Reculturing Curriculum within a Nursing Context in

Taiwan: An Action Research Approach

This thesis is submitted in fulfilment of the

requirements of the degree of Doctor of Philosophy

School of Nursing Centre for Health Research

Queensland University of Technology

By

Li-Yu Chien RN. BSc (Nursing). MN.

2007

i

Key words: curriculum change, reculturing, nurse education, Taiwan, action research, student-centredness, empowerment.

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Reculturing Curriculum within a Nursing Context in Taiwan: An Action Research Approach

Abstract

The focus of this study is on curriculum change within a nursing institute in

Taiwan where there is a growing demand for reform to nurse education in order to

produce more competent practitioners. I conceptualised a framework to guide the

transformation process in ways that were empowering, sustainable and generative. I

argued that curriculum change also involves the beliefs, customs, attitudes or

expectations of those who participate in the process: essentially it is a reculturing

process. My conceptual framework included notions such as student-centredness,

reculturing, collaborative practices and reflections, personal growth, and professional

development.

A plan of action was developed based on the notions contained in the

conceptual framework and carried out within an Action Research methodology.

Action Research provided the mechanism by which the collaborators explored and

understood their conceptions of teaching and learning and then planned and

implemented action to change the current situation, and evaluate and reflect on the

transformations. Strategies such as personal practical theorising, focus group, critical

debate, and collaborative reflection were used to bring about the curriculum change.

The significance of this study lies in its practical contribution to all aspects of

curriculum making including innovation, planning, implementation and ongoing

review. Although information generated from this study is not generalisable, lessons

learned from it may be utilised by other educational institutes with similar issues and

similar contexts.

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Table of Contents

Chapter 1

The Problem and the Procedure …………………………….. 1

Introduction …………………………………………….…………… 1 Introducing the Focus ……………………………………………… 2 Contextualisation - An Overview …………………….…………. 4 Conceptualisation - An Overview ………………….……………. 6 Methodology and the Action Plan ……………….……………... 10 Significance …………………………………………………..………. 12 My Role in the Collaborative Journey …………………..……. 13

Chapter 2

Contextualising and Conceptualising the Problem …... 16

Introduction ……………………………………………….…………. 16 Contextualising the Problem …………………………………….. 16 Nurse Education Systems in Taiwan …..………………….……… 18 The Nursing Curriculum Guideline ………………………………. 22 The Accreditation Report ………………………………………….. 26 Overview of Nurse Education in Chang Gung Institute of

Technology …………………………………………………………… 27 Reconnaissance: Current Approaches to Teaching and Learning

in CGIT ………………………………….…………………………… 29 The Reconnaissance Survey ……………………………………….. 30 Reflecting on Cultural Influences.….…………………………...…. 35 Reflecting on the Curriculum …………………………………...…. 38 Conceptualising the Problem …………………………………….. 41 The Content of the Change ………………………………………… 43 Student-centred teaching and learning…………...……………. 43 The Process of the Change …………………………………………. 47 Conclusion ……………………………………………………. 57

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Chapter 3

The Methodology and the Action Plan………..……………. 59

Introduction ………………………………………………………….. 59 Determination and Justification ……………………..…..………. 60 Conceptualising the Action Plan………………………………….. 64 Generating and Gathering the Information……………………….. 67 Pre-action Phase: Team Formation ……………….…………… 67 Action Phase 1: Recognising the Need to Change …………….. 69 Action Phase 2: Curriculum Decision Making ………….…….. 73 Action Phase 3: Implementing and Reflecting on the New

Curriculum ………………………………..……………………… 74 Action Phase 4: Evaluating the Collaborative Journey ….……. 75 Organising the Information…………………………………………. 76 Examining and Monitoring the Information …………….………… 78 Summary of the Action Plan ……………………………………… 80 Trustworthiness ……………………………………………………… 81 Ethical Considerations ………………………………………..……. 83 Limitations ……………………………………………………………. 85 Conclusion ……………………………………………….……………. 86

Chapter 4 The Story of the Collaborative Journey Action Pre-Phase and Action Phase 1: Team Formation and Recognising the Need to Change

87

Introduction …………………………………………………………... 87 Action Pre-Phase: Team Formation ……………....……..………… 89 The Introductory Seminar …………………..………….……… 90 Action Phase 1: Recognising the Need to Change …………….…... 93 Introduction …………..………………..…………………………. 93 The 1st Meeting ……………..………..…………………………… 96 The 2nd Meeting ……..……………………………………………. 102 The 3rd Meeting ………..…………………………………………. 106 The 4th Meeting ……………..……………………………………. 110 The 5th Meeting ………………..……………………….…..…... 118 Reflecting on Action Phase 1 ………....…………………………… 119

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Chapter 5 Continuing the Story of the Collaborative Journey Action Phase 2: Curriculum Decision-Making………….... 121 Introduction ……………………………………………………………. 121 The 1st Meeting of Action Phase 2 …………………………………... 121 The 2nd Meeting of Action Phase 2 ………………………………….. 125 The 3rd Meeting of Action Phase 2 …………………………………. 129 The Pre Curriculum Confirmation Meeting ………………...…….. 134 Reflecting on Action Phase 2……….………...……………………. 137

Chapter 6 Continuing the Story of the Collaborative Journey Action Phase 3: Implementing and Reflecting on the New Curriculum……………………………………………………… 139 Introduction …………………………….……….……………………. 139 Pre Implementation Preparation …………………..……………….. 139 Meeting 1- Talking about the 2-Tech PE Curriculum (1)…………. 141 Meeting 2 - Talking about the 2-Tech PE Curriculum (2)………… 151 Meeting 3 - Talking about the 2-Tech PE Curriculum (3)………… 157 Meeting 4 - Talking about the 2-Tech PE Curriculum (4)………… 168 Meeting 5 – Further Development of the Curriculum…………….. 174 Reflecting on Action Phase 3……………………….………………. 180

Chapter 7 Continuing the Story of the Collaborative Journey Action Phase 4: Evaluating the Collaborative Journey 182 Introduction……………………………………………………………. 182 The Evaluation Meeting……………………………………………… 182 Reflecting on Action Phase 4……………………………………….. 193 Concluding the Story of the Collaborative Journey………….. 194

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Chapter 8

My Critical Examination of the Collaborative Journey 196

Introduction …………………………………..………………….…….. 196 My Critical Examination …………………..………………..……… 199 Examining Outcome Validity ……………………………………….. 199 Examining Process Validity …………………………………………. 205 Examining Democratic Validity ………………….…………………. 210 Examining Catalytic Validity ………………….……………………. 214 Examining Dialogic Validity ………………………………………… 219 Conclusion ……………………………………………….……………... 222

Chapter 9 Implications and Value of the Collaborative Journey: Reconstruction and Transformation …………………..…….

225

A Revisit and Introduction ……………………………………..…. 225 The Implications and Value of the Study for the

Collaborative Team and Educators in Similar Contexts ….... 227 The Implications and Value of the Study for CGIT and

Other Similar Contexts ………………………………..………….… 231 Looking Forward …………………………………………………….. 233 Closure ……………………………………………………..…………… 236

Appendices ……………………………………………………………… 239

Appendix A Questionnaires Descriptions …………………………………………… 240

Nurse Educator’s Conception of Teaching and Learning Questionnaire ……………………………………………………........ 240

Revised Two-Factor Study Process Questionnaire (R-SPQ-2F) ….. 241 Appendix B-1.1

Nurse Educator’s Conception of Teaching and Learning Questionnaire (English) …………………………………….………….. 243

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Appendix B-1.2 Nurse Educator’s Conception of Teaching and Learning Questionnaire (Chinese) ………………………………………….……. 245

Appendix B-2.1 The Revised Two-factor Study Process Questionnaire (English) …… 248

Appendix B-2.2 The Revised Two-factor Study Process Questionnaire (Chinese) …… 249

Appendix C-1 Ethical Clearance: Permission from QUT Human Research Ethics Committee ……………………………………………………………… 250

Appendix C-2 Ethical Clearance: Permission from CGIT ………………………….. 251

Appendix D-1.1 The Reconnaissance Survey Information Sheet for Conception of Teaching and Learning (English) …………………………………… 252

Appendix D-1.2 The Reconnaissance Survey Information Sheet for Conception of Teaching and Learning (Chinese) …………………………………… 253

Appendix D-2.1 The Reconnaissance Survey Information Sheet for R-SPQ-2F (English) ………………………………………………………………… 254

Appendix D-2.2 The Reconnaissance Survey Information Sheet for R-SPQ-2F

(Chinese) ……………………………………………………......................

255 Appendix D-3.1

The Research Information Sheet (English) …………………….……. 256 Appendix D-3.2

The Research Information Sheet (Chinese) ………………….………. 257 Appendix D-4.1

Research Consent Form (English) ………………………….………… 258 Appendix D-4.2

Research Consent Form (Chinese) …………………………………… 259 Appendix E

Introductory Seminar Invitation Card …………………………..…… 260 Appendix F

Pre reading Information: the Revised Bloom’s Taxonomy …………. 261 Appendix G-1

Unit Details-1: for Theory or Lecture Session ……………………….. 264

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Appendix G-2 Unit Details-2: for Practice or Laboratory Session ……………….… 268

Appendix H The Attendance Chart ………………………………………………….. 271

Appendix I Questionnaire Permission to Adapt and Use (Lecturer’s Conception

of Teaching and Learning) ………………………………......................... 272 Appendix J

Questionnaire Permission to Use (R-SPQ-2F) ………………………... 273

Reference List …….……………………………………………………. 274

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Illustration and Diagrams

Table 1 Nurse Education Systems in Taiwan ……………………………………… 19 Table 2 Two Levels of PE Units Provided in CGIT in 2005 ….…………………… 67 Table 3 The Action Phases and the 16 Meetings ………………………………….. 88 Figure 1 Current Nurse Education Systems and Student Advancement in Taiwan 20 Figure 2 The Conceptual Framework of the Study ………………………………… 56

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Statement of Original Authorship

The work contained in this thesis has not been previously submitted to meet

requirements for an award at this or any other higher education institution. To the

best of my knowledge and belief, the thesis contains no material previously published

or written by another person except where due reference is made.

Signature

Date

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Acknowledgement

I am sincerely grateful to my principal supervisor, Dr. Helen Chapman, who brought

me into the world of action research, offering her encouragement and support,

putting her faith in me and my work, and being my critical friend throughout my

PhD journey. Her encouragement, support and faith are significant in the completion

of the study. I also thank my associate supervisors, Dr. Ruth Elder and Dr. Robert

Thornton, who gave generously of their time and knowledge to my study.

I thank, in particular, those colleagues in Chang Gung Institute of Technology who

worked with me during the collaborative journey. I am thankful to be able to work

with and learn from them. Although there is some distance to go, it has been a great

and enjoyable journey.

I am also grateful to the many people, too numerous to mention here by name, who

have offered their support and encouragement on my study in various ways. Some

presented me with warm support; others prompted me to think in different ways.

They all served as the motivating power that enabled me to refine my study.

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CHAPTER 1

The Problem and the Procedure Introduction

This preliminary chapter is intended as a preamble: a foreshadowing of the

more extended details that follow in ensuing chapters. This chapter introduces the

focus of the study and identifies the problem and its importance. It briefly outlines

the context, especially the contextual aspects that impact on the problem. The

conceptual notions and the methodology that guided the study are delineated and

brief reference is made to the critical examination of the information that was

generated, gathered, organised, and monitored throughout the research journey. The

significance of the study is addressed before concluding the chapter with a brief

discussion of the various roles I have undertaken during the research journey.

This study was guided by Action Research methodology - a contextualised

methodological approach (Mock, 1999) and the thesis document is written in first

person which enabled me articulate the research process in narrative form - an

appropriate way of communicating within Action Research (Chapman, 1996).

Writing in first person also allows me to confirm the impression that I took part in

this study – a study with others not on others. According to the American

Psychological Association (APA) style manual (American Psychological Association,

2005), “inappropriately or illogically attributing action in an effort to be objective

can be misleading” (p. 7) and “may give the impression that you did not take part in

your own study”. This supports the claim by Emihovich (1995) that hiding behind

the “sterile prose of academe” may result in a situation where “your disembodied

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voice as author was no longer connected to your research” (p. 42). The use of my

own voice to present this thesis document in terms of my statements, beliefs and

opinions is therefore intentional and without apology.

Introducing the Focus

The focus of the study is on collaborative efforts among nurse educators to

bring about curriculum change within a nursing context in Taiwan. In keeping with

global trends throughout the world, Taiwan institutes of learning, including nursing,

are presently facing extensive educational reform. The systematic curriculum reform

has brought challenges to all schools of nursing in Taiwan, and these challenges

underpin the focus of this study.

There is a growing movement away from teacher-centred teaching and learning

towards student-centred teaching and learning within Taiwanese nurse education

(Hsu, 2001; Lee, Lu, Yen, & Lin, 2004; Lu, 2004; Mu & Shiau, 2002). However,

teaching and learning in the majority of nursing classrooms in Taiwan is still

dominated by teacher-centred approaches (Lee-Hsieh, Kuo, & Tsai, 2004). The

existence of the long cherished and established teacher-centred, content-driven

teaching and learning culture has impacted on the development of student

competencies and their application of theoretical learning to the clinical setting.

Problems of unfit-for-practice quality and rigid curriculum design have been

identified by nursing critics such as Hsu (2005), Lee et al. (2004), Lu (2004), and

Yang (2005). Essentially, the critiques identify a lack of appropriate development in

nursing curricula to educate students to be problem solvers and critical and

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independent thinkers. This deficit has seriously influenced student performances

related to changing health care practices (Lee et al., 2004). I have been a lecturer in a

nursing institute (Chang Gung Institute of Technology, CGIT) in Taiwan for several

years, and the critiques confirm my own teaching realities.

I have been teaching students in both classroom and clinical settings. In the

classroom, I usually teach in the unit Physical Examination and Health Assessment.

The aim of this unit is to enable nursing students to collect information from their

patients, integrate the information collected and assess patients’ health problems and

needs. When I facilitated student learning in the clinical setting however, I was often

frustrated and concerned by the inability of many students to apply their theoretical

learning about fundamental nursing skills such as Physical Examination and Health

Assessment to the clinical setting. There were of course, outstanding students who

were independent and required little facilitation. However, over the period of my

teaching the increasing occurrence of incompetency by students on clinical

placement caused my concerns to heighten. My colleagues reinforced and supported

my concerns. Based on the critiques and concerns within the specific focus and

context, I identified the following research problem:

The curriculum does not adequately facilitate the development of generic and professional competencies in students of nursing in Taiwan.

The research problem led me to construct the following research question:

What changes to the nursing curriculum will better facilitate the development of core generic and professional competencies in students; and what sort of strategies need to be incorporated into the curriculum change process so that transformations are empowering, sustainable and generative?

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Having identified the problem, I elaborated the context in which my study takes

place. I looked at political, academic and practical aspects of nurse education such as

nursing curriculum reform documents, the structure of nurse educational systems in

Taiwan, and some difficulties emerging in my teaching workplace - Chang Gung

Institute of Technology (CGIT). I also conducted a reconnaissance survey in CGIT in

order to confirm those aspects of the context which caused the problem to be a

problem. A brief overview of my contextual considerations is now provided.

Contextualisation - An Overview

Nurse education in Taiwan is facing extensive educational change. The Ministry

of Education (MOE) in Taiwan claims that traditional nursing curricula adversely

impact student learning outcomes and their employment (Curriculum Research and

Development Centre in Allied Health Education, 2004a). The MOE subsequently

launched an innovative program for curriculum reform in order to construct a

coherent, united and appropriate curriculum. A set of generic and professional

competencies have been constructed that nursing graduates in Taiwan are required to

possess. The generic competencies include effective communication, rational

thinking and judgement, life-long learning, respect for different cultures and lives,

capacity to integrate knowledge, and ability to broaden the international scope of

nursing practice (Curriculum Research and Development Centre in Allied Health

Education, 2004a). Professional nursing competencies include delivering appropriate

and independent nursing care, evaluating nursing care outcomes, proposing better

nursing care plans, acting effectively in emergency and/or changing circumstances,

and translating the latest research findings into patient care (Curriculum Research

and Development Centre in Allied Health Education, 2004a).

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The MOE also indicated, through the School Accreditation Report, that there

was a need for the Department of Nursing in CGIT to devote attention to the

improvement of the whole nursing curriculum (Ministry of Education, 2005a). The

Report highlighted the need for the nursing faculty to improve teaching and learning

practices and strategies and suggested faculty strengthen nursing students’

professional competencies as well as develop appropriate curricula for different

levels of nursing students (Ministry of Education, 2005a). It was clear from the

Accreditation Report that curriculum was the major problem of nurse education in

the school.

In order to identify and examine current approaches to teaching and learning in

nursing at CGIT I conducted two surveys. Nurse educators were surveyed using

Nurse Educator’s Conception of Teaching and Learning Questionnaire (modified and

translated from Gow & Kember, 1993; Kember & Gow, 1994); and the 2-year

technical nursing students’ approaches to learning were surveyed using the Revised

Two-factor Study Process Questionnaire (R-SPQ-2F, developed by Biggs, Kember,

& Leung, 2001 and translated into Chinese by Leung & Chan, 2001). The results of

the survey of conceptions of teaching and learning show that nurse educators in

CGIT who participated in the survey believed that facilitating student learning is an

important teaching role, however, they spent more time standing up and giving

information in the classroom rather than encouraging active learning. On the other

hand, the results of the survey of student learning approaches revealed that

participating students understood the relationship between learning satisfaction and

effort made, however, they only paid attention to what was specifically set. One

student wrote a comment on the back of the questionnaire, claiming that she could

only learn by rote because of the heavy study workloads in CGIT. The results of

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these surveys supported problematic teaching and learning within the school. These

contextual considerations formed the background to my conceptualisations of a way

forward.

Conceptualisation - An Overview

In order to conceptualise appropriate and acceptable transformations to nurse

education, I looked into the literature of educational change. Authors such as Fullan

(1993; 1998; 1999; 2001a; 2001b; 2003; 2005), Fullan and Hargreaves (1991; 1992),

Grundy (1987; 1995), Hargreaves (1994; 1995), Hargreaves, Earl, Moore, and

Manning (2001), Hargreaves and Fink (2000; 2004; 2005; 2006), Kember (1997a;

1997b; 2000a; 2000b), Kember and Jamieson (1995), Kember and Kwan (1997,

2002), Kember and McKay (1996), Kemmis and McTaggart (1988; 2000), Smith

(1993), Smith and Lovat (2003), and Weimer (2002) particularly drew my attention

for their experienced investigations into educational change and their associated

contentions.

Smith and Lovat (2003) claim that curriculum is part of teaching, not separate

from it, and it is “only at the classroom level, at the level of the experience of

teachers and learners, that curriculum is not only intentional, but also actual” (p. 18).

Smith and Lovat (2003) also claim that when talking about educational change,

particularly curriculum change, there is a need to consider both the content of change

and the process by which the change occurs. According to Smith and Lovat (2003),

although it is difficult to entirely separate the content and the process, the content of

the change denotes the concepts, skills, ideas and examples associated with the new

curriculum; and the process of the change denotes the introduction of the new

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curriculum, the commitment to the change among teachers, and the implementation

of the change into the classroom.

The content of the change in this study includes pedagogical knowledge related

to the Nursing Curriculum Guideline (Curriculum Research and Development Centre

in Allied Health Education, 2004a) and Weimer’s (2002) model of student-centred

approach. Weimer’s (2002) model provides detailed description of what needs to be

changed for student-centred learning, including notions of the balance of power

between teachers and students, the function of content, the role of the teacher, the

responsibility for learning, and the purpose and processes of student assessment.

Weimer’s (2002) model also presents a practical discussion for how to implement the

student-centred teaching and learning approach into the classroom with powerful

examples to guide teacher practice. I believe this model is a feasible tool to facilitate

the development of generic and professional competencies in students of nursing

within this study.

With regard to the change process, Smith and Lovat (2003) claim that change is

more about process and people than product and objects; it inescapably involves the

beliefs, interests, perceptions and feelings of individuals who are involved, and it is

dynamic. Smith and Lovat (2003) also argue that curriculum change that involves

individual teachers’ intrinsic motivation is more fundamental and sustainable than

extrinsic or imposed strategies based on the control of rewards and punishments,

because it has the capacity to alter individual teachers’ conceptions, perceptions,

meanings, and practice in accord with the change content. These arguments are

supported by many studies that investigated the relationships between conceptions

and customs of teaching. Research results have shown that most lecturers who have a

8

learning-facilitation conception of teaching adopt student-centred approaches to

teaching whereas most lecturers who have a knowledge-transmission conception of

teaching adopt teacher-centred approaches (Kember & Kwan, 1997, 2002; Parpala,

Bolander, Lindblom-Ylanne, & Lonka, 2004; Trigwell & Prosser, 1996a, 1996b;

Trigwell, Prosser, Marton, & Runesson, 2002).

Fullan (2001a), Hargreaves (1994), and Hastings and Squires (2002) all claim

that educational change that involves beliefs, customs, attitudes or expectations of

those who participate in the process is an issue of reculturing. Fullan (2001a)

conceived reculturing as “transforming the culture - changing the way we do things

around here” (p. 44). This supports Smith and Lovat’s (2003) argument that any

successful strategy for change must deal effectively with people’s feeling and

perceptions. In this sense, nurse educators in CGIT are more likely to become

committed to the change and implement it in the classroom when their beliefs and

perceptions are in accord with that change.

Along with identical conceptions and commitment to the desired change,

reflection is another key strategy for quality change in education. This is because

reflection can be a kind of experiential, ongoing learning for teachers working in the

constantly changing world of the classroom (Jay, 2003). Through reflection, teachers

are able to re-evaluate situations in relation to their teaching and/or student learning

which otherwise may not be remembered, much less improved (Smith & Lovat,

2003). In this sense, I began to think that through reflection, nurse educators may be

able to look back on their previous teaching practice, evaluate the practice and link

its relationship with student learning, and then make curriculum decisions

appropriate for the development of core competencies in students. With deliberate

9

reflection by the stakeholders involved in the curriculum change process, the change

is more likely to be fundamental and sustainable.

Sustainable change also requires collaborative relationships (Fullan, 2001a,

2003; Smith & Lovat, 2003). Developing collaborative cultures among teachers will

enable teachers to learn from each other, support each other, and share and develop

their teaching expertise together (Hargreaves, 1994; Smith & Lovat, 2003; Smith et

al., 2000; Smith, 1993). Collaboration is conceived by Smith and Lovat (2003) as

one of the most important aspects of developing effective educational change. When

working collaboratively with equal relationships, teachers are more likely to share

the power, control the change process, and build a sense of ownership of the

curriculum. Therefore, democratic principles such as equal relationship, collaborative

control and ownership are also valued by Smith and Lovat (2003) as essential

components for facilitating effective change processes.

Fullan (1993; 1999; 2001a; 2001b; 2003; 2005) argues that the change process

is always a complexity. Both Fullan (2001a) and Smith and Lovat (2003) suggest

starting with a small achievable plan when attempting to bring about educational

change. A small but fundamental change by individuals can lead to further change

within the community and society (Kemmis & McTaggart, 1988; 2000; Smith &

Lovat, 2003). A change that starts small has the capacity for emancipation, because it

empowers participants to make changes (Grundy, 1982; Kemmis & McTaggart, 1988;

Smith & Lovat, 2003; Zuber-Skerritt, 1996). In this sense, strategies for

empowerment also need to be taken into account during a change process.

When considering empowerment, Smith’s (1993) work particularly caught my

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attention. He conceived three identifiable and interrelated spheres of empowerment:

self-growth, political consciousness raising, and collective action or struggle (Smith,

1993). Smith’s (1993) constructs of empowerment complement Smith and Lovat’s

(2003) propositions about strategies for bringing about curriculum change. Both

authors emphasise the importance of starting with individuals, the importance of

personal and professional development, and the importance of collaborative action. I

believed that the strategies incorporated into this study would result in empowering,

sustainable and generative transformations.

The recommendations advanced in the literature on educational change led me

to conceptualise a way forward based on conceptual notions such as student-

centredness, reculturing, collaborative practices, collaborative reflection, and

personal growth and professional development. These contextual considerations and

conceptual notions are elaborated in Chapter 2. Having conceptualised what needed

to be done within a specific context, I began to conceptualise a way to bring it all

about. That is, my conceptual notions informed the planning of the methodology.

Methodology and the Action Plan

Action Research with its critical and postmodern theoretical and philosophical

underpinnings, and the praxis-oriented, participatory and cyclic reflective process

was chosen as the most appropriate methodology to bring about the envisioned

change. Action Research would provide the mechanism by which the participating

nurse educators in CGIT could explore and understand their conceptions about

teaching and learning; then collaboratively plan and implement action in order to

transform the current situation; and finally to evaluate and reflect on the

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transformations.

Within the mechanism of Action Research methodology I conceptualised an

action plan to generate, gather, organise, examine and monitor the information. The

Pre-action Phase consisted of team formation. Action Phase 1 encompassed

recognising the need to change; Action Phase 2 involved curriculum decision making.

Action Phase 3 constituted implementing and reflecting on the new curriculum.

Action Phase 4 was comprised of evaluating the collaborative journey. These phases

are elaborated in Chapter 3 along with the determination and justification of Action

Research as an appropriate methodology to guide this study.

In keeping with Action Research methodology and the action plan, this project was

developed to go beyond understanding and interpreting phenomena; it was developed

for the purpose of bringing about a change to a specific educational situation and

practice. This study does not aim to show difference or relationship between variables,

prove anything, or provide statistical evidence.

The information that served as evidence in this study was derived mainly from

“autobiographical data” (Herr & Anderson, 2005, p. 77). As the focus of the project

is the collaborative efforts by a group of nurse educators to bring about curriculum

change, we studied ourselves in terms of our own professional practice. The evidence

was generated and gathered mainly from our own personal experiences, including the

stories written by team members in terms of their personal practical theories of

teaching, the tape-recorded and transcribed group meeting records, and my reflective

journals.

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The collaborative journey was carried out in accordance with the action plan

with some modification. During the collaborative journey a body of information was

generated, gathered, and organised and subjected to a process of continuous

monitoring or checking. Chapters 4, 5, 6 and 7 constitute my narrative of the

collaborative journey, divided and determined by the main action phases.

In Chapter 8 the information was critically examined using Herr and Anderson’s

(2005) model - Criteria of Quality for Action Research. In this model, the Criteria of

Quality for Action Research consists of outcome validity, process validity,

democratic validity, catalytic validity, and dialogic validity (Herr & Anderson, 2005).

The model fits the conceptual notions and methodological approach of this study and

served as a framework on which to build my critical examination of the collaborative

journey. My critical examination was also guided by two questions which relate to

the research question (See p. 3):

Did the changes made to the curriculum better facilitate the development of core generic and professional competencies in students? And Did the strategies incorporated into the curriculum change process result in empowering, sustainable and generative transformations?

My critical examination into the five criteria of validity supported affirmative

answers to these two questions.

Significance

The significance of this study lies in its contribution to all aspects of curriculum

making including innovation, planning, implementation and ongoing review. This

13

study proved to be of particular value to team members who participated in the

collaborative journey, and to the Department of Nursing at CGIT. In this study, team

members shared and recultured their knowledge and conceptions of teaching and

learning, and generated and reconstructed a curriculum. The curriculum might be

subjected to change as the journey is resumed each academic year. However, the

curriculum we generated on the collaborative journey was an appropriate and

acceptable resolution to our shared problem regarding teaching and learning.

As team members, this collaborative journey enabled us to gain more

understanding of our teaching and improved our teaching practice. In this sense,

team members developed individual and professional growth through the

collaborative journey. We also brought about an educational change that better

facilitated the development of student generic and professional competencies.

Furthermore, as a result of this study, the student-centred approach (Weimer, 2002)

was inextricably blended into our teaching and learning practices, thus, this project

helped bridge theory and practice. In addition, team members who participated in the

collaborative journey developed better understandings of their own teaching, their

teaching practice and their workplace, and therefore, I believe that the collaborative

journey also had liberating or emancipatory value. The implications and values of the

study are discussed in terms of reconstructions and transformations in Chapter 9.

My Role in the Collaborative Journey

While officially this was my doctoral research project and I was the chief

investigator, once the team was formed it became our research project and we were

all co-researchers: power was shared among the team. During the collaborative

14

journey I was an insider collaborating with other insiders. I was also the ‘catalyst’

who began the transformative process; who organised the group meetings; who

arranged the gatherings; who organised the information and ensured that the change

dynamic was “staying healthy and not beginning to decline” (Hargreaves & Fink,

2005, p. 6). Pan (2003) refers to this role in an Action Research project as that of the

‘core researcher’; Fullan (2001a; 2003; 2005) and Hargreaves and Fink (2004; 2005)

refer to this role in an educational change endeavour as that of a ‘leader’.

In recent years Fullan (2001a; 2003; 2005) and Hargreaves and Fink (2004;

2005) have stressed the importance of leadership in terms of bringing about

sustainable educational change. However, Fullan ((2001a) also claims that although

the leaders’ role is to guide the educational change, it is also to make themselves

“dispensable in the long run” (p. x). Following this advice, I never referred to myself

as the ‘leader’ but instead, called myself ‘a critical friend’ (Stenhouse, 1975) – a

classical term in Action Research.

A critical friend, according to Kember (2000a), can be a facilitator who

encourages teachers to start projects but leaves the choice of subject to the teachers; a

rapport builder: one who builds harmonious and mutually trusting relationships

between team members; and a coffee maker who creates a comfortable environment

in which team members can talk and discuss issues (Kember, 2000a). Apart from

these various and rather mundane roles, a critical friend fulfils another very

important role.

Most importantly, a critical friend can be a mirror that provides alternative

angles or interpretations of the situation (Kember, 2000a; Smith & Lovat, 2003).

15

Kemmis and McTaggart (1988, p. 26) describe a critical friend in a similar manner and

use the term to denote someone who helps others to find the limits of the ways they are

thinking, enabling them to recognise and challenge underlying assumptions, and to

prepare for further action and change. This suggests that a critical friend encourages

people to find their own answer; that rather than providing answers, a critical friend

stimulates reflection through probing questions. In this sense, a critical friend “assists

people to develop their potential and encourages their sense of autonomy and purpose”

(Chapman, 1996, p. 159).

Once the collaborative team was formed I fulfilled many of the activities

ascribed to the role of critical friend above. I became a supportive collaborator, who

endeavoured to create an equal and harmonious relationship among team members;

who built a comfortable environment for the team to engage in dialogue; who

promoted critical reflections on our work; and who helped team members explore

and develop their personal and professional potential. Certainly, I believe that my

role during the collaborative journey was that of a critical friend.

This brief overview of what was done and why and how it was done is intended

to introduce the major component of the study. This chapter has foreshadowed the

more extended details elaborated in the following chapters. It has also explained the

style and format of the thesis document and the role I undertook in the study. The

extended details of the contextual considerations and conceptual notions that directed

the investigation of the research question are contained in the next chapter.

16

CHAPTER 2

Contextualising and Conceptualising the Problem Introduction

The preceding chapter briefly delineated the focus of the study and identified the

problem and its importance. Based on the critiques and concerns within the context

the following research problem was identified:

The curriculum does not adequately facilitate the development of generic and professional competencies in students of nursing in Taiwan.

The problem was embedded in the following research question:

What changes to the nursing curriculum will better facilitate the development of core generic and professional competencies in students; and what sort of strategies need to be incorporated into the curriculum change process so that transformations are empowering, sustainable and generative?

This chapter elaborates the contextual considerations and the conceptual notions

previewed in the previous chapter and which directed my investigation of the

research question

Contextualising the Problem

In keeping with the 21st century and the global trends of educational change,

the Taiwanese government has engaged in educational reform during the past decade

(Commission on Educational Reform, 1996; Ministry of Education, 2005b). The

emphasis on teaching has been replaced with an emphasis on learning (Commission

17

on Educational Reform, 1996). Nurse education in Taiwan is also facing this

extensive educational change.

Under present nurse education curricula in Taiwan, students are not adequately

prepared in terms of the essential competencies needed in the profession (Curriculum

Research and Development Centre in Allied Health Education, 2004a). Although

little evidence can be found in the literature to support the inadequacy of current

nurse education in Taiwan, a study by Chiu, Gau, Kuo and Chung (2003) reveals

some disturbing findings. Sixty baccalaureate students were randomly sampled from

213 second year students undertaking a four year nursing course at a technology

college. The results show that 44 out of 60 (73.33 %) students failed the clinical

breastfeeding examination (Chiu et al., 2003). They had difficulty distinguishing the

infant consciousness status fit for feeding, and did not know when to stop feeding

while performing breastfeeding instruction. Chiu and her associates (2003)

concluded that book knowledge alone was not sufficient for students to master

professional capabilities. These researchers advocated providing students with more

opportunities to promote their professional competencies, such as arranging situated

or real-life, role-play scenarios in the classroom teaching (Chiu et al., 2003). The

findings from the study by Chiu and her associates indicate that the students were

unable to demonstrate either critical thinking abilities or professional competencies.

The findings lend support to the reality of a discrepancy within the design of the

current nursing curricula, the student learning outcomes, and the essential

competencies needed in the nursing profession.

The adverse impact of current educational approaches on nursing students has

led to the improvement of student learning and the enabling of their thinking abilities

18

becoming the main focus of the educational reform in Taiwanese schools of nursing.

There is a movement from long cherished and established teacher-centred teaching

and learning towards student-centred teaching and learning (Hsu, 2001; Lee et al.,

2004; Lu, 2004; Mu & Shiau, 2002). There is also a movement to educate nursing

students beyond recipients of discipline specific content towards becoming critical

thinkers and problem solvers (e.g. Chen & Lin, 2003; Chen, Chen, Lee, Lee, & Lee,

2006; Hsu, 2000; 2002; Mu, 2004; Sheu, Lin, & Li, 2000; Su, 2002; Tan, 2000; Tang,

Huang, & Hsu, 2005; Yeh & Tasy, 2001; Yu, Lu, & Liu, 2003). The educational

reform associated with nursing involves changes to the structures of nursing

educational systems and to curricula.

With regard to nurse education systems in Taiwan, there is a very pluralised and

flexible school entrance system. Change in this area is beyond the parameters of this

study and will therefore be only briefly described. With regard to curriculum reform

in nursing, a Nursing Curriculum Guideline was drafted by the Curriculum Research

and Development Centre in Allied Health Education (Curriculum Research and

Development Centre in Allied Health Education, 2004a), introducing new

requirements for teaching and learning in nursing. The systematic curriculum reform

has brought challenges to all schools of nursing in Taiwan, and these challenges

underpin the focus of this study. Before discussing the new requirements for nurse

education curricula the nurse education systems in Taiwan will be briefly described.

Nurse Education Systems in Taiwan

In Taiwan, the Ministry of Education (MOE) directs affairs in connection with

academic, cultural and education administration in both private and public

19

organisations, including nurse education. In consideration of the need to provide high

quality care to meet the growing health needs of the population and to keep up with

international trends in nurse education, there is a movement towards all students of

nursing being educated to degree standard through the higher education sector (Chao,

2004; Department of Technical and Vocational Education, 2004). The present

pluralised and flexible school entrance system in nursing has been criticised as being

too interwoven and complicated (Lu, 2004; Yang, 2005).

As shown in Table 1, the nurse education system in Taiwan consists of the

Technological and Vocational Education system and the Higher Education system.

According to the MOE in Taiwan (Ministry of Education, 2005b), there are three

levels of the current Technical and Vocational Education system in transition: 3-year

senior vocational high schools, 2- and 5-year junior colleges, and 2- and 4-year

technical colleges. The Higher Education system in nursing consists of 4-year

Table 1 Nurse Education Systems in Taiwan Technological and Vocational Education System Senior Vocational High School 3-year vocational training Junior College 2-year diploma program 5-year diploma program Institutes of Technology/ University of Technology 2-year technical baccalaureate program 4-year technical baccalaureate program Higher Education System University or College

4-year baccalaureate program Postgraduate programs (Masters and PhDs)

20

baccalaureate programs and postgraduate programs.

The interwoven and complicated student advancement in nurse education in

Taiwan is shown in Figure 1.

Due to the promotion of technical and vocational education in nursing, senior

vocational high schools were to cease in 2005 if they did not succeed in upgrading to

junior colleges (Curriculum Research and Development Centre in Allied Health

Education, 2004b). For 2-year and 5-year junior colleges in nursing, students enter

from senior vocational high schools and junior high schools respectively, and they

tend to further their education because of the need for higher qualification in the

nursing profession and the increasing opportunities for higher education entry.

Figure 1. Current Nurse Education Systems and Student Advancement in Taiwan, Modified from Lu (2004, p. 11).

Postgraduate Postgraduate

2-Y Technical

Nursing Programs

2-Y Technical

Nursing Programs

4-Y Baccalaureate

Nursing Programs

4-Y Technical

Nursing Programs

Generic Senior

High Schools

Senior Vocational

Nursing High Schools (ceased in 2005)

Generic Junior High Schools

Higher Education Technical and Vocational Education

HIGH SCHOOL

BACHELOR

DIPLOMA

5-Y Junior

Nursing Colleges

2-Y Junior

Nursing Colleges

POSTGRADUATE

21

Junior nursing colleges in Taiwan are also attempting to upgrade to technical

colleges due to the closure of senior vocational nursing high schools and oncoming

difficulties in student recruitment. Technical institutes of nursing or nursing colleges

produce 2- and 4-year baccalaureate nursing graduates; and the students are mostly

from junior colleges and senior vocational high schools respectively. Recently, the

Technical and Vocational Education system in nursing also recruits students from the

Higher Education system. The technical nursing institutes or nursing colleges

provide not only baccalaureate programs but also postgraduate programs

(Department of Technical and Vocational Education, 2004; Lu, 2004).

The Higher Education system in nursing consists of 4-year baccalaureate and

postgraduate programs. In general, 4-year baccalaureate students are from generic

senior high schools. However, universities have started recruiting students for 2-year

technical baccalaureate programs in recent years, thus students graduated from

technical institutes or colleges are able to advance their study in the Higher

Education system (Department of Technical and Vocational Education, 2004; Lu,

2004). The complicated nurse education systems result in a hybrid of student sources

from Higher Education and Technical and Vocational Education systems.

The complicated nurse education system and the hybrid of student sources have

led to censure of nurse education in Taiwan. The hybrid of student sources has led to

student baseline competencies being so varied that teaching planning is challenged to

meet the various learning needs of students. Easier access to higher education has

also led to a growth in nursing graduates in terms of quantity rather than quality

(Yang, 2005). Furthermore, the complicated system and student sources have also led

to nurse education in Taiwan, especially curricula, being censured as “overlapping,

22

inconsistent and incoherent” (Curriculum Research and Development Centre in

Allied Health Education, 2004a).

The MOE in Taiwan claims that present nursing curricula within the complex

and diverse Technical and Vocational Education and Higher Education systems

greatly impacts student learning outcomes and their employment (Curriculum

Research and Development Centre in Allied Health Education, 2004a). Therefore,

the MOE launched an innovative program for Technical and Vocational educational

reform in order to construct a coherent, united and appropriate curriculum.

Subsequently the Department of Technical and Vocational Education through the

Curriculum Research and Development Centre in Allied Health Education developed

a Nursing Curriculum Guideline on which to base future curricula.

The Nursing Curriculum Guideline

According to the Nursing Curriculum Guideline (Curriculum Research and

Development Centre in Allied Health Education, 2004a), nurses play significant and

direct roles in restoring, promoting and maintaining human health. Therefore, the

main task of nurse education is to produce nurses who are competent to meet the

human health needs of society. The Curriculum Research and Development Centre in

Allied Health Education began the development of the Nursing Curriculum

Guideline with the construction of core competencies that nursing graduates are to

possess.

The core competencies embraced in the Nursing Curriculum Guideline

(Curriculum Research and Development Centre in Allied Health Education, 2004a)

23

consist of generic and professional competencies. Although the competencies

constructed are described depending on educational levels in nursing, generic

competencies include effective communication, rational thinking and judgement,

life-long learning, respect for different cultures and lives, capacity to integrate

knowledge, and ability to broaden the international scope of nursing practice

(Curriculum Research and Development Centre in Allied Health Education, 2004a).

Professional nursing competencies include delivering appropriate and independent

nursing care, evaluating nursing care outcomes, proposing appropriate nursing care

plans, acting effectively in emergency and/or changing circumstances, and

translating the latest research findings into patient care (Curriculum Research and

Development Centre in Allied Health Education, 2004a).

In addition to the core generic and professional competencies, the Nursing

Curriculum Guideline (Curriculum Research and Development Centre in Allied

Health Education, 2004a) also contains many suggestions for curriculum

construction. These include suggestions for curriculum design, teaching and learning

materials, teaching approaches, and student assessment. For example, it is suggested

that development of curriculum has to consider student learning needs, their

employment and further education needs, the school characteristics, and the nature of

the society. It is also suggested that the selection of teaching materials has to meet

the student’s educational level. It is suggested that teaching approaches should be

diverse and flexible, and the development of student active learning abilities and

independent and logical thinking and judgment capabilities is emphasised. The

Nursing Curriculum Guideline also directs that the curriculum evaluation process

considers “summative, diagnostic and formative evaluation”, and contains “cognitive,

affective and psychomotor domains” (Curriculum Research and Development Centre

24

in Allied Health Education, 2004a).

