MOOCs and Clinicals

This week I had one of those “duh” moments when I realized that I had been missing something basic.

The dean of the Health division -- which includes nursing -- and I took a field trip to a local health care provider to talk about working together to give nursing students some exposure to what goes on there.  These wouldn’t be full-fledged clinical placements -- we already have those -- but a sort of structured introduction to a part of the health care system that isn’t always top-of-mind for nursing students.  The meeting went well, and I think there’s potential for something good to happen.

In the course of the meeting, though, the dean and the director of the facility got to talking about the difference between the ways that they were taught when they went to school, and the way the health field actually works.  When they went through, they had “lectures” which taught “theory,” and “clinicals” that taught “practices.”  Students who were relatively good at one weren’t always good at the other, and the connections between the two weren’t always obvious.  

Now, largely due to technology, theory and practice are all mixed up, and students are better for it.  

We have increasingly and incredibly complex simulators in class, to create the clinical situations the professor wants, on cue.  To make time for those simulations in class, lectures have been largely displaced to out-of-class time, online.  By the time the students are loosed upon actual people, they’ve already had to bring theory to bear on situations repeatedly.  Even better, a student can make and learn from a harrowing medical mistake on a simulator without harming an actual person.  (Last year, apparently, some students made a dosage mistake with a simulator, and nearly “killed” the “patient.”  After that, those students got religion in a significant way.)   

In this model, MOOCs and their variants aren’t threats to our business model or our usefulness; they make us better.  They let us focus on where we can add the most value, and they pick up the part of instruction that was least custom.  

To the extent that we use online resources this way, I see our business model doing just fine.  MOOCs and similar expedients can pick up some of the most rote, least interesting elements of what we do, leaving us free to tend to the integrative, interactive, more applied stuff that often gets neglected.  Used well -- that is, integrated thoughtfully into a curriculum -- they can actually help students learn more effectively than they did in the older style.  

Nursing lends itself to this kind of blending particularly well, but I could see other disciplines doing something similar.  Let the online tool take the students through “Congress is divided into the House and the Senate,” and use class time to have students work on a constitution for a society on a desert island.  (I always enjoyed that one.)  Let the online tool illustrate the layout of the audience in the Globe theatre, and use class time to show how Shakespeare wrote for each section.  

The choice to be made is to re-imagine class time as a scarce resource.  Given new and alternative ways to “deliver” information, can class time be used to help students actually wrestle with the information and make it their own?

That should have been obvious -- a “duh” moment -- but it’s largely missing from the public discussion.  Can we use the new online tools to offload the least interesting parts of the classroom experience, precisely so we can upgrade the classroom experience?