Michael Rowe

Background. Clinical educators are being challenged to graduate students who can adapt to complex situations. Evidence suggests that one must go beyond teaching students what to know and what to do, and help them learn how to be.
Objective. To identify teaching strategies that could be used to help develop students beyond technical proficiency.
Methods. This study used a nominal group technique to gather input from clinical educators, requesting them to identify teaching strategies for developing lifelong learning, emphasising the development of students’ knowledge and skills, and taking into account students’ emotional responses to the clinical context. Participant responses were transcribed and analysed thematically.
Results. Participants reported that clinical educators should be role-models to students in a process of lifelong learning, including demonstrating the vulnerability of ‘not knowing’. They also suggested integrating a variety of different teaching methods that aim at achieving the same goal. Finally, participants emphasised the importance of intentionally incorporating personal values into reflective learning activities. By creating space for the shared learning experiences of teachers and students, participants high­lighted the possibility of helping students to develop the mindset necessary to adapt to complex health systems.
Conclusion. Clinical educators emphasised the developmental nature of the teaching and learning process, highlighting the importance of an authentic interaction between students and teachers.

Background. It has been suggested that improved collaborative competency in multidisciplinary teams may help understand how health professionals
can address problems that no single-disciplinary expert can manage independently.
Objective. To describe the development of the ability to collaborate in a South African university physiotherapy department.
Methods. Focus group discussions and interviews were conducted with 3rd- and 4th-year physiotherapy students and lecturers, respectively. Participant
responses were analysed thematically and evaluated against a self-developed framework that described the key and enabling competencies in collaboration.
Results. The study found that students and lecturers had a basic understanding of collaboration, but lacked a more comprehensive perspective.
Students and lecturers suggested that group work had the potential to develop collaborative competency, but expressed concerns about task design and
implementation. While interprofessional education was a required component of the curriculum, both students and lecturers questioned the value of
the module as it related to collaboration. Finally, challenges to the development of collaborative competency in the clinical context were highlighted.
Conclusion. The study found that the development of collaborative competency, while recognised as important for addressing complex health needs,
had several challenges that need to be addressed in order to be effective. Recommendations are provided for curriculum developers.

Evidence-based practice (EBP) is positioned as an inherent good in the medical and clinical literature, and not without reason. It relies on the integration of research evidence, clinical expertise and patient preferences, [1] and has become a foundation on which health systems are built and improved. There is however, a growing body of literature that takes a more critical stance towards EBP, especially when practitioners make assumptions about what constitutes 'the evidence' and how the data informing that evidence are gathered. [2,3] The evidence upon which EBP is premised is usually derived from experimental research conducted in professional disciplines that are firmly rooted in the positivist paradigm; the research method most closely associated with this is the randomised controlled trial (RCT). RCTs are quantitative, controlled experiments in which the effect of an intervention can be determined more objectively than by observational studies. [4] There is no doubt that the method has utility in determining cause-effect relationships between medical treatments and patient outcomes, making it a powerful design for intervention studies with the objective of determining the influence of one variable on another. [5] In an educational context it may initially seem reasonable to expect that an experimental design could determine the effect of a teaching intervention that aims to improve student learning. The argument is that by using randomisation to average out the differences between students, one would be able to demonstrate which teaching and learning strategies lead to the largest effect sizes. These data, presumed to be free of subjective interpretation, could then inform policies that drive the implementation of effective teaching interventions. [6] However, if we assume that the evidence gathered via experimental research provides insight into an objective reality, we must take a position on teaching and learning that is at odds with our best explanations for how learning happens. Therefore, if we want to use RCTs in educational research, we must assume that there is a cause-effect relationship in the teaching and learning interaction that can be objectively measured. In this article we argue that RCTs are an inappropriate design choice for educational research because they force one to assume ontological and epistemological positions that are at odds with theoretically informed perspectives of learning. RCTs in educational research We begin by highlighting the biased way in which RCTs are positioned relative to other forms of research endeavours, explicit in the language employed by RCT proponents. Goldacre [7] suggests that 'Evidence-based interventions in teaching could … replace the current system where untested methods are passed to teachers through a variety of often dubious outlets' , and 'We need a slow revolution that puts evidence at the heart of teaching'. Torgerson [8] asserts that RCTs are the ultimate expression of evaluative research, referring to 'the importance and supremacy of the RCT' , and expresses concern that educational research tends to rely on 'manifestly inferior' qualitative methods. It seems clear that those who most strongly advocate the use of RCTs in education have an inherent bias against other methods of data collection, strongly positioning themselves within a positivist interpretation of reality. This does not mean that RCTs and other forms of experimental research are not valuable tools in the repertoire of the researcher; randomisation is rightly considered an appropriate design choice in clinical trials. By controlling for the influence of all other variables between groups – through the assumed equal distribution of those differences in a large enough randomised sample – any differences in outcome can be more confidently attributed to the intervention. [5] As the RCT is a powerful tool successfully used in medical and clinical research, some have suggested that it should therefore underpin all 'good' research regardless of context'. [9] However, one cannot assume that RCTs can provide more – and better – evidence, which inevitably leads to improvements in education. [6] RCT proponents hope that these trials can do for educational researchers what they have done for medical researchers, i.e. provide clear-cut answers around the relative benefits of one intervention over another. [7] RCTs are presented as a gold standard, able to determine 'the truth' by simplifying and Randomised controlled trials (RCTs) are a valued research method in evidence-based practice in medical and clinical settings because they are associated with a particular ontological and epistemological perspective that is situated within a positivist world view. It assumes that environments and variables can be controlled to establish cause-effect relationships. However, current theories of learning suggest that knowledge is socially constructed, and that learning occurs in open systems that cannot be controlled and manipulated as would be required in a RCT. They recognise the importance and influence of context on learning, which positivist research paradigms specifically aim to counter. We argue that RCTs are inappropriate in education research because they force one to take up ontological and epistemological positions in a technical rationalist framework, which is at odds with current learning theory.

