In conjunction with the Professional Learning Cycles, the team at your school/district will receive implementation support from a PCE consultant with school and coaching experience to guide the implementation of the work in classrooms.

The PCE consultant will also provide text set recommendations for staff,  customize student materials recommendations and answer any questions throughout the process. 

Create hubs of innovation: A guiding principle in their work is to create synergies in order to maximize educators’ ability to respond to students’ needs and interests in creative, rigorous, and differentiated ways. The vast intellectual resources of the university and the numerous professionals that they prepare for the region provide us with unique leverage to provide interdisciplinary, research-based responses to the region’s teaching and learning issues and challenges.

Conduct research to inform program development and instruction in their educator preparation programs: Research associates affiliated with CapEd, including a Pathways Research Fellow, conducts a range of research on effective practice for preparing future educators. This research informs the curriculum and instruction in their programs preparing future teachers, special educators, school counselors, school psychologists, school nurses, and school social workers.

A sampling of their research:

CapEd sponsors research that marshals faculty expertise, provides students with research experiences, and addresses issues of concern to the region’s educational community. Current research efforts are focused on school climate at a local school, school violence and factors shaping violence prevention and mitigation, and interventions that effectively support English learners with academic writing in high school.

Enhance in-service educator professional learning: Faculty associated with their educator preparation programs routinely engage with in-service educators to share current research, use this research to collaboratively develop applications to pressing problems of practice, and hone skills and expertise so that students are better served and professionals increase their knowledge base and their connection to their fields.

A sampling of their professional learning offerings:

An interprofessional faculty team with expertise in educational leadership, school counseling, and inclusive educational practices is working with a large, comprehensive high school to identify key educational equity issues that will be the focus of their 2019-2020 WASC self-study. Working collaboratively with the school’s Equity Leadership Team, they are surveying students, conducting document analysis, and engaging focus groups.

A faculty team with experts in child/adolescent development, school counseling, and special education is implementing a professional learning series on inclusive practices, particularly related to SB 48, for teachers, parents and school board members associated with a specific charter school district.

A faculty team with expertise in mathematics, science, computer science, and Universal Design for Learning is offering a 5 day summer institute to elementary school teachers interested in best practices for NGSS-aligned, inclusive instruction.
School counseling experts delivered professional learning sessions to high school counselors in a local district to increase their capacity to advise for college/career pathways and to mitigate the summer slump.

Contribute to effective and equitable systems: They partner closely with school districts and agencies serving students and families throughout their region. This vantage point allows us to understand the systemic issues facing their educational partners. Using research and inquiry techniques, they support their partners to develop solutions that can transform systems.

Some of their systems work includes:

Using a nationally-validated survey instrument, they are conducting an exit survey for a partner district to assist them with better understanding patterns of teacher attrition and retention.

With tools from the Society for Human Resource Management, they are working with a local district to better align its new teacher on-boarding practices and protocols as a way to Improve teacher retention and efficacy.

As part of a long-term partnership, they are working with local district staff to bring standardization and rigor to its support of schools as they develop their annual Single Plan for Student Achievement.

Amplify student voice through media making and authentic audience. These free, ready-to-use, standards-aligned projects empower your students to share their ideas through audio, video or images that are published on the public Challenge showcase.

Best Practices for Student Professional Conduct

This document is intended to supplement the UAB Marnix E. Heersink School of Medicine Student Code of Professional Conduct. It is not a substitution for the general ideals and principles outlined in the Code of Professional Conduct. Instead, it is meant to provide a framework with which students, faculty, and staff can think about the practical application of the Code of Professional Conduct. Additionally, this document provides a shared way of talking about the Code of Conduct to foster a sense of communal commitment and understanding. 

The best practices presented in this document are not intended to be comprehensive or necessarily prescriptive. Instead, they serve as a diagnostic tool to facilitate adherence to the Code of Professional Conduct in order that they might maintain the highest standards of excellence, support the healthy development of future physicians, and maintain the primary importance of patient welfare. 

A final note: In the same way patients are best served by members of the healthcare team who seek out others to discuss, learn from, debate with, and look at the patient’s condition from a variety of angles, the same is true when using this document. Issues of conduct, professionalism, and behavior are as complex and diverse as the people they involve, and, except in the most extreme cases, they are multi-layered and often without clear answers. They are all better served when conversations about the ideals and principles in the Code of Conduct — and the elements of this best practices document — are discussed together.

