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Teaching remotely: Navigating uncertainty, the digital divide and social justice in Health Professions Education

This piece was written by Simone Titus and the Learning with Technologies Special Interest Group (SIG). Should you wish to join this SIG, please register here.

We are in the midst of transitioning into remote teaching and learning as a means to mitigate the emergency situation we find ourselves in as a result of the COVID-19 pandemic. Although we have become accustomed the terms ‘blended’, ‘distance’, ‘online’ and ‘e- learning’, the term ‘remote learning’ has gained considerable traction as a ‘new normal’ within the global education discourse. To accommodate this shift, we have rushed to adopt different ways of thinking, doing and designing (or re-designing) curriculum to meet the everchanging demands that this pandemic has placed on us in the academia. As a result, we have become more familiar with applications like Zoom, Google Meet, Microsoft Teams and our university’s Learning Management System (LMS) to ensure that there is minimal disruption to course delivery in response to the COVID-19 crisis.

However, as we transition into remote / online spaces, we need to be mindful and considerate of students’ needs with regard to access. Distance and remote does not mean connectivity, and whilst we are a building our own capacity to accommodate remote teaching and learning, we are called upon to exercise our creativity in a manner that acknowledges the digital, social and economic divide which may prohibit epistemological access for the majority of students in our classes. Since there is no equity in access; when creating online content, we need be cognizant of the decolonial project and our move towards curriculum transformation. At the same time, as academics, we need to remember to be kind to ourselves during these very uncertain time as many of us are probably juggling multiple roles including home-care, childcare, assisting children with schoolwork and also working remotely. Although many of us are accustomed to a face-to-face and/or a blended learning and teaching approach, this moment has catapulted us into delivering online content, in a manner which we have not done before. Whist remote learning may be less than ideal for the development of clinical skills competencies in the health sciences, it does afford us an unique opportunity to reflect on our current practices in search for alternative ways, platforms and applications which may be useful for fit and purpose.

With all of this in mind, let’s start by asking ourselves how might we can possibly replace face-to-face lectures, offer practical instruction, present theoretical content and teach clinical skills components within a community and health sciences curricula?

Below, I offer TEN TIPS FOR LEARNING IN LOCKDOWN- The COVID-19 Edition. These tips are borne out of conversations with other educationist, colleagues, readings from scholars in the field and my own reflections as an academic who is experiencing this collective trauma, and trying my level best to be as productive as I possibly can.

1. BE REALISTIC AND BE CAREFUL: Be realistic about what is possible to teach remotely. For instance, in the health sciences, there is a level of personal contact which is required for students to learn clinical skills, communication skills, empathy, resilience and other essential skills which may not be entirely possible through remote activities. Be clear what should be prioritized in the remote lessons and explore other mechanisms for outcomes which cannot be achieved remotely. Whilst many of you may be quite excited to try new technologies to simulate the clinical environment – HALT! – We are doing the most to deal with this pandemic and like you, students are also dealing with A LOT. Be realistic about your time and the students’ time, access and digital literacy to learn a new technology remotely. This also means that you need to be flexible with deadlines for assessments and offer alternatives for how assignment activities could be completed. This means that you may need to have multiple options for the same assessment activity. With this in mind, prioritize what students need to know and focus on how you can offer this to them using low-tech alternatives. The COVID-19 pandemic has sprouted with many new tech companies and applications offering ‘the best solution’ for remote teaching and learning. Beware that learning design is not a one size fits all approach, even if they offer customized service. Often, some of these applications offer free trial periods but beware of these as they may expose privacy issues for you and your students. Furthermore, these applications might not be context-specific and are not reflective of the transformed curriculum we may envisage.

2. ALL THINGS ARE NOT EQUAL: All things are NOT equal, but as academics, we can try our best to level the playing field. Despite the zero-rated provision, many of your students may not have access to the websites or applications which you would like to use due to not having devices and/or the data to participate in your learning environment. Whilst you may want to use the simulated virtual labs for clinical skills activities, some areas, especially in rural communities and informal settlements, mobile connectivity may be poor. This is further compounded by unequally weighted digital literacies amongst the student population. It is important to acknowledge this when designing learning activities and understanding that many of these factors are out of your control. Thus, perhaps consider low-tech and mobile-friendly activities and think about how your learning activity may look on a mobile device, as many students may have access to a basic smartphone. In an attempt to create access, you could survey your students to ascertain which tools, applications and internet platforms they have access to, and which they would be in agreement using in your course. Remember, these are stressful times for both students and staff and this might not be the ideal time to introduce new platforms which may be complicated to learn and use.

