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Maintaining Humanity in Technology-Rich Environments

Technology is just a tool. In terms of getting the kids working together and motivating them, the teacher is most important.

—Bill Gates in Bain & Zundans-Fraser, 2017, p. 137

In this chapter, we examine how educators can maintain humanity in the technology-rich learning environments that have become an essential part of life for most health professionals. How do we define such environments within a technology-rich world? As society has evolved over the decades, so have educational practices. Today we find a variety of classrooms, some that resemble the one-room schoolhouse of the 19th-century Western world, others that are fully virtual learning environments, and everything in between.

Of most interest in this chapter are the current face-to-face, blended, and online learning environments. Even if traditional face-to-face classrooms are not using digital technology for instruction, learners have their own technology at home and with them in the form of smartphones, laptops, and tablets. In most developed countries, postsecondary students have access to computers in classrooms, libraries, and computer labs, or they use their own equipment. The same is true for many practising health professionals. Technology is now ubiquitous in learning, and milieus are changing daily as educators introduce new technology-based learning activities and as computer scientists introduce new programs, apps, and technologies for learners to use. People are constantly adapting to new ways of communicating and learning.

Today parts or all aspects of a course, workshop, or orientation program can be offered online. As well, administrative activities in formal programs of higher education are frequently online, such as program applications, payments of fees, and transcripts for viewing. Learners have access to “frequently asked questions” electronically. Sometimes their questions are answered by a robot. Learners can choose from a plethora of online opportunities, including offerings such as massive open online courses (MOOCs). There are huge (and growing) repositories of books, journals, lessons, videos, podcasts, and so on available electronically to anyone anywhere without cost. Given the potential geographical, physical, and social distance that learners might experience when they utilize these advances in technology, how do educators develop and maintain relationships with learners in online learning environments?

Health-care service organizations and clinical agencies (which can include hospitals, public health units, and laboratories) are also learning environments for many health professionals. Health-care environments are usually rich in technology, with an abundance of pumps, machines, and monitors. The technologies that facilitate optimum patient/client care are changing constantly, with new devices and tools being adopted regularly. For example, the use of robots to provide patients/clients with companionship and support is a reality in some geriatric facilities, and other robots perform complex surgeries even though the surgeon is kilometres away from the patient.

“Technologies invite or afford specific patterns of thought, behaviour and valuing. They open up new possibilities for human action and foreclose or obscure others” (Vallor, 2018, p. 2). How can educators in the health professions maintain a human presence as they use online classrooms and clinical technologies to teach learners? How can educators choose wisely from among the multiple options available? How can we help learners to enhance real-world communications without becoming engulfed by the immediacy of social media? There are few if any straightforward answers to these vital questions. It is beyond the scope of this chapter to provide an in-depth explanation of all the technological supports available to educators to implement, particularly in online settings. Rather, we offer brief insights into approaches that educators can use to help make learning experiences with technology more humanized. We share suggestions drawn from our own practice as experienced online educators at Athabasca University, Canada’s Open University. We note how social constructivist and humanist thinking can create a foundation for developing the human connections essential for meaningful learning. We offer strategies to humanize online learning environments. We include ideas that educators beginning to work with simulation activities might not have considered yet. We close the chapter with a snapshot of considerations that educators should heed when incorporating social media into their teaching approaches.

INSIGHTS FROM ONLINE EDUCATORS

Social Constructivist and Humanist Thinking

In our practice as experienced online educators at Athabasca University, we are privileged to work extensively with learners in online classroom settings. In this section, we share insights from our “on the ground” work in technology-rich learning environments. In our view, social constructivist (SC) and humanist thinking provides a valuable theoretical foundation for establishing the human connections so necessary in technology-rich online learning environments.

Briefly, in social constructivism, knowledge is actively constructed (rather than acquired) through social interactions within a community of learners (Vygotsky, 1978). The social context of the learning environment is essential to learning success. Learning strategies focus on drawing from personal experiences and collaborations with others to achieve the assimilation of new information. Learners are motivated by goals that they set for themselves (intrinsic motivation) and by extrinsic motivation provided by the class community through expressions of support, encouragement, and praise for learning success. The educator’s role is primarily that of facilitator, helping learners to work together to achieve their goals. Educators acknowledge that each person brings a unique perspective, experiences, and culture to the learning environment. As we have mentioned throughout the book, modelling appropriate and effective humanizing community-oriented behaviours is a task for SC-based educators.

