Learning in vivo

Gazetted Terminology for Professional Nurse and Midwife Education and Training

The terminology for cooperative and work-integrated education within the South African nursing education and training sphere is worth noting. It is gazetted that the Minister of Health, after consultation of the South African Nursing Council (SANC)—a statutory body—in accordance to §58(1)(f) of the Nursing Act (Act No 33 of 1995); made regulations pertaining to the education and training of professional nurses and midwives.

Of specific interest are the definitions of:

• Clinical accompaniment, which “means a structured process by a nurse education institution to facilitate assistance and support to the learner by the nurse educator at the clinical facility to ensure the achievement of the programme outcomes;”
• Clinical facility, which “means a continuum of services to promote health and provide care to individuals and groups, used to teach learners;”
• Clinical learning opportunities, which “means the range of learning experiences available in a healthcare setting or other experiential learning sites for a learner to gain the required clinical skills;”
• Clinical placement, which “means the period spent by a learner in clinical and other experiential learning sites to ensure that the purpose of the programme is achieved;”
• Clinical supervision, which “means the assistance and support extended to the learner by the professional nurse or midwife at a clinical facility with an aim of developing a competent, independent practitioner;”

The gazetted regulations further includes several other definitions of terminology such as assessment / assessment method / integrated assessment / assessor / moderation / moderator; competence / learning outcomes / programme outcomes; comprehensive nursing; fundamental learning; programme / qualification; and recognition of prior learning. The regulations further deal with issues such as requirements for registration in the two said nursing categories; accreditation of education institutions; admission criteria; minimum programme requirements; clinical education and training; the assessment and moderation of learning outcomes; transfers; recognition of prior learning; application of these regulations, as well as transitional arrangements.

Nursing Act: Regulations: Approval of and minimum requirements for education and training of learners leading to registration in categories professional nurse and midwife, (G 36235, RG 9927, GoN 174), 8 March 2013

Restorative Formative Normative Custodian

In an article titled ‘But I thought you were doing that’ Rowe, Mackaway and Winchester-Seeto (2012) attempt to clarify the role of the host mentor/supervisor in the experience-based learning setting. They present the following model:

The model identifies four key roles: Restorative (supporting the student); Formative (fulfilling an educatinal role); Normative (administrative functions); and Custodian (guardian role within the community of practice). 

The article elaborates on the aspects that make up the four roles.

Rowe, T.; Mackaway, J. & Winchester-Seeto, T. 2012. ‘But I thought you were doing that’ – Clarifying the role of the host supervisor in experience-based learning. Asia-Pacific Journal of Cooperative Education, 2012(2), 115-134.

Rhizomatous propagation of Co-op & Work-integrated Ed support

Propagating involves the breeding of specimens by natural processes from the parent stock. Rhizomes are creeping plant rootstalks or rootstocks that send out shoots and roots from its nodes. The word rhizome originates from New Latin rhizoma, meaning a "mass of roots"; which stems from Ancient Greek rhizóō, meaning "cause to strike root"; and rhiza, meaning "a root".

Cooperative and Work-integrated Education qualifications/programmes are distinguished by two characteristics, namely:

• Credit bearing work-experience forms an important part/s of the curriculum that is aimed at producing work-ready graduates.
• The curriculum is designed in conjunction with, supported by, and retained relevant by representation from the occupational-field that the programme is intended for.

Good Cooperative and Work-integrated Education practice is characterised by:

• An appropriate advisory system ensuring the retained relevance of the programme through providing regular updating input and critique about the existing curriculum.
• Continuous propagating and cultivating activities to retain and expand a supportive occupational community which is vital for (a) providing real-life work experience opportunities; as well as (b) mentoring of students by workplace supervisors during period of experience; and (c) evaluative input about the competence acquisition of students for graduation purposes.

