Use of Shadowing-Based Learning in an Allied Health Microbiology Course.

INTRODUCTION

Active learning occurs in an environment where students can create their own mental constructs from the course material rather than just passively listening to lectures (5). Shadowing, the practice whereby students follow professionals in their work activities, is quite commonplace and often a requirement for students to enter health professions schools. While there have been studies done and comments made on the impact of shadowing in medical education (1–4, 6), these studies did not address the use of shadowing as an active-learning exercise in undergraduate life science courses. In many nursing and dental hygiene programs, students take microbiology prior to entering the clinical portion of the curriculum. Therefore, these students are not usually exposed to clinical experiences while taking the course itself. Shadowing may be a way for students to apply lessons learned in microbiology directly to the clinical setting.

This paper describes an ongoing shadowing exercise in an undergraduate microbiology course primarily for students interested in nursing, pharmacy, and allied health professions. Although its goal is to help students connect abstract microbiological ideas to concrete practices in health care and public health, the shadowing exercise could be adapted to other life sciences.

PROCEDURE

Students in a sophomore-level microbiology course (40 to 70 students per semester) are given the option of shadowing a healthcare professional for their course projects. While other active-learning options are available to students (these include doing a scholastic review paper, service-learning, or laboratory research), the focus of this article is on the shadowing exercise. The instructions for the shadowing assignment and suggestions for projects are shown in Appendix 1. Students are directed to seek shadowing opportunities in the surrounding community (for example, finding mentors at local hospitals, medical and dental clinics, nursing homes, and pharmacies). Some students may find mentors among family members or friends employed in healthcare facilities. Whatever the case, students need to begin searching early in the semester to allow ample time for the lengthy vetting process that sometimes follows shadowing requests. On the other hand, some students may be healthcare professionals in their own right and, as such, can shadow themselves and/or serve as “mentor-partners” to other students (for example, students who are currently employed as surgical technicians, dental assistants, certified nursing assistants, or pharmacy technicians). Depending on the particular mix of students in any given semester, the number of students choosing the shadowing option may vary from as little as 25% of the class to over 75% of the class, and a variety of shadowing experiences ensue each semester (see Appendix 2 for a list of recent examples).

Concept themes

Students should incorporate 3 or 4 microbiology “concept themes” into their project design and presentation. These concept themes collectively embody the significance of microbiology in various healthcare and public health settings and were adapted from the specific learning objectives of the course.

The physical, chemical, physiological, or genetic nature of microorganisms (viruses, bacteria, fungi, algae, protozoa, or helminths) important to human health

The detection or measurement of microorganisms

The biological, environmental, or health effects of microorganisms on humans or other mammals

The control of the growth and spread of microorganisms (e.g., by the immune system, by sterile/aseptic techniques, by physical or chemical antimicrobial agents, by chemotherapy, or by other public health methods)

Students should wait until at least mid-semester before shadowing to allow time to acquire sufficient conceptual knowledge from the course. Depending on the particular experience, a student need not spend more than 3 to 6 hours shadowing, though some may choose to do it longer to satisfy professional program entrance requirements. Following the shadowing experience and near the end of the course, students share their reports with the class as PowerPoint presentations (worth 15% of course grade; see Appendix 3 for a grading rubric).

CONCLUSION

A serious limitation of the shadowing exercise is that it may not be feasible for all students in the class. Only those students who have access to shadowing mentors will be able to do this exercise. Liability issues that arise from students performing academic activities outside of class may present another problem. If this is an issue at your institution, note that shadowing is an optional and voluntary extracurricular activity. Any liability should rest with the student, the professional mentor, and the facility where the shadowing takes place.

Since most undergraduate students interested in health professions need shadowing experience anyway, it makes sense to take advantage of this to create practical active-learning opportunities comparable to other types of active learning. Indeed, when all students were asked in an anonymous survey to rank the “educational/career development value” of their particular projects (be they scholastic review, service-learning, lab research, or shadowing) on a Likert scale, there was no significant difference among the rankings for shadowing and the other project types (ANOVA, p = 0.16). Still, student comments from course evaluations over the years indicate that students enjoy the shadowing exercise and feel that they profit greatly from it. A typical example is this student’s comment: “The shadow project was more relevant to my career, and seeing things in action helped me better relate things we studied in class.” Furthermore, all students in the class, even those who do not take part in the shadowing project, benefit from the shadowing presentations made by others. Many students are unaware of the similarities and differences in aseptic/sterile procedures used in various health professions. With nosocomial infections an ever present concern in the healthcare community, the shadowing exercise focuses student attention squarely on the importance of prevention, highlighting the clinical aspects of microbiological concepts, before students enter their particular healthcare professions.

Although this shadowing exercise is directed more at microbiology students interested in healthcare careers, shadowing could also be used in other applied life science contexts, such as botany, zoology, or ecology, where students could shadow forestry or wildlife conservation professionals. Note that shadowing is not the same as an internship, which is usually conducted as part of a capstone or independent study course (whereas shadowing can be used in any life science course). The point is to have established and specific concept themes, tied to course learning objectives, that guide and focus the shadowing experiences of the students. Helping students connect course concepts to specific professional practices is the core objective of shadowing-based learning.

Appendix 1: Assignment instructions

Appendix 2: List of shadowing examples

Appendix 3: Grading rubric