In an increasingly connected world where solving complex problems is not possible by solitary experts, educators and learners need opportunities to develop ways of thinking that allow them to engage with the dynamic and complex situations that arise in the world. The development of graduate attributes has been suggested as one way in which students can be prepared as active agents of social good. However, there are significant challenges with respect to developing these graduate attributes. This paper argues that the use of authentic learning in the design of open online courses may provide a structure for educators to develop generic graduate attributes. The use of collaborative technologies that are informed by authentic learning enables new forms of communication that allow students to fully engage with the academic process in ways that are difficult to achieve with traditional, classroom-based teaching methods. This study made use of a blogging platform to create a collaborative open online course using principles of authentic task design in order to develop graduate attributes in undergraduate physiotherapy students. The study used an interpretive, qualitative design that gathered data via focus group discussions. Transcripts were analysed inductively in order to determine categories, which were then analysed in relation to the graduate attributes of the institution in which the study took place. Student discussions suggested that they had developed at least some components of generic graduate attributes, including an approach to learning that was personal and internally motivated, the ability to consider alternative points of view and acknowledge different perspectives, the confidence to challenge knowledge and authority, and skills as empathic communicators. Background Higher education institutions from around the world are emphasising that their graduates must do more than simply reproduce the discipline-specific knowledge and skills that form the core of most university courses (Barrie, 2007). Higher education must encourage students to do more than simply accumulate facts and should aim to fulfill a need in society for spaces that encourage a deep and critical investigation into the nature of our world (Ovens, Wells, Wallis & Hawkins, 2011). In an increasingly connected society where solving complex problems is not possible by solitary experts, educators and learners need opportunities to develop the skills, knowledge and mindsets that are necessary for them to participate in dynamic and complex situations (Cormier & Siemens, 2010). The development of these non-discipline specific skills informs the rationale for the integration of graduate attributes into the higher education context.

Background: Good conceptual knowledge is an essential requirement for health professions students, in that they are required to apply concepts learned in the classroom to a variety of different contexts. However, the use of traditional methods of assessment limits the educator's ability to correct students' conceptual knowledge prior to altering the educational context. Concept mapping (CM) is an educational tool for evaluating conceptual knowledge, but little is known about its use in facilitating the development of richer knowledge frameworks. In addition, structured feedback has the potential to develop good conceptual knowledge. The purpose of this study was to use Kinchin's criteria to assess the impact of structured feedback on the graphical complexity of CM's by observing the development of richer knowledge frameworks.

Background: In order to negotiate complex clinical environments successfully, healthcare professionals must be more than competent – they must demonstrate an ability to adapt to dynamic situations and continually improve performance. However, emphasis on knowledge and skills alone may ignore opportunities for professional development that enables students to become practitioners.