Although the design of curricula for nurse education programs is largely left to

the discretion of each individual school, the MOE clearly directs that curricula be

student-centred (Ministry of Education, 2003). The draft of the Nursing Curriculum

Guideline was disseminated to schools in August, 2003, asking for evaluation and

further suggestions (Ministry of Education, 2003). According to the Official Letter to

schools of Technological and Vocational Education (Ministry of Education, 2003),

the final Nursing Curriculum Guideline was to be incorporated into the curriculum of

all schools of nursing in Taiwan in school year 2005.

Despite the Nursing Curriculum Guideline not being finalised and its

implementation postponed, there is an explicit and growing demand for schools of

nursing in Taiwan to reform nurse education in order to produce competent nursing

practitioners. I am in sympathy with this demand to reform nurse education because

through my teaching experiences I have had concerns about many aspects of student

learning.

As a lecturer in a nursing institute (Chang Gung Institute of Technology) for

several years, I have taught students in both classroom and clinical settings. In the

classroom, I have taught nursing students from different levels of education in units

related to ‘Physical Examination and Health Assessment’. The objectives of the units

were related to enabling nursing students to collect information from their patients,

integrate the information collected and assess patients’ health problems and needs.

When I facilitated students learning in clinical settings, however, I was frustrated by

students’ lack of application of theoretical learning to clinical settings.

25

More exactly, my frustration was that students failed to apply what they learned

to their clinical practice. For example, it was taught in the classroom that when the

rhythm of a patient’s pulse is regular, the number of beats can be counted in 30

seconds and multiplied by two (Jarvis, 2000). It is also reiterated in many nursing

units that the normal heart rate range is 60 to 100 beats per minute (Jarvis, 2000).

However after palpating her patient’s pulse rate during clinical practice, a student

reported “my patient’s pulse rate is 32 beats per minute”. This report was given

without any concern or suggestion that this observation required further discussion or

investigation. It appeared that the student neither multiplied the beats she counted nor

realised that 32 beats per minute indicated an abnormal pulse rate.

Another example of failure to connect theoretical learning to practice is when a

student came and asked for my help saying that “my patient suddenly complains to

me about dizziness, what I can do for her”? I asked the student what information she

needed to collect in order to assess her patient’s health problem so that appropriate

actions could be taken. The student was unable to answer my question. One vital and

simple assessment related to dizziness is measuring blood pressure (Jarvis, 2000).

However, the student was unable to link dizziness with blood pressure.

Moreover, students on clinical practice often neglected to assess the

effectiveness of the medication their patients were taking. For example, I observed

that a student’s patient had taken antihypertensives for one day in order to control

high blood pressure, but the blood pressure had not been effectively lowered. I

remarked on this to the student and asked her if she believed the antihypertensives

had worked effectively to control the patient’s blood pressure. I also asked the

student’s opinions about solutions for the situation. The student replied by saying “I

26

don’t know”. It looked to me as if the student had failed to understand much less

assess and monitor the situation. From an educational perspective, the student lacked

the professional competencies required in the Nursing Curriculum Guideline such as

rational thinking and judgement, the provision of appropriate nursing care, or

effective communication.

The occasions described above might be individual. There were also

outstanding students who were independent and required little facilitation. However,

through the period of my teaching the increasing occurrence of student incompetency

attracted my attention. Similar occasions were also discussed and enumerated by my

colleagues who supported my concerns. Concerns about teaching and learning and

other aspects of the curriculum were also expressed by the MOE through the school

accreditation report.

The Accreditation Report

A school accreditation for Technical and Vocational Institutes was held by the

MOE in school year 2004. The Department of Nursing in CGIT was classed as

second-rate in the accreditation (Ministry of Education, 2005a). According to the

Accreditation Report (Ministry of Education, 2005a), several improvements were

required in the department. The Nursing faculty were required to improve the whole

nursing curriculum. The MOE also suggested the faculty strengthen nursing students’

competencies as well as develop appropriate curricula for different levels of nursing

students.

The Accreditation Report highlighted the need for the nursing faculty to

27

improve teaching and learning practices. Nurse educators needed to improve their

abilities to create appropriate teaching materials and investigate more effective

teaching strategies. Student thinking and judgement abilities also required

improvement (Ministry of Education, 2005a). The Accreditation Report showed the

nursing faculty was second-rate, the lowest rate ever. Before 2002, oftentimes the

school received first-rate in accreditation conducted by the MOE over the years

(Chang Gung Institute of Technology, 2005). Being classed as second-rate was a very

disappointing result for the faculty and clearly demonstrated that the curriculum was

a major problem for the Department of Nursing.

Overview of Nurse Education in Chang Gung Institute of Technology

Chang Gung Institute of Technology (CGIT) is a private educational institute

within the Technical and Vocational Education system so the CGIT nursing

curriculum is obliged to meet the requirements of the Nursing Curriculum Guideline.

The predecessor of CGIT was built as a department of nursing under Ming Chi

Institute of Technology in 1983 due to a shortage of clinical nurses (Chang Gung

Institute of Technology, 2003a). The chairman of the Formosa Plastics Group

established Chang Gung Institute of Nursing in Tao-Yuan County in 1988. Followed

by the development of the school, two- and five-year junior college students were

gradually recruited into three disciplines, namely nursing, child care and education,

and information management (Chang Gung Institute of Technology, 2003a).

Upgraded as Chang Gung Institute of Technology in school year 2002 (each

school year starts in August), the institute started recruiting technical baccalaureate

students into these three disciplines. In school year 2004, there were 7518 students

28

studying in the institute and 87.7 % (6594 out of 7518) were nursing students (Chang

Gung Institute of Technology, 2004a). Moreover, in order to provide nurses in

southern Taiwan opportunities to further their studies, CGIT opened a campus in

Cha-Yi County in the beginning of 2004 (Chang Gung Institute of Technology,

2004b). CGIT is one of the largest nursing institutes in Taiwan, and the program

opened in school year 2005 included 4-year and 2-year technical baccalaureate and

5-year diploma programs (Chang Gung Institute of Technology, 2005).

With solid supportive resources from Chang Gung Memorial Hospitals and

relative business units in the Formosa Plastics Group, the Work-Study Program was

developed and has become one of the major characteristics of the institute (Chang

Gung Institute of Technology, 2003a). In conjunction with core courses and clinical

practices, the Work-Study Program is designed to provide students with opportunities

to situate themselves in clinical practice settings so that they will be more likely to

meet the needs of society (Chang Gung Institute of Technology, 2003a).

The goal of nurse education in Chang Gung Institute of Technology, under the

directives of the educational reform led by the Ministry of Education, is to reinforce

nursing students’ competences in the profession (Chang Gung Institute of

Technology, 2003b). It also aims to produce students with the core generic and

professional competencies described in the Nursing Curriculum Guideline and

outlined earlier on pages 22 to 23.

With solid supportive resources from Chang Gung Memorial Hospitals, CGIT

stands at the cutting edge of educational innovation. The Work-Study Program

provides students in the institute with opportunities to link what they have learned

29

from school to clinical practice. From this vantage point, CGIT is considered likely

to provide appropriate learning experiences for students to acquire the capabilities

described in the Nursing Curriculum Guideline. However, the importance of the

curriculum, especially classroom teaching and learning experiences, tends to be

overlooked in the institute, and this has undoubtedly contributed to some inadequate

applications of theoretical learning to clinical settings.

Reconnaissance: Current Approaches to Teaching and Learning in CGIT

Nurse educators who teach nursing in CGIT classrooms are all registered nurses

and possess a masters degree or above (Chang Gung Institute of Technology, 2005).

However, as commonly exists in the academic world, most have little or no formal

preparation and minimal in-service training related to teaching and learning (Allan &

Jolley, 1987; Dunkin, 1995; Hativa, 2002; Hsu, 2005; Willcoxson, 1998).

Consequently, I believe we tend to teach in the same way as we were taught: mostly

by didactic ‘chalk and talk’ methods.

I also believe that we endeavour to teach all the topic content set out in the

prescribed text within the classroom. This is possibly because we believe that

providing all the content covered in the textbook will enable students to correctly

answer all questions in a given examination or thus perform competently in a clinical

situation. Nurse educators in CGIT who teach the same topic tend to concur on what

content is to be delivered, thus ensuring that the large number of students in the

institute receive the same quality and quantity of professional knowledge. Some

educators attempt to bring process-driven concepts into their classrooms, but due to

the large amount of content they believe they are compelled to deliver, they feel

30

unable to pause and encourage students to engage in active participation. These

statements and beliefs are supported by the reconnaissance survey I conducted during

the end of semester 1, school year 2004.

The Reconnaissance Survey

A reconnaissance survey was conducted in order to determine what actually was

going on: a fact-finding mission about the situation (Lewin, 1946). The results of the

survey served as a basis for reflection and for planning my next step.

Nurse educators’ conceptions of teaching and learning were examined by the

Nurse Educator’s Conception of Teaching and Learning Questionnaire. The

Lecturer’s Conception of Teaching and Learning Questionnaire (Gow & Kember,

1993; Kember & Gow, 1994) was modified, translated into Chinese and renamed the

Nurse Educator’s Conception of Teaching and Learning Questionnaire. The

questionnaire consists of forty-six items and indicates two orientations to lecturers’

teaching at institutions of tertiary education: Knowledge Transmission

(teacher-centredness) and Learning Facilitation (student-centredness). Responses

were recorded on a five-point Likert-type scale ranged from 1 (definitely disagree) to

5 (definitely agree). (See Appendices A & B-1.1 /pp. 240-241 & 243-244 for details).

The questionnaire was distributed to 121 nurse educators in CGIT and the final

return was 70 questionnaires. Sixty nine were useable which represented a return of

57%. There were some noticeable responses while ranking the means and

frequencies of each individual question.

31

The nurse educators in Chang Gung Institute of Technology strongly agreed

with the importance of learning while responding to statements such as:

This institution should produce good learners who can carry on learning when they leave the institution (mean = 4.94, out of 5), A good nurse educator is someone who cares for the students and is in-tune with their problems (mean = 4.94, out of 5), and A good nurse educator guides the students in the process of learning so that they have an understanding of how they can approach the subject material and actually learn instead of memorising (mean = 4.91, out of 5).

These three statements scored the highest among the Learning Facilitation

orientation. This suggests that participating nurse educators believed that good nurse

educators should concentrate on students’ learning process and needs. In other words,

they appeared to hold conceptions consistent with the central notion of the school

and the Nursing Curriculum Guideline. However, there may be little congruence

between these stated beliefs and teaching practices. This supposition is supported by

the survey information.

The participating nurse educators revealed that their teaching practices were less

student-centred while responding to statement: “In my teaching I now spend less

time standing up and giving information, and more time directing discussion” (mean

= 2.87, out of 5). Rather, the frequency of each response to this statement also

indicates that 52.17% of the participating nurse educators disagreed with the

statement. That is to say, the majority of nurse educators in this survey spent more

time standing up and transmitting information in the classroom rather than

encouraging active learning.

32

Moreover, only 7.25% of the participating nurse educators strongly believed

they spent more time directing discussion without reservations. The results of the

survey echo Biggs’ (1996) claim that “All teachers say they teach for understanding,

but few do in any sustainable way” (p. 351). There appeared to be an inconsistency

between what the nurse educators in CGIT believed and what they were actually

doing. That is, a discrepancy existed between the rhetoric and the reality. As Schaefer

and Zygmont (2003) argue, faculty members in nursing may be ready to move to a

more student-centred environment, but are uncertain about how to accomplish this

goal. The nurse educators in CGIT might be informed about and agree with the

institute goals but might not comprehend their importance; or they might be

acquainted with the importance of student learning but have difficulties facilitating

learning. Consequently, the content-driven teaching approaches persist in most

nursing classrooms in CGIT.

Under content-driven teaching approaches, students tend to be rote and passive

learners and try to pass examinations by memorising (Gow & Kember, 1993; 1994;

Saroyan & Snell, 1997; Trigwell, Prosser, & Waterhouse, 1999). Some students

might have queries and would like to ask questions while the class is in progress,

however, the overflowing syllabus does not allow, much less encourage, students to

ask questions in the classroom. Rather, the overflowing syllabus promotes the notion

of ‘sit and listen’ with little opportunity to reflect and digest what is taught.

Nurse educators at CGIT also appeared to overlook the time available for

students to learn. According to the General Guideline on Technical and Vocational

Curriculum (2003), there are seven established units with 14 credit points for 2-year

technical college nursing students to undertake, and the rest of the design of the

33

curriculum is left to the discretion of each individual school. In CGIT, the minimum

credit points for 2-year technical college nursing students to undertake are nine in

each semester and 72 in the two-year nursing program (Chang Gung Institute of

Technology, 2004c). The same status can be found in other nursing institutes in

Taiwan (e.g. Hungkuang University, 2006; National Taipei College of Nursing, 2006).

That is to say, 2-year technical nursing students in Taiwan have an average of 18

credit points with about nine units to undertake per semester. (A unit normally stands

for 2 credit points, except the laboratory and clinical practice units). Under the

content-driven nature of schooling, the nine units undertaken also require students to

spend about 18 hours per week in the classroom, mostly sitting and listening. Nurse

educators in CGIT tend to assign homework to baccalaureate students for after class.

We also tend to expect students to demonstrate their critical thinking abilities through

assignment writing but give little if any instruction on how to do so. It is not

surprising that under the pressures of time and without knowing how to do otherwise,

nursing students in CGIT tend to study for rote and superficial learning. These claims

are supported by my reconnaissance survey conducted among the first year of 2-year

technical college nursing students in 2004.

The 2-year technical nursing students’ approaches to learning were examined by

the Revised Two-factor Study Process Questionnaire (R-SPQ-2F). The questionnaire

was developed by Biggs, Kember and Leung (2001) and translated into Chinese by

Leung and Chan (2001). The R-SPQ-2F consists of twenty items measuring two

main scales of Surface Approach and Deep Approach. Responses were recorded on a

five-point Likert scale from 1 (this item is never or only rarely true of me) to 5 (this

item is always or almost always true of me). (See Appendices A & B-2.1 /pp.

241-242 & 248 for further details).

34

The R-SPQ-2F was distributed to 186 students in the classrooms in CGIT

during the end of year 2004, shortly near the end of semester one. The final return

was 184 questionnaires, which represents a return of 99%. There were certain notable

student responses.

The results indicate that the 2-year technical nursing students in CGIT leaned

toward no particular approaches to learning. Fifteen out of twenty of the items in the

questionnaire were most frequently scored with “this item is sometimes true of me”

(mode = 2), including seven out of ten items of Deep Approach and eight out of ten

items of Surface approach. Ambiguous responses were also evident in the other two

items. The participating students responded “frequently true of me” (39.13%, mode =

4) to the statement “I find that I have to do enough work on a topic so that I can form

my own conclusions before I am satisfied”. However, while responding to the

statement “I find the best way to pass examinations is to try to remember answers to

likely questions”, their responses also centred on “frequently true of me” (34.78%,

mode = 4).

Perhaps the most noteworthy response was that of a student who defended

herself and her classmates by writing the following opinion on the back of the

questionnaire:

The student would like to learn something from this unit [Physical Examination and Health Assessment]. But due to studying in Chang Gung that you have only limits of time spending on this unit. It doesn’t mean we don’t take this unit seriously but we have too many assignments from other units . . . . Finally when the final exam is coming, we can only pass the exam by memorising.

35

It appeared that the students were clear about the relationship between learning

satisfaction and effort made but due to study workloads felt they could only pay

attention to what was specially set. The results also suggest that students felt they

only had time to learn superficially even though they did not intend to do so.

The results echo Kember’s (2000b, p. 107) claim that “The curriculum design

and the way the course is taught can, therefore, affect the learning approach which

students adopt”. Biggs, Kember and Leung (2001) claim that “Teaching and

assessment methods often encourage a surface approach when they are not aligned to

the aims of teaching the subjects” (p. 138). The results of the reconnaissance survey

about student learning, together with the results of the survey about teaching

conceptions, are consistent with the above claims by Biggs et al. (2001) and Kember

(2000b). In other words, the superficial learning of nursing students at CGIT may be

a result of the influence of curriculum design, including the nonalignment of

objectives, teaching and learning activities and student assessment approaches.

The results of the reconnaissance survey provoked me to reflect on the cultural

influences on teaching and learning approaches and on the curriculum design in

terms of its alignment of objectives, teaching and learning activities and student

assessment approaches.

Reflecting on Cultural Influences

The teaching and learning culture in Taiwan, like other Asian areas such as

China, Hong Kong, Korea, Japan and Singapore, inherits largely from Confucianism

(Biggs, 1998; Gao, 1998). Confucius was a thinker, political figure, educator, and

36

founder of the Ru School of Chinese thought (Riegel, 2002). He made education

available to students from all social classes and thus education has been an

equalizing force since Chinese ancient times. Confucius taught his students morality,

proper speech, government, and the refined arts (Riegel, 2002). In his teaching he

emphasised the Six Arts which included ritual, music, chariot-riding, archery,

calligraphy, and arithmetic (Liu, 1955; Riegel, 2002). Confucius is the spiritual

ancestor of later teachers. His birthday, September 28, has been decreed Teachers’

Day in the Chinese context.

Confucius’ most famous sayings refer to education without class distinction and

educating in accordance with intellectual differences (Ware, 1980). He asserted that

individual differences do not inhibit one’s educability. He also encouraged pursuing

knowledge by emphasising the importance of effort and motivation in learning.

There are frequent references to his forgetting food and sleep in the eager pursuit of

knowledge. As a role model for his students, Confucius used to spend whole days

and nights in meditation; if with no result, then he would go back to study again (Liu,

1955; Riegel, 2002; Ware, 1980). In the Chinese tradition, teachers are viewed as

models of good conduct and learning for students. Therefore teachers are expected to

be highly responsible for student learning.

Education in the Confucius tradition stresses not only effort and motivation but

also thinking and reflection. According to Analects, for instance, Confucius said “I

only instruct the eager and enlighten the fervent. If I hold up one corner and a student

cannot come back to me with the other three, I do not go on with the lesson”, and

“He who learns but does not think is lost; he who thinks but does not learn is in great

37

danger” (Riegel, 2002). However, the value of the Confucius tradition of thinking

and reflection appears to have become overshadowed by other extrinsic rewards.

In the Confucian tradition, education is greatly valued for not only personal

improvement but also societal development. Confucius claimed that the student who

has completed his learning should apply himself as a civil servant (On, 1996, p. 27).

The Chinese Imperial Examination began around the sixth century as a means for

appointing the learned to civil service positions (The Chinese Imperial Examination

System, 2000). Due to this innovation education became greatly valued although the

success rates in the exam were extremely small (only about 2% during the Tang

Dynasty). Passing the exam meant developing one’s fame and glorifying family by

raising them in social prestige and wealth (The Chinese Imperial Examination

System, 2000; On, 1996). Among Chinese, studying hard thus became a significant

driving force for a better future.

The connection between Confucius and the Chinese Imperial Examination

system was crucial right up to present times. Candidates for the Civil Service

Imperial Examinations memorised a vast amount of classical material but were not

required to demonstrate their ability to either theorise or challenge a particular

premise (Confucianism and the Chinese Scholastic System, 2000). This assessment

approach may have led candidates to rely mostly on reciting the material to pass the

Examination. The Chinese Imperial Examination system evolved and endured for

several thousand years. In recent decades, succeeding in the National University

Entrance Examinations is more commonly seen as the means for a better future (Gao,

1998). As a result, traditional Chinese education, including nurse education, has been

38

sharply focused on preparation for external examinations. Didactic teaching methods

dominate in highly authoritarian classrooms, and learning has fallen primarily into a

pattern of rote memorization of material. Under pressure for successful examination

results, teachers in Chinese classrooms tend to overlook any conflict between this

style of teaching and the idea that students should be at the centre of schooling.

Reflecting on the Curriculum

The results of the reconnaissance survey also provoked me to reflect on the

curriculum document, which used to be called: the Teaching and Learning Standard

at CGIT. A review of the Teaching and Learning Standard, for the unit ‘Physical

Examination and Health Assessment’ (Chang Gung Institute of Technology, 2002),

revealed that the objectives, teaching approaches and student assessment approaches

for this unit did not link well to each other. For example, one of the objectives was to

enable students to integrate collected health data from the patient and then identify

appropriate nursing diagnoses/problems for the patient. However, none of the student

assessment approaches was concerned with health data collection or nursing

diagnoses/problems.

The teaching process was focused on lecturing. Some case studies were

designed to provide students with opportunities to practice diagnostic reasoning

abilities but only one hour was available on this activity for each of the four main

body systems taught (namely the cardiovascular, chest, abdominal and neurological

systems). There was no alignment between the objectives, the teaching and learning

activities, or the assessment tasks. The design of the Physical Examination and

Health Assessment curriculum was problematic.

39

Moreover, Physical Examination skills (namely inspection, palpation,

percussion, and auscultation) were usually practiced and evaluated by skill-based

approaches for both the lower and higher level of students. The reality was that the

student assessment approaches for Physical Examination skills for different levels of

students were generally the same, although the rhetoric was that the teaching and

learning principles between these two levels of students were different.

There was a different emphasis on the Physical Examination units between the

lower level of students (junior college or diploma nursing students) and the higher

level of students (technical college or baccalaureate nursing students). The junior

college level of Physical Examination unit emphasised acquisition of physical

examination skills whilst the baccalaureate level emphasised integration of the

complete health assessment. The difference was mainly based on the premise that

Physical Examination is a compulsory unit for all junior college nursing students and

baccalaureate technical nursing students are mostly from junior colleges. That is to

say, the baccalaureate technical nursing students have acquired basic knowledge and

skills of Physical Examination in their junior college days. Therefore the higher level

of Physical Examination unit was designed to advance students’ health assessment

competencies in not only basic knowledge and skills but also integration and

application of the knowledge and skills. However there was little, if any, difference

in student assessment approaches between the two levels of students in terms of the

Physical Examination skill test. In the skill test, a list of Physical Examination

techniques was provided to students for test preparation; then accuracy in carrying

out the proper procedure was examined. It was possible for students to pass the

examination by simply memorising and imitating the skills without any integration or

application abilities. As a result, there was no opportunity for the technical nursing

40

students to learn how to integrate knowledge or think critically.

As the unit coordinator who, with a group of Physical Examination nurse

educators (PE educators), took charge of designing this unit for a new 2-year

technical nursing course in 2002, I realised that the design of the unit was based on

past experiences and imagination. There was little, if any, deliberation on the

curriculum process. Curriculum decisions were made with not only inadequate time

on deliberation, but also insufficient understanding of the nature of curriculum

construction and limited connection to meeting the aims or objectives of the

curriculum. Moreover, the Teaching and Learning Standard (the Unit Outline or

Guideline) remained largely unarticulated and unrevised. It was doubtful whether the

curriculum fitted with the school goals much less met the requirements of the

Nursing Curriculum Guideline.

The educational problems occurring in CGIT are likely to be a common

predicament for all nurse education in Taiwan. It is claimed that classes in Taiwan

consist mainly of lecturer, ‘chalk and talk’, and students sitting and listening

(Lee-Hsieh et al., 2004). The challenges for change to Taiwanese nurse education

have been acknowledged and specified in recent years (e.g. Chao, 2004; Chen &

Chiu, 2003; Chung, 2004; Hsu, 2005; Lee, Chen, & Chen, 2001; Lee & Lee, 2002;

Lee et al., 2004; Lu, 2004). While describing the current status of nurse education in

Taiwan, problems of rigid curriculum design and unfit-for-practice nursing quality

have been identified by nursing critics such as Hsu (2005), Lee et al. (2004), Lu

(2004), and Yang (2005). There is a lack of rigorous development in nursing

curricula to educate students to be ‘fit-for-practice’ graduates. This has seriously

influenced student competency for the changing health care practices (Lee et al.,

41

2004).

Through my contextualising I identified the following research problem:

The curriculum does not adequately facilitate the development of generic and professional competencies in students of nursing in Taiwan.

In order to investigate the research problem I began to consider what, as an

individual nurse educator, I could do to initiate some sort of effective change. I

believed that to facilitate the development of core generic and professional

competencies in students the curriculum change would have to go beyond a mere

paper document that was developed and handed down by authorities. I believed that

the solution to the problem would involve not only change to the content and process

of the curriculum but also would require commitment and ownership by those who

implement the curriculum if the change was to be sustainable. These notions led me

to construct the following research question to guide my conceptualisations of a way

forward:

What changes to the nursing curriculum will better facilitate the development of core generic and professional competencies in students; and what sort of strategies need to be incorporated into the curriculum change process so that transformations are empowering, sustainable and generative?

Conceptualising the Problem

In order to conceptualise solutions for the research question I began to search

the literature for answers. Smith and Lovat’s (2003) work about curriculum change

particularly caught my attention. They argue that a discrepancy might occur between

42

the rhetoric and the reality if curriculum planners and developers are different from

the curriculum executants - those who implement the curriculum (Smith & Lovat,

2003). They claim that curriculum is part of teaching, not separate from it, and it is

“only at the classroom level, at the level of the experience of teachers and learners,

that curriculum is not only intentional, but also actual” (Smith & Lovat, 2003, p. 18).

From this basis they defined curriculum as “decision-making action that integrates

both intention and the manner in which the intention becomes operationalized into

classroom reality” (Smith & Lovat, 2003, p. 24). In this sense, curriculum is a

dynamic term which represents all actions and decisions made for teaching and

learning experiences in the classroom.

Smith and Lovat (2003) also claim that when talking about educational change,

particularly curriculum change, there is a need to consider both the content of change

and the process by which the change occurs. According to Smith and Lovat (2003),

while it is difficult to entirely separate the content and the process, the content of the

change denotes the concepts, skills, ideas and examples associated with the new

curriculum; and the process of the change involve the introduction of the new

curriculum, the commitment to the change among teachers, and the implementation

of the change into the classroom.

I see the content of the change within the context of this study including what is

presented in the Nursing Curriculum Guideline (Curriculum Research and

Development Centre in Allied Health Education, 2004a), especially the required core

competencies of nursing students. The content of the change will also include

ensuring that appropriate pedagogical knowledge and principles, such as

student-centredness and curriculum alignment, are available to nurse educators so

43

they can achieve the change. The process of change will include actions related to the

curriculum change; to the development of beliefs, perceptions and practices in

accordance with the change; to the raising of nurse educators’ commitment to change;

and to the implementation of the change into the classroom. The nature of the content

and process of the change will now be further explored

The Content of the Change

I regard the content of the change in this study as the underlying rationale, the

base or the starting point from which the change develops. Without understanding the

concepts, knowledge and skills underpinning the change, it is likely that teachers will

not be able to critically reflect on, or effectively evaluate, the change (Chou, 2002).

I am looking for an approach that will enable nurse educators to better facilitate

the development of core generic and professional competencies in students. I believe

that the first areas of knowledge that need to be introduced or reinforced with the

nurse educators are the core competencies presented in the Nursing Curriculum

Guideline (Curriculum Research and Development Centre in Allied Health Education,

2004a). I also believe that nurse educators who attempt to school nursing students to

graduate with the core competencies will especially need to understand the relevant

concepts, knowledge and skills related to student-centred teaching and learning.

Student-centred teaching and learning

The terms student-centredness and learner-centredness are interchangeable.

However, there is a lack of a common definition for this term (Pederson & Liu,

44

2003). Hodson (2002) holds a humanistic view that a student-centred teacher is one

who knows what the students are talking about, faces towards his/her students when

writing on the board, determines who the students are, and listens to students’ voices

and experiences. However, the majority of scholars stress the importance of

understanding student-centredness in terms of teaching for student learning needs,

and emphasising the development of learning skills and the ability to comprehend

and apply knowledge (Gow & Kember, 1993; Hubball & Burt, 2004; Kember & Gow,

1994; Musinski, 1999; Pine & Boy, 1977; Schaefer & Zygmont, 2003; Weimer,

2002).

Gow and Kember (1993; 1994) found that student-centred teachers focus their

teaching on facilitating students’ learning; they believe their teaching role is to

provide motivation and interest in learning; they prefer interactive class sessions to

one-way or didactic lecturing; and they view education in terms of developing

students’ problem solving skills and critical thinking abilities. As this type of

teaching stresses student learning, it is also called learning-centredness (Candela,

Dalley, & Benzel-Lindley, 2006; Hubball & Burt, 2004). However, the studies by

both Pederson and Liu (2003) and Scharfer and Zygmont (2003) found that faculty

may know the term student-centred teaching but not fully understand the

significance or meaning of the term. Consequently, there is a need to clarify the

concept of student-centredness among teachers who are to implement a

student-centred curriculum.

Weimer (2002) proposes a set of key changes to teaching practice for promoting

student-centredness. Her model provides detailed description of what needs to be

changed for student-centredness and how to implement a student-centred teaching

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and learning approach. Weimer (2002) explains that in order to be student-centred,

educational practice needs to change in five key areas: (1) the balance of power, (2)

the function of content, (3) the role of the teacher, (4) the responsibility for learning,

and (5) the purpose and processes of evaluation.

According to Weimer (2002), the notion of balance of power is based on the

belief that a shift in power from teacher control to shared decision making with

students is necessary to enable student ownership, comfort, and enthusiasm for

learning. The function of content is not only for knowledge acquisition but also for

the development of learning skills. Using content as a tool to develop learning skills

enables students to be aware of their roles as learners, to recognise their strengths and

weaknesses in learning, and to acquire strategies to improve their learning, and thus

become confident, self-directed, and lifelong learners. When discussing the role of

the teacher, Weimer (2002) claims that teachers need to accommodate

student-centredness and become guides and facilitators for student learning. In a

student-centred classroom, teachers no longer play the traditional role of exclusive

content experts, or authoritarian classroom managers, or presenters of sophisticated

teaching skills. The goal of learner-centred approaches is to produce independent and

autonomous learners with critical thinking and life-long learning abilities, with

learners taking responsibility for their own learning (Gow & Kember, 1993; Hubball

& Burt, 2004; Kember & Gow, 1994; Musinski, 1999; Pine & Boy, 1977; Schaefer &

Zygmont, 2003; Weimer, 2002).

The fifth and last key area of change proposed by Weimer (2002) is the purpose

and processes of evaluation. It is argued that when faculty and students consider

evaluation, both tend to focus on grades more than learning (Pollio & Beck, 2000;

46

Weimer, 2002). However, Weimer (2002) claims that evaluation can be used to not

only generate grades but also to promote learning. Therefore, Weimer (2002)

suggests educators use evaluation activities to promote learning and open the

evaluation process to develop student self and peer assessment skills. Weimer (2002)

not only clearly describes these five key changes to practice but also presents

practical suggestions for implementing the approach in the classroom and gives

powerful examples to guide teacher practice.

Student-centred teaching ties all the aspects of curriculum, including innovation,

planning, implementation and ongoing review, to the process and objectives of

learning rather than to content delivery alone. The student-centred teaching approach

can change practice, produce better teaching, and provide a more constructive

learning environment. The model for change to a student-centred approach proposed

by Weimer (2002) appears to be a feasible tool to facilitate the development of

generic and professional competencies in nursing students within this study.

The Nursing Curriculum Guideline also calls for teaching implementation to be

based on “cognitive, psychomotor, as well as affective educational objectives”; and

curriculum evaluation to be based on “diagnostic, formative, as well as summative

evaluation” (Curriculum Research and Development Centre in Allied Health

Education, 2004a). Furthermore, alignment of each curriculum element is an

important issue for the success of an educational program (Anderson, 2002; Aviles,

2001; Biggs, 1996a; 1999; 2003; Biggs & Moore, 1993; Hall, 2002; McMahon,

2005). These pedagogical concepts, ideas, or skills associated with what is presented

in the MOE Nursing Curriculum Guideline made up the basic content for the

curriculum change in this study.

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It will initially be a challenge for nurse educators to apply these pedagogical

concepts to the curriculum. As with most disciplines in the academic world, nurse

educators in Taiwan are qualified in the nursing profession but tend to have limited

pedagogical training in preparation for the teaching task (Dunkin, 1995; Hativa, 2002;

Hsu, 2005; Louie, Drevdahl, Purdy, & Stackman, 2003; Weimer, 2002; Willcoxson,

1998). However, powerful educational reform requires professionalism in pedagogy

(Wu, 2006). Essential pedagogical knowledge related to the content of the change are

“basic competencies” (Wu, 2004, p. 41) and these are required before attempting to

change any curriculum. That is, possession or understanding of contemporary

pedagogical principles is essential if nurse educators are to be enabled to successfully

bring about a change towards student-centred learning.

The Process of the Change

According to Smith and Lovat (2003), the educational change process includes

the process of introducing the curriculum content, enabling people to become

committed to the importance of change and implementing the change into classrooms.

Smith and Lovat (2003) claim that change is more about process and people than

product and objects; it inescapably involves the beliefs, interests, perceptions and

feelings of individuals who are involved, and it is dynamic. They also argue that

curriculum change that involves individual teachers’ intrinsic motivation is more

fundamental and sustainable than extrinsic or imposed strategies based on the control

of rewards and punishments, because it has the capacity to alter individual teachers’

conceptions, perceptions, meanings, and practice in accord with the change content

(Smith & Lovat, 2003).

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Smith and Lovat’s (2003) argument is supported by research which suggests

that educational innovation projects that attempt to change teaching practices and

improve student learning are not likely to be successful unless teachers’ conceptions

of teaching and learning are taken into account (Kember, 1997a; Martin, Prosser,

Trigwell, Ramsden, & Benjamin, 2002; Trigwell, Prosser, & Taylor, 1994; van Driel,

Verloop, van Werven, & Dekkers, 1997). Smith and Lovat’s (2003) argument is also

supported by Fullan (1993; 1999; 2003), Ho (2000) and Ramsden (1992; 2003), who

claim that providing teachers with prescribed skills and recipes for teaching is not

sufficient; more fundamental interventions such as conceptual change are required to

transform teaching practice.

In order to bring about curriculum change that will encourage and develop

nursing students’ generic and professional competencies, nurse educators’

conceptions of teaching will have to be consistently student-centred so that students

learn to think more deeply and judge more rationally. This assumption is discussed in

the following section.

With respect to concepts of student-centredness, research has shown logical

relationships between teachers’ conceptions of teaching and learning, their teaching

practices and student learning in tertiary education. Most lecturers who have a

learning-facilitation conception of teaching adopt student-centred approaches to

teaching whereas most lecturers who have a knowledge-transmission conception of

teaching adopt teacher-centred approaches (Kember & Kwan, 1997, 2002; Parpala et

al., 2004; Trigwell & Prosser, 1996a, 1996b; Trigwell et al., 2002). A predominant

view of teaching as transmission of knowledge appears to encourage students to

adopt surface and rote learning approaches, while beliefs in teaching as the

49

facilitation of learning are more likely to induce deeper and more meaningful

approaches to learning (Gow & Kember, 1993; 1994; Saroyan & Snell, 1997;

Trigwell et al., 1999).

These research findings suggest that if nurse educators are expected to adopt

student-centred approaches to teaching and students are expected to adopt

meaningful approaches to learning, then it is important to direct efforts towards

transforming nurse educators’ conceptions of teaching to emphasise the facilitation of

student learning. The research findings also echo Biggs and Moore (1993), Kember

(1997a; 1997b), and Kember and Gow’s (1993; 1994) arguments that teachers’

conceptions of teaching can be one of the most significant elements affecting the

outcomes of student learning.

If nurse educators cling to an information transmission conception consistent

with long established content-driven approaches, even in a restructured

student-centred curriculum, teaching practices are likely, as Kember (1997a) claims,

to end up largely as “monologues” or “mini-lectures” (pp. 270-271). Conversely, if

nurse educators’ underlying beliefs about teaching and learning are consistent with

the change content presented in the Nursing Curriculum Guideline, we are more

likely to transform our teaching customs and thus better facilitate the development of

core generic and professional competencies in nursing students. In short, there is a

need to incorporate strategies for transforming beliefs, customs, attitudes and

expectations of those involved into the curriculum change process. This sort of

transformation can be seen as a process of reculturing.

Authors such as Fullan (2001a), Hargreaves (1994), and Hastings and Squires

50

(2002) claim that changing the beliefs, customs, attitudes and expectations of the one

who participates in the process is reculturing. Fullan (2001a) conceived reculturing

as “transforming the culture - changing the way we do things around here” (p. 44).

Hargreaves (1994) claims that in terms of educational change, reculturing solutions

are less fashionable but more enduring and effective than the politically popular

restructuring ones. This is not to say that curriculum restructuring is ineffective for

educational reform. However, the change is likely to be more effective when the

deep-rooted beliefs, practices, relationships among teachers and students are taken

into account. This supports Smith and Lovat’s (2003) argument that any successful

strategy for change must deal effectively with people’s feelings and perceptions.

Teachers are more likely to become committed to the change and implement it in the

classroom when their beliefs and perceptions are in accord with that change. Smith

and Lovat (2003) also argue that convincing teachers to become committed to the

change is a very important strategy for curriculum change.

Commitment to change is seen as intrinsic motivation or a sense of moral

purpose within which people work (Fullan, 1993, 1998, 1999, 2001a, 2001b, 2003,

2005). Moral purpose within an educational context is defined as “making a

difference in the lives of students” (Fullan, 2003, p. 18). In this sense, teachers who

have moral purpose are more likely to place importance on student learning rather

than on teaching. Placing emphasis on student learning is not only valued as good

teaching (Biggs, 1999; 2003) but is also considered crucial for sustainable

educational change (Fullan, 2003, 2005; Hargreaves, 1994; Hargreaves & Fink,

2005). As the current content-driven approaches to teaching and learning have been

long established, even cherished, within Chinese educational contexts, fundamental

and sustainable change will require time and moral purpose.

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Not only time and moral purpose but also reflection is crucial for all aspects of

curriculum change, including elements of innovation, planning, implementation and

ongoing review. Reflection allows teachers to be more deliberate in their work

(McAlpine & Weston, 2002). However, there is a tendency for today’s teachers in

tertiary education to spend more time on research, and little, if any, time or

opportunities on reflecting on their teaching practices (Hatton & Smith, 1995; Jay,

2003; Miller, 1990; Weimer, 1997). Reflection is at the heart of quality teaching

because it is a kind of experiential, ongoing learning for teachers working in the

constantly changing world of the classroom (Jay, 2003).

Jay (2003) constructed the following definition of reflection by summarising the

concepts of reflection-on-action (Schon, 1983, 1987), reflection-in-action (Schon,

1983, 1987) and reflection-for-action (Killion & Todnem, 1991):

Reflection is looking back on experience in a way that informs practice, learning in the midst of practice, and/or making informed and intelligent decisions about what to do, when to do it, and why it should be done. (p. 14)

Reflection represents one way teachers grow and learn from their own teaching

practices (Jay, 2003). Through reflection, teachers are able to re-evaluate situations in

relation to their teaching and/or student learning which otherwise may not be

remembered, much less improved (Smith & Lovat, 2003). I began to think that

through reflection, nurse educators may be able to look back on their previous

teaching practice, evaluate their practice and link its relationship with student

learning, and then make curriculum decisions appropriate for the development of

core generic and professional competencies in students. With deliberate reflection by

the stakeholders involved in the curriculum change process, the change is more likely

52

to be fundamental and sustainable. Through reflection, teachers learn to learn about

their teaching practice and therefore become better practitioners in the profession

(Schon, 1983).

Sustainable change also requires collaborative relationships. Although teachers

socialise with colleagues, they largely work in isolation (Fullan, 2003; Hargreaves,

1994; 1995). When there is no collaborative culture teachers are possibly less

confident about changing what they do towards what they really want to do, and as a

result tend to take fewer risks and ‘play it safe’ when teaching (Fullan, 2003). To

compound the problem, there may even be a lack of coherence between what

teachers teach and what is intended to be taught (Fullan, 2003; Smith & Lovat, 2003).

Developing collaborative cultures among teachers enables teachers to learn from

each other, support each other, and share and develop their teaching expertise

together (Hargreaves, 1994; Smith & Lovat, 2003; Smith et al., 2000; Smith, 1993).

The individual is also more likely to commit to the change if an alteration in the

sentiment of the group becomes apparent (Lewin, 1952). Collaboration is conceived

by Smith and Lovat (2003) as one of the most important aspects of developing

effective educational change.

A collaborative working relationship among teachers produces the capacity for

them to communicate, understand, and critically reflect on their teaching practice

together, and thus build group cohesion (Hasseler & Collins, 1993; Kim & Lee, 2002;

Manouchehri, 2002). More particularly, when collaborative reflection occurs the

process not only encourages a culture for individual improvement of one’s practice

but also joint work that raises commitment to help others improve their practice

(Osguthorpe, 1999). When working collaboratively with equal relationships, teachers

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are more likely to share the power, collectively control the change process, and build

a sense of ownership of the curriculum. Therefore, democratic principles such as

equal relationship, collaborative control and ownership are also valued by Smith and

Lovat (2003) as essential components for facilitating effective change.

Effective educational change, particularly curriculum change, needs to take into

account all the characteristics described above. The characteristics are inevitably

interwoven with one another. In this study, the change content is largely addressed by

the MOE Nursing Curriculum Guideline. I believe that a student-centred curriculum

will better facilitate the development of core generic and professional competencies

in students. The change process is seen as a process of reculturing and will

unavoidably involve individual nurse educators’ beliefs, interests, commitments,

customs, and teaching practices. The change process also needs to include strategies

that promote reflection, collaboration, and democratic values. In this sense,

curriculum change is clearly, as Fullan (1993; 1999; 2003) maintains, a complex

process.

