Final Blog Post for EC&I 834

I had no idea what to expect when I signed up for this class. I knew I enjoyed online learning, and I was excited to learn “how to do it right”. I am so happy with all the content we learning this term and I am excited to bring it into action.

My course prototype at the moment is on my wish list for the School of Radiation Therapy. I chose this topic because I believe it is something that should be incorporated into the current curriculum. I used the Canvas LMS, as it is simple, straightforward, and fairly similar to Brightspace which I have experience with. I kept the course design simple. Each week of the course covers one module. Each module has three sections: Didactic material, Extra resources, and Assessments. I am hopeful that this will be incorporated into the RT curriculum. Now that I have the first two modules done, it will be easier to get some buy-in from those who need to be convinced that this is a good thing to do. I am proud of my final course prototype, I feel it is conducive to adult learning while keeping the students engaged.

And well, if it doesn’t become a reality, I still have a new toolbox of skills to bring to my current class that I teach.

I appreciated the way Katia guided us through the process and how it fostered a comprehensive creation process. The ADDIE model, while not the only model available, served as an example of how to use a framework to guide the development of a project through to creation.

The creation was a multistep process using the ADDIE model. The ADDIE template provided by Katia guided the creation of my course profile.

The model puts the course into context by thinking about who the learners are and what are their needs. Creating course objectives from the outset provided direction and helped focus the content and keep the learning content on track. Thinking about the instructional approach then took us to the next step of how is the content going to be delivered.

I felt my course profile in the end was robust and considered all the required elements. Once we had chosen the LMS platform, I felt it was quite straightforward to create the shell and other elements using the course profile.

Once that was done, I appreciated delving into the finer details of online/blended teaching such as community building, interactive content, AI, and accessibility. To be honest I had never considered any of those four elements to any great detail before this class. Sure, I had built in teacher-student interactions as relationship-building strategies, but not with a focus on building a class community. I can see how this approach contributes to class engagement, not only theoretically, but I have seen it in our class, as encouraged by Katia, especially through Discord. I did enjoy the breakout rooms as well, and appreciate the learn by example approach that Katia takes to this class.

While there were some growing pains with learning how to create interactive content, these solidified the lesson in how to create, and the result showed the why. Adding this extra dimension to the course content not only promotes engagement, but it offers yet another way to showcase the course content. The AI content was an eye opener for me and I learned that instructors and content creators can take advantage of these new tools. I also realized it is fruitless to fight against it with the students. Important conversations need to be had at the beginning, laying down my expectations of the use of AI in the classroom, as well as professional integrity and what that means. I wrote about this in this blog post.

Accessibility is important, and in my small classroom, personally, it means addressing the different learning styles and asking the students “What do you need from me to help you learn?”

Having the opportunity to provide and receive feedback is a great way to promote growth. As I said in my blog about feedback, it sparks creativity and improvement.

You can visit my course prototype screencast here. Thanks for watching!

A-eyes Open

Until now, my experience with AI has primarily involved experimenting with ChatGPT by asking questions alongside a traditional internet search. I was able to see how AI synthesizes information compared to manually sifting through search engine results. I knew it was being used to complete complex tasks, but I had not looked into this as I did not realize it could influence my classroom, beyond figuring out if students are using it to cheat.

My interactions with ChatGPT only consisted of asking for information; it never occurred to me to ask it to do a job for me.

Reading the blog posts from our class about how to incorporate AI into the classroom has inspired me to seriously consider bringing it into my course development. I am cognizant that any information I use from generative AI needs a critical eye to look for inconsistencies, accuracy, and biases. In addition, it is necessary to assess the usefulness of the information, as it is clear there is a skill to writing effective prompts.

I found our class members’ blog posts inciteful. For example, Christina demonstrates revising the prompts given to ChatGPT until it provides a lesson that meets her classroom criteria. Lauren discusses using AI for various administrative tasks such as creating the course outline and improving accessibility and Matthew suggested using it to create multiple-choice questions. I find creating well-written multiple-choice questions very time-consuming. I went to ChatGPT and asked for some multiple-choice questions for my course prototype and was happy with the results. What it provided were questions that serve as an excellent starting point, which is often the most time-consuming part of the development process.

Bringing AI into course development is only half of the equation. I see now that it is essential to address the role of AI with the students. Continuing to ignore, ban, or combat ChatGPT is not an ideal option. It is widely accessible to all and has rapidly become integrated into the mainstream.

To mitigate the potential misuse of ChatGPT by students looking for answers to the lessons, Christina adopts a strategy I have seen among other students in this course, such as Leanne and Matthew. Christina emphasizes the students’ role as learners and reinforces their responsibility in the learning process.

I believe this approach would be effective with the adult learners I teach. This is an approach that I now envision in my own classroom. I teach adults who are there to learn a particular profession. A profession that requires honesty and integrity. They should be reminded that they are there to learn, and they are accountable to themselves, to learn what is required to make them successful in the ‘real world’ which is the clinical environment. Appealing to their sense of integrity from the outset will ideally guide them to make the right choices if their integrity is ever challenged.

