Abstract
This paper examines possibilities and challenges when implementing distance teaching of theoretical content in a regionalized medical program (RMP). It will be argued that Cultural-Historical Activity Theory (CHAT) and the concepts of dominant and non-dominant activities, including conflicts and transitional actions, can lead to an understanding of the distance teaching implementation process. The concepts further provide a theoretical lens through which one can understand the complex relationship between the established and historically rooted, face-to-face teaching activity and the new non-dominant distance teaching activity introduced in the educational setting. Data in the study was collected through an online survey, log data, observations, and in-depth interviews. During the analysis, conflicts between the dominant face-to-face teaching and non-dominant distance teaching activity were identified, and they partly inhibited medical teachers at the program from adopting and developing distance teaching. By illustrating transitional actions as small, innovative bottom-up solutions, further analysis revealed how medical teachers tried to overcome those conflicts to facilitate the adoption and development of distance teaching. The non-dominant distance teaching activity, even if not fully adopted, actually influenced and facilitated change in educational practice. The discussion argues that understanding the implementation of a non-dominant teaching activity in medical education in terms of mere success or failure is not fruitful. Instead, we should strive for sensitivity by closely analyzing the implementation process as interplay between dominant and non-dominant teaching activities. Such sensitivity will make it possible to cultivate future educational development and change.
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References
Baker, P. G., Eley, D. S., & Lasserre, K. E. (2005). Tradition and technology: teaching rural medicine using an internet discussion board. Rural and Remote Health, 5(4). Available online: http://www.rrh.org.au.
Balacheff, N., Ludvigsen, S., de Jong, T., Lazonder, A., & Barnes, S. (Eds.). (2009). Technology enhanced learning: Principles and products. Milton Keynes: Springer.
Beetham, H., & Sharpe, R. (Eds.). (2007). Rethinking pedagogy for a digital age: Designing and delivering e-learning. New York: Routledge.
Birch, B., & Burnett, B. (2009). Bringing academics on board: Encouraging institution-wide diffusion of e-learning environments. Australasian Journal of Educational Technology, 25(1), 117–134.
Burbules, N. C., & Callister, T. A., Jr. (2000). Universities in transitions: The promise and challenge of new technologies. Teachers College Record, 102(2), 271–293.
El’konin, D. B. (1977). Toward the problem of stages in the mental development of the child. In M. Cole (Ed.), Soviet developmental psychology (pp. 85–93). White Plains: M. E. Sharpe.
Ellaway, R. (2011). Is it ok to say ‘no’? Medical Teacher, 33(1), 88–90.
Ellaway, R., & Masters, K. (2008). AMEE guide 32: E-learning in medical education part 1: learning, teaching and assessment. Medical Teachers, 30(5), 455–473.
Engeström, Y. (1987). Learning by expanding: An activity-theoretical approach to developmental research. Helsinki: Orienta-Konsultit Oy.
Engeström, Y. (2001). Expansive learning at work: Toward an activity theoretical reconceptualization. Journal of Education and Work, 14(1), 133–156.
Engeström, Y. (2009). The future of activity theory: A rough draft. In A. Sannino, H. Daniels, et al. (Eds.), Learning and expanding with activity theory (pp. 303–328). Cambridge: Cambridge University Press.
Foot, K. (2002). Pursuing an evolving object: A case study in object formation and identification. Mind, Culture, and Activity, 9(2), 132–149.
Hauge, T. E., & Norenes, S. O. (2010). Videopaper as a bridging tool in teacher professional development. In A. D. Olofsson & O. Lindberg (Eds.), Online learning communities and teacher professional development: Methods for improved education delivery (pp. 209–228). Hershey: IGI Global.
Kaptelinin, V., & Nardi, B. A. (2006). Acting with technology: Activity theory and interaction design. Cambridge: The MIT Press.
Karsenti, T., & Charlin, B. (2008). Information and communication technologies (ICT) in medical education and practice: The major challenges. International Journal of Technologies in Higher Education, 5(2), 68–81.
Kvale, S. (1996). Interviews: An introduction to qualitative research interviewing. Thousand Oaks: Sage Publications.
Laurillard, D. (2008). Technology enhanced learning as a tool for pedagogical innovation. Journal of Philosophy of Education, 42(3–4), 521–533.
Leont’ev, A. N. (1981). Problems of the development of the mind. Moscow: Progress Publishers.
Lillis, S., Gibbons, V., & Lawrenson, R. (2010). The experience of final year medical students undertaking a general practice run with a distance education component. Rural and Remote Health, 10(1). Available online: http://www.rrh.org.au. Accessed 16 May 2013.
Lindberg, J.O., & Olofsson, A.D. (2012). Sustaining a professional dimension in the use of educational technology in European higher educational practices. Educational Technology, 52(2), 34–38.
Nestel, D., Ng, A., Gray, K., Hill, R., Villanueva, E., Kotsanas, G., et al. (2010). Evaluation of mobile learning: Students’ experiences in a new rural-based medical school. BMC Medical Education, 10, 1472–6920.
Pettersson, F. (2013). Implementing a Swedish regionalized medical program supported by digital technologies: possibilities and challenges from a management perspective. Rural and Remote Health, 13(1), 2173. Available online: http://www.rrh.org.au. Accessed 17 May 2013.
Pettersson, F., Olofsson, A. D., Söderström, T., & Ljungberg, C. (2013). Medical education through the use of digital technologies: the implementation of a Swedish regionalized medical program. The University of the Fraser Valley Research Review, 4(3), 16-30.
Reid, P. (2012). Categories for barriers to adoption of instructional technologies. Education and Information Technologies. doi:10.1007/s10639-012-9222-z. Available online: http://link.springer.com/article/10.1007%2Fs10639-012-9222-z.
Sandars, J., Homer, M., Pell, G., & Crocker, T. (2008). Web 2.0 and social software: The medical student way of e-learning. Medical Teacher, 30(3), 308–312.
Sannino, A. (2008). Sustaining a non-dominant activity in school: Only a utopia? Journal of Educational Change, 9(4), 329–338.
Schneckenberg, D. (2010). Overcoming barriers for elearning in universities- Portfolio models for ecompetence development of faculty. British Journal of Educational Technology, 41(6), 979–991.
Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge: Harvard University Press.
Zayim, N., Yildirim, S., & Saka, O. (2006). Technology adoption of medical faculty in teaching: Differentiating factors in adopter categories. Educational Technology & Society, 9(2), 213–222.
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Pettersson, F., Olofsson, A.D. Implementing distance teaching at a large scale in medical education: A struggle between dominant and non-dominant teaching activities. Educ Inf Technol 20, 359–380 (2015). https://doi.org/10.1007/s10639-013-9289-1
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DOI: https://doi.org/10.1007/s10639-013-9289-1