Action Plan

Current Situation

Students in my DNH 120 Management of Emergencies hybrid course need to abide by current health care laws encompassing verbal and electronic communications on patient medical records. In some instances, patients will present with medical conditions that pose a higher risk for an emergency during dental treatment. To decrease the emergency risk, students must send a physicians clearance form to the patients treating physician prior to any treatment in the clinic.

To obtain these records, students must identify when a clearance is needed and learn how to send a cover letter and physician’s clearance form via a dental hygiene facsimile machine to an appropriate medical office. In turn, the physician will return this form stating that the patient is permitted or denied dental treatment in the dental clinic. In addition, the physician’s signature is required on this form.

Prior to performing this task, students are informed on:

o   current health care laws such as HIPAA (health insurance portability accountability act)

o   medical conditions that warrant a physician’s clearance prior to treatment

o   location of fax cover letter and physician’s clearance referral form

o   proper legal documentation and format use of each form

o   location and use of the facsimile and scanner machine in the dental hygiene clinic on their campus

Students are evaluated on this information via an Exam, but may never apply the information as a task. Currently, students complete and send cover letters and physician clearance forms on an “as needed” basis. Not all patients need a physician’s clearance. Therefore, not all students will perform this necessary task prior to entering the “real-world” dental workforce.

Desired Change

All dental hygiene students need to reflect on their knowledge of medical conditions that warrant a physicians clearance. To ensure that all students have an experience in sending a cover letter and a physician’s clearance form to a medical office in a law abiding and professional way, I propose the following action plan.

During the student pre-clinic laboratories, faculty will review the location of and provide instruction on the use of the dental facsimile and scanner machines on their campus. Each student will review a provided sample medical history, determine the condition needing a physicians clearance, and successfully communicate, utilize, send, and receive a sample cover letter and physicians clearance form via the dental facsimile and scanner machine. This assignment will be performed in assigned virtual teams and completed prior to students scheduling or seeing patients in the dental clinic. Furthermore, all students in the course will view other team posts that hold attachments of their shared assignment documents. This part of the activity will allow for peer-to-peer learning and foster a sense of community between the students at both of the campuses.

Plan Elements with Warrants

Elements	Warrants
Ask students to play the role of dental hygiene student and/or a physician. To decrease the likelihood of an emergency in the dental clinic, have students review a sample patient medical history:  identify medical conditions that warrant a physician’s clearance identify why a physician would approve or disapprove dental care in our clinic for their patient obtain, complete, send and receive cover letters and physician’s clearances in a law abiding, ethical and professional way.	Teachers provide the information, but students are going off and learning more on their own (Powers et al. 2012). Social constructivism is important for online learning practices: “Social constructivism reminds us that learning is essentially a social activity, that meaning is constructed through communication, collaborative activity, and interactions with others. It highlights the role of social interactions in meaning making and knowledge construction”. (Oztok et al., 2011 & web 2014; Swan, 2005).
All students will be assigned to a 2-person virtual team.  TEAM # 1            Assign 1 student from the VWCC on-site campus to 1 student from the LFCC distant-site campus.           Assigned teams will have a TEAM #  & folder within discussion board forum.	The size of the team and the extent of the team members shared work experience are examples of variables that have been found to have a major influence on communication patterns, level of trust, and project leadership and coordination (Henry et al.1998; Kerzner,1997; Shaw, 1976).
Ask students to follow a process: Decide how you will communicate with your assigned partner to discuss and accomplish this assignment (e-mail, text, phone) by the assigned due date. Discuss and decide which role each student will take (dental hygiene student or physician). Identify the medical conditions warranting a physician’s clearance and/or the reason for approval/disapproval for dental care from the physician. Review how to use the dental hygiene facsimile and scanner machine within the dental clinic. Identify correct facsimile numbers. Properly complete forms and successfully send facsimiles to your teammate at the distant-site campus via a dental clinic machine. Upon receiving your teammates forms, utilize the scanner to scan these forms to your VCCS e-mail account. Save these attachments. Post your e-mail attachments (scanned cover letter and physician’s clearance forms) under your assigned Team # within the discussion forum.	Virtual teams have access to a wide array of media and are able to choose among them for specific purposes (McGrath and Hollingshead, 1994). All teams need a vision, a mission and objectives with individual accountability to the team’s work (Henry et al.1998). When social constructivism is employed as a theoretical framework, social presence becomes critical as it connects individuals in an online learning environment and motivates them to take an active role in the knowledge construction and meaning-making processes (Oztok et al., 2011 & web 2014; Fung, 2004; Henning, 2004; Stacey, 1999).
Monitor team progress. Offer advice or support when problems arise (such as the facsimile machine not working). Upon teams meeting the assignment, let the teams know that you have received the assignment and share any positive or negative (corrective) feedback.	Social support relations are desirable for creating a atmosphere that fosters collaborative learning (Haythornethwaite, 2002 ). Negative feedback is never easy to give, but sandwiching criticism between layers of praise makes is more palatable and more effective (Dohrenwend, 2002).
Ask students that are not in the assigned virtual team to review 2 other teams attached forms and comment on their completion.           Are the other teams forms ethically and sufficiently complete?            Offer the other teams advice, suggestions for possible changes, improvements for future, etc. when applicable.	When students participate in activities, they project their own identities into cyberspace, “feel the presence of others online”, and create “ conventions and norms that bind them together in exploring issues of common interest”. (Oztok et al., 2011 & web 2014; Gunawardena et al. 1997). Students can study asynchronously on their own or cooperatively by accessing content when it is convenient and appropriate to them (Powers et al. 2012). Paragogy, or the new andragogy, is a concept of self-directed learning based on ‘Knowles’ (1980) theory of peer-to-peer learning where students learn more from their peers through social media (Powers et al. 2012).