Fullan (1993; 1999; 2001a; 2001b; 2003; 2005) argues that the change process

is always a complexity, it can only be understood or led rather than managed or

controlled. Both Fullan (2001b) and Smith and Lovat (2003) suggest starting with a

small achievable plan when attempting to bring about educational change. A small

but fundamental change by individuals can lead to further change within the context

(Kemmis & McTaggart, 1988; 2000; Smith & Lovat, 2003). Thus, a small change

initiated by a small group of nurse educators to a unit within the Department of

Nursing at CGIT can over time promote larger scale changes within the department

and the entire institute. A small but fundamental change has the capacity for

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emancipation, because it empowers participants to make changes (Grundy, 1982;

Kemmis & McTaggart, 1988; Smith & Lovat, 2003; Zuber-Skerritt, 1996).

Empowerment is a commonly used term, however, it is difficult to define and

thus the term is used in a variety of ways (Leyshon, 2002; Rappaport, 1984).

Rappaport (1984) views empowerment as a process in which “people, organisation,

and communities gain mastery over their lives” (p. 3). From a critical education

research perspective, Smith (1993) conceived three identifiable and interrelated

spheres of empowerment: self-growth, political consciousness raising and collective

action or struggle. Conceptions offered by Smith (1993) in relation to these three

spheres of empowerment can be seen as a complement to the change process

proposed by Smith and Lovat (2003). The three spheres of empowerment advocated

by Smith (1993) are summarised as follows.

The first sphere – empowerment as self-growth, according to Smith (1993, pp.

78-79), focuses on self-understanding and feelings of worth of individuals. It is a

personal and psychological level of empowerment that “increases an individual’s

self-esteem and personal confidence while decreasing feelings of guilt, self-denial or

inadequacy” (Smith, 1993, p. 78). The outcome of this level of empowerment is to

enhance personal autonomy, self-determination, assertiveness, and a commitment to

greater responsibility. This conception of empowerment can be related to the

acquisition of knowledge, skills and predispositions which prepare an individual to

contribute effectively to the productivity of a particular enterprise. I see

empowerment as self growth as an important starting point in preparing nurse

educators at CGIT to bring about an effective and generative curriculum change.

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Empowerment in the second sphere, that of political consciousness raising, can

be seen as “enlightenment or liberation from understandings constrained and reified

through false consciousness” (Lather, 1985, p. 8). False consciousness is “the

systematic ignorance” (Fay, 1987, p. 27) that members of a society have about

themselves and the society. By having a different understanding of themselves and

the society, the members might be able to reorganise themselves into an empowered

group in order to alter their social arrangements and thereby to solve their socially

embedded problems (Fay, 1987). This level of empowerment is therefore concerned

with professional growth and participation in decision-making. It promotes a more

profound scepticism of the routine, common-sense understandings and practices of

education, and confronts the constructed, interest-serving and oppressive realities of

dominant cultural norms and practices (McConnell, 1992; Smith, 1993). In this study,

I believe that by raising political consciousness through professional growth and

decision making nurse educators will be able to reflect critically on the long

established teacher-centred, content-driven teaching practices and then commit to the

change actions.

In the third sphere of empowerment – empowerment as collective action or

struggle, the central argument lies in the notion that “simply changing

understandings, or the way we name reality, is not to change reality” (Smith, 1993, p.

81). Significant change requires groups of stakeholders working collaboratively for

change. This sphere of empowerment concerns the effectiveness of authentic

participation in generating lasting transformations. Thus it also requires a shared

conviction based on knowledge about institutions, organisations and their ideological

foundations. In this study, I believe collaborative work, together with consistent

student-centred conceptions, will enable nurse educators to develop confidence and

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take risks in bringing about desired educational change. Smith’s (1993) constructs of

empowerment complement Smith and Lovat’s (2003) propositions about strategies

for bringing about curriculum change. They both emphasise the importance of

starting with individuals, the importance of personal and professional development,

and the importance of collaborative action.

The conceptual framework of this study is presented in Figure 2. It is

underpinned by concepts such as student-centredness, curriculum alignment,

reculturing, collaborative practices, individual and collaborative reflection, personal

growth, and professional development. The conceptual notions interweave with one

another throughout the curriculum reculturing process, thus the framework is

CURRICULUM CHANGE

Figure 2. The Conceptual Framework of the Study

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presented as a circle rather than a presentation of linear sequence.

Conclusion

This chapter reported the contextual considerations and the conceptual notions

that guided this study. It is recognised that present nurse education in Taiwan does

not adequately prepare students to develop core generic and professional

competencies needed in the profession to cope with the demands of today’s health

care environment. The Ministry of Education and nursing critics in Taiwan have

identified a macro-problem of nurse education and subsequently the Nursing

Curriculum Guideline (Curriculum Research and Development Centre in Allied

Health Education, 2004a) was developed, indicating not only the core generic and

professional competencies nursing students should possess but also the ways in

which nursing curricula should be developed.

I have argued that the curriculum change is not simply about the curriculum

document per se, it is about the teachers and teaching and about the learners and

learning, and the whole curriculum making process. I have argued that the

curriculum change process is very complex and involves transformations of people’s

beliefs, conceptions and customs of teaching and learning, and is thus a process of

reculturing. The primary change to curriculum content in this study is related to

student-centred learning – an approach that will, I believe, better facilitate the

development of core generic and professional competencies in nursing students. The

change also involves achieving alignment in all aspects of the curriculum. I have

argued that during the curriculum change process, the curriculum content needs to be

introduced; that commitment to the change should be encouraged; that consistent and

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coherent conceptions of teaching and learning need to be developed toward

student-centredness; that both personal growth and professional development need to

be considered; and that nurse educators need to engage in democratic and

collaborative practices as they reflect on teaching and learning, on decision making

and on actions to bring about change. In short, the whole curriculum change process

in this study will be a reculturing process – the process of transforming the way the

nurse educators plan, develop, and carry out teaching and learning practices in

classroom situations. I have also argued that an achievable innovation with a small

group of nurse educators is the most effective way to bring about empowering,

sustainable and generative change that have the capacity to develop into large scale

change.

This study does not contribute by providing a cookbook of recipes that dictate to

CGIT nurse educators what they ought to do. Rather, it is a collective work based on

reculturing. The purpose of the study was to enable a group of nurse educators to

reculture the way we teach and the way students learn through a collaborative

curriculum making process. In doing so, we will be able to improve the development

of core generic and professional competencies in students of nursing. The conceptual

framework detailed in this chapter informed the planning of the methodology. I was

looking for a methodology that would guide and promote curriculum change within

the specific context of the study. The research methodology and the conceptualisation

of a plan of action are the focus of the next chapter.

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CHAPTER 3

Methodology and the Action Plan Introduction

In the preceding chapter I provided details of the contextual considerations and

conceptual notions that directed my study. My contextual considerations included the

development of the Nursing Curriculum Guideline (Curriculum Research and

Development Centre in Allied Health Education, 2004a) in Taiwan, which outlined

the way in which nursing curricula should develop in the future. I also provided

details of how nurse education in Taiwan, particularly the curriculum, has been

censured by the MOE and other critics for its inadequacy in preparing nursing

students to develop the generic and professional competencies needed in the

profession and thus cope with the demands of today’s health care environment. In my

workplace, Chang Gung Institute of Technology (CGIT), nurse education has not

only received censure from the MOE, but also from me and my colleagues as we

became increasingly frustrated with the inadequacy of student learning

The contextual considerations substantiated the research problem of the study:

The curriculum does not adequately facilitate the development of generic and professional competencies in students of nursing in Taiwan.

Underpinned by the contextual considerations within the specific focus, my

enthusiasm was provoked to investigate the following research question:

What changes to the nursing curriculum will better facilitate the development of core generic and professional competencies in students;

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and what sort of strategies need to be incorporated into the curriculum change process so that transformations are empowering, sustainable and generative?

Based on the research problem and question, I conceptualised a framework to

guide the transformative process in ways that would be empowering, sustainable and

generative. I argued that curriculum change is not merely about the curriculum

document but also about all aspects of the curriculum process as well as about

individual nurse educators’ beliefs, interests, perceptions and feelings: essentially, it

is a reculturing process. My conceptual framework was based on ideas such as

student-centredness, curriculum alignment, reculturing, collaborative practices,

collaborative reflections, personal growth, and professional development.

This chapter reports the methodology of the study and how I planned to

investigate the research questions in light of the conceptual framework. The

determination and justification of Action Research as an appropriate methodology to

guide the study will be addressed first, followed by a plan of action detailing how the

information will be generated, gathered, organised, examined, and monitored. Finally

ethical considerations will be addressed.

Determination and Justification

In Chapter 2 the curriculum change process was conceptualised in ways that

were empowering, sustainable and generative, and these conceptual notions

underpinned the planning of the methodology. I was looking towards a

methodology – a body of knowledge that would promote the conceptual notions

within the context of the study. As this research project “is not on or about education,

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[but rather] it is research in and for education” (Carr & Kemmis, 1986, p. 156),

Action Research with its critical and postmodern theoretical and philosophical

underpinnings was chosen as the preferred methodology to bring about the

envisioned change.

In brief, postmodernism challenges an ‘orthodoxy’ about the notion of truth and

objectivity by arguing that truth is relative, conditional, and situational; and that

knowledge is always an outgrowth of previous experiences (Mills, 2003). From the

critical theory perspective, human beings are social beings and practice settings are

constructed historically, socially and discursively (Carr & Kemmis, 1986; Kemmis &

McTaggart, 1988; 2000; McTaggart, 1991). In addition, knowledge is the outcome of

social activity that is stimulated by human needs and interests (Carr & Kemmis,

1986). Grounded in critical theory and postmodernism, Action Research removes the

distance between the researcher and subjects, bridges theory and practice, and

includes the community being studied, with an end goal of empowering the

community to create change (Kemmis & McTaggart, 2000; Meyer, 2000;

Zuber-Skerritt, 1996).

Action researchers treat the others involved in the setting as co-researchers,

understood as ‘us’, making and learning from changes as they go (Kemmis &

McTaggart, 2000). The Action Research process is regarded “as socially constructed

and as a matter for collective and collaborative decision making” (Kemmis &

McTaggart, 1988, p. 16). Furthermore, action researchers attempt to change practice

by involving not only themselves and the participants but also the discourses, social

relationships and histories of the practice (Kemmis & McTaggart, 2000). As the

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curriculum reculturing process had been conceptualised to involve not only the nurse

educators in the school collaborating but also the socially constructed conceptions

and actions within the context, the praxis-oriented nature of Action Research

provided justification for choosing Action Research as an appropriate methodology

to guide the study.

The term ‘Action Research’ was first coined by the social psychologist Kurt

Lewin (1946; 1952) through his work in the group dynamics movement of the

post-war reconstructionist period. Lewin (1946) claimed that “research that produces

nothing but books will not suffice” and the research needed for social practice is “a

type of action-research, a comparative research on the conditions and effects of

various forms of social action, and research leading to social action” (p. 41). His

Action Research model was composed of the action cycles of planning, fact-finding

(or reconnaissance), and execution (Lewin, 1952). The cyclic action process remains

one of the distinct features of Action Research.

Kemmis and McTaggart (1988) termed the cyclic action an “Action Research

Spiral” (p. 11). It is a systematic self-critical process which takes place in a

self-reflective spiral consisting of cycles of planning, acting (implementing plans),

systematically observing, and reflecting on the action (Kemmis & McTaggart, 1988).

This cyclic process of research provides opportunities for participants to deepen their

understanding of the problem, to learn and grow, and to reflect and react on their

work as well as on their relationships with each other (McNiff & Whitehead, 2002).

Therefore Action Research “provides the mechanism for changing practice and

simultaneously evaluating the success of change” (Jenks, 1999, p. 255).

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According to Kemmis and McTaggart (1988), Action Research is defined as:

A form of collective self-reflective enquiry undertaken by participants in social situations in order to improve the rationality and justice of their own social or educational practices, as well as their understanding of these practices and the situations in which these practices are carried out. (p. 5)

This definition fits well with the aim and conceptual notions of this study. The

aim of this study also fits the objective of Action Research, which is to bring about a

change in a problematic situation within a defined context (Burns, 1994; Kember,

2000a; Kemmis & McTaggart, 2000; McNiff & Whitehead, 2002; Rice & Ezzy, 1999;

Schwalbach, 2003). The curriculum change process was conceptualised in ways that

involve collective self-reflective enquiry by nurse educators so that their

understandings of their teaching and learning practices and contexts are improved.

Furthermore, Action Research also starts small and works towards extensive changes

(Kemmis & McTaggart, 1988) and this is one of the strategies conceptualised for this

study. Action Research is therefore considered an appropriate methodology to guide

this study.

The terms “Action Research” and “Participatory Action Research” are

interchangeable in this study. Participatory Action Research, according to Kemmis

and McTaggart (2000), stresses the interdependence of, and practical theoretical

convergences within, the practice, the practitioners and the practice settings. It

emphasises reflective and collaborative processes. Kidd and Kral (2005) claim the

centre of Participatory Action Research is “a sharing of power” (p. 189) with “a

frame of mind that includes respect, genuineness, and a good dose of openness to

experience” (p. 188). All the participants’ values and experiences are central to the

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collaborative process. During the collaborative process, people develop goals and

methods together, participate in the gathering and examination of information, and

implement the results in a way that will raise critical consciousness and promote

change in their practice, the practice setting, and themselves (Kidd & Kral, 2005;

Reason, 1994b). The emphasis of Participatory Action Research on reflection,

collaboration and empowerment ideally provides the theoretical basis of knowledge

to guide this study.

In this project I was attempting to bring about curriculum reculturing in a way

that would better facilitate development of core competencies for nursing students

and thus meet the requirements of the Nursing Curriculum Guideline. In order to

make the transformation not only effective and appropriate but also empowering,

sustainable and generative, the discourse, social relationships and the history of the

practice (that is, the context of the study) were involved. Action Research, the chosen

methodology, provided the mechanism by which the participating nurse educators in

CGIT were able to explore and understand their conceptions about teaching and

learning in relation to teaching the unit ‘Physical Examination and Health

Assessment’ (PE); then collaboratively plan and implement action in order to

transform the current situation; and finally to evaluate and reflect on the

transformations. This initially was a small change but nevertheless had the potential

to generate similar changes throughout the entire institute.

Conceptualising the Action Plan

In order to bring about transformations that would adapt to the circumstances

and constraints of the context, I conceptualised a specific Action Plan of ‘how to

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bring about empowering, sustainable and generative curriculum change’. However,

given the democratic and collaborative processes inherent in Action Research, my

plan of action was open to change by my co-researchers at any time. Grundy and

Kemmis (1981) state that “one of the underlying reasons for the significance of the

change. . . is the shift in power that occurs through the operation of the action

research process” (p. 331). This project was about enabling nurse educators to

change their own situation and to feel a sense of ownership of the change. Thus

throughout the whole process it was essential that ‘owners’ felt free to alter the plan

as many times as they felt necessary. Once the PE educators began to participate as

collaborative researchers, the plan could be altered as it became “our plan, a truly

collaborative plan of and for action” (Chapman, 1996, p. 77). The Action Plan I

conceptualised and anticipated we would use was my “best guess as to what will

transpire in the field” (Herr & Anderson, 2005, p. 76), but my ‘best guess’ would be

open to alteration during the collaborative journey. The following plan and the

reasoning behind the intended actions concerns what I was proposing we do as a

collaborative team and is therefore largely reported in terms of future rather than past

actions. Alterations to the plan will be reported in the story of our collaborative

journey.

The framework for the Action Plan was based on the propositions by Smith and

Lovat (2003) concerning the content and process of change and on the three spheres

of empowerment proposed by Smith (1993). As described in Chapter 2 (See pp.

43-47), the content of change in this study referred to the core generic and

professional competencies required in the Nursing Curriculum Guideline and the

concepts, knowledge, and skills related to student-centred teaching and learning. The

change process for this study included introducing the content of the change, and

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enabling the nurse educators in CGIT to become committed to the change and to

implement the change into classrooms. The three spheres of empowerment proposed

by Smith (1993) are also described in Chapter 2 (See pp. 54-55). Smith (1993)

constructed indicators for each of the three spheres in terms of empowerment

outcomes. The key indicators that suggested empowering outcomes in this study

were “changes in self knowledge” (Smith, 1993, p. 79) in terms of self-growth or

personal empowerment; “developing scepticism about appearances” and

“recognising historical and political antecedents to contemporary practices” (Smith,

1993, p. 80) in terms of political consciousness raising or professional growth and

decision making; and “the development of a shared ideology critique which is

integral to subjecting individual and shared understandings to critical review” and

“collective strategic action” (Smith, 1993, pp. 81-82 ) in terms of collective action or

struggle. The conceptualisation of the initial Action Plan was guided by these

outcome indicators and the propositions by Smith and Lovat (2003) concerning the

content and process of change

The Action Plan for the collaborative journey included five phases: Pre-action

Phase: Team Formation; Phase 1: Recognising the Need to Change, Phase 2:

Curriculum Decision Making; Phase 3: Implementing and Reflecting on the New

Curriculum; and Phase 4: Evaluating the Collaborative Journey. The Action Plan

detailed the purpose, activities and strategies used during the collaborative process

and how the information was generated, gathered, organised, examined and

monitored.

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Generating and Gathering the Information

Pre-action Phase: Team Formation

The purpose of the Pre-Action Phase was to form a collaborative team to bring

about a curriculum change. The unit ‘Physical Examination and Health Assessment’

(PE) for 2-year technical nursing students at CGIT was chosen as a starting point for

the change. CGIT provides two levels of programs for educating students about the

theoretical and practical aspects of health assessment: 1) ‘Physical Examination’ for

junior college nursing students, which is predominately skill-based; and 2) ‘Physical

Examination and Health Assessment’ for technical college nursing students that is

also skill-based but also emphasises integration of theoretical information and critical

thinking and judgement.

The unit ‘Physical Examination and Health Assessment’ (PE) for 2-year

technical nursing students was chosen because commencing the curriculum change

process with this unit was in keeping with the strategy of starting small so that the

change could be more achievable (Fullan, 2001b; Smith & Lovat, 2003). Moreover,

as a former unit coordinator, I was familiar with the unit and considered it

appropriate for commencing the curriculum reculturing endeavour. The learning

Table 2

Two Levels of PE Units Provided in CGIT in 2005

Junior college nursing students 2-year diploma

5-year diploma Technical college nursing students 2-year bachelor

4-year bachelor

The Unit ‘Physical Examination

and Health Assessment’

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objectives in this unit emphasise integration of theoretical information and critical

thinking and judgement abilities in students. However, there were problems related

to the ways we worked towards achieving these objectives. Commencing the

curriculum reculturing with this unit could, as Fullan (2001b) suggests, save

spending time in the early stages on needs assessment.

All PE educators in CGIT taught in either or both levels of programs in any

school year, depending on the teaching arrangement settled several months before the

school year begins. Therefore, all the educators were potential participants in the

curriculum reculturing process.

The proposed Action Plan called for all PE educators and the administrators

who coordinated the 2-year technical nursing program to be invited to form the

collaborative team at CGIT in semester 2, school year 2004 following an

introductory seminar. During this one-hour seminar the Nursing Curriculum

Guideline would be presented, the results of the reconnaissance survey (See pp.

30-35) described to highlight the present teaching and learning problems, and the

research project introduced. An information sheet, including the cyclical nature of

action research, the proposed timetable for the change, and a consent form would be

distributed.

In the forming stage of group development, according to Wood et al. (2004),

people are interested in not only determining the real task of the group but also

discovering what is considered acceptable behaviour and defining group rules.

Therefore, ample time at the end of the seminar would be provided for questions. The

notion of “working rules” (Kemmis & McTaggart, 1988, p. 108) would also be

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introduced in the seminar. The development of the working rules is described in

Chapter 4.

Action Phase 1: Recognising the Need to Change

The purpose of Action Phase 1 was to raise awareness within the collaborative

team of the need to change the current, problematic curriculum. Strategies for doing

so included activities such as creative writing and group discussion which would be

arranged for team members to reflect on their personal practical theories of teaching

and improve their understanding of contemporary pedagogical principles. I believed

McCutcheon’s notion of teachers’ personal, practical theories of teaching

(McCutcheon, 1992, 1995; McCutcheon & Jung, 1990; McCutcheon & Milner, 2002)

would prove to be an appropriate strategy to enhance team members’ self-awareness

and self-knowledge about their teaching practices.

Many authors, for example, Jay (2003), McCutcheon (1992), and Rogers (2002)

propose that a starting point for promoting teachers’ self-growth and further

improvement in their teaching is to encourage them to reflect on their own personal,

practical theories of action. Teachers’ personal, practical theories are a set of

interrelated concepts, beliefs, and images that provide teachers with reasons for

acting as they do, and for choosing teaching activities and curriculum materials

(McCutcheon, 1995; McCutcheon & Jung, 1990; Sanders & McCutcheon, 1986).

Teachers’ activities and decisions are guided by the personal, practical theories that

they hold (McCutcheon, 1992). Although sometimes teachers may not be conscious

of the reasons for their actions, their personal, practical theories are the propositions

that undergird and guide their appreciation, decisions and actions (Sanders &

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McCutcheon, 1986). However, it is often only through articulation that we become

fully aware of the existence of what has tacitly been there as theory, and are then in a

position to reflect on that theory (McCutcheon & Jung, 1990). When teachers

understand their own theories of practice, they can articulate their beliefs to one

another, examine and reconstruct those that might be inappropriate, and deliberately

justify their practices (McCutcheon, 1992).

McCutcheon’s (1992, p. 203) approach, which aimed at reflecting on practice in

a manner similar to creative writing was considered an accessible strategy of ‘how’

the PE educators can be encouraged to reflect substantively on their own personal,

practical theories of teaching. The creative writing approach requires participants to

write about their philosophy and understandings of the nature of teaching and

teachers, learning and learners, subject matter and the “house keeping chores”

involved in maintaining the class (McCutcheon, 1992, p. 203).

Combined with teacher’s personal, practical theorising, I also considered the

strategy of “storytelling” (Connelly & Clandinin, 1988, p. 44) as a useful strategy to

facilitate reflection. Carter (1993) claims that teaching is experienced as complex

social events and the acquisition of teaching expertise is the acquisition of

event-structured knowledge. The richness and nuances of meaning in this sense of

knowledge in teaching can only be demonstrated or evoked through story rather than

definitions, statements of fact, or abstract propositions (Carter, 1993). Teacher’s

personal, practical theories are embedded within the narrative unities which

“emerges from our past, bring about certain practices in the present, and guide us

toward certain practices in our future” (Connelly & Clandinin, 1988, p. 75).

Storytelling provides a way of looking across the temporal span of our narratives and

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reflecting on our own personal, practical experiences (Connelly & Clandinin, 1988).

Through the strategy of storytelling team members would be encouraged to articulate

their personal, practical theories of teaching and learning so that they could better

understand the theories which guide their reflections and decision-making.

To adapt the strategy of reflecting on personal practical theories of action to the

educational context of Chang Gung Institute of Technology, I combined and

modified both these activities - writing to the clone and storytelling - as follows:

You have just won millions of dollars in a lottery. You tell the Director of the Nursing Department that you want to take one year off from teaching to do something you’ve always dreamed of doing. However, she says you may not because you’re too good a teacher. Undaunted and wealthy, you have a clone made of yourself. You are fortunate that human cloning has just become available and you only have one unit to teach next year – the ‘Physical Examination’! The clone arrives and looks just like you. But now you need to help the clone understand how you teach so that you’ll be able to get away with taking off a year, unbeknown to the Director of the Nursing Department. Clearly you cannot teach your clone each little detail about how you teach. Tell your clone your story about how and what you do as a teacher, particularly a PE educator. Describe the general principles underlying what you do when you teach (your role and responsibilities as a PE educator and the nature of teaching), how you treat students (the conceived role and responsibilities of the students in the PE classes and the nature of their learning), and how you treat the content (the importance of subject matter in the PE classes). Explain this in a paper of one to two A4 pages. You could start with “I remember when I teach PE in the classroom . . .” or “I remember once when I . . .”

I anticipated this activity would motivate the participating nurse educators to slow

down, reflect on, and gain more conscious understandings of their personal, practical

theories of teaching. Such change in self-knowledge is a form of personal

empowerment (Smith, 1993).

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After this individual and reflective activity, team members would be invited to

participate in group discussion sessions where they could share their personal,

practical theories of teaching, and their associated beliefs, perceptions and feelings.

The purpose of these group discussion sessions was to provide opportunities for team

members to share and understand each others’ personal practical theories about

teaching and learning, and to further reflect on their own personal practical theories.

Several group sessions with a focus on essential pedagogical knowledge related

to the curriculum content, including the notions of student-centred teaching and

learning would then be held. These group discussion sessions were planned to raise

team members’ self-understanding, enable them to reflect on their current teaching,

and bring into their awareness the need to change. According to Smith (1993),

indicators which would empower people in terms of political consciousness raising

are those concerned with professional growth and participation in decision making

processes. “Making teachers more knowledgeable is an obvious step in enhancing

their power” (Maeroff, 1988, p. 474). In conjunction with the propositions by Smith

and Lovat (2003) in relation to the content of change (i.e., student-centredness and

core competencies), providing the PE educators with essential knowledge about

curriculum would enable them to develop scepticism about contemporary practices.

The acquisition of knowledge would also enable the PE educators to recognise the

content-driven and teacher-centred nature of the curriculum and schooling in the

institute. This strategy of knowledge provision, as well as most of the time spent for

the rest of activities in this study, would involve the PE educators in group

discussion.

In consideration of the team members’ limited time and energy due to their

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already busy academic lives (Grundy & Kemmis, 1981) and also in consideration of

the feasibility and effectiveness of the plan, the schedule set out for group discussion

sessions was flexible, and open to negotiation and alteration in accordance with the

decisions of the team. What actually happened in each group discussion session

during Action Phase 1 is reported in Chapter 4.

Action Phase 2: Curriculum Decision Making

The purpose of Action Phase 2 was to enable team members to make decisions

about new curriculum content and its alignment with objectives, teaching and

learning activities, and student assessment approaches. Several group discussion

sessions were planned for this collaborative decision making. Strategies intended for

these sessions were nominal group techniques (Caroselli, 2002; Dunham, 1998;

Swansburg, 1995), critical debate (Kemmis, 1986) and negotiation, and analysis of

the old curriculum document.

Nominal group technique would be used in this study to facilitate “judgemental

decision making where creative solutions are sought” (Dunham, 1998). By following

the procedures of generating ideas, recording ideas, discussing ideas and voting on

ideas, team members would be able to individually and collectively produce and

examine creative ideas, and collaboratively select what was to be included in the

curriculum.

Through group discussion, a sharing climate would not only enable the

participating PE educators to learn from each other but also ensure collaborative

decision making. Working collaboratively creates a sense that all group members

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“are in the same boat and trying to accomplish the same goals” (Fiszer, 2004, p. 11).

Collaboration thus has the potential for empowerment in terms of not only

collaborative decision making but also collective action or struggle (Smith, 1993). In

this study collaborative work would occur once the team was formed. Team members

would engage in group discussions throughout the whole collaborative journey. It

was anticipated that group discussions, in the form of nominal groups (Caroselli,

2002; Dunham, 1998; Swansburg, 1995) and critical debates (Kemmis, 1986), would

facilitate not only curriculum decision making during Action Phase 2 but also

accomplishment of the goals in Action Phase 3.

Action Phase 3: Implementing and Reflecting on the New Curriculum

In the proposed Action Plan this phase involved individual implementation of,

and simultaneous reflection on, the newly developed curriculum. This was to be

followed by collaborative reflections - a cyclic process of team members acting,

reflecting, evaluating, and re-planning aspects of the new curriculum (such as

objectives, teaching and learning activities, and assessment approaches) they felt

could be further improved. As there were four main body systems taught in the unit

with teaching duration for each system about a month, and each PE educator taught

one body system, monthly meetings would be negotiated for this phase.

In order to encourage collaborative reflection, the techniques and attitudes

proposed by Pan (2004a), and summarised below, would be introduced to team

members.

Techniques: 1. Questioning: articulate concerns and answer questions so that shared

understanding is reached

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2. Hold our own opinions and pay attention to the spokesperson first to focus on her theories of action

3. Question first and express our own opinions later 4. Do not discuss two issues at one time to avoid divergence from the focus 5. Cross-question the spokesperson’s original intension even though it is a familiar

concept 6. Cross-question the spokesman’s answer when it is off the point Attitudes: 1. Put ‘looking for the improvement of teaching’ in first place 2. Be willing to accept opposing opinions and avoid putting ourselves on the

defensive for open-minded communication 3. Be willing to communicate freely, democratically and equally 4. Treat and examine ‘taken-for-granted teaching’ critically 5. Listen and understand each others’ opinions with an open mind when

questioned

Team members would be provided with this summary at the beginning of the first

meeting as a strategy to provoke meaningful and collaborative reflection during this

phase of the collaborative journey.

Action Phase 4: Evaluating the Collaborative Journey

As this project was about enabling nurse educators at CGIT to change our own

situation, team members would be asked to express perceptions of the collaborative

journey and to evaluate our efforts. A focus group activity and the strategy of

collaborative reflection would be used to generate information in this phase. Focus

group is a collective activity that aims to describe and understand perceptions,

interpretations and beliefs of a selected group to gain in depth understandings of a

particular issue from the perspectives of the group (Dick, 2002a; Kitzinger, 1994;

Madriz, 2000; Morgan, 1997; Rice & Ezzy, 1999). It was considered an appropriate

method for determining team members’ perceptions of the collaborative journey.

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Team members would be invited to participate in group discussion focused on

the empowerment outcome indicators constructed by Smith (1993). Four focus

questions were developed to guide and channel these discussions:

1. What does being part of this team or participating in the whole process mean to

you in terms of your work, workplace and work practice 2. To what extent do you think you influenced the transformation of teaching and

learning 3. Are there any issues that concerned you or over which you felt you had no

control? 4. What are they and why; and how would you describe this collaborative process

and your role as one of the team members.

This group discussion session would be held at the end of the semester after team

members had implemented the new curriculum.

Organising the Information Any information generated and gathered during the research process can serve

as evidence for this study. As the focus of this Action Research project was on

collaborative efforts among a group of nurse educators with an aim to bring about

curriculum change and transform teaching and learning, we studied our own

professional practice. The evidence of the change was thus mainly generated from

our own personal experiences and it is characterised as, in Herr and Anderson’s

(2005) words, “autobiographical data” (p. 77). The information serving as evidence

in this study will include stories written by team members in terms of their personal

practical theories of teaching, the meeting records, the new curriculum document,

and my reflective journals. The information will be organised into four research files:

the Meeting Files, the Reflection Files, the Group Activity Files, and the

Administration Files.

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Audiotape recordings, as suggested by action researchers (for example, Kember,

2000a; Kemmis & McTaggart, 1988; McKernan, 1996; McNiff & Whitehead, 2002;

Stringer, 2004), will serve as evidence of the changes that occurred. All the group

meetings will be tape-recorded and transcribed verbatim immediately after the

meeting by me. The transcribed group meeting records are then to be reviewed by

both myself and team members. In doing so, the meeting records will serve not only

as evidence of the change but also as a source to facilitate reflection. The meeting

records will be documented as ‘Meeting Files’ and reported throughout the narratives

chapters (Chapter 4 to 7) of the collaborative journey.

I also planned to keep two reflective journals to document what happened

throughout the whole collaborative journey: one for reflecting on what happened

during the group discussion sessions (Reflection File A) and the other for reflecting

on events that happened between group meetings (Reflection File B). Keeping a

journal is one of the favourite techniques used by action researchers to reflect on

what happened (Atweh, Kemmis, & Weeks, 1998; Connelly & Clandinin, 1988;

Kember, 2000a; Kemmis & McTaggart, 1988; McKernan, 1996; McNiff, Lomax, &

Whitehead, 2003; McNiff & Whitehead, 2002). Keeping a journal is also

recommended by Koch (1994; 2006) and Rolfe (2006) for all researchers to reflect

on the research process in order to not only raise self-awareness, but also enhance the

credibility of the research. Keeping journals during the research process will allow

me to record my ideas and impression of the curriculum change process, to

accurately record what happened, and to critically reflect on the collaborative

journey (Kemmis & McTaggart, 1988). The journals will also provide records of how

my own perceptions changed over time and how the team make better sense of the

situation (McNiff & Whitehead, 2002).

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In addition to the Meeting Files and the Reflection Files, the written stories of

team members will be documented as PPTs (Personal Practical Theories of teaching)

and kept in my Group Activity Files together with information generated from the

nominal group technique activities. I will also keep Administration Files for

documenting all meeting arrangement and the curriculum. The information recorded

through these strategies will be examined and interpreted in order to make systematic

and logical sense of what happened.

Examining and Monitoring the Information Paradigmatic analysis of narrative (Polkinghorne, 1995) will be applied to the

stories relating to personal, practical theories of teaching written by team members.

Polkinghorne (1995) discusses two types of narrative inquiry as an extension of

Bruner’s (1986) two ways of knowing the paradigmatic and narrative modes. These

two modes of narrative inquiry are labelled paradigmatic analysis of narrative and

narrative analysis (Polkinghorne, 1995). According to Polkinghorne (1995), analysis

of narrative using paradigmatic reasoning requires the location of “common themes

or conceptual manifestations among the stories collected as data” (p. 13). Applying

paradigmatic analysis of narrative (Polkinghorne, 1995) to the stories written by

team members is intended to help move team members’ experiences, shared from the

reflective writing, the narratives, into common themes. The process moves from

narratives to common elements, according to Polkinghorne (1995), and can be

accomplished through two approaches:

(a) one in which the concepts are derived from previous theory or logical

possibilities and are applied to the data to determine whether instances of these concepts are to be found; and

(b) one in which concepts are inductively derived from the data

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(Polkinghorne, 1995, p. 13)

I believed that application of the first approach to the stories would help team

members understand the nature of their teaching - whether they tended to use a

student-centred or teacher-centred approach. The derived concepts would serve as

information to help team members be more aware of the relationships between the

nature of their teaching and student learning outcomes – that is, whether or not their

teaching encouraged generic and professional competencies in students. In other

words, using this approach would help team members explore previously

unexamined parts of their personal, practical theories of teaching and link them in

explicit ways, thereby helping to make sense of problems in their teaching practice.

Such a process would further help the team, to use Hones’ (1997) words, “recover

memories, renegotiate the present, and reconsider the possibilities of change” (p. 1).

In order to keep track of the action and make sense of what happened I plan to

constantly ask team members, including myself, questions related to the aims of the

project such as: what did we set out to do and did we do it? Do we as a group think

we did well? Did we facilitate the development of generic and professional

competencies in students? Does the collaborative group work provide an

empowering, sustainable and generative mechanism for transformation? These types

of questions will be asked throughout all phases of the project with the answers

recorded in my journals and in the transcripts of the tape-recorded group discussions.

As the whole collaborative journey can be seen as a narrative, paradigmatic

analysis of narrative (Polkinghorne, 1995) will be used both inductively and

deductively to interpret what happened (the process) and whether or not the desired

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changes had occurred (the result) during each phase of the journey. In doing so, the

information will be interpreted by plots (Polkinghorne, 1995) or larger units of

discourses (Rice & Ezzy, 1999). For the curriculum decision making phase, the

meeting records will be examined in terms of how the decisions were made. For the

phase of implementing and reflecting on the new curriculum, the recorded group

discussions will be examined to determine if the curriculum was taught in ways that

are student-centred and the students been facilitated the development of generic and

professional competencies. All the information will be examined to determine if any

social and political issues had emerged that might hinder or improve the desired

change. If so, the team could reflect on them and replan the action accordingly.

All the group discussions will be guided and channelled by focused questions.

Some of these questions will be concerned with the empowering, sustainable and

generative intent of the transformations. The response to these particular questions

will be interpreted in light of the conceptual framework of empowering, sustainable

and generative curriculum change or improved understandings.

Summary of the Action Plan

Pre-Action Phase: Team Formation - Main Purpose: forming a collaborative team and raising commitment to the

action. - Main Activities: holding an introductory seminar to present the purpose of

the project, describe the project, recruit team members and generate working rules.

- Strategies: group forming; negotiation.

Action Phase 1: Recognising the Need to Change - Main Purpose: reflection on current teaching and learning and raising

awareness of the need to change.

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- Main Activities: creative writing, group discussion. - Strategies: teacher personal, practical theorising, sharing and discussing

pedagogical knowledge related to curriculum change, collaborative reflection.

Action Phase 2: Curriculum Decision Making

- Main Purpose: curriculum decision-making and documentation. - Main Activities: group discussion. - Strategies: analysis of curriculum document, critical debate, negotiation,

nominal group techniques, curriculum documentation.

Action Phase 3: Implementing and Reflecting on the new Curriculum - Main Purpose: implementing the new curriculum in the classroom. - Main Activities: individual curriculum implementation and monthly group

discussion for reflection on the implementation. - Strategies: collaborative reflection, take home questions.

Action Phase 4: Evaluating the Collaborative Journey - Main Purpose: evaluating the team’s perceptions of the collaborative

journey. - Main Activity: focus group discussion. - Strategy: collaborative reflection.

Trustworthiness

Various sources of information generated from the whole research process will

serve as trustworthy evidence for this study. The curriculum change, including the

content and the process, will be evident from the reconstructed curriculum document,

the tape-recorded and verbatim transcribed group meetings, and from my journals.

The tape-recorded and transcribed group meetings, the written stories and my journal

will also serve as evidence of team members’ increasing understanding of the

transformative process. Furthermore, in conjunction with my journals, the

tape-recorded and transcribed group discussions focused on team members’

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perceptions of the collaborative journey will provide evidence for whether or not the

empowering intent had occurred. The use of multiple sources of data, namely

triangulation, serve as an acceptable and effective strategy for this action research

project to ensure the trustworthiness of information (McKernan, 1996; Meyer, 2000;

Mills, 2003; Stringer, 2004).

Trustworthiness involves the credibility of the interpretation of the information

(Lincoln & Guba, 1985). In order to enhance the credibility of the information

gathered, member checks are, according to Lincoln and Guba (1985, p. 314), “the

most crucial technique for establishing credibility”. The technique of member

checking (Li, 2004; Lincoln & Guba, 1985) will be used as a strategy to monitor the

authenticity of the information gathered and interpreted in this study. The

documentation of the reconstructed curriculum will be validated by team members

before being implemented. The group meeting transcripts will also be distributed to

each team member for member checks during the information gathering stage.

The technique of member checking will also be useful when examining the

information during the data analysis stage (Li, 2004; Lincoln & Guba, 1985), due to

the bilingual nature of the information. The language spoken during group discussion

will be Chinese but reported in this dissertation in English. Although Twinn (1997)

found that the use of either Chinese or English made no significant difference during

data analysis, translating qualitative data from Chinese to English is complex due to

the lack of equivalent concepts and expression (Esposito, 2001; Twinn, 1997).

Moreover, tenses and pronouns are not used in the Chinese language. Because

possible team members in this study all have some degree of English writing and

reading ability member checking will be a feasible and useful strategy for not only

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establishing the authenticity of the information that is examined and interpreted but

also ensuring the credibility of my translations and interpretations and thus

authenticating the trustworthiness of the information.

The action-oriented, participative, and cyclic characteristics of Action Research

have been regarded as distinguishing features of the rigour and validity of Action

Research in recent decades (Badger, 2000; Dick, 1999, 2002b; Hope & Waterman,

2003; Kemmis & McTaggart, 2000; Waterman, 1998). This is especially so in its

more participative forms because, as Dick (1999) asserts, “participation can mean

more informants and therefore richer data”. Furthermore, the cyclic and

action-oriented nature of Action Research also strengthens the subsequent validity of

the research because information collection and interpretation tends to co-occur and

be immediately tested in later cycles (Dick, 1999; Hope & Waterman, 2003;

Waterman, 1998). This project was designed to involve the PE educators as

co-researchers and collaborators and to engage them in deliberate individual and

collaborative reflections, thus rich information and deep understandings should

emerge. The cyclic process would also avoid “premature foreclosure on data” (Hope

& Waterman, 2003, p. 124) and allow team members to continue to generate and

gather information. As a consequence of the cyclic design of this action research

project, to use Hope and Waterman’s (2003) words, “needless vagueness and

ambiguity is reduced, but amplification and deepening of the research focus is

enhanced” (p. 124).

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Ethical Considerations

This project was designed to improve an educational situation and involved

nurse educators, associated administrators and first-year nursing students of the

2-year technical program in CGIT. Permission from both the QUT Human Research

Committee and Chang Gung Institute of Technology was obtained (please refer to

Appendices C-1 and C-2 /pp. 250-251). Other ethical considerations for this project

were related to anonymity, confidentiality and informed consent (Badger, 2000;

Cardno, 2003; Williamson & Prosser, 2002).

In order to ensure the identity and rights of all participants were protected, the

questionnaires used in the reconnaissance survey were anonymous and distributed

with an information sheet (please refer to Appendices D-1.1 to D-2.2 /pp. 252-255).

The transcriptions of recorded discussions and the use of any materials the participants

write would only be used for educational or research purposes. Participants were referred

to by aliases. (I referred to myself by my initials, LY). The nature of Action Research

and the overall research processes were articulated and clarified in detail before the

educators were asked to consent to take part in the study. Other issues, such as

ensuring participants’ rights to withdraw from the research at any time and

guaranteeing confidentiality of information, identity and data, were fully addressed

in both the research information sheets (Appendices D-3.1 and D-3.2 /pp. 256-257)

and the introductory seminar.