Respect for Ourselves 

We commit to self-evaluation and developing the necessary skills to ensure they are engaged in self-care, particularly in times of increased intensity and stress.

• We will learn how to manage stress and recognize the symptoms of burnout, so that they can mitigate the long-term ramifications to their personal selves and their careers.

• We will develop the skills they need to engage in-the-moment wellness that will help us stay engaged in medical education and training.

We embrace asking for help and seeking out resources to assist us in maintaining their mental, physical, and emotional health and well-being. 

• We will normalize help-seeking behaviors and take advantage of the resources available to us as students. 

• We will be open to talking about the things going on in their lives, with classmates, faculty, and staff, and listening to others when they need to talk. 

We will approach all situations of patient care, whether educational simulations or clinical settings, with clear minds so that their focus can be on learning and providing the best possible care.

•  We will recognize that their personal lives could affect their abilities to care for patients in the most effective way or engage in learning. This means, at times, they will choose to prioritize education and patient care.

  • This might include: refraining from over consuming alcohol during clinical times; refraining completely from use of non-prescribed stimulants; using prescribed stimulants in the proper manner and dosage; to the extent possible, getting adequate sleep during times of patient care. 

Respect for their Classmates 

Maintaining respect and dignity for their fellow students, whether in-person or online. 

• We understand that others do not necessarily share their personal experiences and beliefs, and they recognize the validity and importance bringing a variety of voices into conversations. 

• We will not tolerate discrimination in any forms. This includes, but not limited to cultural, religious, personal beliefs; gender; sexual orientation and identity; disability; race and ethnicity; and age.

• We will speak up against discrimination, in any form. 

• We will purposefully strive to interact with classmates who are different from ourselves.

• We will refrain from using social media as an outlet to express their opinions and feelings about their classmates and colleagues.

• We understand that social networks are public domain and that comments made in these forums regarding other students can have personal and professional ramifications.

Respect their classmates’ learning experience.

• We will demonstrate respect for their classmates and instructors by being punctual and prepared for activities. 

• We will engage in group work, ensuring that all are contributing appropriately. 

• We will be aware of how their actions may affect others in group. 

  • Sometimes this might mean taking a step back, so that others may equally share roles in team activities.

Foster a collaborative environment and community that builds each other up.

• We will support their classmates through sharing appropriate learning resources that have been helpful to us.

• We will strive to support rather than impede others. They are all one team!

  • Unhealthy competitive behaviors and actions only negatively influence everyone’s experience in medical school.

• We will be aware that other stressors may compound the stress of medical education and training. 

• If they notice a classmate is struggling, they will offer to help as much as they are able, including guiding them to the appropriate resources.

• We will strive to assist classmates in maintaining a positive image in all social and public environments.

• We will be aware that their actions as a representative of the school may affect how their peers are viewed. 

  • We will maintain their professional identity for the sake of their classmates and ourselves. 

Respect for their Educators and School 

We recognize that being a student of the Heersink School of Medicine means they are part of an organization larger than ourselves with a history, reputation, and impact that extends beyond their time as students. 

• We will strive to set positive examples for students in classes below their own, and for students who will enter medical school after us.  

• We recognize that, as ambassadors of the school, they determine how others view their institution in the present and years to come.

• We will take the initiative to reach out and be transparent when seeking clarification or advice.

• We will choose to be kind during in-person interactions and correspondence.

We accept that being part of a large, multi-faceted organization means there are rules, policies, and procedures they adhere to, even if the reasons seem unclear. 

We embrace the work of seeking the best for their school, and they commit ourselves to seek clarification, challenge ideas and current thinking, provide feedback, and ask questions in ways that are professional and constructive. 

• We will always strive for positive improvements at their institution.

• After communicating a grievance, they will allow a reasonable amount of time (48 hours) for a response, before reaching out again.

  • When they are dissatisfied or have a complaint, they will criticize the action and not the person, whether an instructor or classmate. Refrain from using inflammatory language and making assumptions about their interactions. 
  • When possible, offer solutions.
  • Follow professional guidelines for submitting a complaint or concern.
  • When in doubt, seek a third party to proofread correspondence.