Humanism focuses on human freedom, dignity, and individual potential and is a paradigm compatible with SC. According to humanism, people act intentionally and according to their personal values (Huitt, 2009). There is a focus on the whole experience and person rather than on segmented aspects, and the task for the person is to become self-actualized and autonomous (Maslow, 2013). Teaching is student centered and personalized, and as in SC the educator is a facilitator who works to create a cooperative and supportive learning milieu that guides learners to achieve both affective domain and cognitive domain learning outcomes (Cooper, 1993).

Humanizing Online Learning Environments

Most postsecondary institutions now offer some online courses (or at least blended courses, with a portion of a course online and another part of it face to face). Some universities, such as Athabasca University, offer programs that are totally online, from admission application to graduation parchment. In such situations, learners are geographically isolated from one another and from their educators. There is a lack of physical presence, and participants can complete entire degree programs without ever sharing physical space with classmates or educators.

Online courses run the gamut from machine content broadcasts with no human instructor monitoring the class, to all-text presentations of content and discussion, to live video presentations with real-time discussion with all participants fully audio and video enabled. When selecting strategies to encourage human interaction with (and among) online students, the diversity in how online courses are offered needs to be considered. Self-paced courses not monitored by a human instructor do not elicit interaction (except when the student experiences a problem, and then there is contact for disciplinary, remedial, computer support, or other assistance between a student and an educator, administrator, or “help desk” staff member). This type of online course will require more effort by an educator to enhance the human element than an online class in which learners and educators regularly interact using audio and video. In the section that follows, we offer ideas for presenting introductory activities, facilitating interaction throughout courses, promoting teamwork, and offering feedback that can help educators to humanize online environments.

Introductions. The importance of introductions in teaching and learning interactions is often not given the time, effort, and attention required. Almost all successful human encounters begin with “hi, my name is. . . .” The other person reciprocates by sharing a greeting and his or her name. This basic human nicety is important in facilitating dialogue and discussion and learning. If we do not know the other person’s name, how do we ask that person a question in a respectful way? How do you recognize whom you are addressing if you do not know that person’s name? People enjoy hearing their names; they are symbols of who they are, among the most personal things about them, and many take pride in their names. Taking the time to get to know the names of other people in a class is an essential foundation for important learning experiences that will occur later in the course.

Spending time on introductions is congruent with SC and humanist theoretical foundations of learning. If the social context is where most learning occurs (a pillar of SC), then participants need to know one another on social and personal levels. This is a precursor to collaborative learning that will occur throughout the course. Likewise, humanists believe that a cooperative and supportive learning milieu is conducive to achieving affective domain and cognitive domain learning outcomes. For class members to be supportive of one another, and for educators to know learners personally so that they can provide individualized support, meaningful and memorable introductions seem to be essential.

With the use of technology, it is now relatively easy in asynchronous online classes for the educator and learners to introduce themselves to one another using video. There are many options, from YouTube to Zoom to other platforms. In synchronous learning environments, a group session on Zoom, Adobe Connect, Skype, or other similar programs will afford a chance for participants to meet one another, and these interactions can be the beginnings of relationships that develop further throughout the class.

If real-time video is not available for introductions, tools such as Swoop will allow participants to create and post polished static presentations with words and pictures. Using these strategies, introductions can be meaningful for the participants. The lack of opportunity for real-time interaction is a disadvantage of this approach. However, since photos are a part of these “presentations,” these introductions can be more meaningful than a post in a course forum or an email introduction.

Introductions are not interactions until someone responds. The tone for the course will be set by the way in which educators introduce themselves and respond to learners’ introductions. An educator can convey enthusiasm for the course content (and a passion for teaching) with a positive, upbeat, and perhaps even humorous introduction. By asking learners individualized questions based on their introductions, educators display a concern for each person and a genuine interest in learners as people first. Below is one technique that educators can use to enhance the humanizing potential of introductions.

Facilitation. Following thoughtful introductions, educators facilitate and support interaction throughout a course. Originally, Athabasca University provided distance instruction in a way that mirrored correspondence courses. Interactions with learners were primarily via written comments on mailed assignments and during weekly office hours when individual learners could telephone educators (named tutors at our institution) to ask them questions. Learners could sense the humanity of their tutors through their encouraging words on assignments and through rare telephone conversations.