This Action Research project plans to reculture a curriculum, which involves

transforming peoples’ beliefs, customs and attitudes about current practices. Therefore

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tensions might exist within the participants due to the challenges made for example, to

their current teaching style. The establishment of “working rules” (Kemmis & McTaggart,

1988, p. 106) might enable the participants to adopt an ethical stance of “mutual

acceptability” (Badger, 2000, p. 205) to one another. Thus tensions might be largely

negated through partnership (Badger, 2000; Titchen & Binnie, 1994).

Limitations

There is a general agreement in the literature that Action Research does not aim

to be generalisable. This is certainly the case with this Action Research project which

was designed for a group of PE educators to change a particular situation within a

specific context. As Kemmis and McTaggart (2000) maintain, most action

researchers “make sacrifices in methodological and technical rigor in exchange for

more immediate gains in face validity: whether the evidence they collect makes

sense to them, in their context” (p. 591). These authors (Kemmis & McTaggart, 2000)

also stress that:

[A]ction research differs from other forms of research in that it is more obstinate about changing particular practitioners’ particular practices, rather than focusing on practices in general or in the abstract. In our view, action researchers need make no apology for seeing their work as mundane and mired in history. (p. 596)

On the other hand, Action Research is “generative, not generalisable” (Chapman,

1996, p. 94). Although it starts small in a specific context, effective changes can

impact on the community so that it gradually involves and affects more and more of

the community (Herr & Anderson, 2005; Kemmis & McTaggart, 1988). This project

started small, initially involving 22 Physical Examination educators and about three

hundred 2-year technical baccalaureate nursing students, but it was anticipated that

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the changes would eventually generate involvement throughout the entire institute.

Furthermore, much of the information generated from Action Research projects is

transferable to a similar context with similar characteristics (Herr & Anderson, 2005;

Kember, 2000a; Kidd & Kral, 2005; Kral, Burkhardt, & Kidd, 2002; Lincoln & Guba,

1985; Meyer, 2000). Learning experiences from this Action Research project may be

utilised by other educational institutions with similar issues and similar contexts.

Action researchers, ‘think globally, act locally’ (Kemmis & McTaggart, 1988; 2000).

Conclusion

From this point my project, to use Lewin’s (1952, p. 51) words, makes “no

attempt at high-pressure salesmanship”. Rather, the action to be taken will be the

result of a combination of my personal views and decisions and those of the other

team members. The plan of action is flexible and open to change. It is up to the

collaborative team to decide what is useful for the students and for their teaching and

learning practices. Based on the contextual considerations and conceptual notions

that drive this project, Action Research is an appropriate methodology to guide the

research. It is expected that this study will improve nurse education in CGIT and

bring about empowering, sustainable and generative curriculum changes for the

institute. In the next few chapters the details of the collaborative journey undertaken

by a team of educators to bring about curriculum change will be told.

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CHAPTER 4

The Story of the Collaborative Journey Action Pre-Phase and Action Phase 1:

Team Formation and Recognising the Need to Change

Introduction

Chapters 4 to 7 constitute a narrative of the collaborative journey of the

curriculum change. The chapters relate how the collaborative team was formed, what

we did, what challenges we encountered, and how we felt and dealt with those

challenges as we progressed together through a curriculum change process. It is a

long story and therefore I have arranged the rich information that was generated,

gathered, organised and monitored during the year long collaborative journey into

four separate chapters.

This chapter reports what happened during Action Pre-phase and Action Phase

1 - how the collaborative team was formed and how we prepared to bring about the

desired change. Chapter 5 reports what happened during Action Phase 2 - the

curriculum decision making process. The story of team members’ curriculum

implementation experience and reflections -Action Phase 3 are told in Chapter 6.

Chapter 7 presents the collaborative evaluation of the collaborative process from

team members’ perspectives. Each chapter is concluded by my reflections on what

happened during the phase.

Although I was aware that curriculum change is a complex process (Fullan,

1993, 1999, 2003), I did not fully appreciate the complexity until I underwent the

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experience. Several events happened spontaneously and simultaneously and this

made the story difficult, almost impossible at times, to tell in sequential order. I

realise this is the nature of an action research project and that clear ‘signposting’ in

the story will be required in order for the journey to be experienced vicariously. A

table of the phases of the journey is presented below (Table 3) to further aid the

reader and the format of the chapters and an issue of translation are then explained.

As shown in Table 2 the collaborative journey consisted of five phases and 16

meetings, including an introductory meeting for team formation.

Table 3 The Action Phases and the 16 Meetings Action Pre-Phase: Team Formation The Introductory Seminar (for formation of the Team)

Action Phase 1: Recognising the Need to Change The 1st Meeting (personal practical theories of teaching)

The 2nd Meeting (student-centred teaching and learning 1)

The 3rd Meeting (student-centred teaching and learning 2)

(three types of evaluation)

The 4th Meeting (the revised Bloom’s taxonomy)

(linking core competencies with unit objectives)

The 5th Meeting (drawing the threads together)

Action Phase 2: Curriculum Decision-Making The 1st Meeting of Action Phase 2

The 2nd Meeting of Action Phase 2

The 3rd Meeting of Action Phase 2

The Pre Curriculum Confirmation Meeting

Action Phase 3: Implementing and Reflecting on the New Curriculum Meeting 1- Talking about the 2-Tech PE Curriculum (1)

Meeting 2- Talking about the 2-Tech PE Curriculum (2)

Meeting 3- Talking about the 2-Tech PE Curriculum (3)

Meeting 4- Talking about the 2-Tech PE Curriculum (4)

Meeting 5- Further Development of the Curriculum

Action Phase 4: Evaluating the Collaborative Journey The Evaluation Meeting

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Following an idea adapted from the work of Chapman (1996), Grundy (1995),

and Weeks (1994), this chapter also reveals some of my personal accounts recorded

during the collaborative journey. These records are located throughout the chapter

and differentiated from the information gathered and generated from the meeting

records by framed and italicised sections. The accounts contain my observations,

feelings, reflections or interpretations of what happened during the collaborative

journey at a given point in time. The records of my accounts provide alternative

perspectives of the journey from the meeting records and thus allowed me to view

the journey from different layers at different points in time. I call these sections

‘Reflection Points’.

As the language written and spoken during the journey was Chinese and is

reported in English, translation was required to report the information gathered

during the collaborative journey. In translating information from Chinese to English,

the sentence structure was reorganised to fit English grammar, some words were

added and depicted in brackets to make the sentence complete, and some Chinese

idioms or expressions were also explained in brackets. In order to ensure the

translation of information did not have a distorting effect on original meanings, the

technique of member checking (Li, 2004; Lincoln & Guba, 1985) by team members

was used.

Action Pre-Phase: Team Formation

In order to start the collaborative part of what until now had been a solitary

journey, I invited everyone who was likely to be involved in aspects of the Physical

Examination (PE) curriculum to an introductory seminar about my project. I sent an

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invitation email followed by a card (See Appendix E /p. 260) to the Director of the

Nursing Department, the course coordinator, and 22 of the PE educators. I also called

each prospective participant by phone to reinforce my sincerity, dissipate any doubts,

and try to determine the number who might be interested in collaborating in this

endeavour. One person immediately refused my invitation; others would be away on

clinical teaching or holidays; some had to attend other commitments at the time of

the seminar.

Regardless of their response to my invitation, I accepted their decision rather

than become an annoying ‘pusher’. I was aware the team had to be formed from

those truly interested in direct and active participation and true collaboration: people

who were in sympathy with the purpose of the study and willing to travel together.

The Introductory Seminar

The introductory seminar was held informally on April 7 in a school conference

room during lunchtime - the time when people are most available to get together.

Seven of the following 15 meetings were held during the lunch period.

Eleven people attended my introductory presentation, which lasted about 30

minutes. It focused on the purpose of the study, reasons for working collaboratively,

and the role of being a co-researcher in the study instead of being a subject. I

described the steps of an action research spiral in order to illuminate what they might

do if they became a member of the team. I also emphasized the flexible nature of the

project - first in terms of the action and secondly in terms of time devoted to team

work. I believed these two issues would be major concerns for people in deciding to

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join the team or not, given their already heavy workloads. At the end of my

presentation, I distributed the research information sheet and explained the content

(Please see Appendix D-3.1 /p. 256 for details). Time was then given for questions.

It was asked if the reconstructed curriculum would be implemented to all 2-year

technical PE classes in the forthcoming semester. I replied that as each PE educator

in CGIT has the right to make any decisions regarding the PE curriculum at the

end-of-semester meeting, the decision about implementation should be left until then.

If the reconstructed curriculum was in agreement, it could be implemented to all

lessons. If it was not, the team would implement the curriculum to part of the 2-year

technical nursing classes.

While we were looking at the research information sheet, the school bell rang.

Two people had to leave for invigilation. Of the nine who remained, eight decided to

participate, signed the consent form, and left their contact details. Janet (Pseudonym),

who had left for invigilation, also decided to join the team. Thus nine out of the

eleven attendees showed their interest in becoming team members of the study. This

excellent response was beyond my expectations and very encouraging. More than

that, most of those who attended the seminar stayed for coffee and continued to talk

about the project and the curriculum for another half hour.

In order to ensure any interested PE educators were not excluded from team

membership, I held another introductory seminar for three PE educators who were

interested but unable to attend the initial seminar. Like the other nine PE educators,

they all became team members. One of the three expressed her feelings after my

introduction of the project. She claimed that the teaching and learning problems I

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outlined in the seminar were exactly what she was experiencing. She was in

sympathy with the purpose of the study and willing to travel together. The number of

the team members was now thirteen including me. Of the other twelve members, five

had experience in teaching 2-year technical baccalaureate nursing students; one was

the former unit coordinator; and all twelve were lecturers and had experiences in

teaching PE for junior college nursing students. At all our group meetings there were

at least seven participants.

Reflection Point: The participation rate was higher than my expectations. I am

well aware that it is the quality of the interest, the enthusiasm and the active

participation that is important instead of quantity. I also realize the more people

engaged in collective and collaborative decision making the more complex the

discussion and situation will be and the harder it will be to reach agreement.

However, the high participation rate meant more to me than the number itself.

First, the high participation rate meant a success of the introductory seminar,

which had raised a certain degree of awareness of the need to change our teaching

and learning. Second, the higher involvement rate might make the change

mechanism more widely recognised and disseminated in Chang Gung Institute of

Technology (CGIT). In this sense, more nurse educators would engage in the

change so that more students could derive benefit from the change. As Alice said

in the talk after the seminar: “Our curriculum does have problems and to ‘use’

Li-Yu this time is a good opportunity to make it better.” This project to me is not

just a doctoral study; it is a pioneering and mutually beneficial action for CGIT.

(LY: Reflection File B, April 12, 2005)

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Action Phase 1: Recognising the Need to Change Introduction

The purpose of Action Phase 1 was to improve team members’ understandings

of contemporary pedagogical principles and continue to raise awareness of the need

to change present teaching and learning practices. Strategies used to achieve this

purpose primarily consisted of illuminating members’ personal practical theories of

teaching and learning and engaging in critical debate. Five meetings were dedicated

to achieving this purpose.

Because the curriculum had to be restructured by the end of the semester (June

2005) and implemented the following semester, there were only three months

available to prepare and restructure the curriculum. The time was short and pressing.

In order to promote more productive meetings pre meeting activities were

encouraged.

A ‘time available’ survey was conducted before each meeting because it was

hard to arrange regular participation times. Once the most appropriate time was

scheduled a meeting agenda was sent to all team members one week before in order

to allow them time to reflect upon, and become familiar with the discussion topics. In

order to promote meaningful discussion, relevant information documents were also

distributed one week before meetings.

The information documents contained pedagogical knowledge associated with

the changes required by various policy documents such as the Ministry of Education

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Nursing Curriculum Guideline (Curriculum Research and Development Centre in

Allied Health Education, 2004a) and also the CGIT school educational objectives for

nursing students (Department of Nursing, 2004). The team members were

encouraged to read the document before the meeting. The agenda and information

documents were distributed one week before each of the five meetings. For the first

meeting only, there was one other activity that needed to be completed before the

meeting – the writing and examination of individual personal practical theories.

The purpose of this individual activity was to enable members to reflect upon

and gain some degree of understanding about the personal practical theories that

guided their teaching. Team members were asked to reflect on their teaching practice

and then write a letter to their clones articulating their beliefs about the roles and

responsibilities of a Physical Examination educator, the roles and responsibilities of

the learners of Physical Examination, and the importance of subject matter in the

Physical Examination classes. Each team member was given a guideline for the

activity and a week in which to write their story. The written personal practical

theories were then examined to see whether the team leaned toward

student-centredness or teacher-centredness. Because of time constraints I undertook

this examination alone.

Eleven team members wrote their personal practical theories of teaching and

learning. The format of the responses varied. Some started as a story with “when

I…”, some expressed a sentiment or an opinion and started with “I think…”, and

others were in the form of a dot point list. All eleven written reflections addressed

the three questions. As the format was not only stories but also dot points I used two

forms of examination. I examined the reflections written in story format deductively

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by paradigmatic analysis of narrative in terms of plot structure for the narrative style

of writings (Polkinghorne, 1995) as discussed in Chapter 3 (pp. 78-79). I examined

those in dot point format by content analysis in terms of small chunks (Rice & Ezzy,

1999).

The results of the written reflections were similar to the results from the

reconnaissance survey with ‘Nurse Educator’s Conception of Teaching and

Learning’ conducted earlier and reported on pages 30 to 32. The team held beliefs

both student-centred and teacher-centred but acted relatively teacher-centred; they

focused more on subject content than the process of learning. They also placed more

emphasis on accurate and clear presentations in their teaching. Three stated that their

teaching is modified by feedback and learner needs however, they did not give any

examples. Three referred to critical thinking but one doubted students’ abilities to do

so; another believed that constraints such as limited time made it difficult to apply

critical thinking strategies in class. Most claimed that the aims of teaching Physical

Examination were to enable students to apply Physical Examination to patient care

but also recognised that learning was a student responsibility. However, none

acknowledged their responsibility to guide students to learn.

Some team members had thought about their present teaching style. They

appeared to be struggling with their present teaching but did not exactly know how to

deal with it:

So far the most difficult part is how to develop students’ critical thinking and ability of integrate [knowledge]. Be honest to say, I am not fussy, just thinking will do. I will thank heaven no matter what kind of thinking it is. This point [critical thinking] is essential to all units in baccalaureate level. But due to time limits for case study I only know the results. Regarding

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the guiding process, I am still unable to do what I want very much to do. (Alice: PPTs2)

Until now, I am still changing my teaching. I wish the way I teach could make my students learn something and then apply it. Therefore, if there is a new in-service workshop or conference, I try to participate in it. This is not only to develop my own knowledge but also to make my teaching more comprehensive. I told myself don’t teach as my Physical Examination

teacher did－just read aloud what the textbook says. It was displeasing.

(Laura: PPTs6) I have a little shortcoming that sometimes I take on too much work or my time management is out of my anticipation, so that my time for lessons preparation is pressing. (Donna: PPTs10)

In brief, the overall results of the written reflections indicated that when

teaching most of the team members paid attention to the subject matter and largely

neglected the process of learning. Although they believed students were expected to

be able to apply Physical Examination knowledge in clinical practice, they did not

make concrete use of teaching approaches to guide students to use application skills

in Physical Examination. These issues were to be shared in the first meeting.

The 1st Meeting

Purpose:

The purpose of the first meeting was to encourage the team to share opinions

about the MOE required competencies, further explore personal practical theories,

and examine personal practical theories in terms of the concepts of

student-centredness. By comparing the MOE required competencies and

student-centred teaching with the results of personal practical theories, it was

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anticipated that the team would become aware of the discrepancy between the

rhetoric and the reality, thus deepen their awareness of the need to change.

Pre reading information:

Before the meeting, the team members were given information regarding the

MOE requirements of 2-year technical nursing graduates’ generic and professional

competencies and the principles of student-centred teaching.

Agenda:

The proposed meeting agenda was as follows:

1. Discuss attendance problems and working rules for the team 2. Share opinions about the student competencies required in the Nursing

Curriculum Guideline 3. Expand on personal practical theories of teaching 4. Share ideas on student-centred teaching 5. Explore/confirm the next meeting agenda

The meeting began with a short discussion regarding attendance problems and

working rules. It was clear from the time unavailable survey that it was almost

impossible to arrange a time when everyone could be available. Therefore we

discussed how team members could obtain information and link up with the progress

when they missed meetings. There was a general agreement that no one had time to

listen to copious meeting tapes but people who missed a meeting should be given a

meeting summary and I would be available to meet anyone on an individual basis.

As this meeting was the first after the team formation and the beginning of the

collaborative work, the ‘working rules’ or “appropriate ways of working with other

participants” (Kemmis & McTaggart, 1988, p. 106) needed to be articulated. I was

aware that development of working rules was a team responsibility. However, from

prior experience and impressions of the organisational culture, people might be more

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interested in what is considered acceptable behaviour than in defining group rules. I

therefore anticipated the need for some examples. I suggested three principles should

guide our work: (1) speaking our own opinions and commenting on others’ with

grace and objectivity; (2) listening to others and participating in discussion with an

open mind and equality; and (3) sharing and partaking in making group decisions and

then adhering to the decisions made. Although I made it clear that these principles

were only suggestions and could be modified, there were no further proposals.

When the topic was shifted to the student competencies required in the Nursing

Curriculum Guideline, the team members appeared to have no definite views of their

own about competencies. Fiona said in a conclusive voice:

These [competencies] came out from scholars and ought to be the principles for our curriculum design. Students’ competencies should fall in these items. Shall we consider which could be achieved by Physical Examination and which need to be added in our school characters later when we design the curriculum? It requires time to discuss. (Fiona: Meeting File, April 21, 2005)

When asked if the competencies set out in the Nursing Curriculum Guideline

conformed to our conceptualisations of student competencies, Alice echoed Fiona’s

view in the following way:

There is no so called good or bad [appropriate or not]. It ought to be achieved in accordance with the [MOE] objectives. (Alice: Meeting File, April 21, 2005)

Reflection Point: The purpose of this strategy was to see if the team could identify

any discrepancy between the MOE requirements and our present educational status

so that awareness of the need to change might be raised. I also hoped that the

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As there appeared to be no queries about the student competencies required in

the Nursing Curriculum Guideline, we moved to the 3rd item on the agenda.

The third topic of the first meeting was planned for the team members to reflect

on or explain further their personal practical theories of teaching. I first presented a

summary of the written reflections and then time was given for reflection or further

articulation.

Rather than reflection on our personal practical theories of teaching and learning,

the discussion became focused more on the perplexities the team encountered in

relation to student performance. For example, some members explained that they

were not sure if students were capable of thinking critically. Some voiced that even

though the students had learnt Physical Examination in their junior college days they

had forgotten and always asked for revision. Some believed that students had lost the

ability to search for information by themselves. Some complained that student

behaviour was worse. The discussion appeared to become a “blame-the-student”

strategy might facilitate a comparison with the team’s present personal practical

theories. However, The MOE requirements were seen as ‘a matter of course’. The

responses led me to reflect on whether or not I had inappropriately arranged the

meeting agenda or asked an unclear question. There might have already been tacit

agreement of the need to change our education in accordance with the Nursing

Curriculum Guideline. It may also reflect that people were used to ‘following the

rules’ without queries. In other words, they treated the MOE requirements as ‘need

to be done’ rules without scepticism, and considered discussion to be unnecessary.

(LY: Reflection File A, April 25, 2005)

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(Biggs, 1999; 2003; Biggs & Moore, 1993) session rather than collaborative

reflection on our own teaching.

However, a few team members remained focused on student learning. They

tried to share effective strategies with the others in order to show how student

learning could be facilitated. Although the number of team members who believed in

student-centred learning was small, their speech provoked parts of this session into a

critical debate. One example was as follows:

Alice: I thought of a problem as I was writing. That is, students feel a great load as well as teachers do. You had taught it, to teach [review] or not to teach? Basically I think different levels should have different learning objectives otherwise there is no need to study further. However, we’ve all been influenced profoundly that our content links to our objectives too tight. If we make teaching always relate to the content, we must be pressured. We would think we have to cover the whole content. Thus we would feel stressed as students’ approaches to learning are changing.

Gloria: I would think if we didn’t cover the content, how about the exam?

Alice: The junior college students would argue against this, but the 2-tech students might…

Monica: It would be also serious, the 2-tech care the most. For instance, it was on the text but I didn’t mention at class. I only gave one on the exam… They came and said that I didn’t teach it and if it could be excluded from the score.

Gloria: But I would think how about the license pass rate [national examination for registered nurses]? It also examines these [content]!

Emma: The 2-tech doesn’t have problem in terms of the licence exam.

LY: Besides, there are some articles about nurse education in the Journal of Nursing. One notes the problems with the license exam. It claimed that if the exam policy makes our education

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problematic, then it oughts to be amended.

Gloria: That is ideal and reality.

Alice: I don’t know. The license pass rate is a heavy pressure indeed.

Reflection Point: The personal practical theorising did not raise an agreement of

the need to change as expected. However, in place of the agreement it served as a

catalyst for critical debate - the process of identifying, articulating and defending

our opinions with others. By listening to different voices and sharing ideas, the team

members could gain more understandings and broaden their viewpoints of

possibilities and ways of teaching. I am glad to see this happening; it was an

unexpected effect that demonstrates the usefulness of written reflection. (LY:

Reflection File B, April 25, 2005)

As a result of the enthusiastic discussion of the personal practical theories the

time passed too quickly to discuss the next item on the agenda: student-centredness.

This topic was left for the next meeting.

I realised a single meeting could not allow too many topics for discussion and

fortnightly meeting might not be adequate for us to restructure the curriculum by the

end of the semester. Before people left, I expressed my concerns and proposed we

meet more frequently. All agreed. They suggested that meeting arrangement did not

have to be regular. They expressed willingness to attend meetings whenever they

were available. I showed my appreciation for their suggestions. Before closing the

meeting the topics suggested for the next meeting were confirmed.

Immediately after the meeting one of the team members, Tina, rang suggesting

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that in order to save time, we refer to curricula designed by other nursing schools.

She thought what we discussed in the meeting was good but nothing to do with the

curriculum. I showed my appreciation for her suggestion and then explained that we

were developing a curriculum which was to be ‘our own’; and having a model to

refer to might confine our creation to a certain frame. I also encouraged her to

express her opinions in the meeting because this was worth discussion and

clarification among the team.

The 2nd Meeting

Purpose:

The purpose of the 2nd meeting was to increase knowledge about

student-centred teaching and learning. Through this knowledge development it was

expected the team members would become more aware of the relationship between

teaching and learning.

Pre reading information:

The five concepts developed by Weimer (2002) in relation to student-centred

teaching made up the pedagogical information for the 2nd meeting. The concepts

were the balance of power, the role of the teacher, the function of content, the

responsibility for learning, and the purpose and process of evaluation.

Agenda:

The meeting agenda for the second meeting was as follows:

1. Share opinions on notions of student-centredness (e.g. your interpretation, reflection, incomprehension or critique, or anything needing to be discussed)

2. Review opinions in the personal practical theories about the following questions in light of shared knowledge about student-centredness and our present teaching situations A. “What do you think of the role and responsibility as a PE educator ought to

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be?” B. “What do you think of the role and responsibility as a student ought to be

in terms of learning PE?” C. “How do you treat the importance of subject matter in the PE class?”

The team first shared ideas about Weimer’s (2002) five notions of

student-centredness. Some people came to this meeting with reflection or questions

and some did not. Some misinterpreted the notion of student-centredness. For

example, while we were discussing the notion of ‘balance of power’, some team

members appeared to misinterpret student-centredness as transferring power

wholesale to the student.

Students have changed. They no longer comply or work hard without complaint. They now have their own opinions. They will be out of sorts, go out to the toilet, express [boredom] on their faces or sleep in the class if you don’t teach well. Therefore I think the balance of power should be half-half. It shouldn’t be teacher-centred or entirely student-centred. If you are totally student-centred the main shaft of learning would be sacrificed. (Fiona: Meeting File, April 28, 2005) I am not sure if student-centred teaching is good. Once when I wanted to illustrate a mechanism with a graph near a break, the student wanted to have a break. They showed in their faces like ‘it’s time for break’. I told them “it’s 8:50 [20 minutes to go before the break]. I know we are all tired, but why not to finish it as now we are all here?” The student then had their facial expressions like “Fine! You just go ahead”. I would like to be student-centred, but students are all self-centred. They wanted a break but I had the problem in scheduled progress. (Laura: Meeting File, April 28, 2005)

From the above expressions it appeared that they had interpreted student-centredness

as transferring power wholesale to the student. However, according to Weimer (2002,

p. 28), “when teaching is student-centred, power is shared rather than transferred

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wholesale”.

In addition to some misinterpretations, some team members showed their

concerns about student-centred approaches to teaching. Although members expressed

their general agreement with Weimer’s ideas, they appeared to be pessimistic about

applying these ideas in classes. This was evident in the questions they asked: what if

there is no consensus of the balance of power among the teacher and the student?

What if there is a discrepancy between the expectations of the student and the teacher

in terms of each other’s roles and responsibilities? What if the student thinks it is

unnecessary to learn what won’t be examined? What if the student is not good at

learning actively? How could we teach students to learn if we lack strategies to do so?

These concerns indicated that they felt there was a distance between Weimer’s ideas

in theory and the application of the ideas in reality. I addressed these concerns by

distributing a summary of Weimer’s (2002) work describing how to implement

student-centred approaches to teaching. It was anticipated that by reading this

summary at least some of their concerns would be alleviated.

Reflection Point: I am not sure whether those team members who considered

student-centredness as wholesale transfer of power to the student had misinterpreted

the main concepts of student-centredness or did not read the information before they

came to the meeting. However I did not interrupt the enthusiastic discussion and

clarify this issue. At this point I could not help reflecting that this was just like

conducting a lesson - if they had come without doing the pre reading, we teachers

are just like the students while playing a learning role. Sometimes we just look at

things on the surface. (LY: Reflection File A, May 1, 2005)

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After sharing ideas about student-centred teaching, we utilised nominal group

technique to review our opinions of teacher roles, students’ learning roles and the

importance of subject matter regarding the Physical Examination unit. I anticipated a

need to practice the nominal group technique as this technique was to facilitate

curriculum decision-making in Action Phase 2. Applying nominal group technique at

this point would not only be a practice session but also help the team gain some

degree of understanding about how our opinions might change with increased

knowledge about student-centred teaching.

I briefly explained the process of the nominal group technique and the team then

wrote their responses to the three questions asked in the agenda. However, this

activity could only be called a ‘semi’ nominal group because once again we did not

have adequate time to complete the whole process. We only had time for written

responses without discussion or vote. Regardless, I thought the responses may be

enlightening so retrieved them for later examination.

This meeting ended with distribution of the pre reading documents prepared for

the next meeting. I briefly described the content and encouraged the team to read the

documents before the next meeting.

The written responses from the ‘semi’ nominal group exercise were examined

by listing and sorting inductively. All the items written by the participants were listed

and clustered. When compared with their written reflections regarding personal

practical theories, the responses to the questions showed a few differences. In terms

of the teaching responsibilities, new clusters that appeared and differed from the

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personal practical theories were: guiding students to achieve their learning objectives;

developing students’ self-awareness of the learner role; and being role models for

learning. Some team members also considered that the setting of appropriate learning

objectives might be a student responsibility. Moreover, one team member thought

that the depth and the amount of the subject content should be determined by

students’ learning needs rather than be determined by the idea that ‘more is better’.

Although not all members ‘talked in the same vein’, some had clearly started

considering student learning after the discussion of student-centredness.

Reflection Point: All the happenings to this point together with the findings of the

‘semi’ nominal group exercise suggest that there has been a change in the way some

team members think about teaching and learning. However, it is also clear that not

all team members recognise the relationship between our teaching and student

learning. This is especially evident in the blame-the-student attitude. In order to

facilitate further reflection on teaching and its impact on learning, I will develop

three questions to put before the team at the next meeting. (LY: Reflection File B,

April 5, 2005)

The 3rd Meeting

Purpose:

The purpose of the 3rd meeting was to discuss issues regarding the

implementation and application of student-centred teaching to the Physical

Examination Unit, and to introduce three types of evaluation methods as outlined in

the Nursing Curriculum Guideline.

Pre reading:

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The three aspects for successful implementation of student-centred teaching

identified by Weimer (2002) – responding to resistance, taking a developmental

approach, and making student-centred teaching work, and the three forms of

evaluation outlined by Print (1993) and advocated in the Nursing Curriculum

Guideline - diagnostic evaluation, formative evaluation and summative evaluation,

made up the pedagogical information for the 3rd meeting.

Agenda:

The agenda scheduled in this meeting was as follows:

1. Share perceptions about student-centred teaching in terms of responding to resistance, taking a developmental approach, and making student-centred teaching work

2. Discuss the three forms of evaluation: diagnostic, formative and summative

However, because of my reflections and the resultant development of three questions

to stimulate further individual reflection by the team members, I felt it necessary to

start the meeting by advocating for further reflection about the relationship between

teaching and learning.

I first presented a summary of the findings of the semi nominal group exercise

carried out in the previous meeting. I reported that most of us believed our main

teaching role and responsibilities are motivating learning, guiding learning, imparting

knowledge and being professional role models. I also reported that we believed

students should learn actively, study harder and be able to think critically. I then

suggested that the team reflect upon the following three questions (the written form

would be available in the meeting transcriptions) in order to better recognise the

relationship between teaching and learning:

1) Is there any relationship between teacher’s responsibilities for teaching and

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students’ responsibility for learning? 2) We generally agreed that learning is a students’ responsibility. Is a teacher

responsible for guiding students to take responsibility for their learning? 3) Do students need guidance to develop competencies in health assessment

and to integrate knowledge, or do we only need to impart knowledge so the student can apply it?

Immediate response was not expected - these questions were proposed for the team

to individually reflect upon later. Time would tell if the reflections came about.

We then discussed the implementation and application of student-centred

teaching. Differing from the 2nd meeting, I highlighted the key points of the work by

Weimer (2002) about implementing student-centred learning and the three forms of

evaluation (Print, 1993) before we started discussing each of the topics. I recognised

that the busy academic lives of all the team members may prevent the reading of

information before coming to a meeting. However, under a collaborative working

condition, people are expected to come with an open mind, not an empty mind. By

using this strategy I hoped to avoid misinterpretations of what the information meant

by those who had come without reading.

However rather than a sharing of ideas, this meeting was more like a mini

lecture. The information document was already condensed so that it was hard to

summarise further. Consequently, I spent half of the 90-minute meeting explaining

the content and responding to team members’ questions. While my voice was

certainly dominant our discussion was more focused and less ‘out of context’.

Despite some issues needing clarification, our discussion focused on how to

incorporate the knowledge into our teaching. The team members asked probing

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questions about Weimer’s (2002) work. For example, one member questioned how

student-centred learning could be implemented in a class that had different levels of

ability. This question provoked enthusiastic discussion, especially around the topic of

the level of ability into which the majority of students might fit. Members were also

concerned with how to reconcile evaluation approaches with student-centred

teaching. For example, a member asked if there was a strategy to evaluate student

learning attitudes – an essential component of student-centred teaching. We also

considered current political problems regarding the school curricula.

People agreed that having political support might make student-centred teaching

more consistent and effective for student learning. However, our school did not have

a concrete action or policy for student learning. One of the team commented that

having an opportunity to share with each other and stimulate our ideas about teaching

was essential but pointed out that the Physical Examination teaching group (an

established group within the school) offered little support in teaching.

I sensed tiredness in the team members from the 90 minutes information session.

At the end I expressed what I felt: “Keeping listening like this actually is tiring. We

might now better understand students’ feelings as they sit and listen in the class all

the time”. Janet then made a comment about her personal feelings:

I was a bit stressed before I came to the meeting because I thought I had to read the document and thus have something to share. After I listened to Li-Yu’s share [explanation and clarification], I got a feeling that “yes, it’s necessary to read in advance”. (Janet: Meeting File, May 5, 2005)

Janet’s comment clearly declared that pre reading was stressful and also supported

the notion that pre reading combined with further explanation and clarification would

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assist comprehension of the pedagogical knowledge.

Reflection Point: Although the team members are all mature teachers, as far as

formal pedagogical knowledge was concerned they were all new learners. I am glad

I did the summary although it is a teacher-centred or content-oriented strategy. This

strategy reduced misinterpretation or ‘quoting out of context’ and made the

discussion more focused. I am aware this is not an appropriate strategy to apply to

the whole process of this research project, but it works for a certain instance with a

specific purpose. (LY: Reflection File B, May 7, 2005)

The 3rd meeting ended with the announcement that the next pre reading

document would be related to the revised Bloom’s Taxonomy of Educational

Objectives (Anderson et al., 2001). Team members were also encouraged to approach

me for resources any time they wanted further information.

The 4th Meeting

Purpose:

The purpose of the 4th meeting was twofold: 1) to discuss the educational

objectives required by the Nursing Curriculum Guideline (i.e.: Bloom’s Taxonomy of

Educational Objectives) and 2) link the MOE required competencies with the CGIT

educational objectives for nursing students and the Physical Examination unit

objectives.

Pre reading:

The Revised Bloom’s Taxonomy of Educational Objectives developed by

Anderson et al (2001) made up the pedagogical information for the 4th meeting.

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Agenda:

The meeting agenda consisted of the following topics:

1. Explore the Revised Bloom’s Taxonomy of Educational Objectives and its application in Physical Examination unit

2. Connect the Physical Examination teaching objectives with the Nursing Curriculum Guideline competencies and the school educational objectives

It appeared that the team members were busier during this period. Some team

members had a full teaching schedule and some facilitated clinical practice in

hospital. Although this meeting was held at lunch time for more attendance, only six

team members, including myself, participated in this meeting.

I started the meeting by asking if there was anything unclear in the document

regarding the Revised Bloom’s Taxonomy of Educational Objectives (Anderson et al.,

2001). The team responded with silence and then a few voices ‘no’. However I had

anticipated that the concept of metacognitive knowledge might be new or abstract to

the team. Thus I offered additional information and a summary regarding the concept

of metacognitive knowledge from Pintrich’s work (2002).

The summary stimulated some questions about how to apply this knowledge to

the Physical Examination curriculum. Some team members were confused about

certain concepts of metacognitive knowledge which they thought conflicted with the

student-centredness:

You just mentioned a need to teach explicitly. But didn’t we share a view that students have to be responsible for their own learning? … Don’t they conflict with each other? (Janet: Meeting File, May 12, 2005)

Janet appeared to confuse ‘the need for teaching learning skills explicitly’ with

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‘revising the subject matter’. One team member also shared that she believed

students in the Physical Examination class do not have to possess metacognitive

knowledge:

Gloria: Talking about the metacognitive, I don’t think the PE unit needs to reach this far. I think it belongs to factual, conceptual and procedural [knowledge], because there are some skills in it [the Physical Examination unit].

LY: OK. Do you believe our students need to develop learning skills from this unit as well as the content of PE?

Gloria: The problem is, I’m not that clear about or good at this [metacognitive knowledge] so that I am not going to ask my students to do so. I think it will do if they can possess up to the procedural knowledge and perform the skill correctly.

LY: But what if we have a case study session in the 2-tech PE curriculum.

Gloria: What it called understanding knowledge of self and learning motivation, it’s just an understanding. . . . Many students are forced to come [and learn nursing by parents]. They may have little motive. I am not sure if we can interfere in students’ self-learning or evaluate it.

LY: That’s talk in this way. In PE, does the student have to be able to collect the patient’s subjective and objective data and then identify the patient’s problems?

Gloria: Definitely. But aren’t these abilities included in the first three types of knowledge [factual, conceptual and procedural knowledge]?

LY: Which do you think they could be in?

Gloria: In ‘integrating’… (looking at the Revised Bloom’s Taxonomy Table) Um, no idea. Because the information provided… (no ‘integrating’ in the table) I think it will do if students can ‘remember’, ‘understand’, ‘apply’ and ‘analyse’. To answer your question, I think ‘analyse’ will do.

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LY: OK. The student has to analyse the data collected from the patient. The data collected from the patient is the knowledge about cognitive tasks, including appropriate contextual and conditional knowledge.

… (people talking to each other at once)

LY: The contextual and conditional knowledge means students are required to understand patients’ conditions so that they are able to determine [the patients’] problems.

LY: Let’s look at this [table of the revised Bloom’s] by verbs and nouns. The verbs from 1 to 6, we are to make decisions about what, but not necessarily all, our students need to reach and ... (interrupted)

Gloria: The students don’t need to ‘create’.

LY: They may not. So we are to decide to what dimension our students need to reach. . . . There is no problem with the verbs. And… (interrupted)

Alice: Actually in the column of ‘create’, the ‘generating’ may be applied [generating nursing problems].

LY: We may need to discuss if the [learning objectives related to] nursing problem will be in the box of ‘create’ or ‘analyse’.

Fiona: When we teach this unit, you see it in different dimension, it comes with different outcomes. Actually they all exist, depending on which dimension you see it.

LY: (said to everybody) So, what are your opinions about what Gloria said concerning students not needing metacognitive knowledge?

Fiona: I just said it. (laughter) It’s not about need or needn’t. The knowledge all exist. The difference is whether if you identify it in ‘strategic [knowledge]’ or ‘self knowledge’. You can’t say it’s [metacognitive knowledge] unnecessary. You can only say where you got to put the knowledge in.

Gloria: Well. I’m sorry. I …

LY: Don’t be. Your question actually is good. There might be people who have the same question. That is also why we need to

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understand the 2-tech PE curriculum and then think about how to develop the objectives, how to guide learning activities, and how to evaluate learning. I believed we’ll have more discussions like this.

Gloria ended the discussion with an apology because she thought she might have

asked an inappropriate question. I responded that every question asked was valuable

and worth discussing so that there was nothing to be sorry for.

The confusions and questions may reflect that the concept of metacognitive

knowledge was new and too abstract for the team to understand in a short time. Or

their brains were too saturated with the new pedagogical knowledge introduced in

these meetings.

Another concern regarding the implementation of the curriculum was

consistency. Because the Physical Examination teaching group is subject to change

every year at the school, some members were concerned that the teachers who were

to implement the Physical Examination curriculum may not know the curriculum

well. I suggested we could leave the issue of consistency to the next phase because it

might be solved by our curriculum decision-making.

I suggested we examine the present curriculum and collaboratively determine

what was selected to be included in the curriculum and what was to be rejected.

However, people preferred to write a completely new curriculum.

Actually I think shall we not to look at the old [curriculum]. We may try to conceive it [a new one] first. Because we would be restrained from the old if we firstly look into it. (Janet: Meeting File, May 12, 2005) Actually it has been suggested that we restructure the curriculum by

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referring to other school’s curricula. I was also afraid our creation would be limited. (LY: Meting File, May 12, 2005) But I think it should be with a feature of our school. I don’t think it should be undertaken from the other’s frame. Since the curriculum is to be renewed we shouldn’t have those… [shadows of others]. (Alice: Meeting File, May 12, 2005)

Their propositions echoed my previous consideration. We all preferred a brand new

curriculum that is ‘ours’ and with a feature of ‘our’ school.

Our next task was to attempt to integrate MOE and school educational

objectives into the Physical Examination curriculum. Some members believed the

Physical Examination curriculum could meet all the 2-tech nursing students’ learning

objectives required by the school; namely to:

1. Enhance understandings of basic medical knowledge [i.e. anatomy and

physiology] and its applications to the nursing profession. 2. Apply complete health assessment skills to the adult, and promote

professional care to the client. 3. Enhance competency in nursing care of the client at different

developmental stages such as infancy, childhood and adolescence. 4. Apply knowledge of health promotion to the community and mental health

nursing in order to broaden the scope of care. 5. Promote professional competencies in long term care and critical care

nursing.

In order to stimulate the team to differentiate between the objectives of the

Physical Examination unit and other units, I tried to challenge the team’s ideas by

questioning. This strategy first provoked advocacy of the unit then reflections on or

scepticism about appearances.

LY: Aren’t we to design our curriculum with any specific objective?

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Alice: They all fit!

Fiona: Yes.

Alice: All fit. But I think the fourth objective wasn’t well written indeed.

LY: OK. Referring to ‘apply complete health assessment skills to the adult’ this can be done by the Adult Nursing unit, can’t it? How could we distinguish the Physical Examination unit from the Adult Nursing?

Alice: They are different. We are up to the [nursing] diagnosis.

Rose: We are up to the assessment.

LY: They [the Adult Nursing unit] also do the assessment.

Alice: Not much.

LY: If so, it could be said the Physical Examination unit can be pruned away because they [the Adult Nursing unit] also teach it.

Fiona: But they don’t teach the skills.

Rose: They don’t teach how to assess. They only show the results from assessment.

…（all talking at once for minutes）

LY: If what we emphasize is the skill, they [the student] have learned it in their junior college days. Why do they need to come to the 2-tech level to learn the same thing?

Fiona: They didn’t learn well. (with embarrassing laughter)

LY: If they didn’t, it [the junior college curriculum] should be reformed.

Gloria: The junior college level stresses the skill, not the abnormal parts.

Fiona: Yes, [the 2-tech level stresses] the analysis and assessment. The integration.