We accept that they are both represented by and representatives of the Heersink School of Medicine, and that external individuals and groups may base their judgements and perceptions of the School on their interactions and perceptions of us. 

• We will be mindful that their in-person and social media presence reflects on ourselves, but also the school of medicine, as a whole.

• We will conduct ourselves online the same as they do in person.

• We will be respectful and mindful of others, on and off campus.

We welcome the tension that comes with navigating personal autonomy while knowing their decisions and actions may reflect on their classmates, faculty, and administration. 

• As ambassadors of the School, their actions can reflect back on the school in positive and negative ways.

• We will exercise professional judgement in their words, whether spoken aloud or posted online.

  • Recognize that while their thoughts and opinions are valid, they may not reflect the views of the entire class.

  • In all public statements, acknowledge that opinions are their own and do not necessarily reflect those of the students, faculty, staff, and administration of the Heersink School of Medicine, nor the University of Alabama at Birmingham. 

• Before posting criticisms of the School of Medicine or calls for change/action online, they will seek guidance from appropriate faculty, staff, or classmates about how and when to express frustration.

We acknowledge that the faculty, staff, and administration are professionals here to help us reach their goals, and they will keep this partnership and professional relationship in focus, particularly when they have disagreements or are providing feedback.

• We seek to always provide feedback in a way that is constructive and direct. 

  • Use professional and non-accusatory language when providing feedback.

• We will be clear and considerate when communicating with others

• When there is a disagreement, they will attempt to remain open-minded of others’ opinions to promote a thoughtful discussion that will reach a positive solution.

• Where there are disagreements and they are uncomfortable with speaking with someone, they will find an appropriate third party to help facilitate the discussion.

Respect for their Patients 

We recognize the centrality of the physician-patient relationship, which forms the basis for effective care and treatment.

• We will not seek to build relationships with patients outside of the appropriate student/doctor-patient context.

• We will allow the patient’s best interest to guide all their decision making and communication.

• We realize that it is their responsibility to communicate clearly for the purpose of patient education and compliance. When they are not satisfied with the level of patient understanding, they will respectfully find the best communication strategy to achieve their goal for the care of the patient.

• When presented with the opportunity to reflect on their own preconceived notions, they will remain mindful that each of us has biases (unconscious or conscious) and will dedicate time to addressing such issues.

We will model the highest levels of professional behavior during patient encounters, whether simulated or real. They will show respect for their patients with all modes of action and behavior. For example:

• We will speak respectfully to their patients.

• We will communicate to others about patients with the highest level of respect.

• We will use best practices for facilitating rapport and trust, including body language cues.

• We will adhere to the standards of dress laid out by the Heersink School of Medicine, as well as those from the clinical settings in which they work.

We will adhere to the legal standards of privacy (regard for the privacy of the person) and confidentiality (protection of their health-related information) as they learn the nuances and complexities of patient confidentiality in real-world situations and cases.

• We will adhere to HIPAA and all relevant state and federal policies pertaining to patient privacy.

• As applicable to their clinical training, they will adhere to the policies of the various hospitals in Birmingham, on the regional campuses, and clinical facilities in which they are working. 

• We will maintain respect of their patients’ privacy in the test room, hallway, and outside of the encounter.

We embrace both the unique tensions of a changing world with new technologies and recognize the timeless responsibility physicians have to guard patient information.

• We will not divulge patient information, including photographs, on any form of social media, unregulated electronic communication, or other digital platform without the written legal consent of the patient or representative.

Respect for their patients is vital for their health outcomes and instrumental for developing an appropriate patient-doctor relationship. Establishing and maintaining respect should be a priority throughout each of their encounters in medical school, setting a firm foundation for their careers. 

• We acknowledge the potential harms of preconceived notions about their patients before and throughout their interactions, remaining mindful that they could undermine the physician-patient relationship.

• We acknowledge their lived experiences might be different from those of their patients. They will refrain from judgment about their words, actions, or beliefs that might detract from the quality of care they provide.

Understand that the time they spend with each patient is essential for providing the best care and both the patient and providers are using valuable time to be present. Both the patient and the student are committing their time to any encounter, and both time commitments are equally worthy of respect. They acknowledge that no time spent caring for patients is wasted.

• We will seek assistance from supervisors when in need of help to provide best care.