The metaphor (rhizomatous propagation) suggests:

• Starting of a new garden from good quality rhizomes (irises, cannas and asparagus) — curriculum design in close collaboration with the vocational community and/or professional/statutory body.
• Keep the programme flavour just right by cooking/brewing with good quality rhizomes (ginger, hops and turmeric) — frequently consult the community of practice.
• The underground rhizome is crucial to longevity — foragers, insects, fungus, and fires may attempt to damage the qualification (the above-ground portion of an aspen colony), but a supportive group of practitioners will keep the qualification healthy and protected against threats.
• Rhizomes send out internodes that form roots from the bottom of the nodes and new upward-growing shoots from the top of the nodes — the members of the programme’s advisory system are instrumental in expanding the network of supportive organisations.
• Similar to a rhizome, a stolon (e.g. strawberry plants) grow long internodes that generates new shoots at the end — active marketing interventions takes place to generate wider support.
• A rhizome (also stem tuber or enlarged stolon) serves as storage organ that is often high in starch (e.g. common potatoes) — enabling survival during winter or drought.
• The rhizomes of some species grow above ground, e.g. iris species lie at the soil surface; whereas other are underground, e.g. bamboo — some members of the community of practice render explicit support whereas the contributions of other are equivocal.
• Generally rhizomes form a single layer, but some form a multi-tiered mass — in some communities of practice a qualification may lead to a variety of career paths, whereas in other it is limited.

Work-integrated learning as method of structured distance learning

The South African Ministry of Higher Education and Training (MHET) published the draft Policy Framework for the Provision of Distance Higher Education in the Government Gazette on 29 May 2012.

Based on the MHET Policy’s glossary (p. 4) definition of distance education work-integrated learning (WIL) can be regarded as a method of structured distance learning:

... a set of teaching and learning strategies (or educational methods) that can be used to overcome spatial and/or temporal separation between educators and students. However, it is not a single mode of delivery. It is a collection of methods for the provision of structured learning. It avoids the need for students to discover the curriculum by attending classes frequently and for long periods. Rather, it aims to create a quality learning environment using an appropriate combination of different media, tutorial support, peer group discussion, and practical sessions (emphasis added).

This is emphasised on page 8 of the draft MHET Policy that states: "Distance education proceeds from the belief that learning can be nurtured without necessarily requiring teachers and learners to be in the same place at the same time, and that the resource based nature of distance education allows for the possibility to achieve economies of scale" (emphasis added).

Page 8 of the draft MHET Policy also points out that distance education 'requires substantial up-front investment in curriculum design and materials development, including attention to issues of structure, pacing and meaningful formative assessment, as well as considerable investment in decentralised student support' (emphasis added), which is also true about WIL. Page 12 of the draft MHET Policy continues to state: 'Online communication allows students and academics to remain separated by space and time (although some forms of communication assume people congregating at a common time), but to sustain an ongoing dialogue. Online asynchronous discussion forums, for example, reflect an instance where the spatial separation between educator and learners is removed by the ‘virtual’ space of the Internet, but where there remains temporal separation' (emphasis added). The facilitation of reflection among students during and after stints of WIL has been emphasised.

Item 4.2.2 (h), pp. 22-23 of the draft MHET Policy giving the example of teacher education should enjoy appropriate attention:

Teacher education is a good example here: it remains in the lowest CESM funding category even though new accreditation requirements require investment in a robust teaching practice placement, mentoring and supervision system. While teaching practice has been funded as a full course at funding level 1, the issue now is to define it as an experiential learning component through the funding review process and thus fund it accordingly. Similar concerns arise regarding any programmes of study that require substantive work-integrated-learning and/or practical components and/or substantial online engagement between teachers and students in synchronous and asynchronous fora. Such requirements militate against the potential of achieving economies of scale.

It needs to be pointed out that the statement above does not mention the role of the teaching community of practice, which is a very important oversight. The collaborative notion in Cooperative and Work-integrated Education is not mentioned in the draft policy. The establishment of a supportive community of practice is crucial with regard to curriculum design, especially if work-integrated learning is decided upon as most appropriate method.

Practitioners, serving as mentors for learners, are the third key players in programmes that include work-integrated learning as preferred method. The up-front investment in for quality work-integrated learning includes appropriate materials development that would structure and pace learning as well as empower workplace mentors to offer meaningful formative assessment. This is where the investment of decentralised student support of quality work-integrated learning should focus. (Page 8 of the draft MHET Policy)

Although improvement of the quality of distance education is mentioned in section 4.3 (p. 23); concern about quality and of “inadequate practical work or exposure to work integrated learning” is highlighted.

Republic of South Africa. 2012. Department of Higher Education and Training. Draft Policy Framework for the Provision of Distance Higher Education in South African Universities. Retrieved online from: http://www.dhet.gov.za/LinkClick.aspx?fileticket=ZgZKPb1fM38%3D&tabid=36

Distance education through sophisticated online format may be a global trend

Like many other, the library profession has evolved from an apprenticeship or vocational training to a fully fledged academic discipline coupled with practical training. The library practicum is field-based, supervised, and a professional learning experience taking place within a library—exposing students to a variety of tasks and learning experiences of a range of library operations. Since the beginning of the present century the mode of library and information science education has undergone change.