From this correspondence course model, the university moved to online courses (synchronous and asynchronous) in which learners primarily read course materials and answered discussion questions by posting written comments in online forms. Other learners and tutors could respond to learners’ posts with additional written comments and questions.

At Athabasca University, there were often discussions among online faculty about how much to participate in these online class discussions. It is a real art to make your presence known, encourage the students, and not hinder their discussion. We have found that, instead of tutors adding content that learners are missing (thereby cutting off the opportunity for them to do so), participants find greater learning opportunities when tutors offer gentle encouragement, ask thoughtful questions that extend the discussion, and provide praise for critical thinking. Many tutors provide regular summaries (written or video) of recent class discussions, giving them the opportunity to highlight important points and allowing them to introduce concepts that might have been missed. Sometimes these weekly summaries lead to an overview of the next topic of discussion. Any learner-specific critique or encouragement is provided via private communication, usually via course mail or regular mail.

The correspondence courses had live phone office hours, and online courses can accommodate that. Individual or group sessions with the tutor can be verbal or audio/video with the technology commonly available now. As well, with most of the online communication software, the interactions can be recorded for future reference or for learners unable to attend a session in real time.

SC and humanist theories are congruent with these approaches to teaching in online courses. For example, SC purports that learning is an active rather than a passive process. As learners engage in online discussions (either synchronously or asynchronously), they actively engage with the course content. When course participants (tutors and learners) comment on one another’s posts or ask each other questions to further the discussion, this is active learning and collaboration, both hallmarks of SC. The opportunities afforded to tutors to react to, question, and praise each learner’s contributions through email are congruent with a humanist theory of learning. Learners feel respected and supported when educators take the time to provide this individualized feedback. Try the following strategy to enact this humanizing approach.

Teamwork. This is a foundational element of humanist online learning environments. We all know that both educators and learners have a love/hate relationship with group assignments. As tutors at Athabasca University who embrace SC and humanist educational theory, we want to encourage the teamwork and collaboration that undergird group projects. New technologies make the experience of group work easier, more accessible, and potentially a better learning experience. Learners can work simultaneously or asynchronously on a single document or presentation. They can meet online in asynchronous or real-time discussions, and they can engage in collaborative writing or work on their own sections of a group assignment.

We also know that online group projects come with the potential for interpersonal issues. However, within the framework of SC, providing opportunities for learners to collaborate is fundamental to learning. When a group project has the potential to affect each learner’s final grade, the stakes are high, and tolerance for non-contributing (or weak) group members can be limited. It is important that the educator provides clear expectations and guidelines for the group project to optimize students’ experience.

For example, how groups are formed can set them up for success or result in angst and detract from the potential positive outcomes of collaborative work. The educator needs to answer the following questions. Should learners choose their own groups, or should the educator assign groups? If the educator creates groups, should members be assigned randomly or strategically? For example, should all learners in the same time zone be grouped together? An educator who seeks to create a positive environment for online learners to engage in group work faces many choices.

One suggestion that educators can follow when forming groups is to assign participants into groups as they log in to a course. For example, for groups of four, the first four students who log in to the course once it opens become a group. This strategy creates groups with similar patterns of participation and possibly levels of motivation. Some would argue that this approach is not fair because most of the “keen” learners are in the first group formed, whereas the less active (and perhaps less engaged) learners form a subsequent group. However, from our observations at Athabasca University, when learners share similar patterns of participation (as evident from when they log in to a course), motivation, enthusiasm, and drive, this approach to group membership can promote a sense of enjoyment and satisfaction among them. Are you interested in a creative way to form groups for this experience? Consider the following idea.

Feedback. An important aspect of educator-learner relationships in any educational experience is feedback. In settings of higher education, such as our university, we strive to provide feedback to learners in ways that will strengthen our relationships with them. We know that learners respond positively to specific and detailed feedback on their assignments (Balaji & Chakrabarti, 2010). Can you imagine spending all that time writing a paper or preparing a presentation and receiving nothing more than a grade and a “well done” comment? What if you receive a mark well below what you expected and the instructor has not provided any justification for the mark (or any ideas for improvement)? When this occurs in online classes, the lack of personal contact makes the scenario even more troublesome for students. They might experience an array of dehumanizing emotions.