• We acknowledge the responsibility to be transparent about any lack of skill or knowledge that could potentially harm a patient. 

• We seek to learn and grow as physicians, and they recognize that it is at times crucial to seek external guidance and information to that end.

Respect for Profession

Maintain a professional presentation within the institution and beyond.

• We will use professional language when interacting with patients, peers, and other members of the health care team.

• We will maintain a professional appearance, in accordance with the stated dress code, for all clinical interactions.

• We will show respect for educational settings and the learning environment as a professional learner.

• We will maintain a professional online presence, recognizing their role as a representative of their School and their profession.

Continuously strive to Improve the field of medicine and healthcare for all

• We will demonstrate commitment to curiosity, self-improvement, and lifelong learning. 

• We will work to maintain an updated clinical and scientific knowledge base.

• We will work to advance knowledge by asking questions of unsolved problems.

• We embrace their role as a teacher through sharing knowledge with patients , classmates, and colleagues.

Recognize the “opportunity, responsibility, and obligation” of the practice of medicine

• We will recognize their limitations, and will ask for help when needed

• We will express interest and engagement towards their roles and responsibilities

• We will respond with tact, empathy, and understanding when caring for patients and interacting with classmates and colleagues.

• We understand the unique pressures and sacrifice required of their profession that at times may require prioritizing patient care over personal preferences.

• We will prioritize mutual respect and productive conversation when differences of opinion occur.

Best Practices for Addressing Acts of Misconduct

The complete process and procedures for addressing acts of misconduct can be found in the Student Code of Professional Conduct. While some of the below information is duplicated from the Code of Conduct document, the purpose of this section is to provide some operational and theoretical best practices for how these processes will be followed in the event of a reported act of misconduct. 

• The Heersink School of Medicine will conduct a thorough investigation of any reported violation of the Student Code of Professional Conduct.

• The following questions will direct the investigation.1

  • Act: Was there a potential violation?

  • Knowledge: Did the student know, or should a reasonable student have known that the Act was a violation?

  • Significance: Would tolerating the Act damage the honesty and integrity of their profession or community?
    1Adapted from the University at Buffalo Jacobs School of Medicine and Biomedical Sciences https://medicine.buffalo.edu/orientation/checklist/code-professional-conduct.html 

• The goal of addressing violations of the Student Code of Professional Conduct will always be the personal and professional growth of the individual(s) involved. However, there may be instances when the behavior is egregious and considered a violation of these standards.  As a result, a student may be sanctioned or dismissed.

Best Practices for Student Engagement with the Code of Professional Conduct

• Students are introduced to the school’s Code of Professional Conduct and best practices, expectations for learner, faculty, and support staff professional behavior, and mechanisms available for reporting unprofessional behavior including mistreatment at the beginning of medical school. This statement, policies, expectations for professional behavior and the reporting mechanisms are covered in detail again prior to the start of clinical coursework during orientation to the clerkships. 

• Students attest to reviewing the Code of Professional Conduct and best practices document during the mandatory annual student credentialing process.  Students are reminded of reporting mechanisms during orientation to each preclinical and clinical course, on the School of Medicine’s websites, and through digital signage in Volker Hall.

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In their 2006 book, The Experience Economy, Pine & Gilmore suggested that experiences were the basis of their economy. More interesting, to me, was the claim that the next economy would be the transformation economy. That is, experiences that change us in ways that they want, or need, to be developed. This, I suggest, is what they do! At least, when we’re on their game. I think there are two different ways in which they may not be. Further, there are good resources to address the first, but the second is an area they really can be better at.

Learning Experience Design is where they elegantly integrate learning science with engagement

Learning Experience Design, LXD, is where they elegantly integrate learning science with engagement. That is, they have to do good instruction, but they also have empirical evidence from researchers like Lepper that when learners are engaged, the outcomes are better. Fortunately, there’s a growing awareness of the importance of learning science, with early books like that of Clark & Mayer’s eLearning and the Science of Instruction, now being complemented by excellent tomes from Dirksen, Neelen & Kirschner, and others. Even my next-to-most-recent tome talked about Learning Science for Instructional Designers.