While distance education is perhaps the most suitable and effective medium for library and information science education in developed countries; it is not necessary the case in developing countries. In countries like Pakistan, the electronic infrastructure situation is not yet adequate for shifting to online teaching. Of particular importance to note is that although two distance library and information science programmes exists in Pakistan students who are remotely located without appropriate information and communication technology (ICT) facilities cannot much use of these programmes. Traditional modes of delivery are therefore prevailing. Furthermore, because libraries in the developing countries tend also to be traditional, content such as classification, cataloguing, traditional reference service, and library management still dominate the curriculum.

Malik, A. & Ameen, K. 2010. Effectiveness of library practicum: perceptions of LIS graduates in Pakistan. Library Review, 59(8), 573-584. Accessed online from Emerald Group Publishing Limited.

Three modes of experiential education

The Best Practices for Legal Education (2007) publication of the Clinical Legal Education Association (CLEA) represents the fruit of 25 years of rich dialogue among American law teachers, lawyers, and judges, regarding the education of lawyers. In the foreword is stated that the American Bar Association convened a 1984 conference ‘Legal Education and the Profession: Approaching the 21st Century’. The foreword further states that in 1987 Justice Rosalie Wahl of the Minnesota Supreme Court and Chair of the ABA Section of Legal Education and Admissions to the Bar rhetorically asked:

Have we really tried in law school to determine what skills, what attitudes, what character traits, what quality of mind are required of lawyers? Are we adequately educating students through the content and methodology of our present law school curriculums to perform effectively as lawyers after graduation?

The purpose of this elaborate prologue is to convey the credible nature of the three modes of experiential education identified in Chapter 5: Best Practices for Experiential Courses (pp 121 – 152, note that the page numbers of individual online chapters differ from the full publication) of the CLEA Best Practices for Legal Education (2007: 122), namely:

• In-house law clinics offering students opportunities to represent clients or perform other professional roles under the supervision of members of the faculty
• Externships — where students represent clients or perform other professional roles under the supervision of practicing lawyers or they observe or assist practicing lawyers or judges in their work
• Simulation-based courses granting students hypothetical situations to assume professional roles and perform law-related tasks

These three modes, although many different terms are used, are common in many disciplines, for example:

• Practicals, laboratory work, applied field experiences facilitated and managed by lecturers
• Work-integrated/experiential/work-based learning in the occupational field under supervision of an experienced practitioner
• Simulated learning providing experience in hypothetical situations

Brayne, Duncan and Grimes (1998: 244) address externships as a means for law students to obtain a credit “working in legal settings”. It is interesting to note that “in the United States, students may not receive financial compensation for work which warrants educational credit”. Brayne, Duncan and Grimes (1998) identify both advantages and disadvantages with regard to externships. Potential advantages include “lower costs, variety of opportunities, work experience, service to the community, and flexibility”. As far as disadvantages are concerned, the main one identified is the potential “lack of control over the quality of the educational experience”.

Brayne, H; Duncan, N & Grimes, R. 1998. Clinical legal education: active learning in your law school. London: Blackstone.

Stuckey, R & Others. 2007. Best Practices for Legal Education. United States: Clinical Legal Education Association. Retrieved 2 November 2011 from: http://www.cleaweb.org/best-practices -- note the hyperlink to the best practices blog at the bottom of the web page.

Semester in-industry learning industry affiliates model

The semester-in-industry model is, according to Edwards (2007) a characteristic of the Australian undergraduate engineering work-integrated learning industry affiliates program. Engineers Australia, the Australian engineering accrediting body, advocates that a key differentiating element of a professional engineering degree from an applied science degree is exposure through work-practice. The industry affiliates program entail students work on a joint industry-university supervised project during the first semester of the final year. Edwards (2007) summarizes the roles and responsibilities of the three partners to the industry affiliates program as follow:

• The industry partner provides the resources for the project; technical supervision for the student; and a suitable workplace for the student similar to that provided for commencing engineers. Industry partners are not expected to pay students.
• The aim is to integrate the student into the professional culture of organization. The student manages the project and adheres to the dress and attendance standards of the industry partner.
• The university selects suitable projects (in consultation with industry partners); help match students to projects; and provides academic supervision of students by visiting student in industry placement to ensure the meeting of requirements.