References

Dohrenwend, Anne. Serving Up the Feedback Sandwich. Family Practice Management. 2002 Nov.-Dec; 9(10):43-46.

Fung, Y. H. (2004). Collaborative online learning: interaction patterns and limiting factors. Open Learning, 19(2), 54-72.

Gunawardena , C.N., and Zittle, F.J. (1997). Social presence as a predictor of satisfaction within a computer-mediated conferencing environment. The American Journal of Distance Education, 11(3), 8-26.

Haythornthwaite, Caroline. “Building Social Networks via Computer Networks: Creating and Sustaining Distributed Learning Communities,” in Building Virtual Communities: Learning and Change in Cyberspace, K. Ann Renninger and Wesley Schumar, Eds. (Cambridge: Cambridge University Press, 2002), pp. 159–190

Henning, W. (2004). Everyday Cognition and Situated Learning. In D. Jonassen (Ed.), Handbook of Research on Educational Communications and Technology (2^nd ed.) (pp. 143-168). Mahwah, NJ: Eribaum.

Henry, J.E. and Hartzler M. (1998). Tools for virtual teams: A team fitness companion. Milwaukee WI: ASQ Quality Press.

Kerzner, H. (1997). Project Management: A systems approach to planning, scheduling, and controlling. (Sixth Edition) New York: John Wiley.

McGrath, J.E. and Hollingshead A.B. (1994). “Groups Interacting with Technology. Thousand Oaks”, CA: Sage Publications, in Challenges of Information Technology Management in the 21^st Century: 2000 Information Resource Management Association. International Conference, pgs. 583-584.

Oztok, Murat and Clare Brett.  Social Presence and Online Learning: A Review of Research.  International Journal of E-learning and Distance Education.  

2011, Vol. 25, No 3, Web. 2 June 2014.

Powers, L, Alhussain, R., Averback, C., and Warner, A. Perspectives on distance education and social media. The Quarterly Review of Distance Education, Volume 13(4), 2012, pp.241-245.

Shaw, M.E. (1976). Group Dynamics: The Psychology of Small Group Behavior. New York: McGraw-Hill.

Stacey, E. (1999). Collaborative learning in an online environment. Journal of Distance Education, 14(2), 14-33.

Swan, K. (2005). A Constructive Model For Thinking About Learning Online. In J. Bourne & J. C. Moore (Eds.), Elements of quality online education: Engaging communities (pp.13-30). Needham, MA: Sloan-C.

Research Report

On May 28, 2014, Group #1 (Sharon Freeman, Heather Harris, Heather Butler, Kim Gregory) analyzed, discussed and posted a Best Practices Consensus Report. This report was based on the following articles, “Best Practices for Online Instructors” by Wade W. Fish and Leah E. Wickersham, “(My) Three Principles of Effective Online Pedagogy” by Bill Pelz, and “Designing for Learning: Ten Best Practices for Teaching Online Quick Guide for New Online faculty” by J.V. Boettcher.

Upon reading the required reading articles and reviewing Group # 1 comprised List of Best Practices for Online Instruction, a few topics stood out that I would like to implement in my own hybrid teaching.