An additional approach is to re-think the assessment tools. As Dr. Couros suggested, an essay may no longer be the appropriate tool to demonstrate learning. Assessments that show critical thinking and synthesis of information need to be refined for each subject.

So how CAN the students use AI? In her blog, Lauren outlines some student opportunities such as asking the students to generate content from different AI sources and compare them. The students would be required to critically assess the outputs for accuracy and comprehensiveness. Matthew points out that in the process of using AI, are the students still not learning? Depending on the assignment or assessment, this may be true.

If our future includes using AI, students must have AI literacy. Educators can foster this by addressing the use of AI with the students at the forefront, providing guidelines that include the opportunities AI offers as well as the ways AI can compromise academic integrity.  Educators must design assessment tools that work in the current age of AI. As more is learned about AI, resources such as those provided by  Camuson College will become available to educators.

I am looking forward to reassessing my current course as well as my course prototype through this new lens. I believe this will only bring improvement.

Educate.AI: A New Era in Learning

*Title created by ChatGPT.

When AI first came to public awareness, there was a general fear amongst educators that student assessment might be compromised. It was immediately recognized that students would be able to use it to complete assignments, or at least make a large contribution to the content. What was not immediately known was how AI could help on the side of instruction. While these are separate topics, both require a great deal of attention.

My readings have revealed that Educators and Universities should embrace AI as it can assist with tutoring, task automation, course creation, etc. These discussions revolve around how to leverage this technology for course improvement and/or time savings. The larger discussion revolves around the use of AI by the students, particularly around assessments.

The webinar suggested by @Lauren presented a speaker panel, including a 4th-year student, which provided a variety of opinions about AI in higher education. You can see the slides here. I will share quite a bit from this webinar as I found it very relevant to this discussion.

In terms of educators using AI, Dr. F. Alex Feltus, a professor at Clemson University, is using AI to an extreme. He created an AI assistant for his courses, called Pria, that has been so successful he now includes Pria in his course syllabus as a Teaching Assistant. Pria can be integrated into Canvas and other LMS.

I previously shared a short article on Discord written by Michael Mace, another panelist who spoke about AI and Accessibility. This article creates an exciting picture for the future.

Dr.Nirmala Shenoy, another panelist, admitted that she has not used AI, and provided some thoughts about student use of AI.

I took this screenshot of her slide as I thought it provided an interesting insight into the concerns educators have with AI use in the classroom.  Despite the slide using words such as advancements and empowerment, her thoughts were not about a future of hope but rather concern. She believes that report writing is an important skill that may be lost and that “garbage in = garbage out” is applicable here. Although she did maintain that AI is here, concluded that we need to figure out “how to best use the tools”. I agree and am particularly interested in the question she posed “Can AI harm the students’ ability for critical thinking and problem-solving or enhance it?”. If we figure out how to best use AI, then it should enhance these skills.

The last panelist I will mention is the student panelist, Josh Garner. As expected, he embraces AI and his message was that students need to develop AI literacy to succeed beyond University. He stresses that allowing it in the classroom levels the playing field. Students are going to use it anyway, which provides an unfair advantage.

While I do agree with his points, I disagree that it levels the playing field. From what I understand AI can be expensive to use, and perhaps not all will have the skill set to engage it to the same level. However, I suppose that can be said for any new technology. I am dating myself here, but I remember in my UBC days my roommate had a computer in her room (which was amazing in itself) and it had Microsoft 3.0 as the operating system (but no internet yet!). I guess it can be said she had an unfair advantage. But boy, did we enjoy playing Minesweeper!

Let’s agree AI cannot be banned for student use (instructors, however, will love it)

As an educator, what I am most interested in are the questions posed by Dr. Shenoy.

  1. Can AI harm the students’ ability for critical thinking and problem-solving or enhance it?
  2. How do we best use the tools?

Some answers, maybe only opinions on the manner, can be found in our readings and Dr. Couros’ lecture. Ben Talsma did a much better job than I did at highlighting examples of new technology that were considered ‘cheating’ in his Chalkbeat article. Calculators and Spell check are great examples, and I lived through these ‘cultural evolutions’. The attitudes toward these technologies within the educational space feel similar to what is being thrown at AI now within the same space.

Ben makes the same point that Dr. Shenoy made: students need to be prepared for the world. He provides an example of how to incorporate this into pedagogy which is to provide a sample of AI-generated work and then work to improve it. I feel this simple exercise alone addresses Dr. Shenoy’s concern about critical thinking and problem-solving. A second example he provided was to have the students fact-check ChatGPT’s writing. If this is done in an engaging way, what a lesson in critical thinking!