In part, the potential in online courses for the feedback experience to be negative is because students submit (and receive feedback on) assignments electronically. This eliminates educator-learner face-to-face interaction (e.g., questions asked and additional comments made), which can be an important part of the assessment and learning processes in traditional courses. For online learners, course technology automates the process of assignment submission and return. However, the software usually offers an opportunity for learners and educators to add personal comments to the assignment documents. These more informal and personalized aspects of the assessment process should be used to help humanize assessment. Assessment and feedback can be made even more individualized if educators provide audio feedback on each learner’s assignment. Audio comments can be embedded directly into the document that a learner submits. Most online learners appreciate this type of response and acknowledge that hearing the tone of the educator’s voice can help them to understand the intent of evaluative messages. Furthermore, audio feedback is often more complete since it takes the educator less time to say a comment than to type a comment. Audio comments feel more personalized since “voice is particularly impactful in our text-based world” (Morrison, April 6, 2013, para. 1).

Another voice-based type of feedback used by online educators is an audio (or video) comment addressed to an entire class explaining the grading of an assignment. In this process, the educator can explain decisions about certain aspects of the assessment, describe the class average, and review weaknesses and strengths common to most (or all) of the papers. Although the audio/video group message is not as personalized as an individualized recording, it still relays a feeling to the group that there is a real educator out there who received and reviewed their assignments. An approach to providing audio feedback is described below.

Simulation

Simulation is interactive technology. There are many types of simulation that range from low to high technology (depending on the complexity of the equipment). In programs for educating health professionals, the main type of simulation used is high-tech human patient simulators. Educators believe that such simulators provide opportunities for authentic clinical practice experiences without the risk of endangering a live patient/client.

As far back as 2001, academics were enthusiastic about patient simulators, though research was limited. One of the first simulators used to complete a cardiopulmonary resuscitation course was the manikin Rescue Annie, on which learners practised compressions. Today’s simulators are much more sophisticated and allow learners to practise on virtual manikins of all types while online (or face to face). Learners report that these simulation experiences are beneficial, saying that they are powerful learning opportunities that “increase ethical decision-making, confidence, and effective advocacy while also building courage to overcome fears and defend ethical practice” (Krautscheid, 2017, p. 55).

The technology that simulation introduces into the learning environment (online and face to face) has become an essential and permanent aspect of health-care education. No doubt simulation will become even more essential as a teaching and learning tool as technology advances. Furthering the technology of simulation is the lack of physical clinical placement learning options for learners. Traditionally, pre-service learners spent parts of their programs in hospitals and other clinical agencies where they practised skills on real people (usually under the watchful eye of a graduated professional). Now such traditional learning opportunities are becoming rare, and the number of learners is increasing, meaning that as simulation becomes increasingly realistic and accessible learners are spending more of their practice time with simulated patients/clients.

Simulation learning is often immersive, and it provides a way for learners to obtain real-time feedback on their actions as the manikin reacts to their movements. Simulation evokes and replicates many aspects of the real world in a fully interactive fashion. Patient/client manikins speak, cry out in pain, ask questions, respond to questions and actions by the caregiver, vomit, bleed, and even give birth.

Skilled educators need to be cognizant of using simulation technology in ways that allow learners to feel human emotions such as empathy. In other words, educators can take steps to make what is essentially a piece of plastic as authentically human as possible in the minds and hearts of learners. Strategies such as choosing realistic scenarios, personalizing the manikin or model (providing a name, demographic details, etc.), encouraging collaboration with other health-care team members, and expecting mistakes (this is real life) can make the scenarios realistic human experiences. Scenarios can also be altered to challenge the specific learning needs and goals of a particular learner to help personalize the experience. Giving the manikin a personal history rather than simply a medical condition helps learners to focus on affective domain learning outcomes as well as on cognitive and psychomotor knowledge.

It is important to emphasize that learners are continually observing how educators behave in relation to simulation. Educators are role models and have an important part to play in making the scenarios realistic and the most effective learning experience possible. Having clear roles for each person who participates in a simulation is important for learning and making sure that the scenario is realistic and that everyone has a chance to participate in it fully and immersively.