The following are my topics of interest and credible resources:

1)    Being present in the course. 

·       Establishing Teaching Presence

Oztok, Murat and Clare Brett.  “Social Presence and Online Learning: A Review of Research.”  International Journal of E-learning and Distance Education.  2011. Web. 2 June 2014.

2)    Providing synchronized and asynchronized activities

·       Encouraging Interaction with Class, Groups, One-on-one, etc.

Nandi, Hamilton, and Harland. “Evaluating the quality of interaction in asynchronous discussion forums in fully online courses. Distance Education.” May 2012, Vol. 33 Issue 1, p5-30. 26p.

Wu and Hiltz.. “Predicting Learning From Asynchronous Online Discussions.” JALN Volume 8, Issue 2 — April 2004

Stefan Hrastinski. Asynchronous and Synchronous E-Learning EDUCAUSE Quarterly, vol. 31, no. 4 (October–December 2008). PDF file.

3)    Focusing on content resources

·       Personalized learning

Powers, Lisa ; Alhussain, Ruqaya ; Averbeck, Clemens ; Warner, Andre.  “Perspectives on Distance Education and Social Media.”. Quarterly Review of Distance Education, 2012, Vol.13 (4), p.241-245

While the above topics and resources are of interest for implementation in my courses, they will be beneficial in comprising and completing a sample action plan as well.

The Trials and Accomplishments of a Full Time Dental Hygiene Faculty Member

In August 2000 I decided to teach dental hygiene. I had worked as a full time private dental hygienist for 8 years. Upon moving to Roanoke Virginia, I met a weak job market. While part time was attainable, I continued to research additional job opportunities. Much to my surprise, Virginia Western Community College had a dental hygiene program and a part time position was open. I took the opportunity. 

I quickly discovered that the Virginia Western Community College Department of Dental Hygiene was not your traditional program. It was a joint venture program that taught students on site and broadcasted to Danville Community College and Lord Fairfax Community College on an ongoing alternating cycle.

            Educating students in front of me and distantly on the same day and time each week intrigued me. Broadcasting offered the ability to communicate with distant site students in present time.  They could hear and see me and I could hear and see them in an assigned classroom on their campus. Classmates from both sites could communicate with each other as well.

Training with Broadcasting Technology

A few days prior to teaching my first class, I thankfully received a brief overview from the program head and a detailed overview on classroom equipment from VWCC IT support. After some practice, I confidently entered the traditional classroom, turned on the computer, four screens/monitors, dialed the IP address of the distant site classroom and broadcasted through the VCCS. I was ready to go, or so I thought.

I had been informed of the delay of transmission with broadcasting. However, it took awhile for students and I to get used to the three-second-lag time to communicate. This led into a snails pace style of teaching with constant repetitive statements and inquiries to and from students.  I had to adapt.

Uncharted Territory

I must preface my first classroom teaching experience with some background information on how I earned my BSDH degree. I was a student that sat in an auditorium sized lecture hall filled with dental hygiene, nursing, premed, and pharmacy students. Our university professors stood upon stages and utilized chalk on chalkboards or projected notes via a micro projector. The following were some styles of learning that students utilized then: sitting and listening to the professor, utilizing a pocket microphone recorder to record the lecture, or writing notes with a pencil and paper that they brought to class. Upon taking the education track within the Bachelor of Science Dental Hygiene Degree, I taught first year dental students on the warning signs of child abuse. I utilized the same methods my professors utilized. I stood before the class and wrote notes with chalk while presenting important topic points to students that took notes and made very little inquiries.

Needless to say, my first classroom teaching experience was eye opening. I began lecture with an immediate student inquiry. “Where are the PowerPoint handouts for this lecture?” I translated this inquiry as a request for a topic outline. I was wrong. Students expected to see and have all notes provided in a handout.

Training on PowerPoint

Virginia Western Community College offered PowerPoint faculty training that was very beneficial. While I embraced the utilization of PowerPoint, I quickly learned the limitations on time. Time for creation, time to get handouts copied for students, time for the mail to deliver the copies to distant site students, etc. I adapted to the time constraints and students were pleased to receive their PowerPoint handouts. While I was happy to accommodate the students, something bothered me.  The amount of paper and printing necessary to create these handouts was staggering. I kept trying to think of ways to decrease the amount of information on the PowerPoint handouts.  I later. Overall, all was going well until our distant site students did not receive their PowerPoint handouts, materials or Exams.