3. BE KIND YOURSELF AND TO YOUR STUDENTS: The current circumstances could not have been anticipated and you may be navigating unchartered territory. As such, there will be many ‘firsts’ for you. Thus, be kind to yourself and take a moment to recognise that you will not know all the ‘ins-and-outs’ of new platforms the first time you use it. It will take time for you and the students master any new application. For them not to feel overwhelmed amid everything else going on, please take care in how you introduce new technologies (if you decide to go this route), express understanding and empathy for their current situation. We all work at a different pace and we need to recognize that the online space allows students to work at a pace they are comfortable in. Lastly, although you are not able to meet students face-to-face, many students may be dealing with anxiety and depression. Let them know that they have your support and refer them to the relevant student support services at your university.

4. CHOOSE ASYNCHRONOUS OVER SYNCHRONOUS APPROACHES. When you are offering a class, it is best to allow students to participate in the activity (e.g. lecture, workshop, seminar, demonstration, simulation etc) in their own time. Students may have other commitments amid this pandemic such as looking after siblings, going shopping for older family members, getting medication etc., which may not allow them to join at a pre-set time. The same can be said for academics. Besides, they might not have a reliable internet connection (or any access to the internet) which may place them at a disadvantage. If however, you have to present something synchronously, then be sure to record the activity so that this can be shared in various forms with those who have not been able to participate when next you meet.

5. BE CREATIVE: Do not rush to do a quick fix as there is no quick and easy solution, and if you think there is, you will do a really bad job of putting your courses online. Take the time to reflect and think how and what your learning environment would look like from the students’ perspective. Your online environment is not going to be perfect the first time, nor the second, nor the third…nor ever. This is an iterative process where you should allow yourself some space to reflect on the learning experience you are trying to offer. To do this you need to understand your students, identify your learning design challenge, share your ideas with colleagues before you develop a prototype, do a quick iteration (and do not be afraid to fail), check what works and implement again…redefine….implement again…and again….and again. This design thinking approach may be used collaboratively and could be used to unlock some of your creativity.

6. SUPPORT STUDENTS WITH DISABILITIES: When shifting your remote learning and teaching activities to the online environment, remember that some of your students may require different support. Please contact student support services to ensure that your content has the required accommodation for students with disabilities. To this point, universal design for learning is advised. For instance, when uploading a video, ensure that there are captions for those who are hearing impaired. This allows them to follow the video whilst reading the captions. At the same time, it caters for students who are visually impaired because there is audio which they can follow.

7. CO-CONSTRUCTION IS KEY: Adopting a student-centred approach may allow students to make collective decisions about their learning. This approach is inclusive and strengthens peer-to-peer and student-lecturer relationships. This does not mean you are abdicating your role as the lecture as you still have full control over your course.

8. LEAN ON THE EXPERTISE AROUND YOU: There is wisdom in the crowd (even though the crowd is dispersed to observe social/physical distancing). There are people at your university, in your library, in your faculty, departments, units and schools who may have ideas for learning design. Some of your colleagues may have even used some of the platforms you would like to explore. Reach out for help. You are not alone in this. If all else fails, contact instructional designers for guidance.

9. TOUCH BASE WITH YOUR TRIBE: Whilst working in academia largely allows for flexibility, however, working remotely may be a new experience for many. Some academics, especially those with young families may have to negotiate space and time due to multiple roles and responsibilities which lockdown has created. This may create anxiety and feelings of depression and therefore it is important to touch base with your work colleagues regularly via your WhatsApp groups, Microsoft Teams or Zoom.

10. Take care of YOU: Whilst working remotely may mean you are constantly online working or engaging with content. Be sure to take care that you are not overwhelmed and bombarded with content (fake and otherwise). Devise a meaningful schedule which will allow you to be as productive as you possibly can be given the circumstances. If, for any reason you are feeling unable to cope, please reach out to the counselling services which may be available at your institution. Self-care is important and you will be in a better position to help others if you are healthy. Remember, this is a shared humanity and we are all in this together.


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