In addition, I think it provides a lesson in using AI to create content, that it should not be relied on to create reliable content. Another “feature” of AI that should be pointed out to students is that it produces biased results which is very well highlighted in Dr. Couros’ AI-created images. This bias will not always be so overt and it is up to the AI user to critically assess the content through an EDI lens.

I found reading the Generative AI guidelines for faculty and instructors at the U of Regina interesting. The document offers guidelines to help instructors prevent the misuse of AI. I think the guidelines are open-minded to the use of AI, what isn’t offered is any guidelines to categorize the “misuse” of AI. Except for the indications of the AI-generated content section, this is left up to the discretion of the instructor. Perhaps over time, these definitions will be refined as various ways AI can be used. Dr. Couros’ lecture highlights different ways AI can be used in the example of the student in the Tiktok video, (0:45:00). Dr. Couros opines that she doesn’t even feel like she is cheating. What do you think? What is cheating? Does this live up to your definition of Academic Integrity?

Is using a calculator in class cheating?

Ban on using a calculator (isolated)

Feedback and Equity

“Feedback is the Breakfast of Champions”

– Ken Blanchard

This quote jumped out at me as I related to and agreed with the message, and thought it was appropriate for projects such as the one we are working on.  As I was inserting the quote into this blog post, I thought that I should find a definition of “Breakfast of Champions” to share to put it into context. This turned out to be a lot harder than I thought! People use this expression in many ways, not surprisingly mostly with sarcasm, and some were unexpected!

I finally found a definition that matched most closely to how I define this phrase, it came from which cited ChatGPT:

breakfast of champions

Breakfast of champions is a phrase used to refer to a meal or food that is considered nourishing, substantial, or of high quality. It can also be used metaphorically to describe something that is regarded as the best or most important, particularly in the context of personal success, achievement, or excellence.

This is the context of the phrase in my mind when I related to Ken Blanchard’s quote above.

I also discovered there is a novel published in 1999 called “Breakfast of Champions”. Of course, I then went down the YouTube rabbit hole to find some Wheaties commercials as Wheaties is the origin of the phrase. I discovered Wheaties is 100 years old this year! If you want to learn more about Wheaties, this 5-minute video from Cereal Time TV has many surprisingly cool facts. Enjoy!

Anyhow, moving on….this past week, Katia provided us with two valuable learning opportunities:

  • working through two other course shells and modules
  • receiving peer feedback on our course shells and module

Being the Reviewer

Working through the other shells, was a great experience for me. It’s so interesting to see how differently and creatively people approach a similar task.

The two modules that I reviewed were developed for 2 very different target audiences. Both of which I learned some new ways of approaching a course. Some things we talked about in class but seeing them in action was insightful. Some ideas I learned are:

  • Use minimal architecture and a straightforward approach to organizing the modules.
  • Incorporating multiple options for teacher-student and student-student interactions
  • Provide pre-testing to identify if the student needs to complete all elements of the module
  • Use case-studies! They are an excellent way to teach adult learners.
  • Perhaps not everything needs to be graded. Maybe some elements simply need to show progression.

Receiving the Feedback

Feedback is the breakfast of champions. It provides substance and nourishment and, if heeded, it can foster growth and sustainability. Effective feedback must be direct, and specific, and include recommendations for improvement. I feel both of my reviewers provided effective feedback in this way that offered substance for positive changes. What did I take away?

  1. Each module is organized into 3 sections: Learning, Activities, and Assignments. Both reviewers found it easy to navigate.
  2. A welcome video would be beneficial.
  3. One of the links did not work for either reviewer. Went I went back I realized I had forgotten to put the link into the section.
  4. Further to 3. Proofreading is important.
  5. I wasn’t sure if the interactive activities were appropriate for the adult learner. However, both reviewers responded positively to them, so I can take away that they are age-appropriate.

One of the reviewers provided a list of ideas to incorporate, however, they acknowledged that it was out of the scope of the assignment, and are suggestions for implementation. I appreciated these ideas very much.

I am grateful to Katia for including peer review in her class. As I move forward and develop further modules, it is very useful to have these experiences to create more effective learning materials.

Equity and Accessibility in Online Learning

I found the equity class had some interesting discussions. The discussions were about equity in general, which highlighted that if one was creating an open public-facing course, it would be extremely challenging to meet all needs. Especially with limited resources. It was nice to hear that some resources exist in SK school divisions such as translating documents into braille. However, it was pointed out that there are barriers to using this service effectively.

For my class, the students are required to have at least one year of university prerequisites, as well as fill the job description of a Radiation Therapist. This includes lifting 25 pounds and being able to transfer patients safely, just to name a few. These job requirements remove some of the learning barriers related to equity and accessibility.