Objectives: The aim of this study was to ascertain what clinical experts believe are the essential characteristics of capable healthcare professionals that go beyond academic and technical competencies.

Method: This study used a nominal group technique (NGT) to gather data from a panel of South African and international clinical experts, using open-ended questions and qualitative data analysis to determine emergent themes. The NGT is an interpretive research method that can be used to explore poorly defined topics, in this case to develop an understanding of the characteristics of health professionals that go beyond knowledge and technical skill.

Results: Panel members highlighted the importance of knowledge and skills for competent practice, but also explored other aspects of the learning process as part of developing professional identity. These included self-evaluation as part of professional development, building relationships with patients, and the importance of acknowledging students’ emotional responses to the clinical environment. Panel members also discussed the challenge of inappropriate role-models in the clinical context, who may have a negative influence on the development of professional practice.

Conclusion: By including the concept of capability alongside competency in undergraduate healthcare curricula clinical educators can help students develop a sense of being that emphasises professional growth alongside knowledge and technical skills.

Clinical practice is complex, requiring practitioners to interpret a diverse range of inter-related variables in order to make clinical decisions as part of patient management. This process is often intuitive and therefore hidden from students and less experienced clinicians, making the cognitive processes that inform clinical decision-making difficult to learn. In addition, educators still emphasise the learning of knowledge and skills through didactic teaching methods, such as lectures, in which students are passive “recipients” of knowledge. Unless physiotherapy educators design activities that aim to induct students into the professional culture and help them to develop ways of thinking and being that go beyond knowledge and skills, our students will continue to struggle with clinical reasoning.In this position paper, we argue that the careful integration of technology as an adjunct to traditional lectures can be used to facilitate discussion and interaction as a way of developing practice knowledge in students. This leads to higher cognitive functioning as it provides the means by which learners construct their own personally meaningful understanding of the world through interaction with others. The promise of technology in physiotherapy education lies in its ability to create transformative learning experiences through enhanced communication that is mediated by more experienced teachers or peers. If technology is used to enhance the learning environment by providing richer and more meaningful platforms for communication and discussion, it may have a role to play in the social construction of knowledge as part of contextualised learning spaces.

Background. Evidence-based practice (EBP) is the process by which a clinician evaluates the quality of evidence before applying it in the management of a patient. Many practitioners struggle to integrate this research-based evidence into their professional practice. Blogs have been identified as useful pedagogical tools that can facilitate the sharing of ideas and clinical experiences among peers to reflect on diverse learning experiences.
Objectives. A qualitative research design was used to examine the use of reflective blogging to teach the process of EBP in physiotherapy.
Methods. A conveniently selected group of postgraduate students who were registered for an EBP module participated in the study. Blogging was used to teach the process of EBP in physiotherapy using Kolb's cycle as a guiding and an evaluative framework. Students reflected on and shared their learning experiences in ways that exposed the limits of their understanding around certain concepts.
Results. The results reflect how students moved from assisted to independent performance by identifying gaps in their own understanding and finding the answers themselves.
Conclusion. Reflective blogging was found to be a valuable tool for promoting meaningful learning activities among participants and assisted students in making sense of their shared experiences. It was also an effective tool to be used in teaching the process of EBP

Background: Practice knowledge exists as a complex relationship between questions and answers in a context of meaning that is often intuitive and hidden from the novice practitioner. Physiotherapy education, which aims to develop patterns of thinking, reflection and reasoning as part of practice knowledge, is often based on didactic teaching methods that emphasise the learning of facts without highlighting the relationships between them.