Alice: … What you are asking is to storm our brains or…? (talking to LY)

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LY: I am talking about the problem of repetition. It is one of the MOE’s major concerns for the nursing curricula. This problem could happen between the Physical Examination and the Adult Nursing units. We ought to have a distinct orientation of our unit from the other.

Gloria: My feeling is that our nursing educational system is diverse. To say it unpleasingly to hear, it’s chaos. However, the junior college or the 2-tech graduates do the same tasks in the clinical even though the depth they learn is different. What we should teach is all there. But if people try to take it apart simply ...

Rose: That is to say, jobs in the clinical workplace are no different for nursing graduates from the high school level, the junior college level or the technical college level so that in education, we are having these… [problems/ dilemma].

Instead of leading the team to specify the features of the Physical Examination unit,

the strategy of standing-by-the-opposite-side provoked defensive response and

scepticism about appearances.

Reflection Point: It is interesting to recognise that peoples’ first response when

subjected to a query is defence. Once a cue is given, they start developing

scepticism. This might reflect human nature that people tend to defend against

questions they have never thought of before. Or people tend to defend then evaluate

the circumstance before they reflect on themselves. It may also be indicative of

people clinging to the ‘status-quo’ – an unwillingness to change from the familiar to

the unfamiliar. (LY: Reflection File B: May 12, 2005)

It appeared that there was never enough time for talking about teaching and

learning in this group because we had talked for one and half hours. As the

participants were so few, it was not appropriate to make any decisions about the

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connection of Physical Examination objectives with the Nursing Curriculum

Guideline competencies and the school educational objectives at this meeting. I

ended the meeting by encouraging the participants to think of any other issues of

concern relating to curriculum making.

The 5th Meeting

Purpose:

The purpose of the 5th meeting was to look back on what had happened in the

previous meetings, extract the core ideas and draw the threads together. I arranged

this ‘synthesis/integration meeting’ before we started to reconstruct the curriculum in

order to determine if general agreement for the need to change, or commitment to

change, had been reached by the team.

Agenda:

The meeting agenda for the second meeting was as follows:

Draw together all the threads and extract a common goal

I began the meeting by proposing the following question to stimulate discussion:

‘what do you think is the purpose for us to get together?’ Some team members

expressed that it was to develop a better curriculum to bring about more effective

student learning outcomes. Some members stated we were together to improve

student learning approaches. Some said they came to learn how to teach better.

Although people expressed the purpose differently, there was a general agreement

that we were here to change the Physical Examination curriculum and improve

teaching and learning.

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This discussion prompted another question ‘what do you think we have been

doing right and what needs to be changed or improved’. Some members stated that

teaching essential concepts rather than covering all the content was appropriate. One

expressed her reflections on the three questions I proposed in the 3rd meeting (please

refer to pp. 107-108). She stated she had taken what-the-student-should-do for

granted but now realised that as teachers we should think about how to develop

student responsibility for learning. Some members argued that clear communication

to students about learning is essential.

These two questions were very effective in drawing together the threads of our

mutual concerns. Although expressed differently, there was general agreement that

we were here for a change of the Physical Examination curriculum or for an

improvement of teaching and learning. Although people pointed to different elements,

we were mainly talking about students’ learning needs. That is to say, although team

members used different language or terms to express our own viewpoints, we all

generally agreed with student-centredness.

I ended the meeting after a 90 minutes discussion when the members started

digressing. I expressed my opinion that during this meeting our common goal had

become clearly evident and we were now ready to move to the next stage –

curriculum decision-making. The meeting ended but there was still a chat about our

academic life among the group.

Reflecting on Action Phase 1

Action Phase 1 was far more complex than I had anticipated. I had expected

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team members to have a ‘clear-cut’ realisation of the need to change and to be able to

transform their conception of teaching and learning once they received new

pedagogical knowledge. However, although pre reading information was provided

and time given for reading and discussion this was not the case. Transforming

people’s conceptions, beliefs and expectations is indeed, as Fullan (2003; 2005)

asserts, a complex process and it requires time spent on clarification and reflection.

However, Action Phase 1 was a valuable phase in this change process. The

phase offered opportunities for us to know more about ourselves and how we teach.

Although not explicit, we gradually changed our understandings of teaching and

learning. Scepticism was developing among team members about the teaching status

quo, and we all agreed that we were there to change our teaching and thus student

learning. This phase also gave the team opportunities to learn essential knowledge

about aspects of curriculum making. To a certain extend, empowering outcomes such

as self-growth and political consciousness raising (Smith, 1993) were gradually

developing among the team. It was expected that this phase would enable team

members to be more ready for collective action and to effectively take control of the

change during the next Action Phase: curriculum decision making.

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CHAPTER 5

Continuing the Story of the Collaborative Journey Action Phase 2: Curriculum Decision-Making

Introduction

The purpose of Action Phase 2 was to work together to develop a Physical

Examination curriculum that was student-centred and with all elements aligned.

Strategies used to achieve this purpose were critical debate and nominal group

technique. The team had decided to make a new curriculum without examining the

present curriculum therefore the proposed strategies of ‘analysis of curriculum

document’ (See p. 81) were not used. A time survey was conducted in order to

schedule appropriate meeting times and a meeting agenda was sent to all team

members one week before in order to allow time for reflection and preparation about

agenda items before the decision-making process.

The 1st Meeting of Action Phase 2

Purpose:

The purpose of this meeting was to develop learning objectives for the Physical

Examination unit. The strategy used to facilitate this purpose was nominal group

technique.

Pre Meeting Activity

Because we were to construct our learning objectives from the verbs (The

cognitive process dimension) and the nouns (the knowledge dimension) used in the

revised Bloom’s Taxonomy Table (See Appendix F /p. 261) this action would require

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careful and possibly lengthy deliberation. In order to advance our progress and save

time, team members were encouraged to individually reflect on the desired learning

outcomes for the unit and then generate ideas for at least three learning objectives

and bring them to the meeting.

Agenda:

The nominal group procedure made up the agenda of this meeting.

1. Generating ideas: generate learning objectives individually with Bloom’s terms 2. Recording ideas: record all the objectives on the white board by Li-Yu 3. Discussing ideas: explain, clarify and cluster the recorded objectives (critical

debate) 4. Voting on ideas: vote anonymously on the priority of five objectives 5. Recording and counting the scores 6. Ranking the objectives chosen 7. Determining how many objectives to be saved for the Physical Examination unit

Early in the meeting it became apparent that not all team members were ready

to apply Bloom’s language to the Physical Examination learning objectives.

Although members were encouraged to term the objectives with the verbs and the

nouns used in the revised Bloom’s Taxonomy, some tried and some did not. Those

who did not use the revised Bloom’s terms said the concept was abstract and hard to

apply to the curriculum. Thus it was decided not to worry too much about using

Bloom’s actual language while we generated ideas for learning objectives.

Reflection Point: What happened here echoed my previous concerns that some

pedagogical concepts might be too abstract to comprehend with only a brief

introduction and discussion session. It also confirmed that it may be hard to apply

knowledge when the concepts are not fully understood. I also realised that although

we are all experienced teachers, it was difficult for us to develop a curriculum with

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educational terminology at this point in time – the very beginning cycle. This is

especially true for university academics who receive little pedagogical training for

the teaching role. (LY: Reflection File B, June 3, 2005)

Although we were not ready to apply Bloom’s terms the team shared ideas and

considered the objectives enthusiastically. After the generated ideas for the learning

objectives were shared, Alice helped me to record them on the white board. We then

discussed and combined the ideas until agreement was reached on nine objectives to

be voted on in terms of their priority. This process was done in a conscientious,

cheerful and harmonious ambiance.

Before we started voting on the priority of the objectives some concerns were

expressed about determining the number of objectives: For example what if some

people believe all the objectives are appropriate or similar objectives are voted

higher and we lose an objective which might be good but of lower priority? Although

determination of the number of objectives was scheduled in the agenda and was to be

discussed after voting, we moved this topic forward.

In discussing these concerns, one member suggested we cluster similar

objectives from the nine generated objectives and then choose one objective from

each cluster. Another member asserted that we should wait until the objectives were

prioritised because that activity might actually diminish our concerns. We generally

agreed to vote for the priority of objectives immediately and determine the actual

number of objectives later.

However, we started losing the participants before we voted on the objectives.

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Although seven team members attended this meeting, only four completed the voting.

It was near the end of semester and a very busy time for academics. Some members

left without voting due to having other school affairs to attend to.

The meeting ended after the remaining participants voted anonymously for the

priority of objectives. As this was a minority vote and not a collaborative decision,

priority of the learning objectives of the Physical Examination unit was not

determined at this meeting. Because of time constraints, we decided to ask those who

were unable to vote at this meeting to record their vote via email.

The email voting elicited five responses and thus nine team members out of

total of 12 voted. The nine objectives are recorded below in their raw format and

according to scored priority:

1. Demonstrate abilities of complete health assessment by seeing individual

as a whole 2. Analyse and integrate assessment data and identify appropriate nursing

diagnoses 3. Apply critical thinking skills to a clinical case study 4. Possess physical examination knowledge and skills about each body

system 5. Critically integrate the assessed data with regard to the individual condition

of the patient 6. Record assessed data about each body system 7. Differentiate and attribute the assessed and integrated data 8. Understand the abnormal findings in each system 9. Analyse abnormal findings with critical thinking ability

The nine prioritised objectives were to be refined at the next meeting when we

would also determine how many to select as learning objectives for the Physical

Examination curriculum. We could then, in accord with the determined objectives,

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begin to make decisions about teaching and learning activities and student

assessment approaches for the curriculum.

The 2nd Meeting of Action Phase 2

Purpose:

The purpose of this meeting was to complete decisions on the Physical

Examination curriculum by nominal group technique. This meeting was planned to

occupy the whole day. It was the second last week of semester and the curriculum

decision-making had to be completed before semester ended. It was meant to be the

last meeting of Action Phase 2.

Agenda:

Decision-making regarding curriculum elements and discussion of preferred

arrangement for next semester meetings made up the agenda of this meeting.

1. Determine how many objectives to select for the Physical Examination unit 2. Discuss teaching and learning activities and student assessment (align with the

determined learning objectives) ………Coffee Break.......

3. Decision-making for Teaching and learning activities by nominal group technique

4. Decision-making for student assessment by nominal group technique ………...Lunch…….…..

5. Propose expectations for curriculum implementation and preferred arrangements for next semester meetings

Eight team members had indicated their availability for this meeting but despite

a reminder email being sent two days before the meeting, only six attended. During

the meeting, participants ‘came in and went out’ due to other commitments. The

‘in-and-out’ movement resulted in discussions that were made up of small numbers

of often different people. There were often only three participants, including myself

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in the meeting.

Reflection Point: Some team members are beginning to not attend meetings and not

let me know they will be absent. I can’t help but interpret it as slackness; however, it

is also ‘freedom of choice’. There have been weekly meetings for two months, and it

is undoubtedly tiring. Sustaining people’s interest in participating in this work and

their convictions about making an educational change is a challenge at this point in

time. I have the impression that only people who hold strong beliefs or interest in

this project will continue to attend. (LY: Reflection File B, June 3 & 10, 2005)

At the 2nd meeting we first finalised the learning objectives. We decided the nine

proposed objectives were all relevant but needed further synthesis. We also agreed

that the objective ‘Demonstrate abilities of complete health assessment in ways of

seeing individual as a whole’, which scored the highest, should become the overall

aim of the Physical Examination unit. We rephrased it as ‘Enable students to

possess health assessment knowledge and skills to carry out complete health

assessment effectively on an individual’. Some similar objectives were combined

and rephrased. Finally the following six learning objectives were determined for the

unit:

1. Understand the relationships among health assessment, problem solving

and decision making in nursing practice. 2. Demonstrate the ability to apply basic knowledge and skills of physical

examination and health data collection. 3. Complete accurate records in relation to health assessment in each body

system. 4. Understand common abnormal findings in each body system. 5. Analyse, integrate and critique the assessment data collected according to

individual situations.

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6. Apply the nursing process to the collection and integration of data, and generate appropriate nursing problems.

After determining the final objectives, we all showed on our faces that we were

content with our work. We then started discussing the student assessment approaches.

We skipped to this 4th item on the agenda because we believed the teaching and

learning activities should be aligned with, and follow the student assessment

approaches.

We first considered assessing students’ Physical Examination techniques in

different ways. Conventionally, we assessed students’ ability in Physical

Examination techniques by providing students with a list of techniques and assessing

their accuracy in carrying out the proper procedures. The team now realised that this

convention encouraged students to memorise techniques rather than to think

critically about what they were doing. Because we wanted the students to apply the

techniques more consciously, we planned to use a case study (scenario) to assess

their Physical Examination abilities.

Many other approaches to assessment were proposed for the unit. I suggested

students assess each others’ Physical Examination techniques through group critique.

Sue proposed a ‘practice experience record’ as bonus credits for encouraging

students to practice their Physical Examination techniques after class. Alice shared

her strategy of using an audio-visual session to assess students’ abilities in judging

abnormal findings. Donna suggested that we encourage students to search for and

read published articles about case study and health assessment. Janet proposed a

written assignment to assess student learning. We were all excited about these ideas.

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As the proposed ideas had to be further considered in terms of their appropriate

utilisation within our teaching circumstances, we spent a lot of time on discussion.

We debated the feasibility of applying the ideas to the classroom, and also tried to

anticipate any problems that might occur should we elect to use any of the proposed

approaches to assessment.

We were unable to complete the curriculum decision making process at this

meeting for different reasons. First, as the unit includes skills practice, our school

divides the unit into lecture and laboratory sessions. Thus two unit outlines had to be

completed for the Physical Examination unit - one for lecture sessions (theory) and

one for laboratory sessions (skills practice). This made the decision-making process

very complicated. Secondly, although this was a three hour meeting there was

insufficient time for us to complete the decision making process. I asked for ideas on

how to solve this problem – how to complete the curriculum decision making process.

None of us had energy for further discussion. The team asked me to develop the

remaining elements of the curriculum and then arrange an email voting on my draft.

The meeting ended with a hurried authorisation by the team.

Reflection Point: The hurried authorisation might be a sign of tiredness in the team.

It is hard to keep fresh and interested if tasks exceed workload. I am gratified I have

been favoured and trusted to develop the rest of the remaining elements of the

curriculum. However, the decisions still have to be made collaboratively by the

team. After several days of ‘taxing my brain’, I decided we would all benefit from a

rest until semester break and then regather to complete our curriculum decision

making process. I do not agree that I should complete the curriculum making even

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though we failed to complete it before the semester break. We, the team, should keep

working together otherwise the curriculum decisions might not be appropriate and

acceptable as ‘ours’. (LY: Reflection File A, June 26, 2005)

After a 2-week rest, team members were emailed asking for a meeting during

the mid-year break. Seven team members responded with ‘yes’. The 3rd meeting of

Action Phase 2 was then held a month after the 2nd meeting. The seven respondents

all came.

During the break between the 2nd and 3rd meeting, I documented some parts of

the curriculum according to our previous decisions. I documented the rationale, aim

and the objectives of the Physical Examination unit. I also adapted the objectives into

two Physical Examination unit outlines - one for lecture sessions and the other for

laboratory sessions. Although the curriculum was documented individually, decisions

for its’ development were made by the team. The documented curriculum was now to

be validated by the team to ensure it was in accordance with the collaborative

decisions previously made.

The 3rd Meeting of Action Phase 2

Purpose:

This was an extra meeting held to complete the curriculum decision-making

process.

Agenda:

The agenda of this meeting was as follows:

1. Ensure documentation was in accord with the thinking and decision making by

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the team 2. Decision-making for teaching and learning activities by nominal group

technique 3. Decision-making for student assessment approaches by nominal group

technique

Eight people including myself participated in this meeting. We generally agreed

that the rationale, aim and the objectives of the two Physical Examination units were

appropriately documented. One member asked about the verbs used, stating they

were not exactly as proposed in the previous meeting. I explained that I was trying to

apply the Revised Bloom’s terms to our objectives. For example, I synthesised the

verbs ‘differentiating’ and ‘attributing’ into a more general term ‘analyse’. The

application of the revised Bloom’s terms also completed the objectives with both

verbs and nouns. I asked their opinion about whether the reworded objectives still

meant the same. The team agreed that they did. We then shortened some sentences to

make the language more concise for students. After rewording, we reviewed the

rationale, aim and objectives. The rationale, aim and objectives were deemed

appropriate and acceptable and we moved to the next item on the agenda.

The next items on the agenda were to make decisions about both Teaching and

learning activities and student assessment approaches. The team decided to carry

them out simultaneously because they link to each other. Alice and Sue suggested we

adapt the student assessment approaches proposed from the last meeting. As we had

some members at this meeting who had not been at the previous one I suggested we

listen to their ideas first and then consider all the ideas together. Therefore, time was

given for the team to generate their ideas about the Teaching and learning activities

and student assessment approaches.

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The ideas generated were varied. Proposed Teaching and learning activities

consisted of lecturing, discussion, demonstration, practice, case study, journaling,

information search, and video sessions. Student assessment approaches suggested

were multiple-choice exams, case study, assignments, journaling, and attendance

recording. Together with the student assessment approaches proposed from the

previous meeting, we had plenty of choice.

Before we started to make decisions, I reminded the team about the need for the

curriculum to be both appropriate for, and acceptable to, both teachers and students. I

suggested each of the team make their decisions in anticipation that we were all to

implement the curriculum. I also reminded them that we needed a curriculum that

was not only acceptable and appropriate but also able to be implemented. My

reminders provoked additional discussion about the proposed Teaching and learning

activities and student assessment approaches.

We discussed student workload, possible learning outcomes, and the score

allocation in terms of student assessment approaches. As a result of this impromptu

discussion we made more changes. For example, after this discussion we made some

changes to a written assignment being proposed for assessment.

Originally the assignment required students to ‘discuss the importance of

Physical Examination in nursing’. Some team members asserted that a written

assignment was good only if the question demands critique rather than description.

Donna suggested we consider some alternative forms of assessment that would

encourage development in terms of metacognitive knowledge and learning skills.

This suggestion resulted in our adoption of a modified version of ‘learning logs’ – a

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strategy for student assessment developed by Weimer (2002). The written assignment

was thus changed to a series of learning logs called ‘Learning plans and evaluations’.

We designed the logs to encourage students to explore how the unit content related to

their individual health assessment skills (Please see Unit Details in Appendix G-1, pp.

265-266). The impromptu discussion of student assessment approaches resulted in

more tangible ideas for the development of student learning skills.

When we attempted to move to the next item on the agenda - decision-making

for Teaching and learning activities by nominal group technique, Alice asked if we

still had to vote because she thought the decisions had been made. She believed there

had been agreement with all the ideas proposed during the discussion. I responded

that there might be some people who did not agree with all the ideas and had not

spoken up. When I asked for the other members’ opinions about this issue no one

responded directly, but instead we went straight into another discussion.

This discussion focused on any ideas considered contentious, unclear or

inappropriate. For example, some members disagreed about recording student

attendance on the grounds that doing so did not contribute to student learning. They

considered the problem of student attendance could be solved through improved

teaching. The member who had proposed the idea of recording attendance claimed

that without students an excellent curriculum is meaningless. She thought that using

attendance as an assessment item might motivate students to “come and learn”.

However, she also agreed that attendance alone does not improve learning.

Consequently ‘attendance’ was deleted from the list of student assessment

approaches. This discussion led the team to another layer of considerations about the

curriculum.

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Although the curriculum decisions were not made through formal voting, the

team appeared comfortable discussing and making decisions openly within the group.

The open discussion ended in a deeper understanding and more general acceptance

of the curriculum.

I ended the meeting with a quote from Schon (1991):

There is nothing in the reflective turn that requires a uniform approach to reflection; on the contrary, researchers who have taken the reflective turn are likely to feel an obligation to give one another reason. . . . Our discussions did not try to reduce one [person’s] perspective to another’s. . . . We could understand each other, criticize and improve each other’s work, and yet we could go our own ways. (p. 6)

This quote was written on a PowerPoint slide and was meant to suggest the

attitude most appropriate for our following meetings in the next action phase of the

project. During Action Phase 3 we were to critically reflect as a group on the

implementation of the new curriculum. This sharing of opinions would undoubtedly

promote much critical debate – a necessary requirement if we were to continue to

develop our understandings and teaching and learning. Some team members read,

and appeared to ponder, Schon’s words; others wrote them down.

Once the curriculum decision making was completed I began to document the

Unit Outline which at our school is a one page brief description of the unit called ‘the

Teaching and Learning Standard’. To meet school requirements, I revised our

‘Teaching Standard’ according to our decisions. Moreover, because I anticipated that

the implementation of the new curriculum would be a new experience for both

students and teachers I also developed a Unit Details document with more in-depth

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descriptions of the unit.

However, while developing the Unit Details document I realised that some

particulars of the curriculum needed further discussion and confirmation before it

could be implemented. This especially applied to the change in the way students’

health assessment skills are assessed. As discussed earlier (See p. 127) the

conventional skill assessment was simply a memorise-and-demonstrate session. This

would be retained but assessment of these skills now included a scenario about which

students were required to think critically to conclude appropriate health problems.

Moreover, we needed to develop a more practical process wherein the assessment

laboratory was properly prepared for a smooth procedure. The completed Teaching

Standard and Unit Details documents also had to be examined and confirmed by the

team. These realisations led me to arrange one more meeting before we implemented

the curriculum - the ‘Pre Curriculum Confirmation Meeting’.

The Pre Curriculum Confirmation Meeting

Purpose:

The purpose of this meeting was to examine and confirm the curriculum

documents and develop a more practical process for conducting the skill assessment.

Pre meeting document:

In order to enable the participants to become familiar with what was now in the

Unit Details, I sent the curriculum documents by email on two occasions: as soon so

I finished documenting and also one week before the meeting. The documents

included the Teaching and Learning Standards and Unit Details for both the lecture

and the laboratory sessions. The meeting agenda was also sent with the second email.

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Agenda:

The agenda of this confirmation meeting was as follows:

1. Validate documentation of the Teaching and Learning Standards 2. Ensure Unit Details are clearly and sufficiently documented 3. Develop a practical process for skill assessment

This meeting was held ten days before we implemented the curriculum and 17

nurse educators including all the team members were invited. The teaching

arrangement issued by the Nursing Department showed that there were nine nurse

educators to conduct the 2-tech Physical Examination curriculum in the first semester

of academic year 2005. Among the nine nurse educators, eight were team members.

The other four team members, who were not in the 2-tech teaching group, were also

invited to participate in our meetings until the end of the project. Although these four

members did not participate in teaching 2-tech Physical Examination classes, they

would play valuable roles as ‘critical friends’ in the implementation phase. Moreover,

in Cha-Yi Campus in southern Taiwan, we also had three nurse educators to

implement the 2-tech Physical Examination curriculum. They were unable to come

due to the distance but were very willing to share their thoughts and experiences via

email.

There were ten participants at this meeting including myself. Six of the eight

team members who were to implement the 2-tech Physical Examination curriculum

came. Two of the four ‘critical friends’ appeared at this meeting. We also had the new

Unit Coordinator join us.

There was general agreement with the new curriculum. There was no

disagreement or questions regarding the content. Some of the wording was changed

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to make the language more readable for students. Donna suggested that the

descriptions of the written assignments ‘Learning Plan and Self Evaluation’ in the

Unit Details might be more clear and readable to students if presented in table format.

I also asked for opinions of whether each student taking this unit needed a copy of

the Teaching and Learning Standards and Unit Details. We decided to print the Unit

Details for each student. A copy of the Teaching and Learning Standards could be

shared by a class.

Development of a practical process for skill assessment was discussed and

directed by three focus questions: who constructs the scenario; how should we

arrange the assessment laboratory; and how long should a student have to complete

the assessment? The questions focused the activity and solutions to each question

were found within a very short time.

Four of us volunteered to coordinate the teaching and learning for each of the

four body systems covered in the unit. The unit content covers four body systems

with the teaching and learning of each system being coordinated by a different

teacher. Each coordinator would arrange a meeting with those who taught that system

and together construct an appropriate scenario.

The arrangement of the assessment laboratory was modified from the previous

setting. The student would be given 15 minutes to demonstrate the Physical

Examination skills and another 15 minutes to complete the health assessment

process.

Towards the end of this meeting, I encouraged people to express their

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expectations regarding the upcoming Phase 3 meetings that would occur while we

implemented the curriculum. There were no particular expectations expressed. We

agreed on monthly meetings as the teaching period for each body system was

approximately a month and it was believed that the 2-tech teaching group could best

share their experiences and reflect on their teaching after they had completed a full

teaching period. Members of the 2-tech teaching group were to share how they

implemented the curriculum and reflect on their works.

Reflecting on Action Phase 2

Like Action Phase 1, this was another complex phase which proceeded

differently from my expectations. I had thought it was a matter of simply gathering

the team together and collaborative decisions would be made. However, gathering

people together seemed to be even more difficult during this phase than the pre-phase

when the team was formed. I suspect factors such as attitude, time constraints and

workload influence participation in collaborative endeavours.

Although all team members volunteered to participate in this study and were

committed to the change, some of us were passionate about the decision making

process and eagerly participated while others participated far less often or

enthusiastically. Some team members may have just wanted to be told what to do

rather than actually make the decisions themselves. If this is the case, commitment to

change also relates to the attitude held towards the whole change process.

Despite commitment or constructive attitudes to the change, time constraints

and workloads may be other factors that impacted the collaborative decision making

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process in this phase. For example, the ‘in and out’ movement of team members

during the second meeting (See p. 125) might indicate that busy academic lives

prevented some team members from having the time or energy to participate even

when they wanted to do so. Also, the hurried authorisation made for me to complete

the remaining elements of the curriculum (See p. 128) echoed the reality of our

academic lives in which many of our collective decision making meetings were

really only collective authorisations of decisions made by one person. In a truly

collaborative relationship teachers communicate together, learn to better understand

their teaching practices, and build group cohesion (Hasseler & Collins, 1993; Kim &

Lee, 2002; Manouchehri, 2002) and therefore any decision making processes should

not be compromised by hurried authorisation.

Although some difficulties occurred during this phase, we were able to work

together as a team to solve problems, made decisions, and generate creative student

assessment approaches. We were excited about our ideas and well satisfied with our

work on the new curriculum. We were all looking forward to the challenge of

implementing the new curriculum, the story of which is told in the next chapter.

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CHAPTER 6

Continuing the Story of the Collaborative Journey

Action Phase 3: Implementing and Reflecting on the

New Curriculum

Introduction

The purpose of Action Phase 3 was to implement and reflect on the new 2-tech

Physical Examination curriculum. In the previous phases the team had engaged in

curriculum decision making for five months and in this phase we were to put our

decisions into practice and then reflect on our experiences.

Activities in this phase took place throughout the teaching semester and

consisted of individual classroom teaching by each of the 2-tech Physical

Examination teaching group and five group meetings. In four of the group meetings

we shared our teaching experiences and reflections using the strategies of

collaborative reflection, critical debate and negotiation. At the end of this phase we

had a fifth group meeting to modify and further develop our new curriculum.

Pre Implementation Preparation

There was an active dynamic within the teaching group as we summoned our

energies to prepare our teaching. As collaborating about our teaching was a new

experience for all of us, we prepared for our teaching with perhaps more diligence

than ever before. Some members of the teaching group shared and discussed their

lesson preparations; some asked others for verification of their preparations; most

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were concerned that their preparations were in accordance with our curriculum

decision making. We were anxious but also very conscientious about our new

teaching roles and responsibilities.

Emma, who was elected to conduct the introduction session of the curriculum to

the students, invited me to a rehearsal. Some of us also attended the actual

introduction session with Emma in order to listen and respond to students’ queries.

Some 2-tech nursing students thought the new Physical Examination curriculum was

more complicated than other units, most considered it interesting.

As before, time surveys were conducted and an agenda sent to all team

members one week before meetings. As the purpose of this phase was to implement

and reflect on the curriculum, the topics for the agenda concerned teaching members’

individual reflections on their curriculum implementation experiences and then a

collaborative reflection. Inevitably members’ experiences and actions would be

questioned in the meeting and I was concerned that this could be stressful for some.

Therefore I avoided words with a negative or stressful association such as

‘examination’ or ‘evaluation’ and called the meeting ‘Talking about the 2-Tech PE

Curriculum’.

In order to reinforce team members’ understandings about reflection I emailed

them information related to techniques and attitudes that encourage collaborative

reflection (Pan, 2004a, see pp. 74-75 for details). Team members were encouraged to

read the information before the meeting.

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Meeting 1- Talking about the 2-Tech PE Curriculum (1)

Purpose:

The purpose of this meeting was to collaboratively reflect on the

implementation of the new curriculum.

Pre reading information:

The techniques and attitudes for promoting collaborative reflection (Pan, 2004a,

see pp. 74-75 for details) made up the pre reading information for this meeting.

Agenda:

The meeting agenda was arranged as follows:

1. Share curriculum implementation experiences 2. Collaborative reflection on the shared experiences

I began the meeting by introducing the purpose and agenda. I also briefly

reiterated the techniques and attitudes suggested by Pan (2004a) for collaborative

reflection. I emphasised listening to the speaker without interruption, and writing

down queries and asking for clarification when the speaker was finished. Team

members were encouraged to continue to share their reflections or raise any

questions via emails if the meeting time was inadequate.

The teaching group expressed that although the 2-tech nursing students were

serious about learning this unit, they were also anxious about the new curriculum.

Generally I clearly explained to them the ways the learning would be done. I also encouraged them to learn on their own. They were anxious when they heard about some unfamiliar activities. They asked me “Will we fail at the end?” They cared about it quite a lot. I also told them “you might be nervous that there seem to be many activities, we will guide you step by step”. (Monica: Meeting File, Oct 5, 2005)

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I knew from the lateral side [informally from other teachers] that students were nervous. They said this unit seems to be difficult to pass. Emma just mentioned the students all submitted their learning logs. I think they would all appreciate the chance of [gaining] bonus [credits from writing learning logs] because they expressed to their mentors that it seems to be hard to pass. But I believe they will take it seriously. (Gloria: Meeting File, Oct 5, 2005)

It appeared the students’ immediate responses to the new curriculum were directed at

fear of failure instead of learning. Laura’s interpretation of the responses was that the

students were grade-orientated. She raised a question about how to transform student

learning from grade-oriented to learning-oriented. She wanted to know how we could

deal with it.

In response to Laura’s question, Alice claimed that students might learn for the

grade but there was no conflict between student learning and grade-orientation. Sue

believed that we were dealing with the problem through our curriculum. She shared

that students had told her they had learned how to set their own learning goals from

the written assignment ‘Learning Plan 1’; a new learning experience. Sue agreed

with Alice, claiming that based on students’ feedback she believed that although

previously students might have done the assignment for credit, they still learned from

the activity. Alice and Sue believed that what we were doing was the answer - we had

used student assessment to facilitate student learning.

Despite the problem of grade-orientation, the teaching group were concerned

more about the depth of student learning. For example, in the learning log they found

students gave very general descriptions of how they could survive the unit –

descriptions such as: ‘prepare in advance’ or ‘revise after class’. The group also

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found the students were very textbook or content dependent:

Through the whole process I found they are still dependent. For instance, the information in my PowerPoint. . . . I told them they didn’t have to write it down. Time was inadequate for them to copy [the information] word by word. I told them they could find the information in their textbook. But they were still worried [about insufficient time to copy the information]. After class they asked “Can we have a copy of your file? Could you email us?” I found that . . . they [the student] may not change all at once. (Monica: Meeting File, Oct 5, 2005) My feeling is that more than half of the students paid serious attention to the class. But they kept turning [pages of] the textbook. They wanted to know where [in the textbook] I was talking about. (Gloria: Meeting File, Oct 5, 2005) The problem is, [our] expectations about them [students] seem to be a bit high. Actually they don’t know what they should know. You could ask them, they won’t know. You [I] reminded them that they learned it before, but they were unable to answer. . . . So what on earth to teach? How fast to teach? Students expect there must be something taught. In other words, they won’t be impatient if you revise what was taught in their junior college days. Their facial expressions showed ‘Oh, so it is’ rather than ‘I already knew it’. (Emma: Meeting File, Oct 5, 2005) I started the class by revising anatomy and physiology. I asked them “Do you think this was actually taught before and I am doing a bit too much? Or it’s not good to spend much time on it? Is there anything you think you know?” I asked each of my classes. Almost all of them responded: ‘No. We have almost forgotten everything’ . . . although they had learned it before. . . . I cannot treat them as if they all knew now. (Sue: Meeting File, Oct 5, 2005)

In the skill practice teaching session, there was a problem with the assignment

‘Skill Demonstration and Critique’. With the previous curriculum it was a two hour

demonstrate-and-practice session, similar to the sessions students had in their junior

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college days. With the new curriculum, we developed the activity ‘Skill

Demonstration and Critique’ which aimed at improving students’ Physical

Examination skills through group work.

Students worked together as a group of three, each in turn playing the role of a

patient, or a skill demonstrator, or an observer. The observer was to assess the

performance of the demonstrator of the PE skills. A critique guideline was given in

advance to students so they could prepare for the session. Students were expected to

complete the questions on the guideline as a group by the end of the session. The

questions were:

How did the [student] demonstrator perform? Is there any aspect which needed

to be improved? What do you suggest the demonstrator needs to learn with regard to her PE skills?

What are your opinions regarding the PE skills learned about this body system? Was there any problem or difficulty that concerned you? What did you understand least well? Is there any gap between what you are learning now and what you learned in your junior college days?

While facilitating this learning activity, the teaching group confronted the dilemma

of allowing time for students to practice or to complete the questions.

In the skill practice session, they became …, especially the observer. I said to them “you still have to practice. You just leave the last 10 or 15 minutes to discuss what the performer needs to do to improve and to complete the critique assignment”. But I saw the observer wrote seriously all the time. She was serious about observing and writing. This impacted her time spending on practice. This is what I found problematic. (Monica: Meeting File, Oct 5, 2005) With regard to the skills, some students were not good enough. For example, their percussion skills were not good enough. Their basic skills were just not good. It seems there is not enough time for practice. A

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dilemma exists regarding the skills critique. You would like each of them to practice. But time seems to be inadequate if you also wanted them to write the critique. In the first class I asked them to submit it before the break. However, you [I] saw them become so anxious that they started writing during the middle of the class. Consequently they had insufficient time to spend on practice. At the last two classes I didn’t ask them to [submit before the break]. I said although it had to be submitted they still had to practice. This time they couldn’t complete writing. I then responded that they could submit it the day after. It seems to be hard for them to complete two tasks at that time. (Sue: Meeting File, Oct 5, 2005) Now students work as a group of three and obviously the student who did the writing had no chance to practice. It is indeed the case. (Janet: Meeting File, Oct 5, 2005)

This issue provoked further discussion and reflection:

Fiona: It was mentioned that time for practice was insufficient. Is there any solution to solve it?

Sue: My perplexity is which is more important, to critique or to practice? Critique sounds important, but if so then they [the students] have to take some practice home. However, from what was not completed I couldn’t see if they could perform well or not. I would then lose my teaching responsibility. Anyway this is my perplexity. I became unclear about which is more important between these two areas.

LY: What do you think about the purpose of it [Skill Demonstration and Critique]?

Sue: Undoubtedly. It’s undoubtedly the critique. The purpose of the assignment is to develop their critical thinking [ability]. . . . I feel worried about their skills because… Like Janet said, their skills are not as good as we expect. Practice is necessary. So I am not clear if. . .

LY: Have we teachers ever thought about why we want students to critique?

Fiona: Because she [student] has to apply the knowledge after she has learned it. She has to think if she wants to apply it. . . . She could judge whether another’s skill demonstration is correct through

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observation and then reflect on her own skills.

Sue: I don’t know what you meant by your question. What I mean is, undoubtedly she has to understand before critique, doesn’t she? But that doesn’t mean her demonstration [skill] is OK.

Gloria: My feeling is that, they [students] are now undergraduates. We might not have sufficient time for them to complete practicing, but I think they have to take [their work] home. Regarding this [the Skill Demonstration and Critique] we are to check [on their preparation] rather than to allow them to come with nothing.

Gloria: I think the critic should know the whole [demonstration] process thus she could critique the accuracy of other’s demonstration.

LY: So you mean the student should do some preparation before class.

Gloria: Yes. Also they will have the skills assessment; they have to practice after class. Physical Examination [skills] naturally requires a lot of practice.

LY: Do you think the students did their preparation?

Sue: I wanted to ask students if they saw the video [of PE skills]. I didn’t ask them officially but I guess the possibility is not good. I guess so. She [the student] probably came and waited for your demonstration. She then would just start practicing.

Gloria: They may just not be proficient. Many of them were our 5-year junior college students, weren’t they? It [the skill] has already been examined.

Sue: But if she cannot, she just can’t. She was taught at the 3rd year [two years before graduation].

Monica: They all forgot…

(Voices came from all directions…)

LY: Regarding Sue’s question: is critique important or is practice. It is written in the assignment guideline that students have to do some preparation to achieve better learning outcomes. We wanted them to develop critique ability through the skill demonstration sessions. Because the students didn’t do their preparation it has become a

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problem. Therefore we may need to communicate ‘preparation’ to the student.

Sue: So they have to do the preparation?

LY: The problem is based on no preparation. Would it be solved if students do their preparation?

Sue: Originally I thought as we arranged this session . . . my question was whether I was responsible for it [checking the accuracy of all students’ skills demonstration]. Would some time be replaced if I let them [the student] complete it [the critique]? This was my question.

The discussion did not end with any agreement of whether the critique or the skill

practice is more important, or whether students were expected to come to the skill

demonstration session well prepared. These issues might require more time for team

members to consider. However, regarding the problem of insufficient time, some

members shared their time management strategies for how to proceed through the

session more effectively.

Reflection Point: The dilemma may have reflected that we are still learning to

implement the curriculum. Although the curriculum decisions were made as a team,

implementation was an individual activity and the details still required

communication among us all. We are still learning to do by doing. (LY: Reflection

File B, Oct 16, 2005)

In this meeting the teaching group also shared their experiences about

implementing the activities and encouraging discussion in the classroom.

In the lecture sessions on the pulmonary system, I only had six hours. In the last hour I had to make decisions about whether to play the video [for skill demonstration] or do an activity. I decided [to let] the students watch

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the video by themselves through the website. Their responses were OK [did not resist]. When doing the activity . . . I found from the students’ feedback that it [the outcome] was quite good. They tried to understand why plural effusion reduced the Tactile Fremitus or why patients with pneumothorax or plural effusion have their tracheas deflect towards the healthy side. . . . I also found some students would come and ask me questions after class. There were fewer [questions] before, now it is apparent that more [students] came and asked questions after class. (Sue: Meeting File, Oct 5, 2005) I had talked to Li-Yu about how to guide student learning. . . . I encouraged a lot of discussion. It was interesting. The students also had fun. . . . They also understood [the text]. When I asked them if anything was still unclear, they believed that they now understood even better. . . . I thought it was fun when I guided their learning, especially when they thought from another angle, the critical thinking, and they also agreed it was important. (Janet: Meeting File, Oct 5, 2005)

It appeared that more active learning brought more positive learning outcomes.

In the collaborative reflection session, I had more questions but time constraints

did not allow discussion. Therefore, I read out my questions and asked team

members to take home a copy and reflect on them. While I was reading my questions

out, some team members responded to them with facial expressions suggesting ‘yes,

now I understand’. I expressed that I would also put my questions in the meeting

record and encouraged the team to pose further questions or share their reflections

via emails. Some examples of my questions were:

You said the student lied to you by travelling instead of coming to have the test and you don’t know how to deal with it. Have you thought of asking her why she chose travelling instead of the test as she knew the test was important? Have you thought of asking her what kind of responsibility she should take for her own action?

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You changed your type of test because of students’ resistance. Is there any reason you did so? Is this what you understand student-centred to mean? Three of you have talked about whether or not to give students your PowerPoint. Does ‘to give or not to give’ affect students’ learning? Why? You said you heard from their mentor that students think this is a hard-to-pass unit and they fear they will fail. Have you asked your students why they feel this way? What are their difficulties? Or is it a type of resistance to the new teaching and learning approaches?

When the meeting ended some members stayed and exchanged ideas about teaching

and learning as well as how to mark the students’ learning logs.

Reflection Point: I was glad we had shared some positive outcomes in the first of

our implementation and reflection meetings. However, after the meeting I looked

for further room for improvement by reviewing the meeting record.

I realised there was a discrepancy between what we did and what we thought

we were doing. We believed we were implementing a student-centred curriculum.

However, sometime we lost the point. For instance, one team member returned to

multiple choice questions to assess students’ understanding of Physical

Examination. Her reason was that students resisted the short answer and

fill-in-the-blank quizzes. Some members had claimed that students had a limited

ability to integrate knowledge, but had failed to help students to learn to do so. The

dilemma of ‘critique or practice’ was another example. We knew critical thinking

ability was more important than rote learning of Physical Examination skills.

However, we wanted to spend more time on skills practice because we saw this as a

teaching responsibility. There was still a gap between our rhetoric and our

practice.

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I also realised that in the collaborative reflection session the questions had

been centred on techniques to raise student interests in learning and to transform

students from grade-oriented to learning-oriented. In this sense, we had asked

questions in order to find technical solutions instead of for reflection or

understandings.

I further realised that we had repeated the old stories about student

incompetency and lack of preparation for lessons. To a certain extent we still

blamed the student instead of considering how we could improve student learning.