For other barriers, I have experienced in the past that students have already identified accommodations that they require in their previous year(s) of schooling. I have also experienced discovering these barriers alongside the student as the term progresses. Working together to figure out what the student needs is part of my job as an instructor and mentor. At the cancer centre where I work, we use what is called the Patient Dignity Question with patients which was put into place by the great Dr. Harvey Max Chochinov. It goes like this – “What do I need to know about you as a person to give you the best care possible?” It is a beautiful question that can be re-framed in different circumstances. For example, as a teacher, you can ask the student, or the parent “What do I need to know about you as a person to help you through this learning journey?” At the Radiation Therapy school, it is a learning journey, not just a one-off class. We are with the students throughout their training, guiding them to be effective, empathetic healthcare providers. Asking this question invites the student in a thoughtful way to be open about learning challenges. I have a small class and have the luxury of tailoring the class content/delivery method from year to year if necessary.

I am looking forward to reading other blog posts.

Module Introduction through Lumi


I am designing a blended learning course for adult learners to refresh and strengthen their knowledge of CT anatomy (also called cross-sectional anatomy). This means finding anatomical structures on images that were acquired with a CT scanner. Looking at images this way is quite different than what we think of as regular X-rays. I am using the LMS Canvas which has impressed me with its clean, simple, intuitive design and has many of the features of robust LMS. I organized the course content into modules, and embedded H5P content created in Lumi.  The first couple of modules of this course focus on refreshing the learner’s knowledge of CT images and 2D radiographs. Being comfortable with orientating oneself to the various views available and understanding anatomical directional terms that are used to describe locations provides a strong foundation for learning cross-sectional anatomy.

After the foundation is set, subsequent modules focus on identifying anatomical structures within the different body cavities. Each module will cover a different body cavity: thorax, abdomen, and pelvis. By the end of the course, the learners should have a solid understanding of cross-sectional anatomy. The learners will be able to explain the significance of this knowledge as it is applied to Image Guided Radiation Therapy, which I discussed in my course profile post.

All the didactic learning and assessment will be delivered online with weekly synchronous “class meetings”. This is a flipped classroom model, where the weekly class meetings will provide some context for the didactic material. I divided the course into weekly sections, and then put each week of work into its module. Completing one module each week should help the students group the learnings and help with retention. When designing the modules, I aimed to have each of them a copy of themselves to keep the structure simple and predictable. Each module includes a course presentation which includes the didactic information in the form of an interactive video, some activities to reinforce the learning (instant feedback), and an assignment worth a small number of marks. I included the assignment at the end of the course presentation so that the learners see it right away and they do not need to click around inside the LMS to access it. I will encourage collaboration on these written assignments, as they usually do anyway. Each module will contain the course presentation, an assignment, a short quiz (to show independent learning), and a weekly discussion. An exception is Module 1 which contains two course presentations. Module 1 Session A and Module 1 Session B can be viewed by clicking these links. After our readings last week, I have realized the importance of building community inside the virtual classroom. I have also witnessed this happen with this class, as we communicate with each other via Discord. Elements to the class that I will add to foster community are collaboration on assignments and discussion boards, providing a forum for a Q&A space as Katia did for us, and encouraging discussion in our weekly synchronous class meetings. We will also have weekly lab sessions when we meet together within the clinical environment to practice the image-matching software.

Working within Lumi was a fun yet time-consuming process. This is my first exposure to H5P, so a little research beforehand was also required. I loved the creativity involved, yet learning this new platform and its limitations took more time than I would have expected. I am still unsure if I completely understand, and I put a lot of things down to “user error”.  I look forward to feedback from the class about the 2 Lumi Course Presentations created for my course prototype.

Stepping Out 2024-02-13 01:42:29

**Long Post Alert**

I enjoyed the readings for this week’s class as they provided clarity into what I was trying to achieve in my online classroom. Over the years, I have learned and applied different engagement strategies, however, my attempts to engage the students within an interactive online environment were not always as successful as I would like.
Completing the readings made me realize that what was missing was community. Yes! This is what I was trying to achieve…. the sense of community. Without being intentional about building a class community was a missed opportunity to properly engage the learners. Making this commitment as an educator means being mindful to who is in your class, and creating interactions that foster relationship building.
How could I have missed that!? I think the answer to that question is, that other than one year during COVID, I have always had a blended classroom environment. (For those that are surprised it was only one year, I will explain. The School of Radiation Therapy is located within a healthcare facility, so the school follows the regulations of that facility. In-class learning was allowed to take place within the provincial masking and distancing guidelines. Since our class sizes are typically quite small, it was not difficult to comply with these rules).
Since the students are in class at times, I believe I relied on these interactions as the only source of community building, leaving the online environment lacking its community structure. Perhaps, this is the missing piece that will help increase online engagement.

The course I am designing is a hybrid/blended course in that it includes in-person lab sessions. All didactic learning will take place online.
Our blog question of the week is What forms of student/student-instructor interactions do you plan to implement in your course prototype? As I plan these interactions, I will be intentional to include relationship building opportunities between the students, as well as between the students and the instructor. In addition, the learning objectives and corresponding activities are guided by Bloom’s Taxonomy learning theory as it aligns well with healthcare programs.

