Frances Rutherford Lecture: Transforming Views of Learning: Connecting Professional Conversations
Penman, Merrolee, New Zealand Journal of Occupational Therapy
The Frances Rutherford Award is presented at the New Zealand Association Biennial Conference. Drawing on her experience as an educator and occupational therapist, the 2006 Frances Rutherford Lecturer Awardee Merrolee Penman gave a presentation that was highly interactive using a range of media including audio and video clips along with actors performing, small paired discussions, larger group discussions, quiet reflective times, and general whole auditorium buzz. Her goal was to engage the audience in the ideas being presented. This article cannot begin to capture the experience of the participants on that day, but where possible the interactivity has been included and additional weblinks provided. The reader will be challenged to define, list, describe and reflect. For this reason, the article is presented in a conversational format, just as in the presentation of the Frances Rutherford Lecture.
Ki a koutou to mana whenua o konei To you the locals, greetings Ki a koutou e whakaroko ki To you who are listening to this I greet you He mild mahana ki a koutou katoa Warm greetings to you all
Introduction and acknowledgements
Clare Hocking in her Frances Rutherford Lecture in 2004 described receiving the New Zealand Association of Occupational Therapist's highest award as "a weighty responsibility" (Hocking, 2005, p.5). In receiving the award, I feel a little as I did at my graduation in 1982. Being just 20, I realised that in receiving my degree, I had accepted the responsibility of providing a service for others with what I thought, said and did having far reaching consequences for those people with whom I worked. The Frances Rutherford Award is an acknowledgement of my contribution to the profession, but there is also the responsibility to share something in return. In doing so, I am reminded yet again that what I share may also have consequences. I am both humbled by this notion, challenged by the possibilities, and indeed grateful for the privilege bestowed by my peers.
I begin by honouring Miss Rutherford (as she was always known to her students) who was born and educated in the Wairarapa. Miss Rutherford's initial education included studying for a Diploma of Fine Arts (Painting) at the Canterbury College of Fine Arts, followed by two years of teaching with further study at the Central London School of Arts and Crafts (Botting, 1984).
Denied a place at the New Zealand Occupational Therapy Training School on the grounds of physical disability, it was a chance meeting with an occupational therapist in England that led to Miss Rutherford achieving her goal of studying occupational therapy in Liverpool. Miss Rutherford's experience was a little different, being employed in the position of student-staff, while teaching art to the occupational therapy students. In 1953, Miss Rutherford returned to Masterton Hospital to establish the occupational therapy department.
In 1955, Miss Rutherford was recruited by Hazel Skilton to be Vice Principal and Assistant Supervisor of Occupational Therapy. Miss Rutherford thought this was a 'high-falutin' title but she was soon bought down to earth when she discovered there were just two staff, herself and Hazel Skilton (Rutherford, 1990). Continuing with study, Miss Rutherford undertook an English Teacher's Diploma in Occupational Therapy in 1958, returning to be the third and last principal of the occupational therapy school in Auckland.
Miss Rutherford not only fostered students' enthusiasm for their study (Christie, 1999; Shooter, 1987), she also had high aspirations for the profession. While principal, she produced detailed plans of an advanced programme for the leaders and teachers of the profession using resources from the New Zealand School of Occupational Therapy, the University of Auckland, and the Auckland Teachers College (Boyd, 19845). Unfortunately Miss Rutherford's vision was not realised as the school transferred to Wellington with the first students commencing there in 1971 (Harding, 1973) as the last class graduated from the Auckland school in 1972 (Rutherford, 1972). An inspirational leader, Miss Rutherford's legacy lives on in those who studied under her, and who in turn have passed on this knowledge. Thank you, Miss Rutherford.
I must also acknowledge the Frances Rutherford Lecture awardees who have come before me; Mary-Anne Boyd (19845), Lyn Shooter (1987), Katy Austin (1990), Jill Gooder (1992), Beth Gordon (1994), Linda Wilson (1996) Anne Christie (1999), Valerie Wright-St Clair (2001), Diane Henare (2003), and Clare Hocking (2005). In the words of Sir Isaac Newton "If I have seen farther, it is by standing on the shoulders of giants" (Lloyd, 2004, para. 8). It is my turn to stand on the shoulders of those who came before me but in turn I also look to those, as yet unnamed, visionaries of the profession who will stand on our shoulders, just as Rutherford (1990) saw that each generation of students stood on the shoulders of the previous ones.
Introduction to the topic for this Frances Rutherford Lecture
As in any good conversation I start with an introduction. My name is Merrolee Penman and I am an occupational therapist who just happens to teach. Having worked at Otago Polytechnic for as long as I have, some of you may think I am an academic, but I beg to differ. The teaching/learning skills that I used everyday as an occupational therapist are just as valuable in my current role, and it is these that I now draw from to create a learning environment; one that enables learning through reading, talking, thinking and doing.