Lack of Support

Distant site faculty was not always available to monitor or support the classroom setting. Mailed PowerPoint handouts had to be distributed. Students needed the material to take notes. Someone needed to administer mailed Exams. Someone was needed to monitor for cheating. Who would re-collect the Exams and mail back to VWCC for evaluation?  At one point, individuals unrelated to dental hygiene were hired to oversee the classroom setting. This did not go well. Issues with student conduct surfaced.

I then tried to e-mail PowerPoint handouts and Exams to specific individuals at the distant sites. Again, items were not always administered or duplicated in a specified or requested way. Some materials were reviewed with the distant site students and not with local students. While I know that everyone involved was looking at the betterment of the students, the trials in communication continued for years.

Something’s Got To Give

Student learning was being affected. All factors were jeopardizing student’s potential of success in passing the national board, clinical boards and ultimately earning their degree. Something had to give. Ultimately resources and funds for equipment improvement were found and installed, IT support and faculty were hired and duties were defined. Resolving these factors was necessary.

            While improved, we faced additional roadblocks such as loss of electricity, loss of broadcast connection, loss of broadcast sound feed, and closing of schools for inclement weather.  Educating our students within a set 2-year cycle is not adaptable. When not in the classroom, our students are in the clinical setting.  Accreditation standards set weekly minimum hours for patient treatment. Clinic times are not flexible. For example, in the event of a lost broadcast connection I had to continue with the lecture and stop at a set time regardless of reconnection.  If not, students would be late for clinic and patient care lost.

The technology experts established that the disruptions in broadcasting were due to poor connections/weak band transmissions. To address the lost broadcast connections, the VCCS began to record lectures. Students could access the lecture recording via a link.  Our program head allowed student access when applicable. Students could view the missed lecture in the event of a lost broadcast connection, lost class time due to an illness or outside obligation. This was truly beneficial.

Something More

Upon attending a New Horizons workshop, I heard about the use of Blackboard. Soon after, our health science dean confirmed that faculty would be required to have an online course. I followed suit and pursued Blackboard training at VWCC.  After a great overview, I decided that Blackboard was the medium that I needed. After some trial and error, I recognized that I could resolve many concerns that kept bubbling to the surface. The following items could be accessible to all students in Blackboard: PowerPoint handouts, quizzes, etc. I no longer had to send items to duplication for printing. I no longer had to get materials in the mail and rely on someone else to distribute to distant site students.  Students could access these materials from anywhere as long as they could access my online Blackboard course.

I found an answer on how to stop the insane printing process as well. I encouraged students to not print the provided PowerPoint handouts. Rather, attend classroom lecture and then look back to review. In addition, students could take quizzes and get instant evaluation feedback within the grade book. I was slowly coming to peace with distance teaching/learning.

I Will Survive

Blackboard continued to work well. However, disruption in broadcasting due to poor connections/weak band transmissions or equipment failure continued to affect the program. Alternative solutions continued to be brought forth and I attended an overview  session on Panopto Lecture Capture. Could this be the ticket?

I became part of a beta team that utilized the technology and provided feedback on use to a committee. It was what we needed! Panopto Lecture Capture could be utilized in the classroom or anywhere with a device that had a camera and a microphone. While the VCCS was recording our lectures, the recordings were limited to one screen in the classroom. Students could only access with permission and the recordings could not be paused. Nor, could students rewind or fast forward. Once open, students were committed to a 2-hour lecture recording.

With Panopto Lecture Capture, students could access the recording within Blackboard. Students could see me and the PowerPoint or Elmo projection at the same time.  Unlike the VCCS recordings, students could rewind, fast forward and pause recordings. They were not bound to a 2-hour lecture recording. They could locate a topic and review it in a brief amount of time.

This tool has helped our program in so many ways. Now, lost time in teaching has been kept to a minimum. There are no disruptions in the sequencing success of the classroom or clinic program schedule. We can continue with lectures regardless of inclement weather or equipment failure. We record faculty meetings for faculty that miss meetings. Skies the limit.

Where I Teach Today

Multiple events have influenced the future of hybrid teaching/learning in our program of study. Resilience and dedication are two words that I associate with my 14 years of teaching hybrid dental hygiene courses.  I’m proud to say that I have met and will continue to meet all of the future challenges that our program and I may face in education.

Based on our current technology resources and methods, I feel that our joint venture program is a quality program that offers educated and competent individuals into the dental field. We are not only graduating students, but we are placing healthcare professionals into our communities.  Ultimately, these students become our colleagues and perhaps future dental hygiene educators.