom has been linked to feelings of invisibility, isolation, and self-doubt, all impairing one's ability to focus on tasks and solve problems.⁵

What can educators do to prevent and manage these threats to the learning environment? If an educator realizes after the fact that they have just said or witnessed a microaggression, the easiest thing to do is to simply apologize to the hurt individual.

Ways to apologize

Purpose

If committed in your presence but did not address the situation when it occurred: Ten minutes ago/yesterday/last week, a statement was made in class that I did not address at the time but want to do so now.6 If you committed a microaggression: [Student], I want to apologize for the comment I made yesterday. My intention, although poorly articulated, was to say [this]. I understand, however, that my words conveyed incorrect and harmful assumptions about you. Please know that I intend to be more mindful and reflective about what I say in the future.6

Apologize for the delay and acknowledge that by not responding immediately, you (as the instructor) may have given the impression that you condone the behavior and comments that caused. 6 Identify the problematic statement(s) that caused the high emotions. 6   State your commitment to responding to incivilities more quickly and desire to better support the learning and well-being of all students.6

As a student in a health professions program, I sometimes felt that I couldn’t be my authentic self because I did not want to affirm others' negative beliefs or be seen as unprofessional. Though some may not have experienced bias, microaggressions, or stereotype threat, I think it’s important to understand how they can negatively impact learning.  These issues are complex, multifaceted, and layered, but raising awareness is a critical first step.

References:

1. Dictionary by Merriam-Webster: America's most-trusted online dictionary. Merriam-Webster, 2011.
2. Glossary of Essential Health Equity Terms. National Collaborating Centre for Determinants of Health
3. Ackerman-Barger K, Bakerjian D, and Latimore D. How Health Professions Educators Can Mitigate Underrepresented Students’ Experiences of Marginalization: Stereotype Threat, Internalized Bias, and Microaggressions. J Best Pract Health Professions Diversity 2015; 8(2): 1060–1070.
4. Sue DW, Capodilupo CM, Torino GC, et al. Racial Microaggressions in Everyday Life. Am Psychol 2007; 62 (4): 271–286.
5. Torino GC, Rivera DP, Capodilupo CM, Nadal KL, Sue DW. Microaggression theory: influence and implications. Hoboken, NJ: Wiley Publishers 2019. pp 11-12.
6. Huston TA and DiPietro M. In the eye of the storm: Students’ perceptions of helpful faculty actions following a collective tragedy. To Improve the Academy 2017; 25 (1): 207-224.

Co-Learning: Students and Faculty Learning Together

by Victoria Goodman, PharmD, PGY1 Community Pharmacy Practice Resident, University of Mississippi School of Pharmacy

As someone who graduated from a professional degree program and returned from the workforce to complete a PGY-1 pharmacy residency, I feel there were few opportunities to truly collaborate with my professors/preceptors until after graduation. There were set roles; I was the student, and they were the teachers. This dynamic was emulated throughout schooling at most institutions. It felt like there was a stark divide between the faculty and students. But upon graduation, students are expected to flip a switch, spring into their professional role, and even teach others.

This style of teaching and learning, where there are strict roles and responsibilities, is common in many fields, including the health professions. The typical class consists of a faculty educator standing and delivering a lengthy presentation that the students are expected to commit to memory. Information flows in one direction to students as they attempt to absorb as much as possible. Unfortunately, this is not the most effective method of retaining knowledge. In recent years, many courses have incorporated active learning strategies.  This is certainly an improvement but can we improve the learning process by building more connections between our educators and students? One potential technique is a concept called co-learning.

Co-learning is the act of grouping individuals to share the workload of a given learning task or share perspectives in a conversation. Group members learn from each other's unique insight and provide a mechanism for each participant to be accountable for contributing to the learning process.¹

The concept of co-learning is not new, but the practice of co-learning among educators and students is underutilized.^2,3,4 When including the educator in the co-learning group, the teaching strategy is similar to Socratic teaching with students and teachers engaged in dialogue and learning from one another. The educator is not the only person speaking or delivering knowledge; instead, students are encouraged to pose questions and further the conversation.

The Cornell University's Center for Teaching Innovation webpage on Collaborative Learning details the benefits of co-learning between faculty and students.  This includes building rapport, improving faculty-student relations as well as increasing retention rates, experience, idea sharing, and organizational involvement.^2,3 All of which lead to more meaningful learning experiences and strengthen the program.

Rapport Building/Deepening Connections. The opportunity is provided for students and educators to interact in a learning setting that opens doors. The traditional roles can be disbanded, allowing for new bonds to be forged. This is called “flattening the hierarchy” of the power differential between students and teachers.²

Increased Frequency and Quality of Faculty-Student Interactions.  Once the lines of communication are paved, this allows for more frequent and higher-quality interactions between the students and educator. Talking about areas of uncertainty are more likely to be discussed and this increases the confidence in both learners and teachers alike.²

Improved Retention Rate.  The practice of nurturing positive relations between students and educators will naturally begin to build positive and uplifting morale throughout the institution. Having a more understanding and embracing work/school environment will help each member of the institution to feel a higher sense of belonging and value within the program.

Sharing Ideas and Perspectives.  Through open and honest communication, everyone will have the opportunity to share the perspective they have on the situation or subject matter.^2,3

Greater Organizational Involvement. Exposing students to professional organizations through the perspective lens of the faculty member will help the learner gain a better understanding and appreciation for these organizations during their tenure and post-graduate.^2,3 Serving alongside each other would be less of a foreign idea and more of an ushering experience.³

Here are some helpful ideas a teacher can use to foster a co-learning model. Activities aimed at increasing social awareness, cultural competency, and connectedness often work well.⁴ Activities such as storytelling to get to know each member, role-playing to gain an understanding of diversity within the group, and then debriefing at the end of each activity to explore the perspectives about the activity itself.⁴

Another activity might involve one member of the group interviewing another member to complete a survey on socio-demographic information.⁴ The other members of the co-learning team can be assigned as observers of the interaction. The purpose of this is to demonstrate support, empathy, and cultural sensitivity. If it’s not possible to divide students into small groups, each with an educator as a participant, the practice and observation activity could be performed on a larger scale with larger classes. This activity will require members of co-learning teams to interact and analyze information in real-time to come together as a group to decide. Group members engage in open discussion and respect one another’s perspectives.

Dialogue and shared decision-making activities, which include the teacher as a group participant, are ideal - allowing greater time and fostering intimate connections within the group. Experiential learning is where co-learning between students and preceptors often occurs.  Using a similar model in the classroom, teachers and students can discuss and grapple with real problems that don’t have easy solutions, making learning relevant, meaningful, and transformative.

Happy Learning.

References

1. Co-learning in education works wonders for future generations [Internet]. Inventionland Education. 2018 [cited 2023 Mar 26].
2. Haddock L, Rivera J, O'Brien B. Learning together: Co-learning among faculty and trainees in the clinical workspace. Acad Med 2023; 98 (2): 228-236.
3. Collaborative Learning [Internet]. Center for Teaching Innovation, Cornell University. teaching.cornell.edu. [cited 2023 Mar 23]
4. Nguyen-Truong CKY, Fritz RL, Lee J, Lau C, Le C, Kim J, et al. Interactive co-learning for research engagement and education (I-coree) curriculum to build capacity between community partners and academic researchers. Asian Pac Isl Nurs J 3(4):126–38.