Learner anxiety. Although many educators talk about the decreased risk to a live patient/client that simulation learning provides, few mention that participating in simulation experiences can bring risks for learners. Some learners report extreme anxiety when they are asked to perform in a simulated scenario. Where does humane interaction fit into this picture? If we are humane educators, then we must anticipate that some learners will experience more anxiety than others (some to the point that they will freeze and be unable to react). Learners, after all, are asked to be actors. Simulations are usually completed in front of peers and educators, and they are often recorded (videotaped) for playback (for either formative or summative assessment). Anxiety is accentuated when learners are asked to suspend reality and behave as though the manikin is a real person. They must make decisions, act, communicate, and evaluate situations while “on stage.” In an integrated review of ten research articles on anxiety and performance in a simulated setting, Al-Ghareeb, Cooper, and McLennan (2017) concluded that simulation can be a profound stressor for learners, that the anxiety can interfere with the stated benefits of simulation, and that simulation practice can actually create a negative non-learning experience for learners.

So we have studies of learners who claim that simulation exercises help them to build confidence and others who have extreme difficulty with anxiety when performing such exercises and need confidence building. Performing successfully in a simulation is the highest level of Bloom’s taxonomy, fitting his descriptor “characterization” well. One of his characterizations is knowing how to seek needed help (Bloom & Krathwohl, 1956). Educators who use simulation (either online or face to face) need to be aware that for some learners the anxiety of being a participant in a simulation experience can be an enhancer, whereas for others the anxiety detracts from learning and can have negative consequences for the learner outside the learning experience. Educators need to have an array of strategies to help prevent the negative effects of anxiety in simulation learning.

As a beginning, all of the strategies in this book that encourage learner self-valuing, help to decrease learner isolation, and promote learner-educator and learner-learner interaction can be helpful in ensuring success in simulation exercises, but additional strategies are needed. For example, it is common practice to have prebriefing and debriefing exercises as part of simulation experiences.

Dr. Nicole Harder, an assistant professor in the College of Nursing at the Rady Faculty of Health Sciences at the University of Manitoba, is the faculty member in charge of the Nursing Simulation Lab. Besides her research in the field of simulation, Harder is the editor-in-chief of the journal Clinical Simulation in Nursing. According to her (N. Harder, personal communication, September 17, 2018), learner anxiety can also stem from the specific simulation. The simulations that most frequently trigger emotions in learners are dying scenarios and those dealing with suicide. Harder structures the pre- and post-briefing conferences in her lab around psychological safety in relation to these especially stressful simulations. The strategy described below outlines safe words for use in simulation scenarios.

Reflection. This is a critical aspect of any successful learning experience and should not be overlooked in simulation activities. Educators need to be able to identify learners who might be at risk of simulation-induced anxiety. By knowing learners well in advance of simulation activities, educators can have some idea of who might need additional help in those activities. Unfortunately, many educational groups who participate in simulation activities are large, and learners move from educator to educator for different courses and workshops. Keeping class groups small and having the same cohort of learners with the same educator for all simulations during a term can be helpful. Dr. Harder has a large group of learners who go through the Sim Lab every term, and she says that by the end of their six-week lab experience she knows them all. Harder states that it is important that a reflective activity be implemented prior to simulation to identify learner anxiety levels so that any potential dehumanizing effects can be prevented. The strategy below describes a reflective exercise that could be adapted to many teaching situations.

Anxiety reduction. Educators in the health professions are usually aware of how anxiety can affect learning, particularly in clinical contexts. Techniques that educators have found valuable in reducing their own anxieties and those of their learners in other situations can be implemented during simulation activities. Any technique that acknowledges how anxiety can be a positive influence on learning rather than a distraction can help.

Additionally, we suggest three that might be of interest. First, consider exploring autogenic training, a form of deep relaxation that has been successfully tested as an anxiety-reducing technique prior to simulation exercises (Holland, Gosselin, & Malcahy, 2017). Second, at institutions with counselling services, invite a counsellor to speak to learners before simulations begin. The presence of a counsellor and knowing that services are available normalize the process of seeking help if and when it is needed. For learners, understanding their own feelings and knowing that they are not alone in their responses allow learner-to-learner support to develop as well. Third, as educators we are aware that learners can experience simulation-induced anxiety for several reasons. We can prepare the students for that possibility, and we can watch for evidence of an issue. We are prepared to act.