Background: While there is evidence to suggest that teaching practices in clinical education should include activities that more accurately reflect the real world, many educators base their teaching on transmission models that encourage the rote learning of knowledge and technical skills. Technology-mediated instruction may facilitate the development of professional attributes that go beyond “having” knowledge and skills, but there is limited
evidence for how to integrate technology into these innovative teaching approaches.
Methods: This study used a modified Delphi method to help identify the professional attributes of capable practitioners, the approaches to teaching that may facilitate the development of these attributes, and finally, how technology could be integrated with those teaching strategies in order to develop capable practitioners. Open-ended questions were used to gather data from three different expert panels, and results were thematically analysed.
Results: Clinical educators should not view knowledge, skills and attitudes as a set of products of learning, but rather as a set of attributes that are developed during a learning process. Participants highlighted the importance of continuing personal and professional development that emphasised the role of values and emotional response to the clinical context. To develop these attributes, clinical educators should use teaching activities that are learner-centred, interactive, integrated, reflective and that promote engagement. When technology-mediated teaching activities are considered, they should promote the discussion of clinical encounters, facilitate the sharing of resources and experiences, encourage reflection on the learning process and be used to access content outside the classroom. In addition, educational outcomes must drive the
integration of technology into teaching practice, rather than the features of the technology.
Conclusions: There is a need for a cultural change in clinical education, in which those involved with the professional training of healthcare professionals perceive teaching as more than the transmission of knowledge and technical skills. Process-oriented teaching practices that integrate technology as part of a carefully designed curriculum may have the potential to facilitate the development of capable healthcare graduates who are able
to navigate the complexity of health systems and patient management in ways that go beyond the application
of knowledge and skills.

"Background: The development of practice knowledge is an important component of clinical education and reflective reasoning is known to play a role in its development. Online social networks may have some potential for developing practice knowledge by providing tools for clinical educators to guide students’ reasoning practices.
Aim: To determine if an online social network could be used to facilitate reflective reasoning in clinical contexts, as it relates to
developing practice knowledge.
Method: The study was conducted within a South African university, physiotherapy department, using an online social network to facilitate engagement. Tharp and Gallimore’s theory of assisted performance was used as a framework to conduct qualitative analysis of students’ reflective blog posts within the network.
Results: The lecturer was able to use strategies within the assisted performance framework to facilitate reflection among students. These included modelling, contingency management, feedback, instruction, questioning and cognitive structuring. The features of the social network enabled enhanced communication between teacher and student, as well as promoted engagement around clinical scenarios.
Conclusion: Online social networks can be used to facilitate reflective reasoning as part of the development of practice
knowledge by exposing students’ understanding of clinical practice. However, careful facilitation using sound pedagogy is still necessary to guide students to deeper understanding."

A growing shift towards research and evidence based practice in academia is associated with requirements to disseminate research results in the form of publication in peer reviewed journals. Mentoring has been identified as an important component of developing young authors, as it increases confidence and competence, and facilitates professional development. This led to the formation of a support group to stimulate peer-review publication in the physiotherapy department at the University of the Western Cape. The Kirkpatrick Framework of Evaluation was used to evaluate the success of the mentoring process which made use of a participatory action research methodology. The writing group consisted of nine academic members of staff and took place over ten weeks. The programme included writing, giving feedback, discussion and peer review on a weekly basis. Focus group discussions were taped and transcribed in order to evaluate the mentoring process by identifying relationships within the data and categorising key concepts, which were shaped into a thematic framework. The findings indicated that participants experienced a variety of emotions throughout the programme, with an overall feeling of personal growth by the end. In addition, participants also reported improved writing, reviewing and communication skills. Six months following the programme, six participants had submitted at least one article to a peer reviewed journal. It is clear from this study that some academics still find the task of writing and reviewing articles daunting, and that guidance and support in the form of a writing programme can be useful.

Institutions of higher learning are under pressure to respond to the changing needs of today's learners and the use of information and communication technology has been at the forefront of that change. Furthermore, the use of social software to enable people to interact with each other in a dynamic way has been identified as one possible solution. This survey sought to identify the knowledge and attitudes of South African physiotherapy students towards the use of social software in a physiotherapy department. The design was a cross-sectional, descriptive survey that took place in a university physiotherapy department in the Western Cape, South Africa. It included 135 students and used a self-developed questionnaire. Results showed that these students had only a superficial understanding of social software and that they did not make use of common services. They did however, show an openness to new approaches and a willingness to interact with lecturers outside the traditional classroom setting. A lack of access to appropriate technology was identified as one possible factor for their lack of understanding. Conclusion Any attempt to incorporate social software to improve teaching and learning practice into this department would have to be accompanied by significant training and support.