The topic for your learning reflects my passions; occupational therapy and learning. I am focusing on this important area, because since graduating I have been involved in therapists' ongoing learning. This has included organising, developing, evaluating, contributing to, as well as being part of courses, conferences, workshops, seminars, and inservices. More importantly I have been part of many conversations about our learning; snippets of which are given in Figure 1. It is now timely to connect these conversations, to interpret what I hear and see and to offer my findings to the profession. I hope these interpretations will stimulate the profession to engage, connect, converse, and change the way we think about the topic of learning.
Figure 1: Snippets from conversations with therapists 'I'm so excited about Anita coming ... I'm absolutely committed to being there.' 'I'd love to keep going with external supervision but my manager won't pay.' 'How can I get access to the polytechnic library?' 'The course was good--but I really wanted to hear the expert talking more.' 'I'm thinking of coming but I need to get support from my manager.' 'Where do I find the answers to my questions?' 'Postgrad study- I'd like to but I just don't think I can manage it.' 'What can I put as an activity for the objectives on my Continuing Competency Plan?'
Overview of learning
In 2004/5 I was a Flexible Learning Leader in New Zealand (FLLinNZ) and at a presentation I saw a television commercial of engineers building a plane as it was flying. The plane they were building carried passengers going about their in-flight activities of listening to music or reading the paper while stewards went about their tasks. In the advertisement the engineers described why they loved their job. They talked about the challenges they faced including the cold temperatures, the wind and the birds saying 'you never know what you might come across'. Their satisfaction comes from the belief that they were building a dream for the passengers. "I get a lot of thanks up here" they say (EDS, n.d.).
In watching the commercial, I compared our work with theirs. I saw the engineers build the plane, and getting the passengers to where they want to be. As Dickson (2003) notes we work with people ensuring they have somewhere to go and something to do, assisting them to acquire the skills, knowledge, or confidence to build or rebuild their lives. To do this well we draw on a knowledge base which I liken to the plane in the commercial. In entering an occupational therapy programme, we have an idea of the plane, which we begin to build through each learning experience we have. When we graduate we can use the 'plane' to assist our clients. As they learn to dress themselves, to manage their pain, or to meet the challenge of creating something, they are learning and so are we; filling in the gaps by adding to, or tinkering with, to reshape our 'plane', but how do we do this? It was the conversations that I had that led me to the need to understand why we choose the learning experiences we do?
Defining learning--the what and the how
To start I needed to define learning. Learning is very much part of our everyday language, therefore it is not surprising that few stop to define the term before talking about how it is we learn or what we need to learn.
Stop now and write your definition of the word learning
I think you will find that learning is not difficult to define; now compare your definition with those I found. Billett (2004) states that "The concept of learning can been understood as permanent or semi-permanent changes in how individuals think and act" (p 314). Billet's definition focuses on the outcome of learning, whereas others suggest that learning is the "acquisition and development of memories and behaviours, including skills, knowledge, understanding, values, and wisdom. It is the goal of education, and the product of experience" (Wikipedia, 2007, para. 1). Siemens (2005a) in quotingVaill (1996) reminds us of the everyday nature of learning; "learning must be a way of being--an ongoing set of attitudes and actions by individuals and groups that they employ to try to keep abreast of the surprising, novel, messy, obtrusive, recurring events" (para. 1). Learning then is more than the mere execution of a process or task, for example attendance at a seminar or reading a journal article. Rather it is the minute change in what we do or think that occurs in response to a situation or an event.Your definition will have some or all of the above concepts. Having defined learning the next question is; how do we learn?
What are all the different ways you learn to be a better' occupational therapist?
When I ask occupational therapists how they learn the following list often emerges: doing, talking, experimenting, observing, working with others, teaching, reading, working it out for myself or listening to someone else. Many of these are doing words, but this is not surprising given that we are a profession that is about enabling people to do. However, it is not enough to know about all the ways we learn, we also need to identify the ways that ensure the 'best' learning for the individual. This is important to ask as it is these ways that assist us to change how we do what we do, or what we think or what we now value.
Pause to reflect which of the ways you have listed provide you with the most valuable learning?
Why did I ask you to complete this task? I hope that it will give you insight into the ways of learning you value the most, and I will ask you to come back to this list again later. What ways of learning do we value? Having identified your own ways, now consider the scenarios given in Figures 2-4. Please respond to the questions before moving on to the next scenario
Figure 2: Scenarios of therapists talking. Scene 1: Miriam and Jane are sitting in their office. Miriam has her diary open and is checking what Jane will be doing tomorrow. Jane has a large pile of files on her desk and is about to open her email on the computer. Miriam: Jane are you still ok for tomorrow? Jane: (with frown on her face) No I'm not going now Miriam: Why not? You have been talking about it very positively Jane: Oh ... I'm just so busy-I've got three reports to finish, an application for funding to get in, and I've got a backlog of calls and emails to deal with--I just don't know whether I'm coming or going at the moment. I can't afford the time away from my clients.
Are Miriam and Jane are talking about Jane's attendance at conference, Jane's next supervision session or the upcoming special interest group meeting?