Despite the anxiety-inducing potential of simulation activities, they can be powerful tools to help learners understand how to be humane with each other, with the manikin, and with other actors in the simulation. For example, simulations can be specifically designed to elicit feelings of empathy and expressions of compassion in learners. These affective domain learning outcomes are often very challenging to “teach,” and a simulation in which the educator makes the scenario real can be an avenue for teaching and learning these often nebulous but essential health-care competencies.

SOCIAL MEDIA

Social media applications are everywhere now, including in courses and workshops for health professionals offered by institutions of higher education and clinical agencies. Of course, even email is a type of social media. Few educators are not involved with internet-based communication with their learners, either individually or as a group. As well, educators in the health professions must teach and encourage digital literacy. Learners (online and face to face) engage in web searches to complete assignments and prepare for simulations and practice experiences, and many postsecondary institutions have online libraries. In progressive settings, learners are now being required to create websites about themselves and their course work (e-portfolios), communicate via Twitter and/or Facebook within their courses, and collate information on sites such as Pinterest and share it with others. Course work is also being shared via podcasts and blogs to help make assessment authentic.

Professionalism. In online settings in which health professionals are educated, addressing professionalism in social media is a key consideration. Educators have many social media applications and search engines available to augment their teaching and learning. How can we as educators help learners to use these technologies (both the advantages and the disadvantages), teach them professionalism while interacting virtually, remind them of the ethics of using social media, and ensure that they use these tools optimally to enhance both patient/client care and their own lifelong learning? In the strategy below, we suggest an icebreaker that educators can implement with learners in pre-service and in-service programs. A key goal of the activity is to initiate discussions of professionalism in online environments. All learners (and educators) should be aware of their digital footprints. The strategy below outlines an activity that all can use to review their digital footprints regularly.

Understanding policies. Most postsecondary institutions and clinical agencies have (or are developing) policies related to social media. As new practices using social media are integrated into educational experiences for health professionals, the opportunities and disadvantages are not well researched. We assume that there are benefits in sharing our work with our peers and in some cases on the World Wide Web. We also know that there are issues related to the overuse of technology, especially the potential negative effects on interpersonal relationships. As educators, it is important that we consider the impacts of social media on our teaching approaches and classrooms.

The technologies (Facebook, Pinterest, Twitter, etc.) are tools and can be used in many ways. What we are interested in is how they affect human interactions in educational scenarios. In their discussion, Schmitt, Sims-Giddens, and Booth (2012) lead us to think about several actions in which educators can engage to smooth the learning process for their students. Most important is for educators, and the organizations that they work in, to have a social media policy. The development of such a policy facilitates discussion on the appropriate use of these technologies and the issues related to them. In the strategy that follows, we call on educators to increase their own awareness as well as that of their learners regarding social media policies at their organizations.

Introduce technologies individually. New technologies can seem overwhelming to educators and learners alike. Schmitt et al. (2012) suggest that new technologies should be introduced one at a time in the educational milieu. Doing so gives educators time to know their learners well before using these strategies in teaching and learning. If all learners (and educators) are tech savvy, then perhaps this initial assessment period is not as important. However, in some organizations, the average age of learners is higher, and many have not been embedded in social media technology for long. The gradual introduction of social media use in course and workshop classrooms also gives learners time to grow into the practices required. If learners are familiar with the technologies before they are used in activities or assignments, then they can focus on presenting their ideas (and learning) as opposed to fretting about using (or learning to use) the actual technology.

Privacy settings. Finally, and importantly, learners should be provided with privacy settings for any required technology used for educational purposes in courses or workshops. Some activities (e.g., following a health professional on Twitter) require access to the web. Learners must be aware of where their comments and posts can be seen. They might be very reluctant to have their names and information available to anyone who wants to find them, and frequently there are legitimate reasons for this concern. Other learners think that it is important to share their academic work as much as possible as a contribution to public good. Caution should always guide an educator who chooses to ask learners to use social media in educational activities or to share their learning with the educator, other learners, or the world.