Essentially, we were ‘marking time’ instead of ‘moving on’.

My realisations prompted me to consider some alternative strategies to

promote reflection. I considered arranging an extra meeting for reflection between

two ‘Talking about the 2-tech PE Curriculum’ meetings. To do so, the meeting

frequency had to be once a fortnight. I also considered modifying the meeting

agenda. Instead of our experiences and our problems, we could also share ideas

and opinions about whether or not we were educating students to meet the learning

objectives. By considering the learning objectives we might be better able to reflect

on and be aware of our teaching roles and responsibility. (LY: Reflection File B,

Oct. 16, 2005)

I emailed team members about my concerns and ideas of increasing meeting

times and asked for their opinions. I had no response from team members. They may

not have liked the idea or may have believed that increasing meeting times would not

guarantee any improvement in the quality of reflection. I decided to simply modify

the meeting agenda. The first item in the agenda would still centre on the teaching

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members’ experiences but in terms of how we reached the learning objectives. Time

would then be given for questions and clarification. The second item of the agenda

would be free time for expression of the reflections regarding the ‘take home’

questions, and a further collaborative reflection. If necessary the last item in the

agenda would be the proposal to ‘take home questions’ related to issues that required

more time for deliberate reflection. Team members did not have to answer the

questions immediately. They could take the questions home, spend some time

reflecting on them, and answer the question at the next meeting if they wanted to. I

anticipated that the strategy of ‘take home questions’ would not only prevent team

members from possibly making immediate and defensive responses but also

minimise emotional distress and facilitate more deliberate reflections on our actions.

Reflection Point: Reviewing the meeting to examine what happened and to reflect

on it appears to be a handy strategy. While reviewing, I identified some missing

points, and gained better understanding of team members’ viewpoints. I can also

reflect on the effectiveness of the agenda I had arranged and replan it for

improvement. (LY: Reflection File B, Oct. 27, 2005)

Meeting 2 - Talking about the 2-Tech PE Curriculum (2)

Purpose:

The purpose of this meeting was to encourage team members to share and

reflect on our teaching and on student learning.

Agenda:

In order to reinforce the critical aspect of reflection, the meeting agenda was

modified as follows:

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1. Share the 2-tech PE teaching experiences, include:

How you facilitated students to meet their learning objectives of this unit The outcome of your facilitation Anything that concerned or bothered you and why

2. Collaborative reflection on previous ‘take home’ questions and further discuss

Share your reflections in the light of questions proposed at last meeting, and

Question and further discuss the issues raised

3. Take home questions

The flow of this meeting was different from previous meetings where I was the

one who announced the start of the meeting and recorded it. This time the discussion

started spontaneously while waiting for other members to come. The discussion was

progressing in such an enthusiastic ambiance that I had no chance to announce ‘start’.

I could only point to the tape recorder and indicate that it was operating. In contrast

to the agenda, this ‘freestyle’ meeting did not have a distinct direction or focus. Team

members kept generating more issues for discussion. We discussed teaching

strategies such as how to score student skill assessment, how to communicate with

students about their learning responsibilities, and how to arrange class sessions that

were flexible enough to complete the necessary teaching activities without

sacrificing the purpose of student learning. During this freestyle meeting team

members appeared insensible to the time and the meeting lasted for nearly three

hours.

In this meeting we failed to mention the student learning objectives. However,

what we shared was important and directed by the team. Team members expressed

that some students thought generating appropriate nursing problems was difficult and

they agreed. However, they also observed that students were able to think critically.

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Sue: When I guided the case study session, I found they were able to generate [nursing problems]. It appeared unproblematic. . . . But I still worried some [students] might not be able to do so. . . . And I found, I brought some examine papers today; I found they could complete it in 15 minutes, and did it very well.

Janet: That’s right. What I thought and what I did were exactly the same as Sue. But I found the outcomes were polarized.

Sue: Yes.

Janet: In my group I had [students] who only generated one [nursing problem] but also an uncompleted one. . . . But I examined three classes and there was only one [student] did so.

Sue: So how is the distribution of the students score, Janet? You said you had students who failed, hadn’t you?

Janet: I had two who failed. One had 35 [out of 100 scores], because her work was not completed. She only identified one [nursing problem] and failed to have related factors [aetiology]. Most of the students got 70 or 80, one got full score, and there may be 2 or 3 who got 95. This was counted out of three classes.

Sue: Actually after the test [skill assessment] many students said they were nervous before the test, but when they put themselves into the scenario, she [they] gradually concentrated on thinking. She [they] never thought she [they] could do it well. They all took it seriously and kept writing until the last minute.

Sue: Monica said that [her group of] students were not able to do so.

Monica: Right.

Sue: But I found they were not bad when I guided the case study sessions.

Although some of team members expressed their concerns about students’ thinking

abilities, our discussion showed that students were able to think critically.

After discussion team members were encouraged to share their reflections on

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previous ‘take home’ questions. This time, the viewpoints of teaching and learning

that were shared were different from the previous meeting. Regarding the issue of

‘critique or practice’ for example, in the previous meeting some team members had

been concerned about insufficient time for skill practice, and were worried that they

were not carrying out their teaching responsibilities. After reflection they now

believed ‘critique’ to be more important than skills alone, and that students should be

responsible for their learning and prepare for lessons.

Regarding the skill [demonstration and critique], although some students didn’t complete practicing they could learn from observation. They would be able to practice at home. And we could put student responsibility for learning into effect. We should tell them this is a revision [session], if uncompleted they should practice at home. She [student] should take a certain part of responsibility for learning. And we can also train them for critical thinking ability. . . . My conclusion is the critique is more important than skill demonstration. (Janet, Meeting File, Nov, 1, 2005)

The team generated and discussed a strategy for improving the conducting of the

session.

Some team members also articulated concern about students’ learning skills.

This provoked critical debate as team members voiced different opinions:

Donna: I would think if I needed information, I would spend the least time to get it. Then I could sooner study further. . . . For example, I could access the internet and the Physical Examination items are all listed right there.

LY: Yes. We could teach the student how to search for information.

Donna: Yes.

Emma: But I don’t know if what she [student] gets would be the same as in the textbook.

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Donna: Does it matter?

Sue: That would be OK.

Donna: I think it’s OK. I hope she could know it before the class so that we could do the analysis [critique] further.

Emma: What if she found it’s all the same as the textbook? She would say ‘I only need to use the textbook’.

LY: But she learned how to use information.

Donna: Maybe she… For example when I arrange information, I can get it from the internet, a book or the textbook. I might prefer one of them. Although they all cover what I want, I like this format more. I might not have to use the textbook because it looks to me annoying. I think as she grows up [learns more] she should be able to chose. The format, the order, what I searched is more usable and this is what I want.

Emma: But the student would worry ‘whether if what I have is what the teacher wants’.

Donna So [they could] just come and discuss it.

The use of ‘take home’ questions was an effective strategy for facilitating reflection

and transforming viewpoints.

We had more critical debate in this meeting compared to the previous meeting.

Team members were very articulate and there was little silence. We asked questions

and clarified opinions during the meeting and there was no need for ‘take home’

questions. However, at this meeting we were inclined to ignore the techniques and

attitudes recommended by Pan (2004a) for collaborative reflection. We tended to

interrupt others’ speech in order to clarify what we were saying or when we

questioned others. These interruptions resulted in the speakers having to reiterate

their opinions and thus the meeting time was prolonged.

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Reflection Point: Although this ‘freestyle’ meeting did not have a distinct direction

or focus we were able to articulate and reflect on our teaching. In this sense the

purpose of this meeting was still achieved. I attribute the achievement to the

modified agenda, especially the strategy of reflecting on take home questions. I will

keep reviewing the meeting record for further improvement, email team members

the meeting record and include some questions for further reflection, and keep the

next meeting agenda the same so that we can keep reflecting and improving our

practice. (LY: Reflection File A, Nov 14, 2005)

Although I had encouraged team members to share their opinions via emails this

had rarely happened. Therefore at the end of this meeting I asked the team if there

was any particular reason they did not like sharing their opinions via email. With

embarrassed smiles, they expressed their preferences for verbal communication over

written. Written expressions of opinion were considered time consuming and there

was little time to spare in busy academic lives.

Irene, a teaching member from Cha Yi campus, was the most enthusiastic about

sharing teaching experiences via email. The following extract exemplifies her

excitement at receiving positive student feedback about the new curriculum:

I have to mention a more important student feedback. A student responded that the way she learned was reading the textbook [rote learning]. She was unable to think. Now she is able to think about ‘why’ and asks questions (I was unable to answer her question. I said I have to check for it). This is the happiest thing to me. (Irene: Reflection File C)

With Irene’s consent, I shared her excitement with the team, but this strategy did not

promote any written expressions from the rest of the team.

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Meeting 3 - Talking about the 2-Tech PE Curriculum (3)

Purpose:

The purpose of this meeting was to share and reflect on the implementation of

the new curriculum.

Agenda:

The meeting agenda was the same as previous meeting:

1. Share the 2-tech PE teaching experiences, include:

How you facilitated students to meet their learning objectives of this unit The outcome of your facilitation Anything that concerned or bothered you and why

2. Collaborative reflection on ‘take home’ questions (from the meeting record)

Share your reflections in the light of questions proposed at last meeting, and

Question and further discuss the issues raised

3. Take home questions

Before we shared our teaching experience, I asked the team whether they

preferred a freestyle meeting or an organised meeting agenda. After a little hesitation

they responded “just talk about what comes”. It appeared that the team was happy to

have the freestyle meeting. However, I expressed my concern about our tendency to

interrupt and interfere with what each other was saying and suggested that we

question others after they finished speaking. Team members nodded agreement.

In this meeting we discussed student feedback from the mid-semester

curriculum evaluation and from student learning logs. We also shared our teaching

experiences as well as our observations of student learning outcomes. One teaching

member also shared the frustrations she experienced implementing the curriculum

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which resulted in a lengthy discussion about teaching. Once again this meeting

promoted informal, chatty, and enthusiastic discussion. This time, however, team

members appeared to be listening more to each other with less interruption.

Questions were largely addressed during the discussion which made the compilation

of take home questions unnecessary.

In the mid-semester evaluation of the new curriculum students claimed that they

were under great stress with the skill assessment as well as when the teacher

reminded them that they had learned the material before. However, the students also

expressed that they had learned how to generate nursing diagnoses. They also

claimed that there was insufficient time allocated for skill assessment. However,

when looking at the learning outcomes we realised that most of the students had not

only completed the skills assessment in the time allocated but also had performed

well:

LY: Monica, you mentioned that they [the students] expressed time for skill assessment was insufficient, how about the outcome? Did they complete it? Was the completeness awful?

Monica: No. . . . Actually eighty percent of them performed very well. There was only one student who performed worse and generated only one nursing diagnosis. The completeness [of the skill assessment] of the other students was very good.

The students also complained about a heavy workload from written assignments.

They expressed that they were burdened with four learning logs and wanted them

reduced to two (The four Learning Logs had been developed in such a way that each

log built upon the other with the learning scaffolded). I was curious about how team

members had responded to this specific feedback and encouraged further discussion

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on workloads related to the four learning logs:

LY: Regarding the written assignment, did you mention to the students that these were for bonus credits and they could choose to write or not to write?

Monica: I did. But they thought they would gain bonus credits. . . . I asked them how many assignments they thought would be acceptable. They seemed to prefer combining four assignments into two.

LY: Do you think the students considered whether that [the combination] would enable them to reach the same learning objectives as the original assessment items [four scaffolded Learning Logs] in terms of their learning?

Monica: I didn’t talk to them in such details.

LY: This [the assignment] is for bonus credits. The students could choose to write or not to write. I was wondering if they considered their learning when they talked about the combination. If it won’t affect their learning, I think we should be happy to do this.

Monica: To write or not to write, maybe they thought ‘to write’ put them at ease. (laughter)

Janet: I had different feedback from students regarding the assignment. Some students said the design of bonus credits such as ‘Practice Experience’ and this [Learning Plan and Self-evaluation] is very considerate. There are students who think they [the written assignments] are good.

Donna: I had written feedback similar to this.

Alice: But it’s difficult to mark [the Learning Plan and Self-evaluation] because she [the student] answered all the questions, but only superficially. She wrote ‘I did the preparation and revision’. Her answers are very superficial. There are no reflections or personal learning attitudes or feelings in it.

LY: So how did you mark it?

Alice: I was… I finally scored it 2.5 credits [5 scores possible for each learning log and scores less than 2.5 are not recorded].

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Janet: As this assignment is for encouragement, I think we should give her [the student] at least 2.5 scores . . . . Although the answer was very superficial, she did reflect on whether she did it or not . . . . As this is [an assignment] for encouragement, she deserves at least 2.5 scores as long as she wrote it and put her opinions in it.

LY: Janet, may I ask WHAT do we encourage for? Do we encourage her [the student] to pursue marks or to improve her attitude to learning?

Janet: Well, because it’s additional [bonus score option] we should encourage her to do it. It encourages reflection.

LY: Did she reflect?

Janet: I think she did. Although she wrote her [learning] goals inadequately she did the reflection. She might write how much percentage she reached, but I think it is [reflection]. It is superficial, not deep, but she did the reflection, didn’t she?

Alice: I have a different opinion. At first I wanted to encourage her so I marked…[higher]. I then had a hard time marking. I was concerned, as Li-Yu was, that we only encourage her to hand it in, not to achieve what we want her to. Actually the purpose of these assignments was [to improve] her learning attitudes. It seems that it isn’t achieved. They are extra credits. I am also considering what Monica said about the students complaining about too many assignments. It seems to me inexplicable. If you [the student] think it’s over your load, don’t hand it in!

Fiona: I think it relates to the organisational and thinking ability of a person. For example for some they may be able to do it but what they write is just poor. Sometimes it is about writing skill.

Emma: I didn’t ask them to write beautifully. . . . I believe these students did [their homework] at the weekend. If they wanted a rest during the weekend, tell you what, [they] all wrote it in a hurry. I don’t believe they could reflect deeply. Anyway, the 2-tech students complained all the time. No matter how we reduce [the assignments], they just clamour and clamour.

Donna: The common problem is the depth [of reflection]. It comes to my

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mind that before they hand it in, should we re emphasise reflection to them? . . . Because they might just superficially follow the description and don’t know the substance has to be deeply written. Shall we reiterate it to the students so that better results might come out?

Alice: If we could guide more, we might be able to get what we want.

Emma: Does writing this need to be taught yet?

Fiona: Of course. Because the students failed to grasp the main points.

Donna: Yes. Because they are not sure what we want them to do.

Emma: I have no word to say about one class share a copy of Teaching Standard. But everyone got a copy [of unit details]. The description on it is very clear.

LY: Yes. But it might be better if we could explain more.

Emma was a little disappointed that the students failed to grasp the main points of the

written assignments. She believed she had clearly explained the unit details,

including the assignments, in the introductory session. Donna offered to reiterate the

main points about the Learning Logs to the students as she was the one teaching the

present body system. The discussion served to raise our awareness of the need for

more guidance in learning.

When the teaching group shared their experiences implementing the new

curriculum, it was noted that students had gradually taken responsibility for their

learning and had been willingly to learn:

It is a comfortable feeling that the [learning] responsibility has been shifted to the students. I found that during the [skill] practice they did practice [seriously] and were able to think. … Because it is her [the student’s] responsibility so she would actively discuss with you about her [learning] problems. (Alice: Meeting File, Dec 7, 2005)

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They liked the Case Study session very much. . . . [They] not only highly participated in it but also expressed their opinions. They were able to express their opinions about why [something] was wrong. I found they had their own opinions. . . . Especially in the class which had most enthusiastic discussion; there was insufficient time to have a test so I discussed with them whether we could have an extra 15 minutes for a test. They said yes. They were even very happy to have more time on discussion. (Monica: Meeting File, Dec 7, 2005)

Team members also shared that some students spent extra time trying to improve

their learning. For example, it was observed that the online VOD system (Video on

Demand, an online learning resource offered in the school) was frequently accessed.

In the Learning Logs a student also wrote that she played the CDs and listened to

heart sounds all the time, even on the bus, because she wanted to be able to

differentiate between, and identify, different heart sounds.

Donna expressed that teaching became easier and more enjoyable when students

accepted their learning responsibilities and actively participated in their own learning.

In Donna’s opinion her “easy” teaching experiences were the results of previous

teaching members’ endeavours to guide student learning in the ways proposed by the

new curriculum.

Alice also attributed the positive learning outcomes to the curriculum design as

well as to gradual influences being exerted on students to change their learning roles

and responsibilities. Emma also believed that our new curriculum was effective and

influenced student learning. However, she was concerned that the students might

return to passive or rote learning once they completed this unit and continued their

studies with traditional approaches to teaching and learning. Emma expressed her

hope that other units would adopt the student centred approaches, so that students

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could keep studying in the ways advanced by our restructured Physical Examination

unit.

In this meeting, some team members shared their reflections about their

teaching. Monica took the initiative by revealing that student feedback about her

teaching suggested she was very strict. Monica believed that she had tried hard to be

less strict with students this semester:

LY: Monica, how do you feel about it? Do you really think you’re strict? I mean your own opinion.

Monica: … (hesitated) Maybe I, of course I think…, I don’t know! I think I was concerned about their learning such as if they didn’t do well they might not be able to assess patients’ … [health problems]. Well, I think I have already been lowering my standard (laughter).

LY: Um…

Monica: For example, formerly I asked them to stand in the corner if they made a noise in the laboratory. They said that standing in a corner meant that I didn’t respect them and they would report me. They would never attribute it to their noise. They claimed that “we were just discussing and then the teacher asked me to stand in the corner. Could it be said that we can’t discuss”? Actually my point was the noise they made had affected the other students. I had said to them as soon as I entered the room “I will ask you to stand in the corner if I hear your noise from a distance”.

LY: Is it possible that your intentions of ‘good-for-them’ were not communicated?

Monica: … (silent with hesitation)

LY: I mean, perhaps you failed to communicate your actual expectations to students.

Monica: Well, I didn’t punish them this semester.

LY: So tell us more about your changes this semester. I mean, how did

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you change your teaching?

Monica: … (hesitated) I did more on asking them if they have problems. Formerly I just finished the lecture, observed their practice, and stressed the points I conceived, from their seniors’ experiences, as what they might be worse at. But I didn’t ask them WHAT are their problems. This time I asked them more like “Which parts are you still not clear on or I need to explain further”?

LY: I am thinking is it possible that your intentions were not understood? In other words, you had asked them to do such and such because you wanted them to reach a certain standard, however, they didn’t understand this and thus gave the feedback [thought you were being strict and disrespectful].

Monica: (instead of direct response) I can’t think of any instance because I’ve never had any other requests.

Although the question was not directly answered, Monica was willing to share and

express her problems openly and the exchange encouraged Monica to consider her

ways of teaching from another angle.

Donna shared that she included more interesting activities in her teaching to

motivate students to think critically. She also shared her difficulty in time pressure.

However, she talked to herself “Do-Not-Rush-to-Cover-The-Content” every time she

was confronted with time pressure. She believed this strategy had created an easier

and more flexible teaching style and students accepted her ways of teaching without

any problems.

Unlike Donna, Tina shared her frustrations in teaching this unit. For teaching

this unit, Tina prepared rich content for lecture sessions and compiled a 4-page

checklist of Physical Examination skills with notice points for practice sessions. She

also paused for students to take notes. However, she had problems in time pressure

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and student feedback. Some students responded “Teacher, we already know it” in the

classroom, and some wrote “the teacher’s demonstration of skills was in disorder” on

the Demonstration and Critique papers. At the second last lecture session, some

students even asked about some medical terms such as “teacher, what is AR [Aortic

Regurgitation], what is MR [Mitral Regurgitation]”? Tina expressed her frustrations

in teaching this unit as follows:

At first I thought of passing learning responsibilities on to students. However, I was also concerned if they don’t take the basic responsibility [review the basic knowledge], they won’t understand what is further taught. Therefore I taught slowly and reviewed it all. Then it became all compressed and I had insufficient time to finish. (Tina: Meeting File, Dec 7, 2005) Actually when compared to teaching the 2-year junior college [students], the responsibility is lighter [teaching is easier] and the [2-tech] students are more active in learning. But I think I need more experiences to understand in which level the students are [their baseline knowledge or ability]. So, this time my teaching might have confused the students. (Tina: Meeting File, Dec 7, 2005)

During the collaborative reflection session we questioned Tina about her

teaching and learning activities, lecturing was the only approach she used. We also

asked Tina how she assessed student learning. She only examined students’

knowledge about Physical Examination rather than their thinking abilities. Tina was

asked whether she thought the students had reached the learning objectives of this

unit. Tina did not answer the question directly. Instead, she expressed her opinion of

the curriculum:

Actually regarding the whole process of skill test, the design, [we are to] assess whether or not the students are able to perform the ability of integrating what they had learned [knowledge]. . . . However, the students

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have never been trained in this way. Suddenly having a curriculum like this, the students must be nervous. (Tina: Meeting File, Dec 7, 2005)

Alice shared her sentiments on Tina’s teaching experiences:

I think Tina has taken back student learning responsibilities which we have tried so hard to push forward to the students. The 4-page checklist, how to perform skills and the notice points, you listed them all with carefulness. Actually I would think the notice points vary with individuals. Some people [students] may have no problem in performing skills so that they won’t need the notice points. I mean, this [student learning responsibility] should again, return to students in an appropriate degree. (Alice: Meeting File, Dec 7, 2005) If I conducted the class before you, they [students] must have problems to get with it. Because finally I had relieved it [learning responsibility] and you took it all back. The students would be idle. I mean they would think ‘the teacher would do it for me’, so, and they even didn’t have to make up their own notice points. (Alice: Meeting File, Dec 7, 2005)

In this meeting Tina also raised some issues she wanted to discuss such as

insufficient time for skill practice, students’ critical thinking abilities, and students’

stress about the skill assessment. In response to Tina’s questions, Janet said that we

had previously spent a lot of time discussing these issues. However, Janet also briefly

summarised what we had discussed to Tina. Some team members also shared our

teaching strategies such as how to prepare teaching sessions or how to deal with

difficulties similar to Tina’s situations.

I was concerned that Tina might have felt stressed or uncomfortable with the

critical ambiance of our meeting because of her relatively limited participation in any

of the meetings throughout this study. Right after the meeting I emailed her,

expressing my concerns and explaining that the purpose of collaborative reflection is

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for our professional growth – the teaching and learning. (Although I had stressed this

point several times it was still necessary to reiterate it). I also expressed that she was

always welcome to come to the meetings and feel free to share her opinions.

Tina gave me a quick response via email and wrote “it was OK”. However, she

later phoned to say that although she did not think the students had met the learning

objectives of the unit under her teaching approaches, she could not say it in the

meeting. She considered her teaching to be unacceptable. I thanked her for calling

me and reiterated that this team was formed for improvement of teaching and

learning and it was important to express our true opinions and learn from each other.

I encouraged her to express herself freely at the next meeting.

Reflection Point: In this meeting the outcomes of two different approaches to

teaching and learning were highlighted: Tina’s frustrations with her didactic

teaching approaches and the other members’ ‘comfortable’ and ‘easy’ feeling

following more facilitative teaching approaches. Tina’s approach to teaching and

learning was not consistent with the unit requirements, a situation that may have

arisen due to her limited participation (she attended less than half the total 15

meetings). Team members had understood and learned from each other through

intensive communication – often in the form of critical debate. Anyone who had not

attended these discussions was likely to get lost in the change process. The situation

also echoes Sue’s claim that communication among teaching group members is

essential: “If only people would communicate with each other - but [I’m] afraid that

some teachers don’t feel like communicating with others”. (Sue: Meeting File, Nov

1, 2005)

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I was glad that Tina finally expressed her true feelings. However, when asked if

her teaching had enabled the students to meet the learning objectives, Tina did not

answer the question directly. Instead, she expressed her opinions of the teaching and

learning approaches in the unit. This tends to support my concerns that immediate

responses to the questions are sometimes only defences, rather than authentic

responses if one has not had time to reflect on the questions. (LY: Reflection File A,

Dec 22, 2005)

Once I finished recording the meeting, I emailed a copy of the meeting record to

each of the team as usual. After reading the meeting record Irene sent me her

feedback. She expressed that previously she had some queries about her teaching but

now found the answers in the meeting record. It appeared that she benefited from the

meeting even though she was unable to attend.

Meeting 4 - Talking about the 2-Tech PE Curriculum (4)

Purpose:

This meeting was held after the new curriculum had been implemented for the

whole unit. The purpose was to share and reflect on implementation experiences.

Agenda:

This meeting was the last meeting before we modified and further developed the

new curriculum. Except for the take home questions, the meeting agenda was similar

to the previous two meetings:

1. Share your 2-tech PE teaching experiences, include:

How you facilitated students to meet their learning objectives for this unit The outcome of your facilitation Anything that concerned or bothered you and why

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2. Collaborative reflection

Thirteen team members attended this meeting, including three teaching

members from Cha Yi campus. The meeting started with the Cha Yi members’

sharing their teaching experiences with the new unit as this was the only opportunity

for them to do so in person. One of them, Maggie, expressed that initially some

students lacked confidence in critical thinking and clinical reasoning abilities and

some were shocked by the new skill assessment approach. One student even insisted

that Maggie point out specific assessment items in the skill assessment. However, at

the end of the semester the students concluded that the learning journey for this unit

was sometimes bumpy but they learned a lot. As opposed to their former learning,

some students expressed that they could now better understand the unit content. They

even felt comfortable questioning the teacher when they were confused about what

the teacher said. Moreover, some students claimed that what they learned in this unit

was practical and applicable to clinical practice.

According to the Cha Yi members, positive student feedback was also detected

in the fourth exercise of the Learning Logs – ‘Letter to the Friend’ (See Appendix

G-1 /p. 266). For example, this exercise was developed to encourage students to

express their opinions of the unit and Irene shared that the students in her classes

believed that they had learned how to learn actively. These students also claimed that

active preparation of the lesson had helped them to develop stronger textbook

reading skills. Some students also claimed that they learned the importance of

collaboration through the repeated process of group skills practice. Furthermore, the

students claimed that by thinking and doing by themselves they are better able to

digest the knowledge and skills of the Physical Examination and Health Assessment

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unit.

Despite the positive student feedback from Cha Yi campus, however, team

members shared that the 2-tech students in main campus expressed that they were

burdened with a large amount of written tests and assignments. This complaint was

verbalised in a forum recently held by the school to promote teacher-student

communication. The students also conveyed that the overload of assignments caused

them to “drift the efforts into formalism” –write to pass or to achieve bonus credits

rather than to learn.

Sue had talked to the students about the written assignments and claimed the

students had raised an interesting point:

Recently everybody is talking about too many assignments for students. . . . Several days before submitting the ‘Letter to a Friend’, a student leader came to me and said “teacher, we have so many assignments to do”. I said “You still have the third and fourth exercise of the Learning Log to submit, don’t you”? [The student said] “Yes, it’s so stressful”. I told her expressly that “No teacher requires that you must do it. It’s all of your own free will. It would be meaningless if you write just because you are asked to do so”. I then said “So you don’t need to worry about it too much”. However, the student said “You teachers know that we always consider bonus credits so we cannot help but do assignments. If I don’t, other students will get the credits but not me”. This is the conflict within the student. (Sue: Meeting File, Jan 13, 2006)

There appeared to be a conflict going on within students. On one hand they

understood that they were free to make a choice about writing or not writing their

assignments. However, they were not confident enough to make their own decisions

and were focused on their grade rather than on learning per se. This might reflect that

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the students were not used to sharing the decision making process or power with

teachers or that they were afraid of taking responsibility for their own learning.

I expressed my concern about the failure by both teachers and students to focus

on learning:

Recently I’ve been thinking about one thing. We tend to overlook learning. . . . Despite the amount of assignments and the associated stress we seldom ask the students whether they believe they had learned from the assignments, or even if they are worth doing. When we communicate with students, we are easily involved in their topics - students want credits so we talk to them about credits. . . . What if we talked about the learning objectives instead? Would they then better understand that what we want them to do is about learning not assessment or marks. (LY: Meeting File, Jan 13, 2006)

There were no direct responses to my concerns. Instead, team members continued to

talk about the students’ negative feedback.

Donna had an optimistic response to the students’ negative feedback about

assignments. She believed the students did learn even though there were some

grumbles. Emma also believed the students knew that we had given much thought to

their learning:

If you go back and ask them [the students about the unit], I believe they will be of the opinion of good; it was good for their learning. However at that moment they were having so many assignments to do, not merely the PE unit. . . . Actually, most assignments are to be submitted during the end of the semester, they are mostly done in this way. As a result, even if they felt like doing [the assignments], they still felt being pressured. “I have no time even though I want to make an effort to learn this unit”. This is their problem. (Emma: Meeting File, Jan 13, 2006)

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This topic provoked further discussion. Alice claimed that as the students

completed this unit and received their results, she felt like holding another informal

discussion with the students about what they thought of the unit. Sue also thought

that students might have different viewpoints about their learning experiences of this

unit after some time had passed. Thus she would like to have another student

feedback session at the beginning of next semester. Donna and I also expressed that

each of us had thought of having another student evaluation but with different timing

and methods. It was interesting to discover that we had all been thinking about

student feedback in similar ways.

We did not discuss the issue of student evaluation further at this meeting.

However, as several of us were interested in having another student evaluation, we

decided to hold an additional meeting for team members who were interested in

ongoing research related to this study.

The other main topic of this meeting centred on Gloria’s concerns about the

appropriateness of the new unit based on her teaching experiences. She claimed that

the skill assessment process was difficult to run smoothly. She believed that asking

students to analyse a scenario was too difficult because she was unable to facilitate

the case study session effectively. She also believed that the body system classes she

conducted had little to do with nursing diagnosis in terms of Physical Examination.

She questioned whether new teaching and learning approaches were necessary.

In the collaborative reflection session Gloria was first asked for her opinions

about whether or not the new teaching and learning approaches were desirable.

Gloria did not give an opinion but instead restated that the skill assessment was

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difficult.

After discussing the points Gloria had raised, we determined that the problem

might lie with inappropriate construction of the scenario or Gloria’s lack of

familiarity with the skill assessment process. Gloria had not involved herself in the

scenario construction process. Janet and Donna shared their opinions about

collaborative construction of the scenario:

I don’t think the scenario could be done by one teacher. It should be discussed and constructed together by the teachers who conduct the same body system. There might be blind spots if the scenario was designed by one teacher. Only by discussing together can we be clear about how to implement it. . . . Regarding Gloria’s problems, they were supposed to be discussed while the scenario was constructed. . . . We [Donna and I] had a lot of discussions and were in good agreement on how to implement it. And students had no problems about it. (Janet: Meeting File, Jan 13, 2006) I think discussing together is better. Janet and I had additional discussions so that we gradually reached an agreement on the scenario. (Donna: Meeting File, Jan 13, 2006)

Janet and Donna raised a very valuable point that illuminated the importance of

collaboration when trying to bring about a change.

The meeting ended when we finished discussing issues associated with the skill

assessment process. Some team members stayed and kept talking about student

feedback of the new curriculum.

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Meeting 5 – Further Development of the Curriculum

Purpose:

The purpose of this meeting was to further develop the new curriculum for the

Physical Examination unit on the basis of team members’ teaching experiences and

student feedback.

Pre meeting reading/activity:

Several issues related to the further development of the curriculum were sent to

team members to consider before the meeting. Team members were encouraged to

review the Teaching and Learning Standard, the Unit details, the Nursing Curriculum

Guideline and the School Objectives while considering the issues. The issues were as

follows:

1. The overall direction of the 2-tech PE unit, including the appropriateness of: The alignment of unit objectives and the MOE and school requirements Our expectations of the students - too high or too low The unit content The unit arrangement of each body system

2. Issues related to the lecture sessions of the 2-tech PE unit, including the appropriateness/acceptance of :

Student learning The alignment of the objectives, the teaching and learning activities and

the student assessment Teacher and/or student workload The arrangement of student assessment approaches

3. Issues related to the laboratory sessions of the 2-tech PE unit, including the appropriateness/acceptance of :

Student learning The alignment of the objectives, the teaching and learning activities and

the student assessment Teacher and/or student workload The arrangement of the skill assessment

4. Any other issues which are not listed above

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Agenda:

The main issues considered in the pre reading information made up the meeting

agenda for this meeting.

1. The overall direction of the curriculum 2. The lecture sessions of the 2-tech PE curriculum 3. The laboratory sessions of the 2-tech PE curriculum

Seven people participated in this meeting, including the unit coordinator and

myself. It was the end of semester and, again, a very busy time for academics. Thus,

as in Action Phase 2, participants moved “in-and-out” of the meeting to attend other

commitments. Five of us attended the whole meeting.

Overall, we considered the new curriculum appropriate. This consideration was

based on the improved learning outcomes and positive student feedback. Despite

students claiming that the assessment workload led them to complete assignments

only to pass or gain bonus credits, we still believed the assignments were

constructive in terms of student learning.

In our discussion about the assessment workload, we recognised that although

we had given detailed explanations about the assignment tasks we had not

communicated the value of the assignments to learning. We also failed to guide

students to reflect on their learning in critical or meaningful ways. We determined to

correct these matters and to make ourselves more available to students so that they

could discuss their learning experiences and reflections with us.

We also merged the third Learning Log and the Letter to the Friend into one

assignment. The purpose of both was to gather information about student learning

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experiences; both required students to reflect on and evaluate their experiences; both

could be submitted at the same time. This change would certainly lower the

assignment workload, but we were very confident that the reasons for the change

were based on pedagogical considerations rather than on student complaints:

Janet: So, we reduced the assignment.

Alice: Not because of too many of them.

Janet: No. It is because we considered the meaning [of them] thus made them merged.

There was also a general agreement among the team that it was unnecessary for

the students to complete the questions on the Skill Demonstration and Critique

guideline. Team members were positive about the whole process of the Critique.

They believed the Critique had enabled the students to develop active learning

attitudes and critical thinking abilities. However, the teaching members expressed

that the students were able to talk about their problems with PE skills during the

session so that it was unnecessary to communicate in written form. We therefore

decided to retain the guideline for learning purposes only. We moved the credits for

the Critique guideline to the Case Study sessions. This was considered to be a more

appropriate increase in weighting for overall unit credit.

We also decided to place additional information in the unit details to make

students more aware of their learning responsibilities and the learning resources

available to them. As the teaching members had shared some online resources for

students, the resources were to be compiled and made available in the unit details.

This trial of the new curriculum had also caused us to recognise how essential it was

to communicate the learning process to students. Therefore, we added information

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about active learning, preparation, and learning responsibilities to the unit details.

The provision of additional information was to align the concepts of

student-centredness with the curriculum and also make the unit details more

meaningful. The process of further development of the new curriculum was smooth

and carried out with enthusiasm and agreement. We were generally content and

confident about the decisions we had made in re working the new curriculum.

At this meeting, Pauline reported that some 2-tech nursing students from Cha Yi

campus questioned the linkage between Physical Examination and Nursing

Diagnosis/Problems. The questioning came from part-time students who worked as

community or school nurses. They believed it was a waste of time learning how to

generate Nursing Diagnosis/Problems because in their day to day work they were

unlikely to use this skill. Pauline thought the student’s viewpoint was realistic,

however, the other team members believed differently:

LY: We can tell the students that this unit is at baccalaureate level and is aimed at a liberal nurse education [they are to be educated as general nurses not solely as community nurses]. This [thinking ability] is one of the basic competencies they are required to have.

Sue: Regarding the mention that they’re school nurses, I don’t think it’s any excuse. It’s about their ability to integrate nursing knowledge. It’s important to possess this ability.

LY: Those students were questioning the connection between them [PE and Nursing Diagnosis]. But I would like to ask them “what is the purpose of doing the physical assessment on the patient”?

Alice: Generating health problems.

LY: Yes, it’s to identify their health problems. And the Nursing Diagnosis is the unified [worldwide] way to go. To me the linkage between them [assessment and Nursing Diagnosis] is very clear.

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Sue: Yes.

Janet: We guided students to think critically [about health assessment] in the Case Study sessions. After guidance and discussion the students no longer thought it difficult. I mean, maybe it’s [the problem] how they [teachers in Cha Yi] guide the Case Study Sessions.

Sue: Yes.

Janet: We might need to share with them [teaching members at Cha Yi campus] about how we guided the Case Study sessions. . . . Well, actually we did exchange our teaching experiences here. But the Cha Yi members… (interrupted).

Sue: We had limited interaction with them.

Janet: Right.

Team members were clearly very definite that the link between assessment and

nursing diagnosis/problems was real and both essential skills for the nursing process.

They were also confident that their guidance in the case study sessions had promoted

student learning.

At the end of this meeting we discussed how to illustrate our teaching and

learning theories at a ‘School Conversation’. This Conversation or forum had been

arranged because of student complaints about the “overload of assignments”. One of

us was elected to be the representative of the 2-tech PE teaching group at the

Conversation. The representative was comfortable talking about the issue of

assignments, however, she wanted to know our opinions about the bonus credits

because some nurse educators outside our team had queried it. The outsiders had

concerns that the distribution of student grades would be skewed to the higher side

which might not be appropriate. Once again we showed our resolute manner when

we discussed the issue:

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Alice: We have evidence [of the learning outcomes]. We can show them the evidence.

Sue: Yes.

Janet: Yes.

LY: Our teaching and learning approaches are completely different from the past. They shouldn’t judge us [our teaching and learning] by the old standard.

Alice: Li-Yu, you might show them our meeting records (laughter). They [the reasons/theories] are all there.

Janet: And our students also performed well and got a good comment from the experts last time at the PBL [Problem-based Learning] seminar. (A seminar held at the school about PBL curricula several weeks before the meeting. Some 2-tech nursing students were invited and demonstrated their thinking abilities in the seminar).

Sue: Yes. That’s right!

LY: The students’ abilities are strengthened under our new curriculum. They deserve higher scores if they meet the requirements and perform well. It is the point.

Reflection Point: This situation reminded me of an occasion Alice had described to

me. Before we implemented the curriculum, team members were asked a similar

question related to the bonus credits when they were in conference with the course

coordinator. They felt embarrassed because they were unable to convince, much less

articulate, how the curriculum decisions were made. Now however, team members

were more likely to stay firm and be able to articulate theories of teaching and

learning when confronted with questions. (LY: Reflection File B, Feb 4, 2006)

This meeting ran smoothly and resulted in further development of the

curriculum. However, there was no clear cut end to the meeting because team

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members kept talking – mainly about the School Conversation to the representative.

Reflecting on Action Phase 3

In Action Phase 3 two very important lessons were reinforced. One related to

the difficulty and complexity of curriculum reculturing and the other related to the

power of collaborative reflection. It was certainly more difficult and complex to put a

student-centred approach into practice than it was to discuss it in theory. For example,

although team members had spent time understanding and discussing the key

concepts of student-centredness in Action Phase 1, and had collaboratively made a

student-centred curriculum in Action Phase 2, we still experienced some difficulties

in transforming our customs of teaching and student learning toward

student-centredness in the initial stages of Action Phase 3. Some team members

believed they were using a student-centred approach to implement the curriculum,

however, there was a discrepancy between what they thought they were doing and

what they actually did. The difficulties we confronted echo Smith’s (1993) claim that

“Simply changing understandings, or the way we name reality, is not to change

reality” (p. 81).

However, through collaborative reflection, team members helped each other to

deepen their understandings, and brought each others’ consciousness of teaching and

learning to a higher level. As a result, we were able to transform teaching and

learning within a unit to a more student-centred approach. For example, previously

team members contended that students were not able to learn actively and think

critically. After reflecting on our teaching customs we tried encouraging students to

do so by engaging them in discussion and by communicating the importance of

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learning. Subsequently, learning responsibility was gradually shifted to the students

and they were able to perform well in the case study sessions, the critique activities

and the situated skill tests. We had gradually recultured our teaching and student

learning toward a more student-centred approach and transformed reality.

This was clearly a phase in which we learnt by doing and by collaboratively

reflecting on what we had done. Through collective action we continued to change

our self knowledge of teaching and learning and develop professional growth. These

outcomes suggest that team members are moving towards empowerment in all of the

three spheres constructed by Smith (1993) and explained earlier (See pp. 54-55 &

65-66). Certainly, I believed that during the collaborative journey we all developed

more confidence in ourselves at both a personal and professional level. I was

therefore looking forward with great interest, and perhaps a little nervousness, to the

next phase of the journey when we were to share our feelings about the whole

collaborative process. The story of what happened in Action Phase 4 is told in the

next chapter.

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CHAPTER 7

Continuing the Story of the Collaborative Journey Action Phase 4: Evaluating the Collaborative Journey

Introduction

At the previous meetings, the issues discussed among the team focused on the

teaching and learning aspects of the PE unit, and we did not spend much time sharing

our feelings about working collaboratively. Because collaboration was an integral

component of this study it was important that we shared our feelings about the

experience. Therefore a meeting was held specifically to discuss the collaborative

process. At the time of this meeting the team members had experienced nearly one

year collaborating. The meeting was called the ‘Evaluation Meeting’ and the agenda

consisted of four focus questions. The agenda was sent to each team member one

week before the meeting to allow time for individual reflection.

The Evaluation Meeting

Purpose:

The purpose of this meeting was for team members to share viewpoints about

the collaborative journey.

Agenda: 1. What does being part of this team or participating in the whole process mean to

you in terms of your work (teaching), workplace (the school or classroom) and work practice (teaching practice)?