The interactions I have planned to include are listed below including justification for their inclusion and any guidelines or assessments attached.

Weekly synchronous class meetings – including polls and MC review questions, exit slips
Justification: students and instructors engage in real-time interaction, which offers several benefits:
Affective domain: Synchronous classes facilitate social interaction among students and between students and instructors. This interaction fosters a sense of community and belonging which can enhance the overall learning experience and reduce feelings of isolation. The instructor will aim to foster intrinsic motivation and assist in maintaining a positive attitude towards learning. The goal is to encourage students to engage in learning for the inherent satisfaction it brings, rather than relying solely on external rewards or pressure.
Guidelines: there are guidelines for the instructor as well as the participants.
1) The class instructor needs to be prepared to facilitate the meeting. The instructor will have 2 topics prepared:
a. Responses to the previous week’s exit slips
b. A topic of the week to discuss
2) The instructor must create a safe space, whatever that means for the particular class. Speaking from experience, each year brings a different set of students from the last. What one group needs, another may not. The goal is to make the learners feel valued, respected, and empowered to participate fully in the learning process. Creating a safe space:

Set clear expectations and ground rules for respectful behavior in the online classroom. Emphasize the importance of kindness, empathy, and active listening. Model respectful and inclusive behavior.

Encourage the learners to ask questions, share their thoughts and experiences, and express their opinions in a non-judgmental environment.

Acknowledge students’ contributions and efforts. Provide constructive feedback in a supportive and encouraging manner.

Include diverse perspectives and voices in the curriculum and learning materials.

Be flexible and responsive to students’ needs and concerns. Listen actively to their feedback and be willing to adapt your approach as necessary to better meet their needs.

3) The students must follow the guidelines set out by the instructor regarding respectful communication and behaviour.
4) The students are encouraged to utilize the exit slips to communicate any questions or concerns in a safe way

In-person clinical lab sessions
Justification: these sessions are important for all three learning domains:
Affective domain – Not only does patient care need to be comprehensive, and delivered by skilled staff, but it also must address the psychosocial needs of the patients. Empathy and compassion also contribute to patient outcomes. Online environments cannot transfer these lessons adequately.
Provides an additional environment for relationship building between the instructor and the learners.
This is the instructor’s opportunity to teach honesty, transparency, and integrity to the learners through role modeling.
Psychomotor domain – Adult learners do well with practical applications where the didactic knowledge can be applied and transferred to practice. labs must happen before any clinical placement so the learners can practice using the matching software (this cannot be done online as this software cannot be accessed outside of the institution).
Cognitive domain – learning the image matching software, developing troubleshooting skills

Following each biweekly lab session, each student will participate in a debrief session. Debriefs following simulations in healthcare are an evidence-based practice that:
• allows participants to reflect on their performance during the simulation. It provides an opportunity to identify what went well and what could be improved. This reflection promotes active learning and helps participants to consolidate their knowledge and skills.
• provide emotional support to participants who may have experienced stress or anxiety during the simulation. Discussing their experiences in a supportive environment can help participants process their emotions and build resilience for real-life clinical situations.
• Are used to discuss evidence-based practices and guidelines relevant to the simulated scenarios. By aligning their actions with best practices, participants can improve the quality and safety of patient care.
• provides an opportunity for facilitators to provide constructive feedback to participants. This feedback can help participants understand their strengths and weaknesses and track their progress over time. Additionally, debriefing sessions may be used for formal assessment purposes, such as evaluating participants’ clinical competencies.

Weekly student-led discussion boards – Discussion groups will be encouraged. Each week one student will be responsible for posting a new topic and moderating the discussion.
Encourages active participation
Develops critical thinking
Can provide a sense of belonging and pride of ownership
A small portion of their final grade is attached to student participation, including this activity. If the learner is having a hard time thinking of a relevant topic.

Collaborative student activities/Assignments – Students will be assigned to work together on a couple assignments, including the final assignment
Collaboration encourages students to discuss and analyze course materials, leading to a deeper understanding of the subject matter. Through collaboration, students can fill gaps in their knowledge, gain new perspectives, and reinforce their understanding of key concepts. It continues to build a sense of community. Students continue to build applicable vocabulary and learn to work with a teammate. This mimics the real world of radiation therapy where RTs are always working with partners/teams
Formative assessments for smaller assignments. However final activity is part of the summative assessment.

Phew! That’s it. In my head, it all makes sense and covers all the bases….

Course Profile for Cross Sectional Anatomy for IGRT in Radiation Therapy

Background information

Radiation therapy is a common cancer treatment that uses high-energy x-rays to kill cancer cells or stoCancer treatment in a modern medical private clinic or hospital with a linear accelerator. Professional doctors team working while the woman is undergoing radiation therapy for cancerp them from growing and dividing. It’s a localized treatment, meaning it targets specific areas of the body where cancer cells are present while minimizing damage to healthy surrounding tissue. The treatments are individually designed for each person’s anatomy and treatment target area; thus precision is required to deliver the planned dose. There are many factors that contribute to differences between the planned dose and the delivered dose. One such factor is reproducibility in patient position on the treatment unit. Patient positioning is crucial  in radiation therapy because it ensures accurate delivery of radiation to the targeted area while minimizing exposure to surrounding healthy tissues.