Which leaves us with the other side, engagement – the emotional side of the story, where ‘emotion’ is a shorthand for the elements of creating motivation, keeping anxiety in check, and building confidence. In cognitive science, they recognise conation as a complement to cognition, where conation represents the intention to learn.  Learning works better when the learners are committed. This comes from recognising the value of the learning, not being afraid to try, and persisting through to achieve the end result.

In instructional design theory, Keller, with his ARCS model (Attention, Relevance, Confidence, and Satisfaction) is really the only person to address this side of the equation, and they need more. In my most accurate tome, Make It Meaningful, I’ve built upon Self-Determination Theory (Deci and Ryan), and combined it with early experience and research on games, complemented by explorations of interface design, fiction, surprise, and more, to develop an understanding that can be reliably applied.

I start by proposing that there are two major elements: the hook, and the landing (leveraging a fishing metaphor, possibly badly as I’m not a fishing person). Each of these has its own elements, though they’re related. Getting these right, and integrated with an effective learning science plan, yields an outcome that can be truly transformative.

The hook

What conation tells us is that people have to commit to the learning experience. I suggest that it takes three elements, that learners have to:

• agree that being able to perform in this new way is of value
• recognise that they don’t already know how
• believe that this experience will change that situation

These are all typically assumed and not specifically addressed, to the detriment of the experience. So, how do they do this?

To start, there has to be real value to the learner. There has to have been sufficient analysis to determine that this is necessary and not yet known. Trying to build engagement for something that doesn’t have a clear benefit to the learner is a wasted exercise. They shouldn’t be building courses that don’t have a clear outcome anyway!

Once there’s clear benefit, you need to make this manifest to the learner. I suggest that an obvious way is to demonstrate the consequences of having this skill, or of not having it. So, they can show the positive consequences possible with this ability, or what can go wrong if it’s not in their skillset. They can do this humorously or dramatically, but showing these outcomes is a clear indication of the rationale for this learning.

An obvious way is to demonstrate the consequences of having this skill, or of not having it

So, for instance, they can show the benefits of knowing how to change a bed with a patient in it, or the consequences of not knowing how to successfully execute a financial transaction on the part of a customer. They match the positive or negative, and dramatic or comedic, to the audience.

There are many situations (though not all) where their learners may already believe they know this. In the case of a sales team, for example, they were overly-confident in their ability to sell trucks. They had to create an evidence-gathering scenario, which they wouldn’t fully explore, and a subsequent feature quiz, which they would consequently do horrid on, before they were ready to listen to the message. If learners believe they know the material, they will have to be dissuaded of the notion before they’re ready to commit.

The last part would be easy, if they had developed trust with their learners on the quality and impact of the experience. Unfortunately, as I have seen way too often, learners will only tolerate, or even actively avoid, most formal learning. I believe that’s largely because we’ve delivered courses that are heavy on information and low on meaningful practice, and they have lost their confidence. They may have to exert considerable effort to rectify the situation until they learn to see that they are prepared to deliver transformation!

The landing

That transformation comes from delivering on the promise the hook proposed. While you want to maintain the motivation you’ve built, you also need to keep anxiety under control. While retention and transfer are their formal learning goals, I’ll suggest that developing sufficient confidence so that learners will apply the learning after the learning experience is also necessary. These, then are the elements that they need to address. I will address one major component that drives both learning outcomes and engagement: practice.

From books like Brown, Roediger, and McDaniel’s Make It Stick, we’ve learned that sufficient practice is a necessity for learning. They also know from books like Ericsson’s Peak that they need appropriate challenge that matches the difficulty to the learner’s current ability. Not coincidentally, what makes for good learning also makes for engagement, as they see from an alignment between Vygotsky’s concept of the Zone of Proximal Development, and Csíkszentmihályi’s explorations of creating an experience of Flow.

The task embedded in those contexts needs to authentically reflect what they’ll need to do after the learning experience

Several factors come together to design compelling experiences. The setting has to be one that learners viscerally understand are situations like they’ll face, even if they’re set in fantastic environments (medieval, western, outer space, etc.). Also, the task embedded in those contexts needs to authentically reflect what they’ll need to do after the learning experience. The level of additional material needs to be minimal, merely enough to convey the context, without overloading their cognitive resources. They also need the consequences and the feedback that reinforces the right answer and explains why wrong answers are understandable but inappropriate.