2. To what extent do you think you influenced the transformation of teaching and learning? Are there any issues that concerned you or over which you felt you had no control? What are they and why?

3. How would you describe this collaborative process and your role as one of the team members?

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4. Are there other issues you would like to address or opinions you would like to share?

Six of the thirteen team members, including myself, participated in this meeting.

All six of us had been deeply involved with the whole collaborative process.

Privately, I referred to the other five participants as the ‘faithful members’: they had

steadfastly attended almost all meetings (See Appendix H /p. 271) and significantly

contributed to all aspects of the new curriculum including its development,

implementation, and evaluation. Although our numbers were few, these were the

team members whose opinions about all aspects of collaborative process would be

not only truly valued but also of significance to the study.

Reflection Point: I believe the ‘faithful members’ hold stronger beliefs or interests

in the project and this was not only evident in the attendance chart (Appendix H /p.

271) but also on several occasions. The time survey showed that no matter how

busy Janet was, she spent as much time as she could attending the meetings. Once

when Alice was making a mental scheme of her schedule diary, she expressed that

attending these meetings was much more fun than attending other school meetings.

She chose to participate in our meeting when two meetings conflicted. Both Janet

and Alice attended 14 of the total 15 meetings. Donna, who always rang me when

unable to attend a meeting, had also given up a workshop to come to our meetings.

She attended 11 out of the 15 meetings. Janet, Alice and Donna clearly showed

their enthusiasm for participating in this work. In contrast, some other members

offered me reasons such as ‘lesson preparation’, ‘don’t have to come to school until

later’ or ‘too busy’ for their absence from the meetings. The contrast I perceived led

me to believe that although only a few team members participated in this meeting,

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they were ‘faithful members’ and their opinions about all aspects of the

collaborative process were not only truly valued but also of significance to the

study. (LY: Reflection File A, Jan 20, 2006)

In response to the questions “what does being part of this team or

participating in the whole process mean to you”, we generally felt that by working

together and participating in regular dialogues where we shared our pedagogical

knowledge, opinions and strategies, we had learned much and developed as

professionals. For example:

I used to teach the ways other people did until we made this new curriculum [as a team] - I was unlikely to make any changes . . . . I also took things for granted. However, after hearing other team member’s opinions I realised there were other ways of seeing and doing things. (Sue: Meeting File, Jan 18, 2006) We did not take any pedagogical courses at school – we have had very limited training in it [teaching and learning]. I made up my own way of teaching. Here we learned some teaching theories and we had directions and learned how to guide students. (Emma: Meeting File, Jan 18, 2006) At some point [during our collaborative efforts] we talked about the importance of listening and questioning [within the group]. I realised that “yes, this is my problem” and then tried to listen attentively. So - I learned a lot. I mean, it was an invisible gain. I gradually appreciated the value of equal and shared communication, that sort of thing. (Donna: Meeting File, Jan 18, 2006) I remembered the first year I taught PE. I was busy. I knew what I ought to do but was unable to do what I wanted very much to do. I had been teaching with my regrets until I joined this team. . . . Ah, this has indeed fulfilled [my wish]. This is a fabulous process in which I have accomplished what I wanted to do. (Alice: Meeting File, Jan 18, 2006)

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We also expressed our feelings of participating in the whole process: “able to talk

about what I want to say at my ease” (Janet), “a good experience” (Sue), “unlikely

painful” (Emma), “having a sense of belonging” (Donna), and “an enjoyable

process” (Alice).

When we shared our views about “to what extent do you think you influenced

the transformation of teaching and learning”, the team members felt positive

about our efforts in transforming teaching and learning:

At first I was worried that I lacked originality or was rigid in my teaching. However, through the interaction with students I think it was not bad. Although this is the first time I have taught 2-tech students I felt I was a competent teacher. (Sue: Meeting File, Jan 18, 2006) During the curriculum construction [making], I participated in all the meetings and freely expressed my opinions. I think I exerted a certain influence on it. . . . At least the framework we constructed came up to my expectations. (Janet: Meeting File, Jan 18, 2006) Before, I spent a lot of time helping students memorise the content; now I spent time discussing with students. Regarding influence, at the end of the semester [the outcome of] our efforts were obvious to all. . . .They [students] are used to direct communication [with us]. . . .They also appreciated the importance of preparation and practice. Many of them did not realise it until the end of the semester. (Donna: Meeting File, Jan 18, 2006)

Many of our perceived influences on the transformations we had made to our

teaching and learning that were “obvious to all” had been gradually shared in

previous meetings, thus we did not spend much time on this question. Instead, we

shared opinions about issues over which we felt we had little control during the

change process.

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The first issue raised was time. Alice and Sue expressed their regret that they

had insufficient time to give students additional guidance or feedback. They believed

deeper, more meaningful learning required more time and guidance. Alice and

Donna’s concerns about time related to other commitments. They claimed that

school affairs had led them to rush and prepare their teaching tasks at the last minute.

As Donna expressed:

Quite often even after the class I still felt the objectives were met with hastiness. I still feel a little sorry for the objectives. (Donna: Meeting File, Jan 18, 2006)

Furthermore, Emma believed that the busy whole school curriculum had led the

students to lack time and energy for deep learning. (There were eleven units with 20

credit points for 2-tech nursing students to undertake this semester.) Emma argued

that students, like teachers were very busy and rushed and therefore “chose the most

convenient way to learn”. We all agreed that both teachers’ and students’ schedules

were too busy to adequately promote meaningful learning.

We were also concerned about the lack of understanding some of the unit’s

teachers had about the new curriculum, especially the learning activities. All the

teachers in the 2-tech PE unit had agreed to implement the new curriculum but a small

number had had limited participation in any aspect of the curriculum making process.

Janet claimed that she felt very frustrated when she had to restate or explain to people

who were unclear about the planned teaching and learning activities due to their

limited participation. Alice and Janet maintained that they felt helpless, sometimes

even hurt, when people did not comprehend an issue but still gave a dissenting vote or

unmindful feedback. Sue believed limited participation a pity because:

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Sharing and enlightening each other together is better than teaching by one’s own in one’s own way. (Sue: Meeting File, Jan 18, 2006)

We all believed that the limited participation of some had made the implementation

of the curriculum difficult. Most importantly, it had impacted on the effectiveness of

teaching and learning in the PE unit.

The third issue raised was the lack of school support. This issue was illustrated

when the school executives discouraged the giving of bonus credits in student

assessment by questioning the necessity for earning higher marks. In response to this

issue, Janet believed we teachers should have the autonomy to decide student marks:

I remembered I was marked 96 in my paediatric practice. The high score was very heartening to me. I think offering higher marks to students is heartening. It was nothing bad. . . . I think teachers should have rights in marking student scores. . . . Maybe people thought “your PE unit offered such higher marks. Is it a nutriment unit [an expression for a unit that requires little effort but offers high marks] or something?” But it isn’t. We all know they pay the price [study hard] for higher marks. (Janet: Meeting File, Jan 18, 2006)

Alice had a further response to this issue:

Before, the curriculum was not made with much thought, it was not very sophisticated. When people questioned it I often responded simply with: “Oh, you might be right”. However, this time it [making the curriculum] has been a long and thoughtful process. Regarding the question about nutriment units, it was a question without nutrition [a question that requires little thought] and I am not going to take any notice of it (laughter). We have our reasons. We aligned it [the student assessment] with the [learning] objectives. So, one of the great things gained from our curriculum making process is that we have confidence in our curriculum. (Alice: Meeting File, Jan 18, 2006)

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Although we were confident about the worth of the unit, Emma expressed that school

support was still an issue of concern:

Well, we certainly constructed a curriculum, which is good, but we still need school support to make learning more student-centred. (Emma: Meeting File, Jan 18, 2006)

Emma believed an entire nursing curriculum design which could get colleagues and

administrators on board and collaboratively supportive of student-centred teaching,

and learning would have made the learning outcome more effective. We all agreed

with Emma’s beliefs about this but felt we had no control over the issue at this point

in time.

The third question focused on how we described the collaborative work and our

roles as team members. We all believed that the team had worked with equal and

open-minded communication, the decision making had been democratic, and the

accomplishment had been truly collaborative. Some team members also expressed

that we had treated each other with respect and there was authentic participation and

interaction within the group. Sue, who was a relatively junior PE educator, expressed

her impression as follows:

I am thankful to all of you. I have only taught PE for 2 or 3 years, but we never treat people [in this group] as senior or junior, as more experienced or less experienced. I felt everyone was equal and we accepted each others’ viewpoints open-mindedly. This was so precious. I am not sure if it happens in other groups with other people. (Sue: Meeting File, Jan 18, 2006)

The team members also believed they had developed a sense of belonging

through participation in the group work. Alice believed the school lacked this sense

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of community. We also believed each of us had played a significant role in the team:

At the end I realised we had developed a sense of belonging. I’ve been in this school for many years, but our work is unlikely to give us a sense of belonging. Instead, we only had social relationships - like a coffee chat. I mean we had a limited relationship with each other in terms of teaching and research. . . . The faculty have been discussing how we could be agglomerated [develop a sense of community]. This is what we have been lacking. . . . I think we make a successful team model. . . . I think the role of each team member was significant indeed. Everyone, in fact each of us guided the group work. (Alice: Meeting File, Jan 18, 2006) Although we applied a shared teaching and learning mode, or framework, or approach to our teaching, there was room for individual variation and flexibility. Everyone had her own opinions. Everyone played a significant role in this team. (Sue: Meeting File, Jan 18, 2006)

Alice enjoyed the collaborative process and believed a curriculum should be made

and implemented with people who share a common goal:

It [Participating in the meetings] was a very enjoyable process. . . . Previously, even when most of us liked an idea we were still unable to work toward our goal because of someone who had a different idea of what we wanted and insisted her opinion was right. We sometimes have to work with people who have different opinions and ideas - well, differences are acceptable, but it is difficult to work with someone who is uncommunicative and not willing to listen to others. So I think this collaborative process was very comfortable. I believe a curriculum should be accomplished by people who have a common goal. (Alice: Meeting File, Jan 18, 2006)

Furthermore, Janet believed the collaborative process should be sustained and

extended:

When we put it [the curriculum] into practice, it was good that we evaluated [the teaching and learning] all the way; we had a meeting for

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reflection once we completed teaching a body system. I believe that the collaborative relationship will be sustained. We will keep doing so next year when we teach the PE unit. Moreover, some students claim they had acquired some learning skills that can be used in other units. I believe it is possible to extend our collaborative process to include other units. (Janet: Meeting File, Jan 18, 2006)

In response to Janet’s ideas, Donna believed we should provide evidence such as

publications in order to gain affirmation from the school. However, Alice thought we

should start smaller and aim to extend the collaborative process to include the PE

units for 4-tech or 5-year junior college nursing students. Alice believed that this was

feasible and sustainable at this point in time.

Janet expressed her regret that we had not formed a collaborative team earlier:

When we had the accreditation (by the MOE), it was sad when we couldn’t answer the reviewers’ questions. If our old curriculum had been made in this way, we wouldn’t have been beaten by whatever they asked. (Janet: Meeting File, Jan 18, 2006)

The expression provoked a further reflection on the accreditation process by the

MOE and the previous school curriculum:

Alice: It was because we were only familiar with the units we taught. The reviewer didn’t ask what units we taught; but that’s what we knew. They asked about the educational principles, even the relationship between units, we had no idea about them at all.

Donna: The point is they [the educational principles] haven’t been established.

Alice: Until now?

Donna: Right. It was just because. . . . For example I [was a unit coordinator and] had to design the curriculum and be the representative for the unit. I asked what the school goal was. . . . The problem is I was unable to articulate it when I did not know the goal.

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Janet: So, we teachers need the common goals from the Department of Nursing. We can then design our curricula on the base of units. The unit coordinators can then lead the discussion of curriculum which shouldn’t be done by the teaching and research committee.

LY: We need common visions, and very clear visions. The people up there [our executives] should be the advocates of the visions so that we people down here could have the same goals and work toward the same directions.

Donna: It would be better.

In this meeting we also shared our opinions about the collaborative reflection

sessions in the previous meetings. Team members believed that collaborative

reflection played a powerful role in enabling understanding and enlightenment within

the group, which was unlikely to be achieved through individual reflection. However,

we had observed that immediate responses to a question were often “barely

reflections, they were just explanations” (Emma), “defending one’s own standpoints”

(Janet) and “superficial in depth” (Alice). We all believed that taking the questions

home and allowing time to reflect on them individually was a facilitative strategy for

generating meaningful collaborative reflections.

Although team members agreed that time was needed to facilitate meaningful

collaborative reflections, we also agreed that this was not always possible given our

busy academic lives. Some of us also admitted that once we left the collaborative

dialogue context, we had limited time to individually reflect on our teaching.

Therefore the take home questions might not have been reflected on at all much less

reflected upon in critical and constructive terms. Time is essential for critical and

constructive reflection of any type.

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The team members also expressed that ‘constructive questions’ and ‘equal

relationships’ were significant in the collaborative reflection sessions. Donna

expressed that she had learned that the type of questions asked during the

collaborative process was important. She believed that only when the question was

constructive and understood could it provoke or facilitate critical reflections. We then

reflected on instances when one question provoked enlightenment among us and

another led the discussion out of focus. Donna claimed that to pose a question that

would specifically facilitate critical reflection during the collaborative process was

quite difficult because of the need to listen closely and share and articulate

understandings with others.

Alice claimed that to be effective questioning should be based on the premise of

equal relationship. She believed only when team members treated each other equally

could we open-mindedly discuss the question asked. Otherwise, it could lead to

discussion of associated concerns beyond the question itself. For example, it could

result in a senior teacher haranguing a more junior teacher with questions and the

junior teacher feeling powerless to resist or question back. The discussion of

collaborative reflection ended with the conclusion that we had done well but there

was room for improvement in how we facilitated reflection both individually and

collaboratively.

This was our last meeting for this study. It ended with verbal commitment for

further collaborative works. The team members planned to meet again to continue to

discuss the student evaluation of the curriculum. We also stayed in the meeting room

and listened to Donna’s descriptions of a handheld computer system which had

potential to facilitate student learning in the next academic year. We finally thanked

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each other for all the support and help during the collaborative process. Janet

verbalized the ambiance of the moment thus:

Thank you. Why do I feel like crying now? I usually stop students from crying in the graduation ceremony. (Janet: Meeting File, Jan 18, 2006)

Like graduates, we felt reluctant to part. However, this was the last meeting only for

this specific collaborative journey; it would not be the last collaborative journey

meeting for nurse educators at CGIT.

Reflecting on Action Phase 4

At the evaluation meeting team members shared feelings about the collaborative

journey. All the team members felt that the curriculum process was carried out under

democratic and collaborative principles, and all enjoyed participating in the process.

However, we had concerns about the lack of understanding and participation of some

team members and believed this had impacted on the curriculum process.

The democratic and collaborative process had resulted in the development of a

sense of community and ownership among team members. However, the democratic

process also allowed team members to have ‘freedom of choice’ to participate. The

limited participation of some team members might have resulted in a lack of

understanding of the curriculum and some degree of ineffectiveness in the

transformations of teaching and learning.

This issue could be seen as a limitation of the democratic research process.

However, it might also reflect issues such as commitment to change, or unmindful

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conceptions of teaching and learning. When people unconsciously lean towards

teacher-centredness, they may have difficulties engaging in collaborative work based

on student-centredness. Although they agree with the importance of student-centred

teaching and learning they may have limited commitment to the change process. As

an individual’s conceptions of teaching and learning cannot be controlled or be easily

transformed by external influences, perhaps the only thing to do about limited

participation in collaborative efforts is to keep the channels for communication and

reflection open to encourage further consciousness raising, and participation and

commitment will increase with time.

Although the effectiveness of the curriculum change process may have been

influenced by a few team members’ limited understanding of, and participation in the

collaborative efforts, most team members held positive viewpoints of the

collaborative work. We enjoyed participating in the journey and believed we had

moved our teaching and student learning toward a more student-centred approach.

Furthermore, we not only believed the collaborative relationship would be sustained

but had planned to take further actions to continue the journey.

Concluding the Story of the Collaborative Journey

This has been the narrative of what happened during the collaborative journey. I

have structured the story to be consistent with the five phases of my action plan. I

found the journey so dynamic and complex that it was difficult to describe in

sequence. I have also interpreted the events that happened at each meeting using

paradigmatic analysis of narrative (Polkinghorne, 1995) both inductively and

deductively. In doing so, the information was interpreted by plots (Polkinghorne,

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1995) or larger units of discourses (Rice & Ezzy, 1999). My interpretations of the

journey were guided by the conceptual notions that informed the study so that what

happened and whether or not the desired changes had occurred during the

collaborative journey became my prime focus. In this sense, the narrative I have

described in this chapter is my primary awareness (Reason, 1994a) of the

collaborative journey. My primary awareness then provided a basis for critical

examination of the information generated, gathered, organised, and interpreted

during the journey. My critical examination of the journey is the subject of the next

chapter.

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CHAPTER 8

My Critical Examination of the

Collaborative Journey Introduction

This chapter constitutes a discussion based on the research problem, the

contextualisation and conceptualisation of the problem, the methodological approach,

and the information that was generated, gathered, organised, examined and

monitored during the collaborative journey. If the description of the collaborative

journey in the former chapter is seen as my primary awareness of the transformation

process this chapter is my secondary awareness (Reason, 1994a, p. 327) of the

process. In other words, this chapter constitutes a critical examination of how the

study influenced, and was influenced by, the collaborative journey. As it is

acknowledged that action researchers naturally and acceptably enter research with a

perspective, or bias, drawn from their own unique experiences (Carr & Kemmis,

1986; Herr & Anderson, 2005), it is necessary to examine the information – the

experience - not only for meaning but also for distortions and this requires critical

reflection. Herr and Anderson (2005) developed a model for action researchers to

examine the information gathered and generated from the research process. I will use

this model, ‘Criteria of Quality for Action Research’, as a framework to acknowledge

and articulate reflection into the examination process.

The model consists of outcome validity, process validity, democratic validity,

catalytic validity, and dialogic validity (Herr & Anderson, 2005). Although the model

was developed in order to evaluate the quality of Action Research studies and the

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criteria refer to validity, it was developed through its link of the following goals of

Action Research:

1. The generation of new knowledge (Dialogic and process validity)

2. The achievement of action-oriented outcomes (Outcome validity)

3. The education of both researcher and participants (Catalytic validity)

4. Results that are relevant to the local settings (Democratic Validity)

5. A sound and appropriate research methodology (Process Validity)

(Herr & Anderson, 2005, p. 55)

The model fits the conceptual notions and methodological approach of this

study. Thus the model will serve as a framework on which to build critical

reflectivity into the examination process. In the model outcome validity denotes the

extent to which action occurs that leads to a resolution of the problem that led to the

study (Herr & Anderson, 2005). In this study outcome validity relates to the

curriculum problems in facilitating student learning, and to the study’s intent to

reculture all aspects of the curriculum toward student-centredness. Process validity

denotes the extent to which problems are framed and solved in a manner that permits

ongoing learning of the individual or system (Herr & Anderson, 2005). In this study

process validity relates to the conceptual notions of individual and collaborative

reflection that encourage sustainable self-growth and professional development.

Democratic validity denotes the extent to which the research is carried out in

collaboration with all parties who have a stake in the problem under investigation

(Herr & Anderson, 2005). In this study democratic validity relates to the extent to

which the conceptualised collaborative practice based on democratic principles

prevailed throughout the collaborative journey.

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Catalytic validity was developed in reference to Lather’s (1986) claim that this

form of validity relates to “the degree to which the research process reorients,

focuses, and energizes participants towards knowing reality in order to transform it”

(p. 272). The ‘reality’ of this study concerns team members’ understandings of their

teaching practices. Therefore, in this study catalytic validity refers to the extent to

which the collaborative journey promoted empowerment - in terms of self-growth,

political consciousness raising or professional growth and collective action - in team

members thus enabling them to transform their reality.

The final criterion is dialogic validity, which refers to peer monitoring of the

research through dialogue (Herr & Anderson, 2005). This criterion also fits well with

this study in which team members engaged in much collaborative reflection and

critical debate as we investigated our teaching and teaching practices throughout the

collaborative journey. This validity also relates to the process of member checking of

transcriptions and translations and to the ongoing review of my reflective journal by

an experienced action researcher.

My critical examination is also guided by my reflections on the collaborative

journey in terms of the following questions:

Did the changes made to the curriculum facilitate the development of core generic and professional competencies in students? And Did the strategies incorporated into the curriculum change process result in empowering, sustainable and generative transformations?

In brief, my critical examination of the collaborative journey is guided by the Criteria

of Quality for Action Research model in light of the conceptual framework which

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underpins the study and by my reflections on the above questions.

My Critical Examination Examining Outcome Validity

The examination of outcome validity involves reflections on the extent to which

actions occurred that led to a resolution of the problem (Herr & Anderson, 2005).

As this research project originated from curriculum problems associated with the

development of core generic and professional competencies in students of nursing,

and aimed to reculture all aspects of the curriculum toward student-centredness,

actions leading to a resolution of the problem will be discussed in terms of

curriculum decision making and implementation.

With regard to curriculum decision making, initially team members had

difficulties in applying the pedagogical knowledge presented in the Nursing

Curriculum Guideline to the PE unit. Although we spent four meetings sharing and

discussing the pedagogical knowledge provided as pre-reading information, team

members still had difficulties comprehending and digesting several pedagogical

concepts in a short time and thus synthesising them into the curriculum. The

difficulties might have been due to team members’ lack of previous pedagogical

training, thus the concepts were new and difficult to comprehend. The difficulties

might also relate to inadequate time and agenda arrangements to enable team

members to understand, digest and synthesise the pedagogical concepts.

However, we decided to lessen the importance of applying Bloom’s Taxonomy

of Educational Objectives (Anderson et al., 2001; Bloom, Engelhart, Furst, Hill, &

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Krathwohl, 1956; Krathwohl, 2002) and the three types of curriculum evaluation (in

this study we referred to Print, 1993). Instead, we prioritised the application of

student-centredness (in this study we referred to Weimer, 2002) to the curriculum

because we believed it related more directly to the research problem. The emphasis

on developing a curriculum based on student-centredness resulted in the curriculum

being constructed with objectives that aimed at facilitating the development of

thinking and integrating abilities in students. In addition, the curriculum was

constructed with all elements of the curriculum, including objectives, teaching and

learning activities, and student assessment approaches, in alignment with one another

(please refer to the Unit Details in Appendices G-1 and G-2 /pp. 264-270).

With regard to the outcome of the curriculum implementation process, it was

expressed at the group meetings that students appeared to have gradually improved

generic and professional competencies such as critical thinking, active learning and

clinical reasoning abilities. For example, it is evident from team members’ accounts

that when first introduced to the curriculum, the 2-tech nursing students’ first

responses were fear of failure, greater stress, and doubt about their own thinking

ability. Previously students had been very textbook dependent; now they were

gradually taking responsibility for learning and were comfortable asking questions.

They were also able to complete tasks with a praiseworthy performance. Like their

teachers, the students also enjoyed group work. Some committed themselves to

spending extra time on improving their learning and considered applying learning

skills gained in this unit to other units. Although there were conflicting thoughts

about ‘to write’ and ‘not to write’ for the bonus credits, the students believed they

had acquired critical thinking and learning skills and also recognised the importance

of collaboration and lesson preparation. Overall, we transformed student learning

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from rote to more meaningful approaches and thus facilitated the development of

core generic and professional competencies in the students.

This suggests that when students are provided with conditions that promote

meaningful learning and are guided to do so, their learning can be transformed from

rote or surface learning toward more meaningful or deeper learning. Although

several research results suggest that Chinese students are more likely to be rote

learners than their western counterparts (Ballard & Clanchy, 1984; Bradley &

Bradley, 1984; Smith, Miller, & Crassini, 1998), this study supports Kember’s

(2000b) claim of “surface learning because of curriculum” (p. 106). Another group of

researchers also devoted themselves to the teaching and learning approaches for the

Chinese learner (Biggs & Watkins, 1996; Kember, 2000b; Kember & Gow, 1991;

Watkins & Biggs, 2001) and their research findings support the argument by Biggs

and Watkins (1996) and Kember (2000b) that many Western educators misapprehend

their Chinese students’ learning. Kember (2000b) argues that the reason students

learnt by memorisation is because they perceive that is what the course and

assessment require. The researchers also argue that the reason Chinese students tend

to learn by rote may be due to related constructs deriving from the Confucius

heritage (Biggs, 1996b; Biggs & Watkins, 1996; Kember, 2000b; Marton, Dall'Alba,

& Kun, 1996; On, 1996).

I would argue that the tendency to rote learn is influenced by both curriculum

and the Confucius heritage - especially from the heritage of the Chinese Imperial

Examination system. This system required candidates to memorise a vast amount of

classical material but did not required candidates to demonstrate the ability to either

theorise or challenge a particular premise (Confucianism and the Chinese Scholastic

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System, 2000). (My earlier discussion of cultural influences can be reviewed on

pages 35 to 38.) The socially-constructed and historically-embedded learning culture

might lead Chinese students to learn by rote. However, this study brought about

noticeable transformations among students who undertook the student-centred

curriculum; student learning can be transformed when curriculum is more

student-centred. For team members, the transformation was encouraging and, as one

of the team members claimed, “obvious to all”. We considered our efforts to be

constructive and successful.

It was difficult to determine which specific action led to a resolution of the

problem. I believe any action in one part of the study may have had a significant

effect on the whole situation. For example, the problem was clearly articulated and

the project systematically presented in the introductory seminar, and my explanation

of the problem resonated with my fellow PE educators. I believe this influenced team

members’ awareness of the need to change. The recognised and shared problem

promoted a group of committed educators with a common goal to join the research

team and thus began the collaborative journey toward the desired outcomes. The

initial actions that led to a resolution of the problem were therefore clear articulation

of the problem and comprehensive introduction to the project. These actions led to

sound commitment to the change, and then collaborative movement toward the

desired outcome. The ‘chain reaction’ of these actions in this study is in accord with

argument by Smith and Lovat (2003) that successful change in schools requires

spending time on explicit and shared perceptions of the problem and the change; and

by Fullan (1993, 1998, 1999, 2001a, 2003, 2005) and Smith and Lovat (2003) that

fundamental and sustainable curriculum change requires commitment to the change

and a collaborative working relationship among teachers.

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Another set of actions that led to the resolution of the research problem are

related to the flexible, cyclic and reflective nature of Action Research process. As

McNiff and Whitehead (2002) assert, the cyclic process of Action Research provides

opportunities for participants to deepen their understandings of the problem, to learn

and grow, and to reflect and react on the works. When the restructured curriculum

was initially implemented, some difficulties occurred and our actions became more

for ‘marking time’ instead of for ‘moving on’. For example, I noticed that although

we thought we were implementing a student-centred curriculum there was a

discrepancy between what we thought we were doing and what we actually did. In

the collaborative reflection sessions, team members also tended to ask questions

seeking technical solutions instead of to promote reflection or understanding.

Furthermore, when asked for clarification, team members were more likely to defend

their actions or restate difficulties in relation to the implementation of the curriculum

instead of discussing the problems in depth. I realised that although information in

relation to collaborative reflection (Pan, 2004a) was provided and introduced to the

team, the provision of information did not provoke a sound reflection dynamic

during the early collaborative reflection sessions. These difficulties might have

compromised the whole project if the Action Plan had been inflexible and had not

allowed for modification.

The flexible, cyclic and reflective nature of Action Research allowed for

reflection on our actions and for replanning. For example, in order to promote

reflection and move the teaching and learning towards a more student-centred

approach, the strategy of ‘take home questions’ was conceptualised and the meeting

agenda modified. Through the ‘take home questions’ and modified agenda, team

members were given more time to reconsider their conceptions and practices related

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to teaching and learning. As a result team members’ recognised that it was as

important to facilitate the development of critical thinking abilities as it was to ensure

the Physical Examination skills were demonstrated. This experience encouraged

team members to be ready and willing to make their teaching practices consistent

with the restructured curriculum, and thus affected the outcomes of the study.

The strategy of ‘take home questions’ served as a useful strategy not only to

promote team members’ reflections but also to facilitate the transformation of beliefs,

customs, attitudes and expectations and thus facilitate movement toward desired

outcomes. The transformation of conceptions and its effect on this study also echoes

repeated research findings that teachers’ conceptions of teaching significantly affect

teaching practices and thus student learning outcomes (Gow & Kember, 1993;

Kember & Gow, 1994; Kember & Kwan, 1997, 2002; Parpala et al., 2004; Trigwell

& Prosser, 1996a, 1996b; Trigwell et al., 2002; Trigwell et al., 1999).

An open mind and willingness to communicate freely are recommended to

avoid defensive responses during collaborative reflection (Pan, 2000a; 2000b; 2004a).

However, the need for ‘take home questions’ illustrates that preparation time is also

required if immediate, defensive responses are to be avoided and professional growth

encouraged. When asked questions for which they are not prepared, teachers like

most people, are likely to construct defensive responses to prevent themselves from

being embarrassed, or threatened, or to sound uncertain (Argyris, Putnam, & Smith,

1985; Pan, 2000b). It was agreed among team members that immediate responses are

more likely to be explanations or articulations of self rather than reflections (Chapter

4, p. 191). Along with an open mind, time for individual reflection is essential for

effective collaborative reflection, self growth and professional development. The

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reflections that influenced the outcomes of the transformative process are discussed

in the next section.

Examining Process Validity

According to Herr and Anderson (2005), discussion of process validity involves

examining the extent to which problems are framed and solved in a manner that

permits ongoing learning of the individual or system. In other words, process validity

involves examining whether the outcomes of this Action Research project can be

attributed to the collaborative and reflective journey. In this section, I examine the

extent to which reflection was carried out among the team, its influences on the

research outcomes, and factors that affected reflection.

The strategies of creative writing, collaborative reflection and take home

questions were effective strategies for facilitating reflection in this study. Although

the creative writing for personal practical theorising of teaching and learning did not

raise awareness of the need to change as anticipated, it served as a catalyst for

discussion as team members shared and articulated opinions, attitudes and beliefs

based on experiences. Through articulating, sharing and discussing, we deepened our

understandings of the problematic situation that we confronted, and thus were able to

reflect more deliberately in our works. Together with collaborative reflection and

take home questions, the creative writing permitted ongoing learning of team

members. Reflection, as Jay (2003) claims, is a kind of experiential, ongoing

learning for teachers working in the constantly changing world of the classroom and

it was at the heart of the curriculum reculturing process in this study. This was

because reflection enabled team members to learn about their teaching practice and

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to become better practitioners and competent in transforming the way we teach and

students learn.

When discussing reflection it is important to consider the level of reflection - or

reflectivity – being undertaken. Based on Habermas’s (1971; 1973) works, Van

Manen (1977) proposed three levels of reflectivity. According to Van Manen (1977),

the first level of reflectivity is concerned mainly with means, the second is an

interpretive understanding for the purpose of orienting actions, and the third level is

the meaning or worth of the social conditions. Hatton and Smith (1995) refer to these

three levels of reflection as technical, practical and critical. Practitioners with

technical reflection are concerned with the effectiveness and efficiency of the means

used for the achievement of certain goals rather than opening themselves to criticism

or modification (Hatton & Smith, 1995). With practical reflection, practitioners allow

open examination of not only the means but also the meanings of the goals; whilst

practitioners using critical reflection are concerned with not only the means and the

meanings of the goals but also make socio-historical and political-cultural

judgements about the practice (Hatton & Smith, 1995).

Team members mostly engaged in critical reflection throughout the

collaborative journey. We discussed technical solutions for teaching and learning

problems we had experienced and most of us opened ourselves to criticism and

modification in terms of our beliefs and customs of teaching. We made judgements

about the lack of a sense of community within the faculty and developed a clear

educational vision to guide teaching and learning. However, the achievement of the

critical reflection varied among team members.

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Information generated from the personal practical theorising and group

meetings suggests that team member’s reflections did not develop to the third or

critical level at the same time. For example, some team members shared and praised

positive student learning outcomes, while others had not moved on from discussing

the inability of students to think; some team members believed that students were

able to generate appropriate nursing diagnosis or problems, while others still

questioned the link between Physical Examination and Nursing Diagnosis.

The focus and form of the reflections among the team also varied. Some team

members tended to be critical of the curriculum design rather than of their own

performance when they found it difficult to achieve the learning objectives. Some

tended to be more concerned with student feedback about their teaching rather than

student learning. Some team members made critical comments about others through

forthright questioning; others softened their critical comments by referring to

themselves, or by sharing examples of what they had experienced in similar

situations.

Although the levels, focus and forms of reflection were different within the group,

evidence from team members’ accounts suggests that the collaborative and reflective

processes affected the ways we think about our teaching, our students, and student

learning, as well as what we actually attended to in the classroom. For some, this

change manifested in their understandings of teacher-student relationships; for others,

it lay in the skills they gained in teaching and in communicating with students.

However, there was general agreement among the team that time was also needed

to facilitate more meaningful reflections but this was not always possible given our

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busy academic lives. In order to promote more meaningful reflections, an additional

strategy such as an agenda that allows even more time for collaborative reflection

might be needed. That is to say, although team members enjoyed the freestyle

meetings, this enjoyment may have been better sacrificed for a more systematic

process of reflection; because the freestyle meetings appeared to result in more general,

superficial discussion.

General discussions about teaching and learning might have led the team to spend

more time on technical issues instead of exploring understandings or meanings during

the meetings. A systematic process of reflection distinct from ordinary thought may

slow down the learning process, but would also reveal rich and complex formations,

allow time for appreciation, and pave the way for a deliberate response rather than a

less thoughtful reaction (Rodgers, 2002). Furthermore, team members preferred

sharing experiences and ideas by verbal communication rather than written format.

The preference for verbal communication over written may also indicate that a

rigorous and systematic meeting agenda is an alternative means for promoting

reflections. If the curriculum implementation and reflection phase had been guided by

a more systematic agenda, we might have been more able to respond thoughtfully in

the moment and engage in more effective collaborative reflections on our individual

teaching experiences. We thus might have learned even more from each other than we

did during the collaborative journey.

A collaborative relationship also promotes meaningful learning and reflection.

As Biggs (2003) asserts, “reflection is often not best carried out alone” (p. 254). When

reflecting collaboratively, peers can help point out problematic teaching actions or

learning issues, thus the level of reflection increases in the process (Manouchehri,

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2002). Rodgers (2002) also argues that supportive and disciplined reflective

communities of teachers have potential to help teachers understand that student

learning is central in the classroom, and their teaching is subordinate to, and in service

of, that goal

The degree of reflection certainly increased throughout the collaborative journey.

Although it is not clear whether team members had seen their teaching being

subordinate to student learning, the reflective process certainly had a positive impact

on the outcomes of this study. It is evident that the beliefs, customs and attitudes of

teaching and learning of the majority of the team members had moved toward being

more student-centred following participation in this study. Initially some of us blamed

the problematic situation on students’ limited abilities to think critically and on their

passive learning attitudes. This blame was shifted when we realised that students were

capable of much more than we were asking, and once we started facilitating their

learning to do so. When learning responsibilities were shifted to the students we

realised that in doing so teaching became easier and more enjoyable. As Fullan (2001b)

claims, “Effective change takes time. It is a process of ‘development in use’ ” (p. 109).

Although team members reflected differently, our reflection activities certainly

enabled us to learn about our teaching practice and therefore to become better

practitioners and competent in reculturing the way we teach and facilitate student

learning. To this point, the change process is not necessarily as distinct as what Lewin

(1952) claimed “a Three-step Procedure: Unfreezing, Moving and Freezing” (p. 55).

Moving could go along with unfreezing, and refreezing may happen along with

moving.

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Examining Democratic Validity

Democratic validity refers to “the extent to which research is done in

collaboration with all parties who have a stake in the problem under investigation”

(Herr & Anderson, 2005, p. 56). It also refers to the degree to which the problems

identified from a particular context and the resolutions are relevant and appropriate

to that context (Herr & Anderson, 2005).

The research problem of the study was carefully identified within a deliberate

contextualisation of the curriculum problem in CGIT. Although I initiated this

research project, team members volunteered to collaborate, my concerns about the

curriculum aroused echoes in the PE nurse educators’ hearts and the research team

was formed from a shared concern. As Alice stated after the introductory seminar,

“our curriculum does have problems and to ‘use’ Li-Yu this time is a good

opportunity to make it better”. Although I was the one who conceptualised the initial

Action Plan, the plan was agreed by team members in terms of the actions we were

to take for solving the curriculum problem. The Action Plan was also altered

according to team members’ opinions and decisions, or with their agreement. All

these happenings indicate that the research problem was identified within CGIT, our

teaching practices were investigated collaboratively by nurse educators in CGIT, and

the Action Plan was conceptualised specifically and appropriately for CGIT and

collaboratively agreed upon and modified when necessary.

Once the team was formed, I was aware that my preconceptions regarding the

goals, means, and actions must be open to change, and that I was now simply a team

member. Therefore I was careful to only make suggestions and not impose my

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opinions. For example, although the group working rules were derived from my

personal suggestions, they were based on the democratic dynamic of the group and

the rules were accepted by the team. Although I was the one who arranged the

meetings, the arrangement was made based on team members’ agreement. Most

importantly, the curriculum decisions were made collaboratively by team members

and the curriculum was implemented and evaluated by them as well.

My awareness of the importance of democratic principles and collaboration in

this study also guided me to solve problems in appropriate ways during the research

process. For example, although time pressures had led team members to make a

hurried authorisation for the uncompleted curriculum decisions during the curriculum

decision making phase, I negotiated another meeting for the completion of the

curriculum decision making process. As a result, the curriculum decisions were

definitely ‘ours’ instead of ‘mine’. My awareness and negotiations had achieved a

delicate balance between time pressures and democratic decision making.

Zuber-Skerritt (1996) states that “action research only works successfully if all

members of a team own the problem and are interested in solving it” (p. 88). Both

Zuber-Skerritt (1996) and Pan (2004b) claim that all team members participating in

action research have to work collaboratively and voluntarily rather than being

manipulated or forced onto the team. These statements are supported by the ‘faithful’

team members’ high attendance rate at the group meetings and enthusiastic

involvement of the whole collaborative process. With enthusiasm and commitment,

the collaborative team functioned far more energetically than I expected. Team

members expressed at the evaluation meeting that they had gradually developed a

sense of community and enjoyed the collaborative work. They also believed that

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through the collaborative process they had learned to see and do things differently,

gained more confidence in ‘our’ curriculum, and developed teaching expertise. All

these happenings confirm suggestions that developing a collaborative culture among

teachers can build group cohesion (Hasseler & Collins, 1993; Kim & Lee, 2002;

Manouchehri, 2002), encourage individual improvement and professional

development ( Hargreaves, 1994; Osguthorpe, 1999; Smith & Lovat, 2003; Smith et

al., 2000; Smith, 1993), and enhance confidence (Fullan, 2003). Working

collaboratively was certainly one of the essential elements contributing to the success

and effectiveness of this Action Research project.

When examining democratic issues, I also asked myself whether any particular

member had dominated the collaborative process. I remembered occasions such as

when Alice claimed nominal group technique was unnecessary for making decisions

about the teaching and learning activities because she believed agreement was made

during the discussion. To ensure Alice’s opinion did not remain unchallenged, I asked

other team members for their opinions about Alice’s proposition. Instead of

responding directly to my question, team members went straight into more detailed

discussion regarding teaching and learning activities. In this situation, Alice did not

dominate the collaborative process; indeed, she may have had no intention of

dictating the action. However, asking for others’ opinions instead of responding on

my own proved a useful strategy for collaboratively neutralising potential

dominance.

Another concern related to democratic issues is that Chinese are more likely to

‘keep face’ for others by responding with euphemisms (Pan, 2000a), and this could

have caused some dilemmas during group communications. It was evident during the

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collaborative journey that different opinions frequently emerged, were freely shared,

and were often the subject of critical debate, although our communications were

never ‘fiery’. To be effective, group discussions involving different opinions should

not become fierce arguments; they should be critical debates. It was evident that

team members not only engaged in critical debate during group discussions but also

enjoyed them. As Janet expressed at the evaluation meeting, “I was able to talk about

what I want to say at my ease”. During the collaborative process, euphemism was

unlikely to have affected the democratic dynamic among the team. Instead, I would

argue that as long as democracy exists in the group, a critical debate is a sign of

mature group dialectic; and results in the collaborative process being, as team

members expressed it: “a good experience” (Sue), “unlikely painful” (Emma), and

“an enjoyable process” (Alice).

Team members also believed that the essential elements for group

democratisation such as equality and open-minded communication, democratic

decision making, respect, and collaborative accomplishment (Habermas, 1984; Kidd

& Kral, 2005; Pan, 2004a) existed within this research team. As a result of

democratisation, team members such as Monica and Tina were willing to share their

frustrations about negative student feedback or ineffective teaching and learning

outcomes at the group meetings. Team members also believed that each team

member had played a significant role. The results of group democratisation are also

evident in Janet’s expression that “the framework we constructed came up to my

expectations” as well as Alice’s praise that “Ah, this is indeed fulfilled [my wish]. I

have accomplished what I wanted to do”.

The benefits of this project lie beyond completion of my doctoral study. It has

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been a mutually beneficial action for CGIT, at least for those team members who

participated, and for the 2-tech PE curriculum. The project has also benefited the

2-tech nursing students who undertook the restructured curriculum. Team members

identified this project as an accomplishment because student feedback indicated that

the students had benefited greatly from the project.