To ensure accurate patient positioning, image matching happens prior to each treatment and is performed while the patient issymbol, radiation therapy room laying on the treatment couch waiting for the radiation beam to start. This is called Image Guided Radiation Therapy, or IGRT. Image matching in short, is looking at the image from the original “planned” treatment and matching it to the daily image of the patient on the treatment couch, the discrepancies are noted, bed movements are entered into the software which results in the patient moving to a position that matches the planned treatment image. Cross-sectional anatomy is included in the foundation of successfulimage matching. Acquiring and improving this skill is important to the success of the patient’s treatment as it is imperative that image matching is done in a time sensitive manner, to avoid any further patient movements. This course presents the function and application of Computed Tomography (CT) in the context of IGRT. The overarching goal is to provide students with a solid understanding of cross-sectional anatomy and its significance as it applies to IGRT.

The target audience for this course is adult learners who have chosen to work in health care. They have a minimum of two years undergraduate prerequisite courses as well as soDoctor examining X-ray images on display in MRI control room while in background nurse preparing the patient for examination radiation therapy course prerequisites. Information in these pre-requisite courses include how CTscanners and Linear Accelerators work, 2D- radiographic anatomy and how knowledge of the lymphatic system is applied in radiation therapy.

The learners in this type of program are usually young adults with a wide variety of lived experiences. Academically speaking, some come directly from completing the required 2 years of undergrad courses, and others with a variety of type and number of degrees. In other ways, some have not yet left the family home, some have children, some have done extensive travelling, some are changing careers. Some have worked in hospitals; some have never been inside a hospital.


This course is a blended design scheduled in weekly modules. It follows a flipped classroom model, as the benefits of this strategy align with this topic. The course includes asynchronous didactic material, weekly discussion boards and one synchronous online class meeting. Every other week there is a face-to-face lab session scheduled for hands on learning and skill practice. The tools used to deliver this course and their application are as follows:

Canvas provides the learning management system (LMS) to host content such as didactic modules that may contain documents, videos, quizzes, discussion forums, collaborations, and student progress/grades.Shot of a screen of teammates doing a virtual happy hour from their home offices.

Zoom provides the platform for the weekly synchronous class meetings. Screen sharing and the whiteboard are key functions for this activity.

ARIA software suite provides the image matching software for hands-on practice. This is only accessible within the CancerCare system.

IMAIOS provides high-quality cross-sectional anatomy and imaging content for daily practice and training of health professionals. This software offers a choice of regular, practice or quiz viewing mode to the learners.

The specific course objectives are listed here.

By the end of this course, learners will be able to:

  • List and explain the three cardinal viewing planes of CT imaging.
  • Using directional terms, describe the position of one anatomical structure as it relates to the position of another.
  • Explain the orientation of a CT cross-sectional image.
  • Compare the location of various structures between a cross sectional image and radiographic anatomy.
  • Describe the boundaries of and the anatomic structures contained within the: thorax, abdomen, and pelvis
  • Complete image matching on a variety of anatomical sites.
  • Explain how the Choose Wisely and Image Gently campaigns apply to Image Guided Radiation Therapy.

These learning objectives are met by providing didactic course modules for learning and virtual tools for practicing cross-sectional anatomy identification and image matching. To see the course layout in more detail, view the course ADDIE Template here. The formative and summative assessments of learning address the three learning domains, Cognitive, Psychomotor and Affective.

Formative assessment opportunities include assignments, multiple choice review questions/polls, discussions and exit slips during synchronous class meeting, discussion boards, module quizzes, and clinical reviews.

Two Summative assessment strategies are used. A final exam and a final clinical assessment where the students are required to complete an Image Matching task.

Risk Assessment

Any online delivery is susceptible to certain risks and barriers. Addressing these risks and barriers requires proactive strategies and support from both educators and institutions.

Mitigation strategies need to address risks and barriers around technical issues, mental health, academic integrity and motivation.

Technical issue strategies involve providing access to technology and resources. The University of Winnipeg as well as the School of Radiation Therapy both provide resources such as space and technology to students who: do not have access to necessary devices such as a computer or tablet, struggle with reliable internet access, or struggle with finding appropriate spaces within their home for working.

Mental health strategies include surveying students about how they feel regarding online learning. This is followed by addressing any concerns that are self-perceived or suspected by the instructor, according to school policies. Online learning can be an isolating environment that leads to disconnection between students and/or instructor. The bi-weekly face-to-face Clinical Development Activities should help mitigate any concerns.