 The schedule of a typical industry affiliates program model is as follow (Edwards 2007):

October (of year before)	Briefing of students and preparation of CVs
November	List of project topics released and student apply
December to January	Students interviewed and selected for projects
February	Pre-industry workshops; agreements signed between industry partner and student; and student prepares project milestones
February to June	Industry experience by executing an assigned project and regular monitoring of project plan by industry and university
June	Exhibition of projects and submission of thesis

Work-integrated Learning (WiL) is a term used by many Australian universities and internationally to refer to activities that integrate the work (or industry) experience with formal studies. Edwards (2007) points out that it can take multiple forms, such as periods of work experience, internships, site visits, industry based projects, case studies using industry experience, having industry experts provide guest lectures, etc.

Edwards, D. 2007. Integrating Work Integrated Learning. Presented at the International Conference on Engineering Education – ICEE 2007, September 3 – 7, Coimbra, Portugal. Retrieved February 10, 2011 from http://www.ineer.org/Events/ICEE2007/papers/226.pdf   

Raw learning materials and learning tools

Sweitzer & King (2004:4-5) differentiates between classroom and internship learning with regard to two dimensions. I am adapting their description to distance education:

	Distance theoretical learning	Internship learning
The raw learning materials	Study guides, reading, tutorial letters, exercises, on-line discussions & tutorial sessions	Intellectual, physical and human experimental interactions—full of feelings and struggles. These emotions are not just a backdrop to the real-work experience, but every bit as real and important. Mastery of psyco-motor skills may also apply.
The learning tools	Memorise, analyse, synthesise and evaluate.	Experience must be processed and organised; reflective dialogue with self and others is a primary tool for learning; and relationships are the medium of internship.

Please note that Sweitzer & King (2004:3) use the internship to refer to a range terms of that entail an academic credit for experiences, for example field work/experience, cooperative/field education and practicum (terms they indicate no consensus exists on about the meaning).

Sweitzer & King (2004:6-7) further clarify the following terms (Download Sweitzer+King-terms):

• Placement or site—refers to the place where the student is working (gaining experience).
• Intern—refers to the student or volunteer who is working.
• Supervisor—person assigned by the placement site to mentor the student.
• Instructor—the academic staff member that oversees the student's placement.
• Coworker—refers to other people working at the placement.

Sweitzer, H.F. & King, M.A. 2004. The successful internship—transformation and empowerment in experiential learning, 2^nd edition. Belmont, CA: Brooks/Cole—Thompson Learning.

Commentary e-mailed by a peer:

"Thomas, my comments:

Perhaps consideration be given to differentiate between and internship and experiential learning/work integrated learning. Internship specifically refers to students after a qualification has been achieved, whilst experiential learning/WIL is while the student is busy with its qualification.

The principle of experiential learning applies to both however there might be a difference. I do recognize a difference since the one is part of a qualification and the students is perhaps less mature than a graduate (intern) who is more mature and is a graduate. Time is an important factor. Maturity in terms of cognitive, emotional, social skills  etc

Wrt internship, I would recommend the integration of the theories of learning which will explain many of the emotional, social and cognitive processes of the learner, in terms of EL/WIL which can be related to an intern as well.

Wrt Terminology:  

I prefer using a workstation instead of a placement site,

Instructor I am a bit uncomfortable with, I would rather use a term like a supervisor or mentor.

Hope this was of value Thomas!

Marius"

Reflective practice for collective learning

Raelin (2000: 101) calls "the process of public reflection" reflective practice; it is a community of inquiry and creates a collective identity. He defines reflection as "the practice of periodically stepping back to ponder the meaning to self and others in one's immediate environment about what has transpired. It illuminates what has been experienced by both self and others, providing a basic for future education", he adds.

Raelin (2000: 101-2) emphasises learning dialogues, as element of reflective practice, taking place in the security of trustworthy peers based on the direct experiences of work. Raelin (p. 103) refers to Plato's statement that 'the unexamined life isn't worth living' meaning that others need to be included in the examination of life experiences. It is more than collective naval gazing; it isintorspection midst of practice and in the presence of others.