Figure 3: Scenarios of therapists talking. Scene 2: Jane and Miriam are having a coffee together in the staff room. It's been a long morning, and they are about to have a quick bite before heading out in different directions for the visits in the afternoon. Jane: I've heard that James is going to run the strengths model workshop in Wellington this year. Miriam: (perks up) Really ... I've got to go--I hear he is so good! Jane: Yes I went to the last one--it was really stimulating ... But I think it will be even better as I've heard he has just finished writing up the last trial where they used the strengths model. Miriam: great-even more reason to go ... but how much is it? Jane: oh.. I think about $200 a day. Miriam: (looks downhearted) That much? But then it would be good to hear him talk--I'll just have to find a way of convincing the boss to pay!
Is James the local expert clinician, the international expert or the local academic?
Figure 4: Scenarios of therapists talking. Scene 3: Miriam walks into the office after a busy afternoon on her visits and is surprised to find Jane at her desk, intent on something she is writing in a journal. Miriam: What are you doing Jane? Jane: I'm mulling over what I heard today Miriam: Sounds like it was interesting? Jane: Absolutely--I learnt so much Miriam: Really--why was that? Jane: Well it's hard to put into words, but the experience made me look at things from another perspective--one I had never thought of--so I'm starting to replan my next sessions --I think it will be quite different from now on.
Where has Jane learnt to consider another perspective? Is it from working with a client, discussion in a team meeting or attending a seminar?
Consider your answers. For each choice you made, what does this tell you about the learning experiences you value? It is likely you selected the option which reflects the ways of learning you value, or the opportunities available to you. While I won't know your answers, I have observed the actions of our profession and have the following interpretations which I offer for your reflection.
We say we value learning through doing, and you may have included this on your list of ways of learning, but our actions suggest that we find listening to the expert more valuable. For instance; why do we make sure we attend workshops, but find it hard to reflect on our practice by discussing with others what we have learnt? In valuing learning by listening, over learning by doing--why do we value what the expert has to say? More importantly, why value the international expert over our own experts? For example, why until this year (2006) has the Frances Rutherford Lecture Award been placed on the second day with an international keynote speaker giving the conference opening speech? For me, this action suggests that the international speaker is seen as being better equipped to open our biennial conference than the person our profession has selected to receive the honour of the Frances Rutherford Award. Why is there a trend to invite international occupational therapists, or non-occupational therapist experts to speak? Look at any recent conference proceedings and it is likely that the invited Aotearoa/New Zealand occupational therapist(s) are in the minority. While it is important to hear from colleagues outside of our profession, and outside of New Zealand, does this mean that we think our own members of the profession have less to offer?
This question can also be asked on behalf of the recipients of the FRI A. Each individual has offered insightful presentations. What has happened to the thoughts Valerie Wright St-Clair (2001) had on caring, or Diane Henare (2003) on the loss and regaining of identity, or Jill Gooder (1992) on the unique role of occupational therapy? Did we invite them to conduct a workshop or seminar where we could further debate their ideas, or were their articles consigned to journals which an undergraduate or postgraduate student might cite in the future in an
assignment or thesis?
Other ways of learning include supervision, yet when we are busy we cancel or postpone the session. What does this action say about what we value about the learning that comes through supervision? We say we value supervision offered externally, but when the employer refuses to fund this option, we accept and find an alternative from within our organisation, even though this option might not best meet our needs. I suggest we do this because we have difficulty thinking of supervision as a learning experience, whereas courses, workshops and seminars are clearly learning experiences and therefore easier for us to justify attendance and financial support from our managers.
I find it interesting to look at the financial investment for supervision, often considered to be an informal learning experience compared with attending a conference, a formal learning experience. Table 1 compares the estimated costs of supervision for a year compared with the estimated costs of attending a three day conference held in a city about a one hour flight away.
Which provides more value for money? The ten hours of supervision provides opportunities for individualised reflection on practice, considering issues from different perspectives, meeting the specific learning needs of the occupational therapist. In comparison, the conference provides 21 hours of presentations, (some as short as 15 minutes) focused on a wide range of topics which are not always all relevant to the specific needs of the therapist. Both experiences provide valuable learning, but is one more valuable? Our actions would suggest so, in that we often argue convincingly to attend a conference (which costs more) but are less able to argue for external supervision. This action suggests that we believe we gain more from listening to an expert, than we can from reflecting on our practice, but is this correct?
I do wonder too why we seem to value what we are told or read compared with the learning gained through discussions. We have electronic and real forums for discussion, but what happens to the discussions and how are they used to shape our practice? A specific example is where people ask for advice on a listserv, ideas are contributed by others; the person says thank you and no more is said or heard. Why does this person not return to the group (real or online) to report the usefulness of the information for their practice and thus inform others' learning? You may not agree with my interpretations of our actions, but it seems that we value:
* that which we have paid for in dollars, especially those our employer pays for
* that which is given to us by the expert. We prefer to listen to the experts and give more value to those who are leaders in occupational therapy in countries other than our own, or are from outside our profession.
* that which is formally organised, hierarchical, structured and produced, even if it doesn't fully meet our needs.
Stop now and consider what you have recently chosen to do to meet your learning needs and why? Now compare this list with your definition of learning, and the list of most valued learning experiences.