Examining Catalytic Validity

Catalytic validity refers to the extent to which “the research process reorients,

focuses, and energises participants towards knowing reality in order to transform it”

(Lather, 1986, p. 272). Although this criterion overlaps with process and democratic

validity it highlights the transformative potential of action research (Herr &

Anderson, 2005). Therefore, I will discuss catalytic validity for this study in terms of

key indicators for empowerment suggested by Smith (1993). I will also discuss my

reflections on how a student-centred curriculum helps students to gain mastery over

their learning. My personal enlightenment will also be discussed.

The main indicators that guide and suggest empowering outcomes for team

members in this study are “changes in self knowledge” (Smith, 1993, p. 79) in terms

of self-growth or personal empowerment; “developing scepticism about

appearances” and “recognising historical and political antecedents to contemporary

practices” (Smith, 1993, p. 80) in terms of political consciousness raising or

professional growth and decision making; and “the development of a shared ideology

critique which is integral to subjecting individual and shared understandings to

critical review” and “collective strategic action” (Smith, 1993, pp. 81-82 ) in terms of

collective action or struggle.

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Outcome indicators of the first sphere of empowerment are change of self

knowledge, including the enhancement of self-determination, assertiveness,

autonomy, and a commitment to greater responsibilities (Smith, 1993). Team

members’ change of self knowledge is evident in their comparative expressions about

what they thought before and after participation in this study. For example:

[Before] I knew what I ought to do but I was unable to do what I wanted very much to do [now] I have accomplished what I want to do. (Alice: Meeting File, Jan 18, 2006); At first I was worried that I lacked originality or was rigid in my teaching. [Now] I feel I am a competent teacher. (Sue: Meeting File, Jan 18, 2006); and It was sad [before] when we couldn’t answer the reviewers’ questions. [Now] we wouldn’t have been beaten by whatever they asked. (Janet: Meeting File, Jan 18, 2006).

These examples illustrate how this study had empowering outcomes for team

members within the sphere of self-growth.

Indicators that suggest empowerment in terms of political consciousness raising

are those concerned with the development of scepticism about contemporary

practices. For example, after reading and discussing concepts in relation to

student-centred teaching and learning (Weimer, 2002), Sue expressed that she had

taken what-the-student-should-do for granted but now realised that as teachers we

should think about how to develop students’ responsibility for their own learning.

After developing a sense of community among the team, Alice realised this was what

was lacking among the faculty:

[W]e had a limited relationship with each other in terms of teaching and

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research. (Alice: Meeting File, Jan 18, 2006)

Alice also realised that previously we were unable to work toward a common goal

because of working with someone who is uncommunicative and not willing to listen

to others. Team members also recognised that the school lacked a common goal to

guide teachers to make changes. These examples suggest that team members had

developed scepticism about what we did and recognised historical and political

antecedents to our contemporary practice in terms of curriculum. This can also be

seen as a form of professional growth.

The accomplishment of the third sphere of empowerment - collective action or

struggle (Smith, 1993) is the most obvious outcome of this study. Team members had

collaboratively made decisions to restructure the curriculum, implemented the

curriculum, and evaluated the curriculum for further development. We gained a sense

of community and were committed to sustaining and extending the collaborative

process. For example:

At the end I realised we had developed a sense of belonging. (Alice: Meeting File, Jan 18, 2006) . . . having a sense of belonging. (Donna: Meeting File, Jan 18, 2006) We will keep doing so next year when we teach the PE unit. . . . I believe it is possible to extend our collaborative process to include other units. (Janet: Meeting File, Jan 18, 2006)

Although student learning was not intended to be examined in terms of

empowerment it is too conspicuous to be overlooked. Rappaport (1984) views

empowerment as a process in which “people, organisation, and communities gain

mastery over their lives” (p. 3). In this sense, the collaborative journey not only

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helped team members to better understand their teaching practices but also helped to

develop more skilled learners. It is evident from team members’ accounts that the

2-tech students gradually transformed their learning attitude from independent and

unconfident to more active, responsible, and confident ways. The students had also

acquired critical thinking and learning skills and recognised the importance of

collaboration and lesson preparation. Through the curriculum, they recognised that

they are able to learn well, even better than what they thought they could do.

I have also benefited from this curriculum reculturing journey. I am one of the

products of the traditional education system and took for granted the notion of

curriculum as product – a syllabus or document developed to produce measurable

outcomes in students (Smith, 2005). When I investigated more closely, I realised that

in order to investigate and make sense of the real world of teaching and learning and

to facilitate student development of meaningful thinking and learning, the curriculum

must be more than a product – a program that exists prior to and outside the learning

experiences (Grundy, 1987; Smith, 2005). The curriculum should centre on not only

process – what actually happens in the classroom, but also praxis –“the curriculum is

not simply a set of plans to be implemented, but rather is constituted through an

active process in which planning, acting and evaluating are all reciprocally related

and integrated into the process” (Grundy, 1987, p. 115). In order to facilitate

meaningful thinking and learning in students, curriculum cannot simply be about

learning ‘things’ with students considered as knowledge recipients. We must

recognise that knowledge is a social construction; learning is as a social act; students

are active participants in the construction of their own knowledge; and curriculum

constructed within the real situation (Grundy, 1987). As the classroom is a constantly

changing world (Jay, 2003), curriculum work is a never finished business that

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requires dynamic operation to fit for the needs of the real and constantly changing

world.

I also recognised that bringing about educational change is more than a planned

action. As Fullan (2001a) claims, change “can be understood and perhaps led, but it

cannot be controlled” (p. 33). This is especially so when the change is concerned

with beliefs, attitudes, and customs. I initially anticipated that all participating team

members would change at similar, if not the same, pace once they were interested in,

and committed to, a shared goal. However, I realised that the occurrence of the

change outcome, including reflections and empowerment in terms of teaching and

learning varied not only in focus and form but also in depth and pace among team

members as well as among students. As Rappaport (1984) claims, the content of the

empowerment process is “of infinite variety and as the process plays itself out among

different people and settings the end products will be variable and even inconsistent

with one another” (p. 3). Although we went through the same change process, the

outcome varied among team members as well as among the students. Indeed, the

outcome has gone beyond the scope of my anticipation.

Team members constantly amazed me with their opinions, efforts and creativity

during the collaborative journey, and I know the outcomes of this study are beyond

the scope of my personal influence. The outcomes of this study were augmented by

the collaborative team within the shared, cyclic and democratic dynamic of this

action research project. If the change had been brought about by a controlled, non

collaborative process, it could have deskilled team members in a variety of ways and

turned them into educational “technicians” (Smith, 2005, p. 6). In other words,

although I knew from the literature that Action Research is generative (Chapman,

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1996) and can promote individual and professional growth (Carr & Kemmis, 1986;

Grundy, 1995; Kember, 2000a; Kemmis & McTaggart, 2000; Mills, 2003; Stringer,

2004; Zuber-Skerritt, 1996), this understanding has been enhanced through this

Action Research experience.

Examining Dialogic Validity

Dialogic validity denotes the extent the research is monitored through a form of

peer review (Herr & Anderson, 2005). Herr and Anderson (2005) suggest action

researchers can promote dialogic validity by doing the research as collaborative

inquiry, participating in critical and reflective dialogue with other action researchers,

or working with a critical friend who is familiar with the setting and can serve as

devil’s advocate for alternative explanations of research information. It is clear from

previous discussion and in the Action Plan that this study was a collaborative inquiry

and my reflective journal for recording my opinions and impressions of the

collaborative processes was reviewed with an experienced action researcher. I will

now discuss the extent to which critical and reflective dialogue occurred, its

influences on the collaborative journey, and factors that might have affected the

extent of the critical and reflective dialogues.

Fullan (2001b) states that “change requires individual implementers to work out

their own meanings” thus “effective implementation is a process of clarification” (p.

108). In this sense, critical and reflective dialogue is not only essential for

understanding and agreement but also constructive for any group working to bring

about effective curriculum change. In this study, critical debates naturally and

frequently occurred during group discussion and stimulated the critical thinking that

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helped team members to see different ways of doing things. For example, when some

members contended that students were incapable of critical thinking, other team

members shared their successful experiences in facilitating learning in order to

encourage more positive thoughts, when some team members felt helpless about

shifting student learning from assessment-oriented to learning-oriented, others

reminded them that we were using assessment to facilitate student learning. Most

team members identified the continuous dialogue as beneficial to knowing “there

were other ways of seeing and doing things” (Sue: Meeting file, Jan 18, 2006).

Furthermore, continuous dialogue, discussion or debate minimised

misunderstandings and promoted agreement among the team during the whole

collaborative journey. In this sense, we built a collaborative relationship among the

team and created a culture where we served as critical friends to one another for

purposes of improving teaching and learning.

Another example of the use of a critical friend lies in an issue related to limited

participation by some of the team members. I initially considered the limited

participation was due to lack of interest or commitment. I recorded my feelings of

disappointment and helplessness and considered the problem a limitation of a

“bottom-up” and voluntary change. My critical friend who reviewed my journal,

however, suggested I consider the issue from another angle: “is it a limitation of a

‘bottom-up and voluntary change’ or is it a limitation of any change endeavour?”

(Reflection File A, Dec 22, 2005). Following reflection on this question, I realised

the problem could relate to issues such as commitment to the change or the difficulty

of transforming entrenched conceptions of teaching and learning. Unmindful

conceptions of teaching and learning were discussed earlier on pages 193 to 194 but

are important enough to repeat here. When people unconsciously lean towards

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teacher-centredness, they might have difficulty engaging in collaborative work based

on student-centredness; although they consciously agree with the importance of

student-centred teaching and learning they might have limited commitment to the

curriculum change process. If so, the situation echoes Kember’s (1997a) claim that if

a teacher clings to teacher-centred conceptions, even curriculum designated as

student-centred is likely to end up with limited outcomes.

Another issue related to critical or reflective dialogue is the issue of ‘asking a

good question’. This issue was raised by one team member, Donna, at the evaluation

meeting while we were discussing collaborative reflection. Donna asserted that the

type of question asked during the collaborative process was important, because only

when the question was constructive and understood could it provoke or facilitate

reflective dialogues. This assertion prompted me to further reflect on my competence

in facilitating reflective dialogue, particularly the questioning skills. In this study,

much of my role was that of a critical friend, and I was aware that a critical friend

should not tell others what to do but rather facilitate reflection (Biggs, 2003).

Therefore, I frequently used the skill of questioning. On some occasions my

questions successfully illuminated concerns or issues. However, on other occasions

my questions only caused silence or confusion, or even led the discussion off track.

Although Pan (2004a) claims that questioning is the core strategy for the promotion

of qualities of collaborative reflection, the conceptualisation of a good question is

difficult.

Donna had also claimed that to pose a question that would specifically facilitate

critical reflection during the collaborative process was quite difficult, because at the

same time we also had to listen closely and share and articulate understandings with

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others. On one hand, this might be, as Burchell (2000) and Pedretti (1996) claim, an

issue of ‘connoisseurship’ that requires experiences to possess. On the other hand, in

order to avoid out-of-focus dialogue, Bruner’s (1990) and Kidd and Kral’s (2005)

advice might be worth keeping in mind: “Be open-minded, but know your

commitments” (Kidd & Kral, 2005, p. 190).

Conclusion

My critical examination of the collaborative journey was guided by the Criteria

of Quality for Action Research model developed by Herr and Anderson (2005) in

light of the conceptual framework that underpinned the study. My critical

examination concludes with responses to the following questions:

Did the changes made to the curriculum better facilitate the development of core generic and professional competencies in students? And Did the strategies incorporated into the curriculum change process result in empowering, sustainable and generative transformations?

In this study, the reculturing of the curriculum towards a student-centred

approach included transformations of beliefs, customs, attitudes and expectations of

team members, even the students. This resulted in better development of core generic

and professional competencies in the 2-tech nursing students. The curriculum

decision making focused on notions of student-centredness and resulted in a

curriculum with objectives aimed at facilitating the development of thinking and

integrating abilities in students. My critical examination shows that through a deeper

understanding of the principles and assumptions underpinning the concept of

student-centred learning, team members were gradually enabled to advance a

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student-centred approach to teaching and learning. Throughout the whole process, we

not only reconceptualised our roles and responsibilities in teaching and learning but

also endeavoured to shift our teaching customs to student-centredness. As a result,

we recultured the curriculum. Student feedback also indicated that we had improved

student learning in terms of critical thinking, active learning, and clinical reasoning

abilities. Therefore, my examination supports an affirmative answer to the first

question.

The strategies incorporated into the curriculum reculturing process included

transforming nurse educators’ conceptions of teaching and learning. This resulted in

consistent and coherent student-centred practices; sound commitment to the change;

democratic principles that allowed modification of agenda and encouraged equal

relationships, a sense of community, and collaborative practices among team

members including collaborative reflection. These strategies undoubtedly facilitated

self growth and professional development of team members. Under the application of

these strategies, this study brought about empowering, sustainable and generative

transformations in teaching and learning. For example, both team members and the

students changed their self-knowledge in terms of roles and responsibilities of

teaching and learning, and enjoyed working together. Team members also developed

scepticism about what we did and recognised historical and political antecedents to

our contemporary practice in term of curriculum; and the students were more

comfortable asking questions. These results suggest that the transformations made in

this study were empowering.

In addition, the collaborative journey also resulted in the development of a sense

of community and commitment to sustain and extend the collaborative process.

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Some students recognised the value of working together and of lesson preparation,

and some considered applying the learning skills gained from this unit to other units.

These results suggest sustainable outcomes of this study. Furthermore, team

members shared and generated knowledge of teaching and learning and

reconstructed a curriculum and these outcomes suggest this study had brought about

generative transformations. Although my examination also highlighted the need for a

more systematic agenda and development of ‘connoisseurship’ in asking a good

question in order to promote collaborative reflection, my critical examination

supports an affirmative answer to the second question.

In this chapter I built my critical examination for making sense of what

happened and dealing with bias or distortions. Through my critical examination, I

confirmed that reculturing a curriculum toward a student-centred approach better

facilitates the development of generic and professional competencies in nursing

students. I also confirmed that this study brought about educational transformations

that were empowering, sustainable and generative. The implications and value of the

study are discussed in the next chapter.

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CHAPTER 9

Implications and Value of the Collaborative Journey:

Reconstruction and Transformation A Revisit and Introduction In the preceding chapters my contextual considerations confirmed the Research

Problem that:

The curriculum does not adequately facilitate the development of generic and professional competencies in students of nursing in Taiwan.

In order to address this problem, I conceptualised a framework for thinking about

and acting upon the following research question:

What changes to the nursing curriculum will better facilitate the development of core generic and professional competencies in students; and what sort of strategies need to be incorporated into the curriculum change process so that transformations are empowering, sustainable and generative?

I argued that curriculum change is complex and not simply about the curriculum

document per se, but also about teachers and teaching and learners and learning, and

the curriculum making process. Thus effective curriculum change requires attention

to both the content and the process of change. Basically, I saw curriculum change as

a reculturing of the beliefs, customs, attitudes and expectations related to the

teaching and learning at our school

My conceptualising about the question of what changes would facilitate the

development of core generic and professional competencies led to notions such as

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student-centredness, curriculum alignment, and curriculum reculturing. My

conceptualising about what sort of strategies needed to be incorporated into the

change process so that the transformations would be empowering, sustainable

and generative led to notions such as consistent and coherent student-centred

conceptions of teaching and learning, personal and professional development,

commitment to change, collaborative practice and reflection, and democratic

principles. These notions, together with the idea that a small achievable change is

more likely to promote acceptance of a larger scale reform formed the basis for the

conceptual framework of the study.

Based on my contextual considerations and conceptual notions, I determined

and justified Action Research with its cyclic and praxis-oriented nature to be an

appropriate methodology to guide the transformation process. A five-step Action Plan

was also conceptualised for bringing about the change. The story of how the

collaborative journey unfolded was told in Chapters 4, 5, 6 and 7.

In the previous chapter I reflected on the collaborative journey in order to make

sense of what had happened. My critical examination validated that the 2-year

technical nursing students who undertook the restructured, student-centred

curriculum gradually improved in certain core generic and professional competencies

such as critical thinking, clinical reasoning, and active learning skills. My critical

examination supported an affirmative answer to the following question:

Did the changes made to the present nursing curriculum better facilitate the development of core generic and professional competencies in students?

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My critical examination also illustrated that the conceptualised strategies

incorporated into the change process resulted in an affirmative answer to the

following question:

Did the strategies incorporated into the curriculum change process result in empowering, sustainable and generative transformations?

In this chapter, I will discuss the implications and value of the collaborative

journey in terms of reconstructions and transformations within the context of the

study. This chapter also offers a set of principles for planning and implementing

empowering, sustainable and generative curriculum change. This chapter concludes

my doctoral study. However, the collaborative journey continues.

The Implications and Value of the Study

For the Collaborative Team and Educators in Similar Contexts

Pan (2000b) states that by reflecting critically on their teaching, teachers can

gradually transform five dimensions of values related to theory or knowledge

generation, professional practice, education, the bridging of theory and practice, and

emancipation. In this study, team members shared knowledge of teaching and

learning and generated and reconstructed a curriculum. The curriculum might be

subjected to change as the journey is resumed each academic year. With the passing

of time comes different “knowings” for both teachers and learners; theory or

knowledge is always comparative, provisional and specific (Pan, 2000b). However,

the curriculum we generated on the collaborative journey was appropriate and

acceptable as a resolution of our shared problem regarding teaching and learning.

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The collaborative journey enabled team members to gain more understanding of

our teaching and to improve our teaching practice, thus the journey also facilitated

the development of individual and professional growth among the team. In this study

we also integrated the student-centred model (Weimer, 2002) into our teaching and

learning practices; therefore the value of the study also lies in the bridging of theory

and practice. The educational value of the study lies in the ultimate purpose for

gathering the team: to facilitate the development and improvement of student’s core

generic and professional competencies. In addition, team members who participated

in this study developed better understandings of their own teaching, their teaching

practice and their workplace; therefore the collaborative journey also had liberating

or emancipatory value.

The value of this study for individual educators may also lie in the use of

collaboration for resolving educational problems. I described in Chapter 2 how my

colleagues and I were frustrated by students’ limited application of theoretical

learning to clinical settings. I also claimed that although nurse educators in CGIT

were informed about and agreed with student-centred teaching and learning, they

were uncertain about how to move away from teacher-centred, content-driven

approaches. As an individual educator, one insight I gained from this study is that

although there might be limits to what can be done by individuals about problems

with teaching and learning, “inaction is not one of the options” (Fullan, 2003, p. 43)

because the problem cannot be solved through inaction. I would argue for individuals

to join together and investigate their problems. When educators build a collaborative

culture into their work, become each others’ critical friends and engage in critical and

reflective dialogue and actions, to use Biggs’ (2003) words, their “teaching is

enhanced, experience is enriched, the teaching theory is enriched” (p. 251). I would

229

also argue that educators who work collaboratively are more likely to be confident

about articulating their views and actions, and more willing to take risks to resolve

the problem rather than “playing it safe” or taking no action at all.

This study illustrates the positive impact of collaboration on teachers’

professional development. Through the collaborative journey, the participating nurse

educators in this study increased their self knowledge and confidence, enhanced their

teaching ability, elevated their professional growth and improved their relationships

among their peers. In addition, the participating nurse educators became committed

to sustaining and extending the collaborative journey. When teachers are enabled to

be equal participants who collaborate in the educational change process, ownership

and a sense of community develop. A collaborative relationship that enables the

development of ownership and community has the potential to develop sustainable

professional growth. This is particularly crucial for the never-ending demands of

professional growth of teachers working in the never-finished business of education.

This study has also strongly indicated that when a student-centred curriculum is

properly implemented, it can enable students to learn actively, think critically, and

perform far better than often expected by their teachers. In this study some team

members initially held the impression that students were incapable of meaningful

learning. However, student learning outcomes showed the opposite – students can

and will engage in deeper learning if the conditions and guidelines for doing so are

present. The information generated through this study suggests that educators need to

reconceptualise their opinions about the learning potential of students. Although the

socially-constructed and historically-embedded learning culture might lead Chinese

students to learn by rote, they can learn more meaningfully if they are enabled to do

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so. A false impression that devalues the depth of student potential not only impacts

on student learning but can also deskill teachers and limit their options and rational

control over their teaching lives. Educators need to hold stronger trust in students,

and this is usually what highly effective teachers do (Bain, 2004). Stronger trust in

students and a carefully implemented student-centred curriculum has the potential to

fully develop student learning.

Although the teaching and learning culture in the majority of Taiwanese nursing

classrooms is still dominated by teacher-centred, content-driven approaches

(Lee-Hsieh, Kuo, & Tsai, 2004), student-centred approaches are becoming more

evident as nurse educators strive to produce fit-for-practice nursing graduates. The

apparent reluctance to replace teacher-centred approaches with student-centred

approaches may be exacerbated by the reality that in Taiwanese classrooms the

Confucius heritage prevails with both teachers and students. The effectiveness of this

study was due in part to consideration of the cultural issues in the context.

Educational change that is expected to be fundamental and sustainable needs to

take into account conceptions, beliefs, customs, and expectations– the cultural issues.

Although nurse educators in CGIT were informed about and agreed with

student-centred teaching and learning, they were uncertain about how to move away

from teacher-centred, content-driven approaches. In this study, team members

reflected on their Personal Practical Theories of teaching and learning, engaged in

critical debate about many aspects of teaching and learning, and examined and

reflected – both individually and collaboratively – on what, and why action happened

in the school. As a result, we collaboratively made changes in the interests of our

teaching and student learning. We made a movement away from traditional

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teacher-centred approaches toward student-centredness. This study has strongly

supported the claim that bringing about fundamental and effective educational

change requires “a new way of thinking about teaching and learning . . . the

piecemeal addition of new techniques does not transform teaching” (Weimer, 2002, p.

185).

Changing the way we think about teaching and learning is a reculturing

approach that can have significant long term effects on educational outcomes. In this

study, as we collaboratively explored the reasons we teach or act as we do, or why

we choose particular teaching activities or curriculum materials, we gradually

transformed of our beliefs, customs or expectations about teaching and learning. In

doing so, we became committed to sustaining a student-centred curriculum that

better facilitates the development of core generic and professional competencies in

students of nursing in CGIT. It is doubtful if this would have happened if only the

techniques related to student-centred teaching had been introduced. In this study we

went far beyond launching new techniques – we established a new way of thinking

about teaching and learning.

The Implications and Value of the Study

For CGIT and Other Similar Contexts

In Chapter 2 I explained that student learning outcomes at CGIT have been

problematic in terms of applying theory to practice. I also reported that the school

Accreditation Report (Ministry of Education, 2005a) suggested CGIT devote

attention to the improvement of the nursing curricula, including educational

objectives, and teaching and learning materials and practices in order to improve

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student thinking abilities. The literature of Taiwanese nurse education also reveals

that like CGIT, schools of nursing in Taiwan are all facing challenges and pressures

in curriculum design and in the ways we educate future nurses (Hsu, 2005; Lee et al.,

2004; Lu, 2004; Yang, 2005). The urgent demand for change to nursing curricula in

Taiwan is also evident in the development of the Nursing Curriculum Guideline

(Curriculum Research and Development Centre in Allied Health Education, 2004a).

Furthermore, while the study progressed a new nursing school accreditation plan has

been developed by Taiwan Nursing Accreditation Council and the focus of the plan is

on examining the development of student core competencies (Department of

Technical and Vocational Education, 2006). All the information suggests that the

demand for educational change in Taiwanese nursing schools, including CGIT, not

only resides simply at classroom or teacher level, but also at school and government

levels. Regardless of the level demanding educational change, it is beyond doubt that

both faculty and students will be involved in the change. The need to change has

become a crucial issue for schools of nursing in Taiwan and other countries.

It is an indisputable reality that the current worldwide trends in nursing policy

and practice are making new and far reaching demands on nurse education. The need

for educational or curriculum change is prominent within public policies in many

different places (Hargreaves, Lieberman, Fullan, & Hopkins, 2005). However, the

literature of educational change is often a catalogue of discouragement (Fullan, 2003;

Hargreaves et al., 2001; Traynor & Rafferty, 1999). Although educational or

curriculum change are ubiquitous issues, little if any attention has been paid to

curriculum reculturing in Taiwanese education literature or nursing literature. This

study generated new information, especially for schools of nursing, about curriculum

reculturing.

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This study introduced a conceptual framework for thinking about, and acting in

theoretical terms to bring about curriculum change in ways that are empowering,

sustainable and generative. The study also introduced a methodology - a body of

knowledge - that was not only compatible with the context and the conceptual notions

of the study, but also provided a way through which critical thinking could be translated

into a transformation of practice. Action Research, with its emphasis on reflection and

collaborative processes, is not just a technical or practical endeavour but a means of

investigating and acting in ways that are critical, participatory, and transformative. The

introduction of Action Research, with its ongoing series of cycles, is timely for CGIT

with its requirements for extensive educational change. Therefore, the value of this

study for CGIT likely lies in the appropriateness of the conceptual framework with its

notions of collaboration and democratic principles combined with Action Research as a

vehicle for change. That is to say, the underlying notions and body of knowledge from

which this study developed and proceeded can provide a model for further change

within the nursing faculty at CGIT and for other schools of nursing within similar

contexts.

Hargreaves (1994) claims that the structures that form and frame school cultures

can “facilitate opportunities for interaction and learning, or present barriers to such

possibilities” (p. 256). As team members all agreed, the school culture in CGIT did

not promote a sense of community among teachers or encourage constructive

interaction for teachers to learn from each other. However, this study provided a

successful model for teachers to emulate in terms of coming together as a community

to collaborate in a change process. This study also demonstrated the impact of a

collaborative culture on the improvement of teaching and learning. Team members

gradually shifted more emphasis from teaching to student learning, and helped

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students become more responsible for their own learning.

Furthermore, this study generated new information of how student-centred

teaching and learning can take place. The shift to student-centred teaching parallels

the shift in nursing practice from nurse-centred to client-centred because both are

relational and generative (Young & Paterson, 2007). Young and Paterson (2007)

believe there are certain features of student-centred teaching that fit well with how

future nursing is envisioned. However, they also claim that while student-centred

teaching and learning can be interpreted literally, it may not be successfully

implemented at nursing schools. This study is an encouraging example of how

student-centred teaching and learning in nursing can be not only literally interpreted

and reconstructed into nursing curriculum but also successfully implemented.

Looking Forward

This study introduced a conceptual framework for thinking about, and acting in

theoretical terms to bring about curriculum change in ways that are empowering,

sustainable and generative. The study also introduced Action Research as a vehicle to

transform theoretical notions into practice. This study also generated information of

how the change can take place. The whole study, from contextualisation and

conceptualisation, to the collaborative journey and examination, has encouraged me

to propose a set of principles that may facilitate the planning and implementation of

future empowering, sustainable and generative curricula change.

♦ Encourage teachers to investigate their teaching practices: Exploration of

their teaching practices can enable teachers to gain more understanding of

what they do and why they do it, and to take control of and accomplish

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what they really want to do in their teaching situation – this is

empowerment.

♦ Use reflection as the central strategy for ongoing individual and

professional development: Reflection enables teachers to re-evaluate

situations in relation to their teaching and/or student learning thus improve

them. Teachers are able to become better practitioners once they learn to

learn through reflection.

♦ Build a collaborative and democratic community: When people own and

share the same concern, collaboration is a powerful means to encourage

active actions. Through collaboration, confidence is enhanced, motivation is

stimulated, commitment is strengthened, and thus change is vitalised.

♦ Reculture the curriculum: Human beings are intellectual and sensible

beings; sustainable curriculum change is more than the change of

techniques or skills. It involves conceptions, meanings and customs of

teaching and learning, and is a reculturing process.

♦ Provide time for individual reflection prior to collaborative reflection:

When people are asked questions for which they are not prepared, they are

more likely to construct defensive responses that result in explanations or

articulations of self rather than reflections. Along with an open mind, time

for individual reflection can promote effectiveness of collaborative

reflection and professional growth.

♦ Move toward the desired goals and be positive and patient: Curriculum

reculturing involves people’s thinking and customs; it can not be mandated

or controlled. The occurrence of individual change varies in forms and pace

236

and may take time. As long as they are looking forward and moving toward

the desired goals, people will change by learning to do it. Curriculum

reculturing is a process that requires patience and ‘development in use’.

Although they interweave with each other, I believe the underlying principles

developed from this study will provide valuable guidelines that can be used in similar

contexts.

Closure

Because of the ongoing nature of Action Research, it is not possible for this

thesis document to include everything that came about through the inquiry and the

collaborative journey which continues to unfold. What is revealed in this document

relates to the inquiry into curriculum change in light of the following research

question:

What changes to the nursing curriculum will better facilitate the development of core generic and professional competencies in students; and what sort of strategies need to be incorporated into the curriculum change process so that transformations are empowering, sustainable and generative?

This study has resulted in an encouraging curriculum change. The literature of

educational change is often a catalogue of discouragement (Fullan, 2003; Hargreaves

et al., 2001; Traynor & Rafferty, 1999) but this study has taken a different course.

Through the cyclic, praxis-oriented group dynamic of Action Research a group of

nurse educators were enabled to bring about transformations in terms of restructuring

the curriculum and reculturing a small community of teachers and learners. The

participating nurse educators in this study carried out demanding changes in the

237

classrooms and made a quality difference in the context in which the study took place.

Moreover, the changes to the culture of teaching and learning and the reconstructed

curriculum encouraged a deeper approach to learning for students; and this had a

positive impact on the development of core generic and professional competencies in

students.

This specific study has concluded and different people may have different views

regarding the significance of the changes the study achieved. The study started with a

small, achievable plan and it remains to be seen if a broader scale change will occur

in the future. It remains to be seen if the team can overcome obstacles such as

insufficient time and heavy workload to sustain and extend the change. It also

remains to see if our collective struggle can meet with school acceptance and support

to extend the change. This study may best be viewed as a handful of fertile seeds –

seeds that were planted in a ready field, nurtured and tended until they took root and

began to grow.

There is evidence to suggest that the changes achieved through this study are the

beginning or initial steps leading to the further changes demanded and required for

nurse education in the twenty-first century. The changes made during the

collaborative journey to the 2-year technical Physical Examination curriculum have

been sustained and thus the learning of successive students undertaking the unit will

be facilitated through student-centred approaches that encourage the development of

generic and professional competencies. In addition, a similar action research project

has been proposed for restructuring the 4-year technical Physical Examination

curriculum in CGIT (Chang Gung Institute of Technology, 2006). These may also be

considered small changes and there may be a struggle to bring about larger changes.

238

However, the changes attributed to this study can be seen as the catalyst for the larger

changes we now look forward to. As the saying goes: from little acorns, big oak trees

grow.

This study introduced a collaborative dynamic into a curriculum change in order

to resolve an educational problem. During the collaborative journey we generated

new understandings about teaching and learning within our specific context and new

understandings about the nature and culture of our school. This study has shown that

although complex, it is possible to achieve an educational change among a group of

teachers who are passionate about teaching, open to themselves and others, and

committed to the change and their students. Although it remains to be seen if the

study will serve as a model for further change within the nursing faculty at CGIT,

this study has initiated the first step, and it is an encouraging one. Small but

fundamental changes can lead to further change within the community and society

(Kemmis & McTaggart, 1988; 2000; Smith & Lovat, 2003). Optimistically, there is

another step to look forward to as change at CGIT is driven forward in the vehicle of

action research. With this in mind, I would like to conclude this document with the

following words of Fullan and St. Germain’s (2006):

…energize your present improvement initiatives and branch out to others as you progress. Don’t worry about doing everything at once. Start small, think big. Don’t wait for the system to get its act together. Lead by example. (p. x)

239

APPENDICES

240

Appendix A

Questionnaires Description

Two instruments are used in the reconnaissance survey of this study – the Nurse

Educator’s Conception of Teaching and Learning Questionnaire (modified from Gow

& Kember, 1993; Kember & Gow, 1994) and the translated Revised Two-Factor

Study Process Questionnaire (R-SPQ-2F) (Biggs, Kember, & Leung, 2001). Both

instruments were developed and tested in Hong Kong (the R-SPQ-2F with Chinese

students) where the educational context developed largely from Confucian heritage

as it did in Taiwanese. Both instruments have acceptable levels of validity and

reliability. Detailed descriptions of these two instruments are as follows.

Nurse Educator’s Conception of Teaching and Learning Questionnaire

The Nurse Educator’s Conception of Teaching and Learning Questionnaire is

referent-altered and translated into Chinese from Lecturer’s Conception of Teaching

and Learning Questionnaire (Gow & Kember, 1993; Kember & Gow, 1994). The

questionnaire consists of forty-six items and indicates two orientations to lecturers’

teaching at institutions of tertiary education: Knowledge Transmission and Learning

Facilitation. The Learning Facilitation orientation is made up of five subscales with

labels: Problem Solving, More Interactive Teaching, Facilitative Teaching, Pastoral

Interest, and Motivator of Students. The Knowledge Transmission orientation has

four scales: Training for Specific Jobs, Use of Media, Imparting Information, and

Knowledge of Subject. Responses are recorded on a five-point Likert-type scale from

1 (definitely disagree) to 5 (definitely agree). Mean scores are calculated for each of

the nine subscales in the questionnaire. Mean scores are also calculated for the two

241

orientations by summing the scores on the constituent scales.

Kember and Gow (1993; 1994) reported the Cronbach alpha values for the nine

scales ranged from 0.63 to 0.77. The scales from the questionnaire were factor

analysed using maximum likelihood extraction followed by varimax rotation. The

two factors show the neat separation between the two orientations. Permission to use

and adapt to local terminology and local practices has been obtained (See Appendix I

/p. 272).

The instrument was developed in English so that back-translation techniques

(Maneesriwongul & Dixon, 2004) was used by two translators for the forward

translation and back translation. The source language version (English) and target

language version (Traditional Chinese) were compared, and referent modification

was made before conducting back-translation and then equivalence was evaluated

between two English (source language) versions.

Revised Two-Factor Study Process Questionnaire (R-SPQ-2F)

The R-SPQ-2F (Biggs et al., 2001) consists of twenty items measuring two

main scales of surface approach and deep approach. Both scales have identifiable

motive and strategy subscales, so surface approach has surface motive and surface

strategy as its indicators, while deep approach has deep motive and deep strategy as

indicators. Each of the four indicators contains five items. Responses are recorded on

a five-point Likert scale from 1 (this item is never or only rarely true of me) to 5 (this

item is always or almost always true of me). Summing up the five constituent items

gives scores for the four indicators, each rating from five to 25 with higher scores

242

indicating those who made greater use of that approach to learning.

Biggs et al. (2001) reported Cronbach alpha coefficient of 0.62 for the deep

motive subscale, 0.63 for the deep strategy subscale, 0.72 for the SM subscale and

0.57 for the surface strategy subscale. In addition, the Cronbach alpha values are 0.73

for deep approach and 0.64 for surface approach which are considered as acceptable.

Besides, confirmatory factor analysis showed desirable goodness of fit of an intended

two-factor model and all the paths from the constructs to the items are statistically

significant at the 5% level. Well defined motive and strategy subscales also emerged

from the deep and surface approach scales.

The English version of the R-SPQ-2F is in the public domain and were

translated into Chinese with monolingual test (Maneesriwongul & Dixon, 2004) by

Leung and Chan (2001) in the Hong Kong context with Chinese students. Under the

construct validity test and the psychometric requirement, Leung and Chan (2001)

reported that the Chinese R-SPQ-2F is acceptable as previously found in the Biggs et

al. (2001) study and specifically tailored for use in the Chinese cultural context. In

addition, permission for its use has been obtained from Dr. Chan (please refer to

Appendix J /p. 273).

The information gathered from both Nurse Educator’s Conception of Teaching

and Learning Questionnaire and the R-SPQ-2F would be examined in terms of

means and frequencies. In both questionnaires, mean scores are calculated for each

questions, each of the subscales, and the orientations by summing the scores on the

constituent scales in the questionnaire.

243

Appendix B-1.1

Nurse Educator’s Conception of Teaching and Learning

Questionnaire (English)

244

245

Appendix B-1.2

Nurse Educator’s Conception of Teaching and Learning Questionnaire (Chinese)

246

247

248

Appendix B-2.1

The Revised Two-factor Study Process Questionnaire (English) Biggs, Kember, and Leung (2001)

1. I find that at times studying gives me a feeling of deep personal satisfaction.

2. I find that I have to do enough work on a topic so that I can form my own conclusions before I

am satisfied.

3. My aim is to pass the course while doing as little work as possible.

4. I only study seriously what’s given out in class or in the course outlines.

5. I feel that virtually any topic can be highly interesting once I get into it.

6. I find most new topics interesting and often spend extra time trying to obtain more information

about them.

7. I do not find my course very interesting so I keep my work to the minimum.

8. I learn some things by rote, going over and over them until I know them by heart even if I do not

understand them.

9. I find that studying academic topics can at times be as exciting as a good novel or movie.

10. I test myself on important topics until I understand them completely.

11. I find I can get by in most assessments by memorising key sections rather than trying to

understand them.

12. I generally restrict my study to what is specifically set as I think it is unnecessary to do anything

extra.

13. I work hard at my studies because I find the material interesting.

14. I spend a lot of my free time finding out more about interesting topics which have been discussed

in different classes.

15. I find it is not helpful to study topics in depth. It confuses and wastes time, when all you need is a

passing acquaintance with topics.

16. I believe that lecturers shouldn’t expect students to spend significant amounts of time studying

material everyone knows won’t be examined.

17. I come to most classes with questions in mind that I want answering.

18. I make a point of looking at most of the suggested readings that go with the lectures.

19. I see no point in learning material which is not likely to be in the examination.

20. I find the best way to pass examinations is to try to remember answers to likely questions.

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Appendix B-2.2

The Revised Two-factor Study Process Questionnaire (Chinese) Translated By Leung and Chen (2001)

學習過程問卷

1. 我有時發覺研習可以帶給我很大的滿足感。

2. 我發覺我要在一個課題上很用功，以致能建立自已的結論，才會感到滿足。

3. 我的目標是盡可能只付出最少努力便能合格完成課程。

4. 我只會認真地研習那些在課堂派發的講義或課程綱要提及的項目。

5. 我覺得當我投入學習時，幾乎所有課題都是十分有趣的。

6. 我發覺大部分新課題都是有趣的，而且會花額外的時間去加深我對它們的認識。

7. 我所修讀的課程並非十分有趣，故此我衹付出少量的努力便算。

8. 我是靠死記的方式來學習，一次又一次的背誦直到我能牢記為止

9. 我發覺研習學術性的課題，有時像欣賞一部悅目的小說或電影般令人興奮。

10. 在重要的課題上，我曉得自我測試至能夠完全明白為止。

11. 我發覺只須將課業的關鍵部分強記，卻沒有嘗試瞭解其義，便能夠在大多數的考核中

取得及格。

12. 我慣常祇閱讀那些特別指定的資料，因為我認為沒有需要做額外的。

13. 我很努力去研習，是因為我覺得所學的東西十分有趣。

14. 在不同課堂上討論過的課題，只要是有趣的，我都會花很多空餘時間去增加我對它們

的認識。

15. 對我而言，深入地去研習課題是毫無幫助的；反會令人混淆及浪費時間，特別是當我

衹需簡略涉獵課題時。

16. 我相信老師是不該期望學生花太多時間去溫習一些人人都知道不會考的東西。

17. 在出席大部分課堂之前，我的腦海中總存在一些尚待解答的疑問。

18. 我常提醒自己要參閱大部分在課堂上派發的建議讀物。

19. 我認為不需要學習一些不大會考核的東西。

20. 我發覺要考試及格的最好方法是嘗試熟記那些有機會出現的題目的答案。

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Appendix C-1

Ethical Clearance: Permission from QUT Human Research Ethics Committee

251

Appendix C-2

Ethical Clearance: Permission from Chang Gung Institute of Technology

252

Appendix D-1.1

The Reconnaissance Survey Information Sheet for Conception of Teaching and Learning (English)

253

Appendix D-1.2

The Reconnaissance Survey Information Sheet for Conception of Teaching and Learning (Chinese)

254

Appendix D-2.1

The Reconnaissance Survey Information Sheet for R-SPQ-2F (English)

255

Appendix D-2.2

The Reconnaissance Survey Information Sheet for R-SPQ-2F (Chinese)

256

Appendix D-3.1

The Research Information Sheet (English)

257

Appendix D-3.2

The Research Information Sheet (Chinese)

258

Appendix D-4.1

Research Consent Form (English)

259

Appendix D-4.2

Research Consent Form (Chinese)

260

Appendix E

Introductory Seminar Invitation Card

261

Appendix F

Pre reading Information: the Revised Bloom’s Taxonomy-1

262

Pre reading Information: the Revised Bloom’s Taxonomy-2

263

Pre reading Information: the Revised Bloom’s Taxonomy-3

264

Appendix G-1

Unit Details-1: for Theory or Lecture Session

265

266

267

268

Appendix G-2

Unit Details-2: for Practice or Laboratory Session

269

270

271

Appendix H

The Attendance Chart

272

Appendix I

Questionnaire Permission to Adapt and Use from Professor Kember (Lecturer’s Conception of Teaching and Learning)

273

Appendix J

Questionnaire Permission to Use from Dr. Leung (Translated R-SPQ-2F)

274

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