"Reflective practitioners 'reinvest' in learning by participating in continuing education" and "engage in problem posing as much as problem solving, continually expand[ing] their solution database rather than select the first solution that works, view inconsistencies as opportunities rather than inconveniences, and enjoy reflecting back on their decision making rather than sealing off debate" (Raelin 2000: 105). Four explicit reflective practices that can be used each on its own or combined are presented by Raelin (2000: 115-145):

1. Learning teams

Work-based learning often involves action learning in teams. Co-workers undertake projects together, discuss dilemmas of work actions, as well as "the application or misapplication of concepts and theories to these actions" (p. 115). The learning device is to pose questions to one another.

2. Journaling

But "the journal is arguably the most endemic technique we have to enhance our self-reflection" admits Raelin (p. 124). Yet, he continues, although it is "often used as an introspective tool for personal growth, it can also serve as an aid to bring together the inner and outer parts of our lives. It offers a lens to view experience—be it before, during, or after the event under scrutiny—and it even allows further reflection on the journal entries themselves." The journal is a potent vehicle to collect private data for public learning dialogues and may include any one or more of the following:

• Logs or reports of specific factual experiences.
• Lists of observations or ideas.
• Portraits or descriptions of people or situations.
• Memoirs of personal experiences.
• Catalogues of feelings/perceptions in situations or about people.
• Intimate accounts including personal sentiments, confessions and notes.
• Dialogues recordings.
• Conceptual understandings.
• Commentary of applications of concepts.
• Social histories (stories) of issues unfolding.
• Maps of consciousness to capture the state of mind.
• Guided imagery, meditated frames of reference and/or dreams.
• Altered points of view in different contexts or timeframes.
• Contradictions or dilemmas experiences or observed.
• Inconsistencies noticed
• Surprises experiences.

3. Developmental planning

Developmental planning often linked to career development. It involves the individual interests, needs and expectations, as well as the organisational objectives and resource requirements. It is often an element of the overall organisational performance management strategy.

4. Developmental relationships

Examples of developmental relationships include coaching and mentoring.

Raelin, J.A. 2000. Work-based learning—the new frontier of management development. Upper Saddle River, New Jersey: Prentice Hall.

Five-stage internship model

While browsing the table of contents of the Sweitzer and King (1999: 59-65) publication The Successful Internship, Chapter 4 caught my eye: The stages of an Internship. Looking at the names of the five stages, it reminded me immediately of a post I did on 14 October 2009, about Oden's (2001) four movements of hospitality. I would like to draw a comparison between an intern's five stages of mind-state and the four movements of hospitality the mentor or supervisor should enact to alleviate the intern's frustration and contribute to better accomplishment:

An intern's likely five stages of mind-state	A mentor/supervisor's four movements in hospitality
Anticipation	Welcoming
Disillusionment	Restoring
Confrontation	Dwelling
Competence	Sending forth
Culmination

An intern usually looks forward in anticipation to her/his internship, only to start at a very low level of responsibility and opportunity to accomplish. The mentor or intern supervisor should be sensitive as host and welcome the intern (as guess).

Often disillusionment sets in, because of the difference between the prior anticipation and the reality taking place. This is where the mentor or intern supervisor, as host, should act hospitably and help restoring the intern—think of a guess that travelled a distance in primitive circumstances, arriving with feet dusty, probably thirsty and hungry. Restoring the guess by attending to her/his needs is important, similarly by engaging the intern by putting her/him at ease, giving the intern an orientation and see to the intern's safety, etc.

Sweitzer and King (1999: 62) quote the saying "The only way around is through", that is confronting the situation. The mentor or intern supervisor preparedness to dwell, that is in Oden's words "hospitality of presence— the mentor's demonstration of willingness to share her/his work knowledge, experiences and expertise; involving the intern in day-to-day work happening and answering the intern's questions; but also asking the intern's opinions and listen to the intern's suggestions in terms of her/his academic knowledge.

The dwelling enables the intern to gain competence, which leads to the culmination phase. Similarly the preceding three movements of hospitality has restored and empowered the guess to go forth, the host sends the intern forth.

I noticed that Sweitzer and King (2008) subsequently produced a follow-up publication: The Successful Internship: Personal, Professional, and Civic Development.

References

Oden, AG (Ed.). 2001. And you welcome me: a sourcebook on hospitality in early Christianity. Nashville, TN: Abingdon.

Sweitzer, H.F. & King, M.A. 1999. The successful internship—transformation & empowerment. Pacific Groove, CA: Brooks/Cole.