Maintaining academic integrity risk strategies recognize that online assessments can be vulnerable to cheating and plagiarism. Online quizzes do use such strategies as randomizing not only the quiz questions, but the order of the multiple-choice answers. In addition, the lock down browser can be used at the instructor’s discretion. However, relying on individual integrity has been the approach of the School of Radiation Therapy. Guiding the students to understand the links between academic integrity and their future as ethical professionals can mitigate integrity breaches. This strategic approach involves communicating this message early and throughout their training.

Online learning has shown to affect a learner’s motivation. However, most adult learners are intrinsically motivated to succeed. In this case, their goal is to become the professional that they have chosen as their career.

“Adults are motivated to learn to the extent that they perceive that learning will help them perform tasks or deal with problems that they confront in their life situations. Furthermore, they learn new knowledge, understandings, skills, values and attitudes most effectively when they are presented in the context of application to real-life situations.”

Malcom Knowles

However, these young adult learners may still have under-developed self-discipline and time management skills. Therefore, a small amount of the final grade is given towards class participation.

If a learner requires extra time to gain the required proficiency prior to clinical placement, this will be arranged on a as needed basis.

Course design and rationale

I believe that no professional healthcare program can be taught exclusively online; nor does it have to be taught exclusively face-to-face. My assertion comes from two variables: the type of work they are learning to do and the uniqueness of the adult learner. The hybrid model is a great way to meet the needs of this group of adult learners; which is important to reaching my goal of developing empathetic, competent healthcare workers.

This course is designed within a hybrid learning environment. Rationale for each approach is described below.

Asynchronous Didactic Learning – Adult learning is less abstract and more goal oriented. They are more autonomous. They are responsible for their learning, which means being prepared for synchronous sessions, especially in a flipped classroom model. They have a full life outside of the program. These learners have family obligations, work obligations and hopefully a social life to keep them balanced. Time management is key to success in this group.

As image matching is completed on computers using special software, this approach to learning is ideal. The students will see the images

Synchronous Class Meetings – Adult learners are ready to learn, which can help with engagement, and their lived experiences can lead to deeper, more meaningful class discussions. Although I have experienced that this is very dependent on the group dynamic. Some classes are quite dynamic and others are not.

Face-to-Face Clinical Development Activities – Adult learners do well with practical applications where the didactic knowledge can be applied and transferred to practice. This course leverages this fact as it is necessary for labs to happen prior to any clinical placement so the learners can practice using the matching software (this cannot be done online as this software cannot be accessed outside of the institution). Here they will practice the specific task that will be required of them when they enter the clinical environment. Initially, the focusin on accuracy. Subsequently, the students’ goal is to to increase their skills to complete the task more quickly by the end of the semester.

While facilitating these sessions, the facilitators can vocalize their decision process, role modelling the importance of each step with the patients’ outcome in mind. As well, simulating the interaction between caregiver and patient, the instructors can role model the care and attention given to psychosocial needs within a certain clinical environment or situation.

Patients need to be the centre of all that is taught and learned. Not only does patient care need to be comprehensive, and delivered by skilled staff, it also must address the psychosocial needs of the patients. Empathy and compassion also contribute to patient outcomes. Online environments cannot transfer these lessons adequately. Of course, instructors provide real life examples that can convey the messages, but it is the real-life clinical environment where this learning occurs. In addition to the formal learning, there exists a hidden curriculum that cannot be ignored. Hidden curriculum can be explained as how unwritten rules are transmitted to the learners. A few examples are workplace cultures, norms, authority structures, gender roles, implicit biases, and attitudes. Over the years the term ‘hidden curriculum’ has been used to describe how negative behaviours, stereotypes, and biases are passed along within the profession. However, it is important to be aware of the hidden curriculum and teach positive lessons through everyday interactions while the learner is still developing their own perception of what it means to them to work as such a PHC provider. This is the instructor’s opportunity to teach honesty, transparency, and integrity to the learners through role modelling.

All three learning domains will be addressed as each plays their own role and are important in this task and career.

The cognitive domain is addressed within the didactic portion of this course through lessons, assignments and quizzes. These should be completed by the learners by the time the synchronous activities are scheduled.

Illustration of a modern radiation plan for cancer therapy of a patient with a brain tumor (meningioma).

Clinical Development Activities, or labs, cover the psychomotor domain. Students will be scheduled in small groups on the RT machines, either on weekends or after hours (as operational requirements permit). Here they will practice the specific task that will be required of them when they enter the clinical environment. Initially, the focus in on accuracy. Subsequently, the students’ goal to increase their skills to complete the task more quickly by the end of the semester. Some learners may require more time to gain the required proficiency than can be provided due to limitations in the availability of both clinical space and staff facilitators.

Discussion groups and clinical development activities will cover the Affective domain. Students will demonstrate the patient centred approach to IGRT through discussion and they will learn from their clinical role models in the Clinical Development Activities.

Already thinking differently..