CONCLUSION

Technology has changed the world of learners and educators. Social constructivist and humanist thinking can help educators to navigate this brave new world. Educators who use technology need to keep the pillars of SC thinking (learning occurs in active, collaborative, and socially rich environments) and the tenets of humanist thinking (learners need to be supported and treated with dignity, learning should be individualized, and affective learning is essential) in mind.

Technology in its various forms (including online learning environments, simulation activities, and social media) can enhance learning in many ways, but it also brings with it the potential to tarnish the vital human element essential to education in the health professions. In this chapter, we discussed ways in which educators can underscore that vital human element. Based on our experience in educating university students in online classrooms at Athabasca University, we encourage our fellow educators to create human connections during course or workshop introduction activities, to consistently facilitate and support interaction, to integrate teamwork, and to provide personalized feedback that includes suggestions for improvement.

Extensive literature exists to guide educators through the simulation activities that they implement with learners. We suggest that recognizing learners’ anxiety, encouraging reflection, and providing opportunities for learners to participate in anxiety reduction activities during both pre-briefing and post-briefing of simulation sessions are especially helpful. When educators integrate social media into technology-rich learning environments, we recommend that they pay special attention to issues of professionalism, organizational policies, sequencing, and privacy.

We can no longer pretend that educators and learners can thrive without knowledge of and practice with educational technologies. In the futuristic work of Harari (2018), readers are invited to imagine a technology-infused, science fiction–like world. Such a world might be imminent, and it is useful to heed his advice to educators. Harari writes that “most important of all will be the ability to deal with change, learn new things and preserve your mental balance in unfamiliar situations” (p. 266).

REFERENCES

Al-Ghareeb, A., Cooper, S., & McLennan, L. (2017). Anxiety and clinical performance in simulated settings in undergraduate health professionals’ education: An integrated review. Clinical Simulation in Learning, 13(10), 478–491. doi:10.1016/j.ecns.2017.05.015

Bain, A., & Zundans-Fraser, L. (2017). The self-organizing university: Designing the higher education organization for quality learning and teaching. Singapore: Springer. doi:10.1007/978-981-10-4917-0

Balaji, M. S., & Chakrabarti, D. (2010). Student interactions in online discussion forum: Empirical research from “media richness theory” perspective. Journal of Interactive Online Learning, 9(1), 1–22. Retrieved from https://pdfs.semanticscholar.org/a7c1/5dfdba9eff739a38dfdd6eed83d380280f98.pdf

Bloom, B. S., & Krathwohl, D. R. (1956). Taxonomy of educational objectives: The classification of educational goals, by a committee of college and university examiners. Handbook I: Cognitive domain. New York, NY: Longmans, Green.

Cooper, P. A. (1993). Paradigm shifts in designed instruction: From behaviourism to cognitivism to constructivism. Educational Technology, 33(5), 12–19.

Harari, Y. (2018). 21 Lessons for the 21st Century. New York, NY: Spiegel & Grau.

Holland, B., Gosselin, K., & Malcahy, A. (2017). The effect of autogenic training on self-efficacy, anxiety, and performance on nursing student simulation. Nursing Education Perspectives, 38(2), 87–89. doi:10.1097/01.NEP.0000000000000110

Huitt, W. (2009). Humanism and open education. Educational Psychology Interactive. Valdosta, GA: Valdosta State University. Retrieved from http://www.edpsycinteractive.org/topics/affect/humed.html

Krautscheid, L. (2017). Embedding microethical dilemmas in high-fidelity simulation scenarios. Journal of Nursing Education, 56(1), 55–58. doi:10.3928/01484834-20161219-11

Maslow, A. H. (2013). Toward a psychology of being. New York, NY: Start Publishing.

Morrison, D. (April 6, 2013). ‘Speaking to students’ with audio feedback in online courses. Online Learning Insights [Blog]. Retrieved from https://onlinelearninginsights.wordpress.com/2013/04/06/speaking-to-students-with-audio-feedback-in-online-courses/

Schmitt, T., Sims-Giddens, S., & Booth, R. (2012). Social media use in nursing education. The Online Journal of Nursing Issues, 17(3). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23036058

Vallor, S. (2018). Technology and the virtues: A philosophical guide to a future worth wanting. New York, NY: Oxford University Press.

Vygotsky, L. (1978). Mind in society. Cambridge, MA: Harvard University Press.