The concept of teaching medical terminology, a systematic approach to scene management and clinical decision-making skills using an interactive book sparked from reading the work of Lamb (2011). These three concepts are abstract or foreign to the majority of learners, and the affordances of dictionary support, images, audio, and video (with expert modelling) offered by an interactive book allows the provision of context and support from the traditional textbook currently used (Hicks, 2014; Kottow & Kottow, 2002; Pearman, 2008; Walsh, 2012).

While audio, imagery and video are included within the learning resource (Part B), it is recognised the failure to include a comprehensive medical dictionary and exemplar clinical simulations are a limiting factor in this first version. These limitations are due to time constraints of deadlines and the choosing of an overly complicated but industry-standard authoring tool (Adobe InDesign).

The target audience for the learning resource is first-year Paramedic students undertaking the second term of study. Significant factors to note regarding the paramedic cohort include:
• age range 17 to 52 years (majority > 25 years),
• On-campus and mixed-mode (distance) in a 30:70% ratio respectively.
• Fourteen per cent are from low Socioeconomic Status (SES) backgrounds with many more from regional or rural areas,
• Over 80 per cent access learning materials on Bring Your Own Device (BYOD), (desktop or laptop computer).
• Inherent requirements ensure no students suffer from significant visual or auditory impairments.
• High numbers are first in family to attend university and from marginalised groups.

Medical Terminology
The decision to teach medical terminology using the digital literature resource (Part B) originated from reading the work of (Korat & Shamir, 2008); Korat and Shamir (2011) in emergent literacy and supporting vocabulary and comprehension in low socio-economic status (SES) children. These works outlined student support mechanisms using interactive features to support the teaching of language. As medical and discipline-specific terminology such as radio communications are akin to a new language, a similar pedagogy is applied within this learning resource. These works along, with that of Holmgren, Fuks, Boudreau, Sparks, and Kreiswirth (2011), in the use of narrative in medicine, informed the design of the resource.

Other benefits afforded by using a lecturer developed resources include the ability to present the learning format in a discipline-specific context, removing the requirement for an expensive medical textbook. This is an advantage for students, particularly the 14 per cent from low SES backgrounds who may find buying resources a financial burden (CQUniversity, 2019).

Furthermore, decisions to include the resource as an online-only version allows for continuous updating to improve the quality and relevance of content. Additionally, the streaming of higher bandwidth elements such as video takes into consideration cost and internet performance issues for low SES and regional and remote students (Selwyn, 2016).

A systematic approach and clinical decision making
Clinical decision-making skills and taking a systematic approach to patient care are difficult and foreign to many within this student cohort. Traditionally these skills were developed over years using the mentor/mentee social hierarchal relationship (expert modelling) while already employed in the industry (Kardong-Edgren et al., 2015). Transitioning to pre-employment university qualification models required the development of problem-focused learning and critical thinking skills in students without the advantage of first-hand authentic experiences gained in the sector (Lord, 2003).

Development of an interactive book which incorporates images, audio and video artefacts assists students in developing transmedia literacy for future studies (Lamb, 2011; Sukovic, 2014; Unsworth, 2006), lifelong learning skills (Oliver & Jorre de St Jorre, 2018) and provides visual and auditory formats for expert modelling (Kardong-Edgren et al., 2015). Due to staff and actor availability, along with assessment deadlines the current expert modelling artefacts are not the planned versions.  Work will continue to develop high-quality videos of clinical simulations, better imagery and more authentic audio (radio transmissions and read-aloud versions).

The addition of a social media platform, Microsoft Teams, also modifies the learning environment from the traditional hierarchal social relationship to the online-only platform (Puentedura, 2012). This modification allows the student to experience peer to peer and student to teacher/expert interaction that is imperative in the theory of assisted performance (Rowe, 2012). The Microsoft Teams platform also provides a zone of proximal development between more knowledgeable students and their peers, and between the student and lecturer (Wass, Harland, & Mercer, 2011). This synchronous and asynchronous social co-construct allows students from geographically isolated areas secure interaction with their peers and teaching staff, with the additional affordance of functionality in low bandwidth areas, (Fontainha & Gannon-Leary, 2008; Selwyn, 2012).

Clinical decision making requires the learner to develop strong communication skills. With this in mind, the narrative developed also modelled the work of Arntfield, Slesar, Dickson, and Charon (2013), who demonstrated enhanced communication in fourth-year medical students. With further development of this first version narrative, expectations are unintended skills such as empathy, patience and observation may also develop (Johna & Rahman, 2011). All of these mentioned soft skills are highly valued in the paramedic profession.
While there is work to be done with peer review and student feedback, I envisage this resource will be continually reviewed and updated.

 

References

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CQUniversity. (2019). Annual Report. Retrieved from https://www.cqu.edu.au/__data/assets/pdf_file/0024/82671/CQUniversity-2018-Annual-Report.pdf

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