The global shift toward the use of information and communication technology (ICT) in health education and practice has been shown to enhance both the educational opportunities and the support provided to students and healthcare professionals. This study aimed to investigate the use of ICT by South African physiotherapy students and what their experiences and perceptions were regarding their use of ICT as part of their studies. The study design was a cross-sectional, descriptive survey using a self-administered questionnaire. The survey population included all of the undergraduate physiotherapy students from six of the eight universities offering the physiotherapy degree in South A frica (N=1105). The sample size consisted of 529 students from the survey population who completed and returned questionnaires, indicating a response rate of 48%. The results of the study showed that the use of ICT by South African physiotherapy students varied according to task, racial group and university attended. Furthermore, the reported use of ICT for communication, research and continuing professional development was low. In conclusion, this study indicates that with a move toward the use of ICT to enhance health education and practice in South A frica, certain groups of physiotherapy students may be at a disadvantage if required to make use of ICT as a means of improving communication, enhancing education, participating in lifelong learning opportunities and accessing support.

Information and communication technology has been shown to be increasingly important in the education and professional practice of healthcare workers. The World Health Organisation (WHO) discusses the benefits of using ICT in the Primary Healthcare setting in terms of better access to information, improved communication between colleagues, facilitating continuing professional development and providing learning tools for healthcare professionals, patients and the community as a whole. This review of the literature describes the role of information and communication technology (ICT) in the education and professional practice of healthcare workers and goes on to outline the challenges facing the widespread adoption of ICT. The conclusion is that ICT does indeed have a positive role to play in both the education and professional practice of healthcare workers, including physiotherapists, as long as it is implemented as an adjunct to established and proven practice, and not a replacement.

Background. Clinical education provides students with exposure to patients for learning experiences that cannot be replicated in a classroom. However, understanding practice knowledge is complex and difficult to teach. Blended learning integrates face-to-face and online engagement to provide greater flexibility in the teaching and learning process but little is known about its potential in clinical education.
Summary of the work. The aim of this review was to determine the impact of blended learning in the clinical education of healthcare students. Articles published between 2000 and 2010 were retrieved from online and print sources, and included multiple research methodologies. Search terms were derived following a preliminary review of relevant literature.
Summary of results. Ninety seven articles were retrieved and 77 were removed after a first round of analysis. A further round of critical appraisal excluded another 13, leaving seven for the review. Each study evaluated the use of a blended learning intervention in a clinical context, although each intervention was different. Three studies included a control group, and two were qualitative in nature. Six showed an improvement in some aspect of clinical education.
Conclusions. There are few well-designed studies looking at the role of blended learning in clinical education and those that were published were not homogenous, making comparison between them difficult. In addition, sample sizes were small, making results hard to generalise to other populations.
Take home message. A blended approach to clinical education may facilitate deeper understanding of practice knowledge, improve reflective skills and enhance clinical competencies.

Communication, collaboration and reflective discussion have been highlighted as important components in the development of practice knowledge, which is often tacit and hidden to the student therapist. The development of clinical and ethical reasoning is particularly challenging, although reflective discussion is known to have a positive impact on this process. However, little is known about the potential of social networks to facilitate the development of clinical and ethical reasoning during clinical practice.This study aimed to determine if participation in an online social network enhances reflection through online discussion in order to develop practice knowledge. Undergraduate physiotherapy students were required to participate in discussions within an online social network with the aim of promoting reflection around clinical and ethical scenarios that they encountered during their clinical placements. The text of these discussions was qualitatively analysed with another reviewer in order to produce categories and themes. Insight was gained into the use of social networks to facilitate reflection during clinical placement. Strengths of the approach included enhanced communication between students and staff, the externalisation of practice knowledge by both students and staff, and increased levels of reflective discussion around patient scenarios. Weaknesses included poor facilitation from staff members. These insights have implications for how clinical education can be undertaken and healthcare educators are encouraged to explore emerging alternatives to traditional approaches. Online social networks can augment learning by promoting reflection on patient scenarios encountered during clinical placement.