Do your recent choices for meeting your learning needs match with the types of learning experiences that you said were most valuable--or do you have a mismatch?
Why do I ask about the match? Although our profession describes learning similar to that of Siemens (2006) who states that professional learning happens "outside of courses through communities, informal conversation, personal research, reflection, and other network forming activities" (p 3), our actions speak otherwise. While I don't have data to support my impressions, I do believe there is a mismatch between what we say we value as a learning experience compared with what we seek. Why might this be?
What does the literature say?
Like any good academic my first thought was to turn to the literature to see if the answers existed. Jesse (Penman, 2005a, 2005b, 2005c) offered to help search the occupational therapy literature as she was very much challenged around her notions of learning last year. Figure 5 shows the conversation we had after Jesse had completed her search
As guidance from the occupational therapy literature about the best ways to learn is sparse, a search of the educational literature was undertaken starting with the defining of professional development. Professional development is often described as an informational update typically consisting of:
Lecture courses ranging from a single hour to several days [where] a single instructor lectures and lectures and lectures fairly large groups of ... people, who sit for long hours in audiovisual twilight, making never-to-be-read notes at rows of narrow tables covered with green baize and appointed with fat binders and sweating pitchers of ice water (Nowlen as cited in Davidoff 1997, p. 15)
Does this description sound familiar, and would you be surprised to know that many criticise this picture as being largely ineffective in improving the performance of professionals?
Lorrigan (n.d.) finds defining professional development complex and states that it is many things including improving knowledge, skills and performance in ways that are both formal and informal, carried out by the individual or the employer, with the aim of extending the personal or general education of the individual. Professional development then is not what happens at a particular event, as outlined by Nowlen (as cited in Davidoff, 1997), but is in fact a process that stimulates and promotes the ongoing learning of the individual.
Having defined professional development, why is it that we appear to place more value on the type of professional development described by Nowlen (as cited in Davidoff, 1997)? To help answer this question I turned to Barbara Daley (1999) who has investigated how professionals (social workers, lawyers, adult educators and nurses) learn. Daley (1999) explored whether new graduate or novice nurses learn differently to expert learners. As I read how nurses learn, I started replacing the word nurses with the word profession to see if this could help to explain the actions of our profession.
Daley (1999) noted that novice learners believe that every problem has a single solution. These learners learn the rules and procedures to follow, and where this is not available, then they spend time "seeking public knowledge outside themselves for the answers to their problems" (Butler, 1996, p. 278). Novices are afraid of using trial and error as they fear making mistakes, and can be impatient with "complex answers or invitations to think the problem out for themselves" (Butler, 1996, p. 278), which may, as Daley (1999) suggests, be because novice learners tend to focus on accumulating information and waiting for others to direct their learning.
In comparison Daley and Mott (2000) note that expert learners have a well-developed awareness of their own learning process, knowing not only how they learn but how to teach themselves (Daley, 1999). Experts know how to learn from their experiences in practice (Dirkx, Gilley, & Gilley, 2004;Yielder, 2004) and most importantly how to construct a knowledge base. They have "an enormous background of personal practical knowledge" (Butler, 1996, p. 279) to draw from which is continually renewed by "the uniqueness of encountered events" (Butler, 1996, p. 279).
Could the work of Butler (1996) and Daley (1999) be used to explain the actions of our profession? We say that we learn through doing, sharing, and reflecting in order to build on our personal practical knowledge, all of which are behaviours of expert learners. Yet when asked about our recent learning experiences, we identify activities such as going to courses, seminars, workshops, journal clubs or ongoing study, all actions of novice learners seeking the answers from experts. Do we behave in this way because we are in fact novice learners in a relatively young profession? After all, the first New Zealand trained occupational therapists started work only 65 years ago with our knowledge base informed in the main by our international colleagues. Has this taught us to look to the expert as we just need to find the person who has the 'right answer'? Perhaps we act this way as it is easier to be given what we think we need than to find it ourselves, or it may be that we don't trust our ability to construct a knowledge base in the ways described by Daley (1999), Daley and Mott (2000) and Butler (1996). While each of these options are possible, I believe we act in the way we do because we have become a little stuck in the way we think about learning, and it is time to look at professional development differently.
Looking for guidance, I turned to the educational literature. Initially educational theorists drew from the behavioural and cognitive theories to underpin the design of learning experiences and selection of teaching strategies which were directed to the transmission of information (Siemens, 2005b). Siemens (2005a) describes two types of learning that come from these theories 'know-how' and 'know-what'. 'Know-how' is the knowledge of how to perform some task being used to encompass learning experiences such as seminars or workshops that focus on the transmission of knowledge or skills (Siemens, 2006). Examples may include learning the skills of evidence-based practice, or learning to administer the Assessment of Motor and Process Skills, or learning how to provide good supervision for your colleagues.
'Know-what' (Siemens, 2005a) is factual knowledge such as the concepts of a new theory, or the signs and symptoms of a specific disorder, or the principles of the International Classification of Functioning, Disability and Health (ICF), which may be offered in a workshop or seminar, as part of a conference presentation, or sourced by reading a journal article.
