I work in the Institute of Health and Society and lead the Post Graduate Certificate – Teacher in Health and Social Care (PGCE) which leads to the registerable qualification of Teacher with the Nursing and Midwifery Council (NMC). I felt it was essential to the success of the programme that the students could make explicit links to their learning by applying it to their clinical teaching practice as I believe learners learn more deeply when classroom-gathered knowledge can be applied to real-world situations; therefore I decided to deliver the PGCE through enquiry based learning (EBL). The students study part-time, one day per week and spend the majority of their time in clinical or clinical teaching practice. The belief was that EBL would engender learning that is integral to professional practice and central to knowing, where knowing how to acquire knowledge for a particular purpose is often more important than the knowing itself.
In the context of higher education it is vital to encourage critical thinking in order for students to challenge their beliefs about the certainty of knowledge, reduce their automatic acceptance of the expert’s word and reduce their passivity as learners. This could be viewed in contrast to current healthcare and healthcare education which is set against a background of tightening fiscal policy and a continually changeable political doctrine due to the politicised nature of the NHS. Parallel to these challenges have been significant reports into NHS standards. The Francis Inquiry (2013) heavily criticised organisational culture which allowed poor quality of care and poor leadership to exist. Following these reports there has been an increase within healthcare to focus on instrumental and technical skill development in order to monitor and regulate competence. However, higher education institutions are encouraged to utilise innovative, student-centred approaches to learning that focus on the process of learning rather than just outcome.
Freire (1970) suggests education that utilises a problem solving approach develops the ability to perceive critically the way learners exist with their reality and involves, through dialogue, the emergence of teachers and students being jointly responsible for the learning process in which all grow. Enquiry based learning develops an environment in which learning is driven by the process of enquiry owned by the student.
It’s important to consider the environment for EBL. Enquiry based learning is socially situated and learning occurs essentially through a community of practice (Lave and Wenger, 1991). The students develop within a community of practice by sharing the knowledge created. Alignment of professionally-focused enquiry provides a vehicle for individual learning and the development of communities of practice and by encouraging students to be knowledge producers gives equal value to their contributions to the knowledge-base about teaching and learning.
Enquiry based learning is characterised by a commitment not only to knowledge creation and sharing but also to an action orientation: to the application and utilisation of knowledge. Enquiry based learning makes the learning, not just the content important and places practice at the heart of knowledge and the student at the centre of learning. Within the literature, EBL is discussed as a constructivist approach to learning and it is noted by Phipps (2003) that epistemological belief can affect engagement with EBL as a constructivist philosophy however, it can be argued that EBL can aid epistemological development (Kreber, 2006). This epistemological development involves more than just skill acquisition and information gathering, it requires a transformation of knowledge, views, identity and relations with others and with the individual. I believe that education should focus on the transformative process of becoming, rather than just on the process of learning.
My doctoral thesis examined the nature of EBL is a holistic experience. My findings indicated that the transformative nature of the EBL experience enabled epistemic development and for some students facilitated an ontological shift. The community of practice was a fundamental part of the process and engendered feelings of responsibility for others’ learning. One of the students stated:
“I think that what struck me most about the EBL was that you can see the simplicity of it is it’s defining point because it can be used in any course but I think the mastery demonstrated was using it in a course about education that not only were we allowed to use EBL but we were allowed to use it in a course about teaching and learning. I think that way you were able to see more than just the one side of learning, we were able to research learning”
Alongside these findings, the overall transformative experience of the PGCE enabled the emergence of leadership qualities, most notably self-confidence, self-identity and self-belief. The majority of recent healthcare policy refers to the need for high quality leadership from all healthcare professionals at all levels (King’s Fund, 2011; Francis, 2013). Whilst it is too ambitious to state EBL improves professional practice and subsequent standards of care, it is anticipated that the enhancement of the PGCE graduates’ ability to lead education in practice will have a positive impact on the students and professionals they lead and teach. The Francis Report (2013) suggests poor organisational culture, through ineffective leadership, was at the heart of poor standards of care. The PGCE graduates, as senior healthcare professionals, will play an important role in leading and shaping practice based education.
Francis, R (2013) The Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. Available at: http://www.midstaffspublicinquiry.com/report (accessed 07.02.13).
Freire, PG. (1970) Pedagogy of the oppressed. London: Penguin Books.
King’s Fund Commission (2011) The future of management and leadership in the NHS: no more heroes. London: King’s Fund.
Kreber, C. (2006) Research-Based Teaching in Relation to Academic Practice: Some Insights Resulting from Previous Chapters. New Directions for Teaching and Learning. 107, 109 – 114.
Lave, J. & Wenger, E. (1991) Situated learning: legitimate peripheral participation. Cambridge: University Press.
Phipps, F. (2003) Educating Midwives: Where do we go from here? Midwifery Matters. 96:12-16.