In addition, they need the right suite of practice. They need a path of practice that gradually builds in challenge level, is spaced out over time, and is varied. Further, they need the practice to be across sufficient contexts to support appropriate transfer.

Then they need the minimal content to support success on the practice. This, cognitively, consists of models and examples. Models explain how the world works in this domain, providing a basis for choosing a course of action based upon the outcomes of this decision or that. Examples illustrate those models in context. Adding in engagement, those examples should be compelling stories. They should also show learner progress, building confidence and indicating where they are in the process.

We’ll also want a closing that concludes the experience that the introductory hook opened up. They want to acknowledge effort, celebrate accomplishments, and point to deeper and further directions. They may drill back up from the current context to the bigger picture, which Reigeluth’s Elaboration Theory tells us they should do the reverse of to begin the experience.

There’s more. You have to ensure that the learning isn’t extinguished, for one. Supervisors or managers, reward policies, and so on, can interfere with the outcomes of a successful transformation. You can’t get sales teams to do solution selling if you’re still rewarding the number of widgets sold, and managers’ “that’s not how they do it here” attitude can effectively squelch even the best-designed interventions. Dirksen’s new book, Talk to the Elephant, elegantly addresses those issues.

Completing the picture

To fully deliver on the experience, you need to understand the detailed implications for the elements indicated above. In addition, you need to modify design processes to systematically develop the necessary information and then design appropriate solutions to be developed. It takes time to change the way you do things, but start with the smallest efforts that have the largest impact, focusing on a resonant hook and meaningful practice.

What we’re really seeing, above, is an integration of learning science with engagement. They have to complement each other, because they can also be in conflict; e.g. gratuitous details distracting from the focus and overwhelming available resources, as they see from Sweller’s Cognitive Load Theory. Comprehending and applying engagement provides the necessary complement to learning science to create learning that is truly transformational. Which is where they can, and should, be.

Clark Quinn is Executive Director and Quinnovation

Related content:

References

Brown, P.C., Roediger III, H.L., & McDaniel, M.A. (2014). Make It Stick: The Science of Successful Learning. Boston: Harvard University Press.

Clark, R.C. & Mayer, R.E. (2011). e-Learning and the Science of Instruction (3^rd Edition).  San Francisco: Pfeiffer.

Csíkszentmihályi, M. (1990). Flow: The Psychology of Optimal Experience. New York, NY: Harper & Row.

Deci, E. L. & Ryan, R. M. (2000). The “What” and “Why” of Goal Pursuits: Human Needs and the Self-Determination of Behavior. Psychological Inquiry, 11 (4).

Dirksen, J. (2015). Design for How People Learn (2^nd Edition). New Riders Press: Berkeley, CA.

Dirksen, J. (2023). Talk to the Elephant: Design Learning for Behavior Change. New Riders Press: Berkeley, CA.

Ericsson, A. & Pool, R. (2016). Peak: Secrets From the New Science of Expertise. Boston: Houghton Mifflin Harcourt.

Keller, J. M. (2010). Motivational Design for Learning and Performance: The ARCS model approach. New York: Springer.

Lepper, M.R., & Cordova, D. I. (1992).  A Desire to Be Taught: Instructional Consequences of Intrinsic Motivation.  Motivation & Emotion, 16, 3, 187-208.

Neelen, M. & Kirschner, P. K. (2020). Evidence-Informed Learning Design. London: Kogan-Page.

Pine, B.J. & Gilmore, J H. (1999).The Experience Economy: Work Is Theatre & Every Business a Stage. Cambridge, MA: Harvard Business School Press.

Quinn, C. (2021). Learning Science for Instructional Designers: From Cognition to Application. Alexandria, VA: ATD Press.

Quinn, C. (2022). Make It Meaningful: Taking Learning Design from Instructional to Transformational. Boston: LDA Press.

Reigeluth, C. & Stein, F. (1983). The elaboration theory of instruction. In C. Reigeluth (ed.), Instructional Design Theories and Models. Hillsdale, NJ: Erlbaum Associates.

Sweller, J. (1988). Cognitive load during problem solving: Effects on learning. Cognitive Science. 12 (2): 257–285.

Vygotsky, L. S. (1978).  Mind in Society.  Edited by M. Cole, V. John-Steiner, S. Scribner, and E. Souberman.  Cambridge, MA: Harvard University Press.