Context. The rise of a networked society has ushered in a period of easy access to vast amounts of content, which has often been misinterpreted as access to knowledge. While the distribution of massive volumes of data is certainly welcome, it misses the point that the power of the internet is not in being a content repository, but as a platform to enhance communication through the network effect. As a result of an increasingly connected society, our acceptance of conventional wisdom is being challenged as the concept of “what knowledge is”, is being redefined as a negotiated outcome of social learning experiences that are integrated within the network, rather than within individuals. This not only forces us to reconsider the traditional meanings of “curriculum”, “education”, and“teacher”, but also challenges us to find innovative ways of guiding students through a curriculum where memorising content is less important than their ability to make meaning of it through reflection.
Aim. To determine the impact of student and staff participation in an integrated social network,on their reflective, and teaching and learning practices in a South African undergraduate physiotherapy curriculum.
What was done. A private social network was created and all physiotherapy students and staff in thedepartment were registered, and four lecturers each volunteered to integrate one of their module assignments into the social network. A survey was conducted prior to the start of each assignment, as well as a workshop to introduce students and staff to the platform. Following completion of each assignment, an additional survey will be completed in order to determine student and staff experiences of using the network as an adjunct to their teaching and learning practices.
Impact. The potential for social networks to change teaching and learning practice in the traditional physiotherapy curriculum has yet to be addressed, and this ongoing study is an attempt to determine whether they have a role to play in developing reflective teaching and learning practices in undergraduate physiotherapy education.

The use of social software in higher education is currently in the spotlight, with it's proponents arguing for the many advantages it brings to the teaching and learning process. Wikis in particular have been highlighted for their potential role in the social construction of knowledge, allowing small groups of learners to engage with each other and with content in a very dynamic way. However, little is known about the true impact of the use of social software in our South African context, and particular in physiotherapy education. This survey was undertaken among a group of South African students in a university physiotherapy department in the Western Cape in 2009. A cross-sectional, mixed method approach was used to evaluate the students' attitudes and experiences towards using a wiki to collaboratively complete an assignment. The survey highlighted some of the advantages, disadvantages and challenges of the use of wikis for collaborative groupwork. While wikis may enable students to learn in new and exciting ways, we must be certain to build upon proven educational frameworks. In addition, if teaching practice is to incorporate the use of social software, much effort is needed to ensure that students are well prepared and supported throughout the process. In conclusion, the introduction of cutting edge tools into the traditional curriculum may enhance pedagogy, but it must be tempered with care and deliberation in it's implementation.

Context. The use of social software in higher education facilitates collaborative learning practices and mirrors the social constructivist principles of education by encouraging deeper engagement with both content and individuals. Reflection promotes higher order cognitive skills that promote critical thinking, and together with ethical reasoning has been shown to contribute to professional development and clinical practice. A blog is a service that allows a user to post ideas online, as well as to solicit feedback from others that serve to contribute to anongoing discussion. This allows for a rich, diverse stream of ideas that provide further input into the reflective process.
Aims. The aim of this study is to evaluate the use of blogging as a tool for enhancing physiotherapy students' reflectivepractice during an ethics module. By participating in an online, networked conversation on human rights in healthcare, students will discuss some of the problems inherent in the South African healthcare system, as well as recognise and acknowledge the different viewpoints of others.
What was done. A blogging environment was created to allow only students and the lecturer access to post, read and comment on reflections. Articles relevant to the ethics module were provided for students to read and to inform their reflections. They were required to read and comment on the reflections of their peers, facilitating an ongoing conversation around the topic. On completion of the assignment, students will be asked to evaluate the process.
Impact. With the move towards a more networked society and the increasing use of online tools in education and practice, educators must take cognisance of new approaches to teaching and learning. The use of blogging as atool for reflective practice has shown positive results in other disciplines but has not been evaluated in physiotherapy education.
Take home message. Blogging as a tool for reflection brings advantages to the process of professional development that are not easilyleveraged with any other medium. The characteristics of the platform allow for collaborative discussion, immediate feedback and encourages deeper engagement with the content, all of which facilitate more meaningful interactions and stimulate professional development.

South Africa’s history of human rights violations is well documented, especially in the fieldof healthcare. The issues raised during the Truth and Reconciliation Commission allowed us to develop a deeper understanding of the complicity of healthcare practitioners inhuman rights abuses, and helped to put into place policies to prevent their recurrence. However, ethical and human rights dilemmas in health are as relevant today as ever before.As educators, our responsibility is to incorporate a human rights approach into our teaching, guiding our students and colleagues towards an awareness of social and distributive justice that is reflected in actual practice. Recently, the role of human rights inhealthcare has been brought to the fore with the announcement by the Health ProfessionsCouncil of South Africa of a mandatory accumulation of 5 Ethics CPD points per year, further acknowledging the importance of human rights in health.This workshop has the following intended outcomes:

1.To describe and illustrate the link between human rights and health in promoting and protecting well-being in a holistic manner for all.
2.To provide a space where dialogue on human rights issues can be openly discussed.
3.To illustrate how to integrate a human rights approach into our educational practice, and how to support students and colleagues in interpreting health through a humanrights framework.
4.To interpret case studies involving human rights dilemmas that health personnel face in practice.

