EDC-638C Participatory Action Research
Cycle Three Report
INTRODUCTION
Overall Goal of the Action Research Project
To improve the students’ ability to have a deeper understanding of
concepts taught in Periodontology courses and then demonstrate this
understanding during patient care.
Cycle One Research Question
The initial and narrower question for cycle one was “if students utilize a wiki to build, discuss and reflect on periodontal concepts presented in DEH-33 Periodontology will it result in a deeper understanding of the concepts addressed during this class? The cycle led to an understanding that the faculty who were evaluating the students’ ability to demonstrate a deeper understanding were not calibrated on their expectations. Therefore, a faculty calibration session was held prior to the implementation of cycle two to address this issue. The wiki was found to be helpful but future research indicated that the design of the course needed to be restructured to allow for students to transfer knowledge into a deeper understanding.
Advanced Periodontology, DEH-43, was restructured to adhere to Understanding by Design model of teaching to attempt to design a learning environment that would support the goal of this action research project. The specific question for cycle two was “can the use of wiki as an ‘information gathering tool’ in conjunction with the peer and faculty lead discussion on a discussion board facilitate a deeper understanding of periodontal concepts?” The redesign of the course had an impact on the students’ ability to have deeper understanding of the concepts discussed. The factor that didn’t allow for a true understanding of what knowledge and deep understanding the students are demonstrating during patient care is lack of a consistent evaluation mechanism and an agreed upon student outcome by faculty members.
TRANSITION FROM CYCLE TWO
TO CYCLE THREE
Cycle
two’s components were included in the course requirements for the students so
they will remind in place until the end of the semester. The focus is now shifting to getting
the faculty members to become more calibrated on the expectations of students which
will allow a more reliable evaluation of the students’ ability to demonstrate a
deeper understanding of Periodontology during patient care.
CYCLE THREE RESEARCH
QUESTION
If
I can provide a the opportunity for faculty members to discuss components of
the periodontal assessment, expectations of students, and then design and
develop an evaluation mechanism, will it increase the consistency in which
students are evaluated and therefore allow for a reliable assessment of
students’ ability to demonstrate a deep understanding of Periodontology?
CYCLE THREE PROCESS
My
plan for cycle three is to hold biweekly, thirty-minute meetings to open
communication about periodontal assessments during patient care. These meetings will allow each faculty
member to voice their opinions and concerns and to have input in the design of
the evaluation tool to be implemented in the fall semester. The meetings are duplicated between the
Monday and Wednesday faculty members. Scheduling will not allow for everyone to
get together with any regularity.
Cycle
three was initiated on the week of May 11h with two meetings. This first week’s meeting was an
open session designed to get faculty members to think about the process of a
periodontal assessment, what it entails and their expectations from students
during patient care.
The
meetings held during the week of May 18th had the faculty members
writing down the key components in a periodontal assessment and providing a
brief statement as to why each step is important to them.
This
is where my action research project must stop due to time restraints. It will
continue and will include the following:
· Presentation of the data gathered on the key components in a periodontal
assessments and discussion about findings.
· Assessment of three scripted videos that have students presenting periodontal assessments at chairside; faculty will critique these with discussion about what they see and what is important.
· Review of current literature on the current trends in Periodontology by
all faculty members and discussion about the readings.
· Build a list of key components for the periodontal assessment that all
faculty members can agree or consent to incorporate into students’ expectations
during patient care.
· Design an evaluation mechanism that includes the agreed upon key
components.
· Have each faculty member pilot test the evaluation mechanism.
· Utilize feedback from pilot test and rework evaluation mechanism.
· Revisit the three videos and have faculty members evaluate students with
the new evaluation mechanism.
Discuss differences and similarities of views and outcomes of this
exercise.
· Make any needed changes to evaluation mechanism that was identified
during video exercise.
· Have each faculty member pilot test the new version of the evaluation
mechanism.
· Utilize feedback to make necessary changes.
· Implement new periodontal evaluation mechanism.
The
deadline for the conclusion of Cycle Three is August 1, 2009.
ACTION OUTCOMES
The action that I sought to initiate was an open, productive avenue of communication between all faculty members about periodontal assessments. I strived not to be the “director” during the meetings but a peer that was passionate about opening dialogue that would lead to the incorporation of everyone’s opinions and concerns. And, ultimately result in an evaluation mechanism that was reliable and it would enhance the learning environment for students through consistent feedback (Butler & Winne, 1995).
The first meeting was held in my office and the environment didn’t lend itself to be productive. We had multiple interruptions by students, faculty and a staff. It was decided that the future meeting would not take place in my office but in a classroom with the door locked.
The second meeting of the first week took place in the Phoenix Airport. This environment led to a very productive and engaged conversation. There were six faculty members plus myself. Two of these members were present during Monday’s meeting. They noted that the conversation and flow was more relaxed and consistent without the interruptions experienced on Monday at the airport.
The third and fourth meetings were held during week two and consisted of
the faculty members writing down the key components of a periodontal assessment
and a statement to why each component is important to them. Nine faculty members, including myself,
participated in this activity.
EVIDENCE COLLECTED
The evidence I collected for the small aspect of cycle three that I have
implemented by the date of this writing includes notes from the introductory
discussion and each faculty member’s key components for the periodontal
assessment.