Sweitzer, H.F. & King, M.A. 2008. The Successful Internship: Personal, Professional, and Civic Development. Thomson Brooks/Cole

Supervising 6-9 interns corresponds to one semester's 3-credit course

The Department of Communications Media at Fitchburg State College found, based on over 25 years of experience, that "supervising between 6 to 9 interns in a full-time internship that corresponds to a semester in length is the equivalent of one 3-credit course" (Sides & Mrvica 2007:69). They also discuss the pros and cons of removing internship supervision from academic departments versus having faculty supervise internships. Although removing supervision from academic departments eliminate encroaching on teaching, research or service time, it may result in result in rudimentary and superficial supervision, reduced to “ensuring that deadlines are met, appropriate forms are completed, and interns are progressing appropriately toward the completion of their internship”.

My personal expereince is that if the cooperative education practitioner (intern supervisor) is a subject matter expert, she can engage with students in dialogue about their learning experiences.

Sides CH. & Mrvica A. 2007. Internships, theory and practice. New York: Baywood

Classic, modern & postmodern internship models

Download Internship models

Supervision, mentoring & coaching - 'ex cathedra'?

Literature on supervision, coaching and mentoring - John Launer (2006: 268) observes - "seems to exist on islands that are not in communication with each other". Some islands identified by professions-such as counselling and psychotherapy-other islands through their theoretical bent-such as psychoanalysis, systhemic family therapy, neurolinguistic programming (NLP) and client-centred approaches-and within most islands appear to be a particular 'ex cathedral' terminological preference (from an infallable authority) with rarely any attempt to contextualise definitions, frameworks or theoretical positions. "Readers are often left to work out for themselves exactly what the author's set of assumptions and agendas might be, and why" Launer remarks.

Yet, it appears from a literature review undertaken by Launer, that authors seem to address the same notions in one form or another. He reasons that perhaps it is not surprising, because of operating from individual professional bunkers. He remarks that few scholars can master the entire literature of their own field/s of interest, let alone other. However, many he states "are guilty of what Freud called "the narcissism of small differences' "(p. 269).

Launer, J. 2006. Reflective practice and clinical supervison: making sense of supervision, mentoring and coaching, Work Based Learning in Primary Care, 2006(4), 268-270.

Modelling, coaching, scaffolding & fading

According to Billett (1994:11) the goal of apprenticeships, as a situated-learning methodology, is to assist learners to acquire and integrate the knowledge and attributes for skilled vocational practice. Billett further states that apprenticeship stresses an interplay between observation, scaffolding and increased independence of learners. As instruction method, apprenticeships ought to involve four phases:

Modelling, according to Billett (1994:11) requires an expert to execute a task so that the learner(s) can observe and build a conceptual model of the process involved in accomplishing the task successfully. However, the expert must also verbalise his or her thinking (the cognitive/internal procedures deployed). Modelling enables the learner to visualise the task execution. The implications for employers, other than the time to sensitise experts to reveal their cognitive processes, are largely beneficial, in that tasks are done according to specifications.

Coaching may result in a decrease in production, since it requires experts to observe and monitor the learners carrying out the tasks. In addition to feedback, experts may provide hints, clues and the tricks of the trade. Repeated demonstrations may also be required (Billett, 1994:11-12), which may consume even more time. However, Dougherty & Tan (1997:32) believe that training costs tend to be systematically overestimated, because the cost of a trainer hour is estimated by using the trainer’s wage rate. However, the real costs may be much less, because the trainer often fits training sessions into periods when he or she would otherwise have been idle.

Scaffolding refers to support given from a greater distance (Billett, 1994:12). Ideally, scaffolding implies an accurate diagnosis of the learner’s skill level and the entrusting of parts of or complete tasks that the learner should be able to complete. Additional suggestions may be offered or help required from the expert. It is further suggested that scaffolding should involve joint problem solving. Employers should start regaining lost production time as learners start to master the tasks and achieve output. Dougherty & Tan (1997:33) claim that several studies have found that training costs are recouped even if the trained worker stayed on for only a short while after mastery.

Fading is the gradual removal of support until learners are able to conduct tasks autonomously (Billett, 1994:12).