Irrespective of the theory used (i.e. behavioural or cognitive) we either listen to the expert and then use the information; or watch the expert working and in turn practice on each other before practicing on clients, but always under the watchful eye of the expert. Our goal in attending is to hear or see the expert describing how we should 'do' occupational therapy. Once we have been told what we should do, and seen it in action, then we will know how to put the new ideas into practice. However, studies (Andersen, 2001; Daley, 2000; Davis et al., 1999; Rappolt & Tassone, 2002) have suggested that these types of learning experiences may not be the most effective in terms of leading to significant changes to our practice.
While the process of transmission of knowledge and skills from expert to novice is well embedded in our professional development, other theories have been proposed, for example Vygotsky's theory of social constructivism (McInerney & McInerney, 2006). Vygotsky suggested that learning is not given (transmitted) but instead is constructed by the learner through processes such as reflection (Siemens, 2005b) where new information is linked with past experiences and is adjusted for the individual's context (Daley, 1999; 2000). An example: listening to a presenter you become aware the information is not new, in fact it reminds you of something you already know. Immersed in the connections you are making, you suddenly realise the presenter has moved on four PowerPoint slides and you've missed the rest. In connecting with the material you are actively engaging in the process of 'constructing', meshing what you know with the new concepts being presented, in relation to the context in which you intend to apply the new learning.
While reflection is important, social constructivists believe that learning occurs more effectively through discussion with others as viewpoints are aired, discussed and debated (Daley, 2000; Siemens, 2005b) which enables the construction of new understandings. A good example is the experience I had when involved in developing the New Zealand Association of Occupational Therapists Position Statement on Occupational Therapy in Educational Contexts (New Zealand Association of Occupational Therapists, 2003). A group of us came together talked, read, debated, agreed and then disagreed, constructing a position statement that certainly drew from the international literature but clearly reflecting our New Zealand practices. More integrated learning occurred for me that day than any amount of solitary reading of the literature would have achieved.
You will also have examples. Think about the challenging circumstance that has you heading to your nearest colleague saying 'you'll never believe what happened to me today'. You go on to describe the situation, your colleague asks questions, or shares a similar story of their own, or suggests who you might talk to. Or, you might find yourself engrossed in an in-depth discussion from which you both go away thanking each other for listening. Together you have constructed your understandings of the issue in question, both learning but in different ways. This situation is exactly what led to the development of the Kawa Model (Iwama, 2006) which came about because a group of Japanese occupational therapists explained their inability to understand the notion of 'self' in the Model of Human Occupation. The need for an occupational therapy model relevant to the Japanese culture was identified, and created by practitioners collaborating with an academic, using the processes of discussion and debate. Social constructivism is about the learning that occurs through the process of deeply probing the meaning of experiences in our lives, sharing this with others and together co-constructing ones' own knowledge (Daley, 2000).
Most educators agree that social constructivism alone doesn't completely explain how learning occurs. Another relevant theory for professional development is that of situated cognition (Brown, Collins, & Duguid, 1989) which suggests that more effective learning occurs when it comes from, or is situated in the context of a real situation. Supporters (Billett, 2001, 2004; Brown et al., 1989) of situated cognition state that in the past knowledge has been treated as something that is self-sufficient, or independent of the situations in which it is learned and used. Think about the first time you heard about the Model of Human Occupation (Kielhofner, 2002), or even occupational justice (Wilcock, 2006) Were you able to understand it on your first hearing or reading? Perhaps not, as it may have been presented as a body of knowledge to learn with little opportunity for application. A practical application of situated cognition in our profession is that of fieldwork, where students "learn and practise in a real life setting" (Mulholland & Derdall, 2005, p. 28) the concrete skills required of an effective practitioner (Cohn, 1989). Students value fieldwork especially where they have had 'hands-on' experiences which enable the development of skills and confidence with 'real' people (Johnson, Koenig, Piersol, Santalucia, & Wachter-Schutz, 2006).
The theories of social constructivism and situated cognition are helpful in that they remind us that learning is an everyday social event with knowledge being socially constructed by the group in the situation for which it is needed. These theories, as Daley (2000) notes, assist us to understand how "professionals acquire knowledge, how they make use of their experiences, and how they learn through their practice" (p 36). However, there are also theories of learning which explore how we construct our understandings of a 'some thing' and through this process we are changed.
Mezirow (1999) recognised the transformation that can occur as a result of an everyday event. He argued that learning occurs in part because we "transform our frames of reference through critical reflection on the assumptions upon which our interpretations, beliefs, and habits of mind or points of view are based" (Mezirow, 1997, p.7).
Practitioners acquire information, but then change their understanding of that information based on experience which through the process has us questioning our assumptions. As a young therapist working with families and their children I knew that while I could facilitate some change in a one hour session with a child, this would not bring about long-lasting change without the full implementation of home programmes. I held dear to this idea until I had children. Being a full-time 'at home' mum I remember after one very particularly busy day with two preschoolers, collapsing on the couch. For some reason my mind leaped to the thought of home programmes and with that a rather large twinge of guilt hit me. I remembered how much I had impressed on the parents the importance of the home programmes, and looking at my own experience that day wondered how would I ever have fitted in home programmes? The experience of being a mother significantly transformed my understandings of what might be expected of parents.