The workshop will include presentations, discussion and groupwork that will allowparticipants to actively engage with the subject matter. The intention is that participants will leave with an increased awareness of the opportunities for incorporating a human rights approach in their respective curricula.

Over the past few decades, there has been a global shift toward the use of information and communication technology (ICT) in healthcare education, which has been shown to enhance both the educational opportunities and the support provided to students and healthcare professionals. This study aimed to investigate the use of ICT by South African physiotherapy students and what their experiences and perceptions were regarding their use of ICT during their studies. The study design was a cross-sectional, descriptive survey using a self-administered questionnaire. The survey population included all of the undergraduate physiotherapy students from six of the eight universities offering the physiotherapy degree in South Africa (n=1105). The sample size consisted of the 529 students from the survey population who completed and returned questionnaires, indicating a response rate of 47.8%. The results of the study showed that the use of ICT by South African physiotherapy students varied according to the task performed, racial group and university attended. Furthermore, the use of ICT in communication, research and continuing professional development, or lifelong learning, was low, which raises concerns with the shift in healthcare education toward evidence-based practices. In conclusion, there is a concern that with the move toward community based service delivery in South Africa, certain groups of physiotherapy students may not be well placed to make use of ICT services as a means of improving communication, enhancing education, participating in lifelong learning opportunities and accessing support.

Background: Practice knowledge exists as a complex relationship between questions and answers in a context of meaning that is often intuitive and hidden from the novice practitioner. Physiotherapy education, which aims to develop patterns of thinking, reflection and reasoning as part of practice knowledge, is often based on didactic teaching methods that emphasise the learning of facts without highlighting the relationships between them. In order to improve health outcomes for patients, clinical educators must consider redesigning the curriculum to take into account the changing and complex nature of physiotherapy education. There is some evidence that a blended approach to teaching and learning may facilitate the development of graduates who are more capable of reflection, reasoning and critical thinking, and who can adapt and respond to the complex clinical environment. The purpose of this study was to develop principles that could be used to guide the design of blended learning environments that aim to develop capability in undergraduate physiotherapy students.

Method: The study took place in a university physiotherapy department in the Western Cape in South Africa, among undergraduate students. Design research was used as a framework to guide the study, and included a range of research methods as part of that process. The problem was identified using a systematic review of the literature and a survey of students. The design of the blended intervention that aimed to address the problem was informed by a narrative review of theoretical frameworks, two pilot studies that evaluated different aspects of blended learning, and a Delphi study. This process led to the development of a set of design principles which were used to inform the blended intervention, which was implemented and evaluated during 2012.

Results: The final results showed that students had undergone a transformation in how they thought about the process and practice of learning as part of physiotherapy education, demonstrating critical approaches towards knowledge, the profession and authority. These changes were brought about by changing teaching and learning practices that were informed by the design principles in the preliminary phases of the project. These principles emphasised the use of technology to interact, articulate understanding, build relationships, embrace complexity, encourage creativity, stimulate reflection, acknowledge emotion, enhance flexibility and immerse students in the learning space.

Discussion: While clinical education is a complex undertaking with many challenges, evidence presented in this study demonstrates that the development of clinical reasoning, critical thinking and reflection can be enhanced through the intentional use of technology as part of a blended approach to teaching and learning. The design principles offer clinical educators a framework upon which to construct learning environments where the affordances of technology can be mapped to the principles, which are based on a sound pedagogical foundation. In this way, the use of technology in the learning environment is constructed around principles that are informed by theory. However, clinical educators who are considering the integration of innovative strategies in the curriculum should be aware that students may initially be reluctant to engage in self-directed learning activities, and that resistance from colleagues may obstruct the process.

Conclusion: The development of clinical reasoning, critical thinking and reflection in undergraduate physiotherapy students may be enhanced through the intentional use of appropriate technology that aims to fundamentally change teaching and learning practices. Design research offers a practical approach to conducting research in clinical education, leading to the development of principles of learning that are based on theory.