(This is an extract form a paper presented January 1998 - Download AICJAN98-Artisans.DOC )

The enabling and ensuring of supervision

Supervision generally entails frequent meetings between the supervisor and student. The student reports on her/his clinical activities and the supervisor discusses what is reported. The supervision often mirrors the therapeutic process. However, the supervisor varies the aim and may use supervision either for teaching or for assessment. Supervision may either be individual or in groups (GAP, 1987). Morton-Cooper and Palmer (2000) state that in order to appreciate the richness and diversity of supervision it is sensible to review the meaning of the traditional roots of supervision. They point out both ensuring and enabling categories in the discourse about supervision. The ensuring function or form of supervision is about ‘getting the job done’ (p. 141) and relates to supervisory management. Another type of supervision, provides an enabling function or form, namely ‘independent supervision’, which is freer from organisational influences but still affected by organisational pressures and constraints. In literature ‘independent supervision’ is also called ‘consultancy, professional supervision or non-managerial supervision’ (p. 141). In addition to categories of supervision, Morton-Cooper and Palmer (2000) also points out styles of supervision, which is how the supervision is carried out. See Figure 3 for a ‘family tree’ of categories and styles of supervision. Tutorial supervision is about facilitating learning and has nothing to do with the execution of work. Training supervision relates to the placement of the student, where the supervisor has some responsibility for the student’s work. It is a trainer/clinical teacher and trainee focus. Peer supervision is a mutually beneficial relationship of collegial learning, support and feedback. Consultancy or professional supervision refers to qualified practitioners and the focus is on mentoring and enabling, rather than ensuring. There has initially been suspicion in both the social work and nursing fields about clinical supervision.

Morton-Cooper and Palmer (2000) review the development of clinical supervision and the theorising about it. They summarised three overlapping tasks that emerged, namely formative or developmental; normative or assessment; and restorative or refreshment and creativity. The first is about skills development and improving understanding, as well as growing the supervisee’s abilities, resulting in professional and personal growth. The second is about ensuring ethical practice and monitoring of standards; and the last about sharing of emotions and recharging energies.

Flemming and Steen (2004) point out that there is a significant collection of publications about supervision in general and also specific to clinical professions. Milne (2004) states that clinical supervision served for many years as foundation for clinical practice. Supervision not only fulfils an important role in training, but also to maintain quality in clinical practice and to ensure that, in the interest of clients, practitioners are suitably fit to practice.

Flemming, I. & Steen, L. 2004. Supervision and clinical psychology: theory, practice and perspectives. Hove: Brunner-Routledge.

GAP: Group for the advancement of psychiatry. 1987. Teaching psychotherapy in contemporary psychiatric residency training. New York: Brunner/Mazel.

Milne, D. 2004. Foreword. In Flemming, I. & Steen, L. 2004. Supervision and clinical psychology: theory, practice and perspectives. Hove: Brunner-Routledge.

Morton-Cooper, A. & Palmer, A. 2000. Mentoring, preceptorship and clinical supervision: a guide to professional roles in clinical practice. 2nd edition. London: Blackwell Science.

Development from rule-based to context-based behaviours

The acquisition of skills, according to Andrews and Burruss (2004), is a developmental process, a movement from rule-based behaviours to context-based behaviours. Six stages of development are identified. The table below illustrates the description of Andrews and Burruss (2004) about the progressive development from rule-based behaviours to context-based behaviours. Rules gradually become subliminal, integrated with intuition and tacit knowledge emerges.

Andrews and Burruss (2004) argue that residents should be exposed to a variety of ways of assessing patients, diagnosing and planning of treatment. This is possible through supervisor contact with several clinicians, in different clinical settings and exposure to a spread of patients across the continuum of disease severity. They substantiate their argument by pointing out that learning theory suggests that repetition (multiple learning ways and methods), as well as timely feedback and acceptance of responsibility for one’s actions together contribute to learning effectiveness. Assessment is further an important form of learning. Four levels of assessment are encouraged, namely (a) the recollection of facts, principles and theories; (b) the ability to solve problems and describe procedures; (c) demonstration of skill in a controlled setting; and (d) real practice. These four levels are alternatively referred to as knows, knows how, shows how and does (Andrews and Burruss, 2004, p. 14). The four levels provide a framework for resident learning and assessment. The overt act of assessment or measuring brings about greater awareness. And therefore improves learning. In this regard Andrews and Burruss (2004) further point out that the American Council for Graduate Medical Education in September 1997 shifted the focus from assessing the potential of programmes to measuring the actual success.

Andrews, L.B. & Burruss, J.W.B. 2004. Core competencies for psychiatric education, defining, teaching and assessing resident competence. Washington, DC: American Psychiatric Publishing.