Take a moment to write down an example of when your understanding of an issue changed as a result of a significant experience. Did your process reflect Mezirow's definition?
Learning then is an everyday social event with knowledge being socially constructed by the individual or group at the time it is required. Mezirow (1997) sums up learning as a process that occurs "through critical reflection of assumptions, validating contested beliefs through discourse, taking action on one's reflective insight, and critically assessing it [learning] " (p. 11).
An emergent theory of learning
Educational theorists have questioned the need for new theories to assist in explaining the emerging trends in learning. Siemens (2005a) identifies some of these trends as follows: many people will have more than one career over the duration of their working life; increasing recognition of the value of informal learning that occurs through our personal and work lives; the knowledge explosion; and a move to plan for lifelong learning (College of Occupational Therapists, 2004). In order to adapt to the newer trends, Siemens suggests that 'know-how' and 'know-what' is being supplemented with 'know-where' or "the understanding of where to find knowledge needed" (para. 11) calling this learning theory connectivism. Siemens suggests that we should not try to learn more, more quickly, but instead focus our energies on 'knowing-where'. In knowing-where, we know where to find what it is we need to know using our networks. Within our networks we co-construct our understandings by drawing from our real-life contexts. In doing so, Siemens suggests that the knowledge created through this process provides greater returns than the seeking of the understanding of one concept. The notion of connectivism is explained in Karen Stephenson's (n.d.) statement that:
Experience has long been considered the best teacher of knowledge. Since we cannot experience everything, other people's experiences, and hence other people, become the surrogate for knowledge. 'I store my knowledge in my friends' is an axiom for collecting knowledge through collecting people (para. 2).
Check back to your list of most valuable learning activities. Did you list any activities which are about sharing with colleagues as described by Karen Stephenson (n.d.)? Research on occupational therapists and their approach to learning appears to support this with Rappolt and Tassone (2002) finding that "three-quarters of the participants, from all levels of experience and practice contexts, reported that informal consultations with peers were their first-line educational resource" (p 173).
In short, indications from the educational literature would suggest that learning is more than just attending and passively 'soaking up' information delivered by the experts. Learning is an active process that occurs through talking and listening, sharing and using a range of resources, reflecting and discussing and at a time that the new learning is required and the person is ready to learn (Andersen, 2001). I'm sure that this does not feel new to you, in fact our profession is one that is grounded in learning through the doing of an activity. If we know this already about the people we provide a service for, then why do we behave the way we do in relation to our own ongoing learning? I believe that we do know something about learning, and we are capable of changing how we approach learning.
We have familiar ways of learning including courses, conferences, seminars/workshops, clinical workshops, postgraduate study, or journal clubs which are mainly the expert telling us what we need to know. These learning experiences provide the basis for the 'know how's' and the 'know what's' (Siemens, 2005b) and can be the source of the 'know where's'. But could we use these activities more effectively for our professional learning, ensuring that events allow for the interaction, the connecting and the opportunity to shape the knowledge according to our context?
We have ways of connecting that we don't use for learning, because we don't necessarily see these as learning experiences. These include the informal learning experiences referred to by Billett (2001; 2004) such as conversations over the coffee break, special interest groups, Local Area Networks (LAN), supervision/mentoring; the morning/afternoon teas at the workshops; mailing lists and other aspects of the internet that we don't yet use. These are all learning opportunities, and the internet provides us with a wide range of resources through which we can connect to further our learning. How might this look?
Jesse's story is presented here as an example of how one occupational therapist in a small region has used technology effectively to support her learning.
Jesse attends the 2006 New Zealand Association of Occupational Therapists National Conference where she hears Michael Iwama speak about the Kawa Model (Iwama, 2006). Jesse has just moved into a new practice area where the services users have ongoing needs. The metaphor of the river of life resonates strongly with her, and her colleague sitting with her. They go off to morning tea talking about how exciting the ideas are, and find themselves standing in line with Michael who is able to answer some of their questions. Michael encourages them to visit the Kawa Model website' and to contribute. Jesse, having committed to take away something from the conference, makes sure she takes the time to visit Michael's site. Here she finds Michael's blog and a wiki where he explains how the Treaty of Waitangi has shaped some of his understandings of cultural difference. Jesse realises that this is something that she can contribute to. With a bit of trepidation, she adds a small bit about the notion of partnership from her perspective. As Jesse does this she realises that she needs to better understand Te Whare Tapa Wha (Durie, 1994).
Jesse spends the next few months meeting with the Maori health team once a week to talk about well-being from a Maori perspective. As they go along, Jesse starts to better understand the information that she vaguely remembered learning in her undergraduate programme. In supervision, Jesse talks about her learning and with her supervisor, creates a mindmap which they add to each session. Different ideas about views of health and wellbeing start to become consolidated for Jesse through these discussions.
