Title case: Cooperation between school and hospital in the education of medical secretaries
In this project, a vocational high school and a University hospital are collaborating on securing high quality in the three-year education of medical secretaries, which is mainly school based. A formal, written agreement was signed and indicate a lasting, continuous form of collaboration, where the University hospital offers the school 50 work placements, providing VET students in their second and third year with opportunities for becoming familiar with professional tasks and functions in the occupation. This agreement will help solve challenges met by both parties.
The research- and development project will last for three years, from autumn 2014 to autumn 2017. The first year (now completed) was an investigation of the current situation aimed at identifying potentials for improvements. Then actual improvements will be tried out, results considered and analyzed, and from spring 2017 the project will be evaluated.
The aim is to develop routines for continuous collaboration between school and hospital securing high quality education, and at the same time increase the competence of students, teachers and instructors.
The general research question is: How can hospital and school secure high quality practical work preparations and placement periods for VET students learning as medical secretaries?
My role as a researcher is to participate as a facilitator in reflective groups where representatives from the school and the hospital meet to discuss how they can collaborate on developing the curriculum. It is also to collect data and write reports from the project, focusing on the VET students’, teachers’ and instructors’ experiences and perspectives.
There is little research on the education of medical secretaries. Existing research has concerned vocational education more generally. Some researchers have asserted that the organization of Norwegian VET is not working as a way into vocational work life but as a wall separating VET students from it (NOU 2003:16). The argument is that vocational education is too general, and that a lack of specialization prevents students from developing vocational identity and pride (Høst & Evensen 2008; Frøseth & Vibe 2012). Instead of fulfilling their vocational education, the VET students try to qualify for education at university level, and only 50% of them pass the exams required for entry into the university (Nyen, Skålholt & Tønder 2013). This means that many young people either get a certificate as skilled workers or are admitted into university. In the end, only 30% of the VET students starting on vocational programs become skilled workers (ibid).
Coherence between theoretical and practical subject matter and content is a main issue in this project. A technological learning-by-objectives approach implying a separation between theoretical and practical knowledge has been influential in Norwegian education and curriculum, generally and in VET (Hiim & Hippe 1999). Also theories on curriculum in VET and on work-based learning are important in the project (Billett 2011, Young 2004).
The medical secretary VET students must develop practical skills to become able to perform professional tasks in their future vocation. Student activity and participation is essential in the learning process, and will be understood in light of Dewey’s (1944) theory of experiential learning. Dreyfus & Dreyfus’ competence model (1986) will also be helpful to understand how the student develops professional competence.
In the development of professionalism and independent professional performance reflection is a necessary tool, and Schön’s (1987) theory of reflection in and on practice is very relevant. In their theory Lave & Wenger (1991) are concerned with people learning in communities of practice where they collaborating on work they are engaged in. These perspectives will also be important in this project.
The research questions in this study requires access to reliable information from students, teachers and instructors about the process and learning outcomes resulting from cooperation between school and hospital on curriculum in the education of medical secretaries. I have chosen to conduct focus group interviews where students, instructors from the hospital and vocational teachers from the school participate. I have also interviewed teachers who are responsible for teaching and placement periods in the second and the third year of the VET program.
Focus group interviews are suitable when the intention is to collect qualitative data on a theme that is decided by the interviewer (Morgan, 1997 in Halkier, 2010). Through group discussions the participants reflect on and describe experiences and thoughts on a phenomenon, and the discussions may also create opportunities for creating improvement and change. In focus groups the researcher will not get access to the individual experiences of each participant, since the data are created through the communication in the group. The differences between individual experiences will not be so clear. In focus groups, the social control may lead to more precise descriptions of factual events since the person interviewed cannot present her or his individual observations without these being nuanced by others in the group (Kristoffersen, Tufte & Johannessen, 2011).
I will also run several observations. Observation can be defined as “to watch, see, discover or pay attention” (Kristoffersen 2011) to get insight into the role of the instructors and teachers’ role in VET students’ placement periods. I collect data through systematically observing and listening to the experiences of the students, teachers and instructors during placement periods in the hospital. To get better insight into the culture and working atmosphere at the hospital I want also to observe VET students in practice with different teachers before I conduct the focus group interviews. I also want to observe VET students presenting their experiences from practice in class. I am planning to do group interviews and observations in the same way every year after the placement.
Analyses of the data from the first mapping are not finished, but the preliminary analyses give us reason to believe that the VET students develop professional pride. Partly because they learn to understand and use medical professional terms and learn much about inter-professional collaboration. The students also learn about the medical secretary’s place and importance at a hospital.
All parties in the project hold the opinion that extensive preparations before placement periods are important to VET students’ learning outcomes, but the teachers and the instructors have to cooperate closely. Now 50% of the medical secretary students in second year say they want to complete their education and work as medical secretaries.
Based on experiences from the placement periods in fall 2015, the parties had collaborative meetings where they planned new placement periods starting on December 1st 2015. The following actions were considered for the next year.
A collaborative forum has been established, consisting of a leader from the school, a leader from the hospital, a representative for the teachers and a representative for the instructors. These are now working on the curriculum, finding tasks, activities and assignments that the VET students can work with during placement periods. They are also planning a seminar for instructors aimed at developing tutorial competence. Also, they want to work with developing good routines for the content of meetings between students, instructors and teachers meetings.
A plan for teachers having their own placement periods in various departments at the hospital has also been developed, providing the opportunities for teachers to become more familiar with the professional tasks and functions of the medical secretaries. The parties also want to discuss how the medical secretary students can be evaluated during their placement periods and if possible develop new methods and routines for assessment.
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