The purpose of this introductory discussion was to introduce the purpose of the subsequence meetings and to initiate an open dialogue between all faculty members. I decided to record the observable behaviors of the faculty members with regard to 1) apparent interest in the process; 2) openness to discuss topic; and 3) openness to listen to others comments.
The data indicates results from two meeting with a total of eight faculty members present. (Table 1)
Table 1
|
Observed Behaviors |
Count |
|
Apparent interest in the process |
7 |
|
Openness to discuss topic |
6 |
|
Openness to listen to others comments |
6 |
n = 8
Key Components In the Periodontal Assessment Process
The main data that was collected involved the process of breaking down the periodontal assessment process to allow the faculty to identify what they view as the key components of a periodontal assessment. After the faculty wrote down their key components, the data gathered was reviewed, and coded to determine trends or themes in the responses. (Table 2)
Table 2
|
Key Components of
Periodontal Assessment |
Count |
|
Understand patients ability to disrupt bacterial flora |
1 |
|
Nutrition and correlation to health of patient |
1 |
|
Role of systemic antibiotics and locally delivered antibiotics |
1 |
|
Oral hygiene strategies |
7 |
|
Vertical BWX |
1 |
|
Crown-to-root ratio |
5 |
|
Gingival description |
6 |
|
Clinical assessments (MBI, BOP, PD, recession, mobility, fremitus,
MGD, CAL, AL) |
7 |
|
Radiographic interpretation |
5 |
|
Connecting clinic to radiographic findings |
7 |
|
Diagnostic FMX for periodontal purposes |
7 |
|
Dental hygiene diagnosis |
5 |
|
Modifying factors |
5 |
|
Perpetuating factors |
5 |
|
Medical history (systemic) correlation to periodontal status |
9 |
|
Tooth morphology |
1 |
|
Occlusion |
1 |
|
Prognosis |
4 |
|
ADA classification |
7 |
|
AAP classification |
8 |
|
Determination of recare intervals |
7 |
n= 9
Based on the information gathered it appears that specific key
components are shared by the majority of the faculty members. When I compare these key components with
the current evaluation tool, there is a discrepancy on what we are currently
evaluation the students on and what is viewed as a “key component” (Table 3). There are many items missing which can
lead to inconsistent feedback to students if they utilize the current
evaluation tool as a guideline for clinical expectations. This confirms that the future steps for
Cycle Three need to occur to eliminate the discrepancy in the evaluation
mechanism.
Table 3
|
Key Components of
Current Evaluation Tool |
Count from Faculty Key
Components |
|
ADA Case Type |
7 |
|
AAP Classification |
8 |
|
Prognosis |
4 |
|
Perpetuating factors |
5 |
|
Modifying factors |
5 |
|
Clinical assessments (MBI, BOP, PD, recession, mobility, fremitus,
MGD, CAL, AL) |
7 |
|
OHI strategies |
7 |
|
Determination of recare sequence and justification |
7 |
|
Medical history correlation |
9 |
|
Dental hygiene diagnosis |
5 |
|
Radiographs interruption |
5 |
|
Gingival description |
6 |
REFLECTION
Cycle three has changed my focus on the action research from the students learning to
how students are evaluated by faculty. This was not an anticipated detour in my
action research project but it is welcomed. I believe that cycle three has
allowed me to look at the design of a course in a boarder sense and therefore
appreciate all the forces that have impact on student learning.
I
feel that most of the faculty members are embracing this opportunity to reflect
and design an evaluation tool that will allow us to evaluate students with
consistency and therefore, reinforce knowledge and understanding that students
are presenting during patient care.
Keeping the faculty engaged may be a challenge but I think that all the
faculty members want to design a learning environment that will enhance student
learning. I believe if I can keep the focus on the students and what this
process has to offer the students, the faculty will remain engaged and
enthusiastic. I’m starting to
think about how to sustain the inevitable change that will be the outcome of cycle three. Returning to old, comfortable
behaviors is risk that occurs anytime change occurs. I need to find
motivational and supporting mechanisms to put into place to support the change
in procedure and/or behavior. Of
possibility the outcomes noted by the students may be all the motivation that
is needed to propel the change into a habitual occurrence by faculty members.
As
I reflect on the change in me during this process, I’ve come to realize that I
work with faculty members that will do anything to improve the learning
environment, including giving up their lunch hours for 14 weeks as we work
through this process. And, the majority are excited and enthusiastic about the
potential impact this process may have on student learning. I realize that this is rarity and I
must not take it for granted. I
also realize I must be an effective, efficient and empathetic leader during
this process in order to keep them fully engaged.
When
I reflect deeper into the process, I realize that I expect the faculty to
embrace this project and if they didn’t I would be extremely disappointed. I
wonder why this is since I’m usually comfortable with individuals not agreeing
or supporting all decisions that are made in our educational setting. I think again it may be because I think
the impact of this action research project may be the start of becoming
competent in teaching all students to be able to take knowledge and transfer it
to a deeper understanding.
I’m
looking forward to seeing the outcomes of cycle three and the impact it will
have on student learning. This
outcome will be realized in June 2010 and I wonder at that time if I will be
able to see how each cycle intertwined and impacted the subsequent cycle or
will it look like a seamless evolution of learning occurred? Either way, it will have a dramatic
impact on how I view learning and the environment that supports learning.
References:
Butler, D. & Winne, P. (1995) Feedback and Self-Regulated Learning: A Theoretical Synthesis. Review of Educational Research, 65 (3) 245-281. doi: 10.3102/00346543065003245