Feeling more confident, Jesse takes these ideas back to the Kawa Model site--and discovers that Michael has set up a Skypp' conference for the next week. With some trepidation she downloads the software for Skype, and dials up at the right point. There are therapists online from Sweden, the United Kingdom, Australia and Japan. Jesse is the only one from New Zealand, but as the others grapple with the notion of cultural safety, Jesse realises that she has quite a bit to offer and responds more in the conversation. At the end of the one hour discussion Michael invites Jesse to lead the next Skype conference. Jesse tries to get out of it (after all what does she know about the Kawa Model) but the others encourage her to describe the service she is working in and how she applies the model and so she agrees.
Jesse knows that the discussion has been recorded and with a bit of assistance from a friend, she downloads the recording to a CD and takes it along to the next LAN meeting. The therapists there are able to listen to and discuss some of the ideas that come from the audio recording. They contribute some ideas that Jesse then puts into her folder ready for when she leads the next Kawa Model discussion. Jesse also shows the group her Delicious' site (del.icio.us), where she has started putting her bookmarked internet sites. Everyone agrees that this is a great way to easily share what they are finding on the net, and agree to start using it as well.
Buoyed by her new knowledge, and the interest shown by others at the conference, Jesse talks with NZAOT to set up a mailing list that focuses on the Kawa Model. Mailing lists are now more dynamic with people asking questions, and then returning to feed back about the usefulness of the suggestions.
On Jesse's mailing list the group understanding of the culture of occupational therapy practice in Aotearoa/ New Zealand develops as they 'play with' the ideas, testing them out in their own practice areas and then feeding these back to the rest of the group. One of the academics in the group offers to pull together the ideas that are emerging. This gets published in the New Zealand Journal of Occupational Therapy, and with the agreement of the editor, a copy of the article is also posted to a number of sites including the Kawa Model website, with a link to the journal website advertising the journal. The editor is enthusiastic as this is a way of promoting the journal to the international occupational therapy community, and at no cost.
As the year progresses the group finds they start to move past discussion on the Kawa Model to talk about a model for occupational therapy practice in Aotearoa/New Zealand. Activity on the mailing list, the newly created blog' and through meetings at conferences and seminars snowballs. Jesse and her colleagues are amazed at the traffic coming to their electronic sites, interest in culture from their international colleagues is very high. But more importantly to the therapists involved--they feel much more confident in their ability to articulate what is at the heart of occupational therapy practice in Aotearoa/New Zealand.
Having read the story, what do you hear? The story describes how a group of occupational therapists come together because of a common interest. As they are willing to share their ideas, to discuss and to debate, to trial in their practice, to reflect openly and to feedback they grow their knowledge, and in doing so are able to clearly articulate why they do, what they do.
This is all possible because they learn how to use technology to enable this. My question to you is: Apart from grappling with the technology, what would stop you from doing this? How long are you going to wait for the future to arrive?
The future is today
The future is already here. Every tool described in the above story exists. Our profession could make this story become a reality if we chose to look at learning differently. For those of you who say, "I don't like computers", you already know the answer--you can only learn how to master the computer by actually doing it. For those of you who say "I don't have the time", then please consider how much time you give to attending a conference or seminar, and don't forget to include the travel and waiting time. How valuable was the learning you gained at that conference in comparison to the experience Jess describes? For those who say that they don't have the money, the investment is a computer and access to the internet, as the tools are all free. If you are questioning the value of that investment, then you should also consider why it is difficult to invest in yourself.
Reflections on the place of learning in our profession.
I started by stating that I had listened and been part of many conversations. This award has provided me with an opportunity to bring these conversations together, to interpret them with reference to the literature and my own experiences, and in turn to share back my interpretations to you as individuals and to the profession. In concluding, there are some key issues for us all to consider.
Thoughts for this profession
Our profession is one that is grounded in the belief that we learn through doing, but then we value learning that is 'given' to us. I want to be part of a profession that wants to know more about how we learn, a profession where our actions reflect our values and where we focus on finding ways of making learning more effective. What I have proposed in Jesse's story can be the start but there are other actions we can consider.
Our professional journal and newsletter are places where we record our understandings, but both publications are only available to NZAOT members or in the libraries of the tertiary sector and some District Health Boards. The older issues of the journal and OT Insight should be available on the NZAOT website for anyone to access at no cost. I believe the easier the access, the more likely the knowledge will be used by therapists in their practice, as well as readers outside our profession. This rich resource of Aotearoa/New Zealand knowledge should not be reserved to only those with exclusive rights.
The need for Aotearoa/New Zealand based research to articulate what it is we do has been identified by our leaders and researchers (Craig, Robertson, & Milligan, 2004; Paddy, Wright-St. Clair, & Smythe, 2002; Shiri, 2006; Vaughan Jones & Penman, 2004; Wright-St Clair, 2001). I believe that the research is there, but it needs to come out of the libraries and out of the journals and into media we can easily access. These budding theory developers, whether doctoral or masters graduates, or experienced clinicians need to be invited to share their understandings through a range of media from discussions online to workshops at conferences, or providing an audio file that sums up their key findings that we can all listen to. From Auckland to Central Otago, many of us spend much time on the road; we could be listening to our peers as we drive along.