Completing the readings after making my first two blog posts makes me realize that I am thinking differently already. It’s interesting to me that I did not think about the LMS I use (Desire2Learn/BrightSpace) as part of blended learning. Thinking about it though, I do post discussion topics, quizzes are done through the LMS, assignments are handed in and delivered back through the LMS, I post practice activities, reminders and other prompts through the LMS.

During the pandemic, like most of the world, I had to quickly move to remote learning (aka emergency remote learning). The course I teach is quite formula heavy with a lot of new concepts, which I demonstrate visually usually on the board. Without time to adapt my teaching modality, I had to quickly borrow hardware (Wacom monitor) and learn how to use Zoom functions such as the white board etc. Once my desk was set up, the rest was fairly easy. Additional challenges were almost exclusively on the students side, such as finding a space in a crowded home, sharing computer time with siblings, and bandwidth issues.

I enjoyed the article Old wine in new Bottles, and what really landed with me was that course design needs to adapt to the different environment, the new online environment. As it state, online learning puts the students in a space that is different than the face-to-face classroom. I find in the classroom it is the collaboration and ‘work together’ time that not only solidifies certain concepts, but it is here that gaps in knowledge are recognized and can be addressed and discussed as a group. New ways of achieving this need to be adopted if using an online model.

A question is posed in 10.5 The future of the campus – Teaching in a Digital Age – Second Edition ( The authors say state that what we need to be asking is “what is the academic or pedagogical justification for the campus, when students can learn most things online?”. They go on to assert that on-campus activities must be meaningful.

Perhaps part of my answer to this question lies in my constructivist view and thoughts on collaboration.

Time for Reflection

Before I start this course, I wanted to spend a few minutes reflecting on what digital technology meant and how it is changing. Prior to 2020, digital content in my classroom meant saving larger files on the shared drive to save paper. It meant delivering the class content via PowerPoint and demonstrating examples on the white board. This picture is not my classroom, but it is surprisingly similar. Just like the instructor of this classroom, I had a tiny space of white board available behind the podium to the left of the screen to do physics equations, draw pictures of diverging radiation beams and stick figure patients. Utilizing more whiteboard space meant rolling up the screen, then pulling it down to continue with the slides – covering up the example I just drew on the board!

It wasn’t ideal but we made it work. I am sure the instructor of this classroom and I could have a very animated conversation about the limitations of this setup 🙂 Another piece of technology I incorporated into my lessons was the iClicker. There are newer tools to engage students, but it worked well, and allowed me to assess the level of knowledge transfer. The pandemic forced us all to learn quickly and change our teaching methods to deliver the same content over an online platform, Zoom in my case.  How do we deliver quizzes? How do we uphold the integrity of the test material? Eventually solutions to these challenges emerged.

Reflections part II

Technology in the classroom is a permanent fixture. Our world is much smaller now, the global landscape is very different, and in response, the way humans interact with each other, and the world has evolved. I am old enough to remember the pre-internet days, I have been a witness to this evolution.

Subscribers to constructivism will argue that face to face learning cannot be completely replaced. However, the practical benefits of online learning cannot be denied.  Beyond the practical, there are other benefits to using technology in the classroom.

Before diving into EC&I 834, I wanted to reflect on the benefits that technology has brought into my own adult classroom. Hopefully this will provide a “before and after” overview of my level of knowledge and beliefs towards technology and the adult classroom.

Within the first week of teaching over Zoom, I noticed an increase in student engagement. My adult classroom is very small (less than 10 students each year) and every year the class has a different dynamic. The class that started in 2020 was particularly quiet, and I had a hard time engaging them individually, with the exception of the iClickers which provided anonymous responses.  Even trying to get information about what they did over the weekend was like pulling teeth!

However, once I started teaching, students were asking questions in a private chat box. I was thrilled! Having the chance to correct misunderstandings or clarify difficult concepts prior to moving on is very important when building the foundations of a new concept, a new way of thinking, and a new way of applying mathematical concepts. I use these opportunities to customize in class review questions, targeting specific learning barriers.

I found that online learning also made using the “Flipped classroom” strategy more palatable for the students. They were better prepared for our synchronous online classes, and I could use our time towards applied learning.

It was interesting having this particular, very quiet, class as the first to teach over Zoom. It seemed to me that the differences in the teaching/learning environments were amplified. Another example. During in person classes, I often broke the students into small groups to work together to solve a particular problem. Collaboration leads to richer educational experiences. This class, however, would sit in groups of 2 or 3, and quietly work on their own.  What I found was, when I used breakout rooms in Zoom, they would actually work together, which also resulted in increased engagement, developing their critical thinking skills.

These are just a few examples of the benefits to switching to Zoom for this particular classroom. Although, I still hold on to my belief that there are benefits to face-to-face learning that cannot be met by the online platform. I found it more challenging to place the lessons into a real-world context. As I instruct future healthcare providers, the social context is very important.