I also have some thoughts for the next conference organising committee. Why don't we follow the lead of the NZAOT Clinical Workshops, with each keynote speaker an Aotearoa/New Zealand occupational therapist capable of raising the challenges, offering solutions grounded in the context of our culture, and inspiring us to move forward? In asking our colleagues to give the keynote presentations, we are saying 'we want to hear from you--you are the ones to inspire us'. Of course we benefit from the knowledge our international colleagues or outsiders to our profession can offer, but I believe we could gain much more if these learned people used learning experiences other than the keynote speech as the means for communicating their knowledge. While the experts can stimulate our thoughts, we also have something to offer. I believe we need to find ways of starting the discussions before the workshop, continuing long afterwards. These conversations are the basis for building knowledge that is situated within our context. The knowledge may come from elsewhere, but needs to be transformed to ensure relevance for the context in which we live and work. This knowledge can then be held up against that which we construct ourselves. In doing so we will increasingly be able to evaluate, critique and challenge the models of practice we use which come from either other cultures such as North America or other disciplines such as psychology or sociology. Just as the Japanese have created the Kawa Model for Japanese practice, I believe that it is timely for Aotearoa/New Zealand occupational therapists to explore our model for practice. We can do this.
Thoughts for the occupational therapists who are academics
Employed in the tertiary sector, we are resource rich but our institutions allow us only to share with enrolled students. We must find other ways of sharing what we know with our colleagues in practice. For example, if all academics made their bookmarks available on del.icio.us, if we created audio files summing up the articles we have written or our latest research, if we shared our thinking-in-progress in blogs, wouldn't the occupational therapy community be the richer for this? Perhaps this is a strategy for bridging the theory-practice divide identified by Taylor, Braveman and Forsyth (2002), and Taylor, Fisher and Kielhofner (2005).
Thoughts for occupational therapists in practice
To draw from Nowlen (cited in Davidoff, 1997) will this conference be another line on your curriculum vitae and a pile of business cards and pens, where you have listened to the experts talking and talking, or will it be a turning point for you? Will you leave conference with a realistic list of tasks to focus on, and more importantly will you 'do' something from that list? The next time you think you are too busy for supervision, will you cancel it or will you stop to think about what that action is saying? Will you join a special interest group? More importantly will you contribute to others' learning by joining in the discussions? If you ask for ideas and then try them in practice, will you make the effort to share your learning with the rest of the group? Will you look around you for the local expert practitioners, and ask them to share their knowledge, and find ways of supporting them to share their ideas across the country? Will you take away the ideas from today about what you find to be valuable learning experiences and will you use these ideas when you next have to justify to your manager why you are seeking support for a particular learning activity?
What do I intend to do differently?
My bookmarked sites are available on delicious (http://del.icio.us/merrolee). I regularly update my blog (http://oteducation.wordpress.com), and other occupational therapy blogs that I regularly read can be found at (http://www.bloglines.com/ public/merrolee)
All of these resources are public and able to be accessed by anyone with a computer and internet access. And do not forget you can just pick up a phone and we can talk.
The gift of the Frances Rutherford Lecture has provided me with the opportunity to connect the many professional conversations I have had the privilege to be part of over the last 25 years. In return I 'gift' back to the profession my interpretations of our understandings of learning. In this gift I have acknowledged the gifts of both Frances Rutherford, and the Frances Rutherford awardees, included concepts of learning and of professional development, and my interpretations of our actions and words which suggest a mismatch. I have also included an overview of educational theories and styles of learning, and a glimpse into what some may see as the future, but which I know can exist today should enough of us get involved. This gift comes wrapped in practical suggestions that are about doing, just as our profession is about doing. As with any gift, it may be put at the back of the cupboard, finally thrown out because it has been found not useful; or may be put away as 'a good thing' brought out to be dusted off from time to time, and one day it will stay out and be used. My hope is that some will welcome the gift, show it to all their friends, and readily put it to good use in their lives.
I ask the profession to accept and use my gift.
He tangata i akona ki to whare Tanga ki to marae tau ana One who has learned in the house and on the marae stands with dignity
(Brougham, 1974 and Kohere, 1951 as cited in Mead & Grove, 2001)
Thank you to my two nominees as well as the FRI A selection panel who had the difficult choice to make. My thanks to Linda Wilson,Trisha Egan, Jackie Herkt, Carolyn Simmons Carlsson, Margi Prisk-Vink, Diane Henare, Yvonne Thomas and Kaye Cheetham who patiently listened to, and contributed many ideas in the development of ideas presented in this paper. Many thanks to my family for supporting me in this endeavour, and special thanks to our daughters Emma and Catherine who successfully portrayed the therapists Miriam and Jane during the conference presentation. But the biggest thanks go to the occupational therapists who engaged me in the conversations that were the catalyst for this topic. Without your conversations this work would not have emerged. I look forward to many more discussions.
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