Welcome to Episode 147 of the Think UDL podcast: Nursing Education with John Gilmore and Freda Browne. Dr. John P Gilmore (RGN FHEA) is an Assistant Professor and Head of Subject – Adult General Nursing, and Dr. Freda Browne, is an Assistant Professor and Program Director of the BS General Nursing, University College, Dublin School of Nursing, Midwifery and Health Systems. I met with these lovely scholars in Dublin at a UDL conference and wanted them to share what they are doing to bring Universal Design for Learning in nursing education to Think UDL listeners, as folks still ask me often about UDL in STEM fields. Today we will discuss how John and Freda infuse UDL into their nursing education program including how they incorporate student collaborators throughout their program. You can find resources associated with today’s conversation on the thinkUDL.org website.
Resources
Contact Dr. John Gilmore on LinkedIn or via Twitter @GilmoreJNurse and contact Dr. Freda Browne on LinkedIn here
Here are John and Freda’s published Case Studies that are mentioned during the podcast.
See their amazing resource: UDL Guidelines for Practice Learning for Nursing here and their article with co-author Phil Halligan: Pedagogy as Social Justice: Universal Design of Learning in Nurse Education
Transcript
57:12
SUMMARY KEYWORDS
Universal Design for Learning, nursing education, student collaborators, inclusive curriculum, alternative assessments, clinical practice, digital badges, social justice, learner variability, practical learning, discussion boards, accessibility, interprofessional learning, student engagement, curriculum design.
SPEAKERS
John Gilmore, Lillian Nave, Freda Browne
Lillian Nave 00:02
Welcome to think UDL, the universal design for learning podcast where we hear from the people who are designing and implementing strategies with learner variability in mind. I’m your host, Lillian nave, and I’m interested in not just what you’re teaching, learning, guiding and facilitating, but how you design and implement it, and why it even matters.
Lillian Nave 00:39
Welcome to Episode 147 of the think UDL podcast, nursing education with John Gilmore and Freda Brown. Dr John Gilmore is an assistant professor and the head of subject of adult general nursing, and Dr. Freda Brown is the assistant professor and program director of The Bachelor of Science in general nursing, and they’re both at the University College Dublin School of Nursing, Midwifery and health systems in Ireland. I met with these scholars in Dublin at a UDL conference, and wanted them to be able to share what they’re doing to bring UDL in nursing education to the think UDL listeners, as I am often asked about how to integrate UDL into STEM fields. Today, we will discuss how John and Freda infuse UDL into their nursing education program, including how they incorporate student collaborators throughout their program. You can find resources associated with today’s conversation on the think udl.org website and thank you for listening to the think UDL podcast. I’d like to welcome my two guests. Thank you to John Gilmore and Freda Brown, I’m so glad to have you both on the podcast.
John Gilmore 02:03
Thanks for having us. This is John here,
Freda Browne 02:06
thanks, Lillian, and I’m Freda.
Lillian Nave 02:08
So glad to have you both. It was a great chance to meet you at the ahead conference, and I really loved your topic, so that’s why I wanted to get right into it. But first I ask all of my guests the same question, which is, what makes you a different kind of learner? And John, I’ll start with you. Thanks. Lillian, I think the more I think about learning and I work as an educator, I realized that we’re all really different types of learners, and actually type typifying learning isn’t always the best way to go about it. I think as nurses, we’re often driven towards experiential learning and practice based learning, and that’s really important in our field. But I think for me, like I really benefit from discourse based learning, chatting to other people, learning from other people’s experience, but also sometimes just sitting down reading and making sense myself. So I think that’s what has drawn me to UDL. You know, it’s been realizing actually I benefit from all this type of learning. So I’m sure my learners that I engage with every day are the same excellent I love that you’ve already linked it into our UDL discussion. And two, I found that too. It’s like, Wow, if I like all of these different things or I’m benefiting from it, maybe I don’t even like all of them, but I can benefit from them. I might as well use them. Frida, how about you? What makes you a different kind of learner? I’m still, I suppose, learning what type of learner I am. And I know this is a podcast, people can’t see me, but like, I’m out of school a long time, and when I was in school, I learned everything off by heart. I don’t remember anything that I learned in school. It’s all gone.
Freda Browne 03:50
So in more recent years, and really, since I’ve come to UDL, I’m starting to acknowledge how I learn. I love learning practically, but I can’t just learn how to do something I need to understand in pure UDL language, the why and the how of it as well. And I need to know like, what the reason why I’m doing it and how it can affect so again, like John mentioned there about nursing being very practical and experiential, I can’t just do something because it’s the way it’s done. I have to understand the hows and the whys. And I know I learn different things differently, so I love the practical. I like to read and kind of figure out. And John used the term sense make myself. But I’ve started to realize I love little, short video clips as well. I find using certain websites, but the video clips I love listening to other people explain the concept, I love the storytelling, and I love images and pictures. I love a good table, flow, graph, figure, and I can just see pages and pages of words in a very nice graphic. And it’s really only in most recent years when I’m starting to recognize how i. I like to learn myself. I don’t think I’m different to anybody else, because I think we’re all very much different in how we do it. And I think the UDL and inclusive curriculum was brilliant, because just acknowledges that we’re all different.
Lillian Nave 05:13
Absolutely. Yeah, I love a good graph. I love that. It’s always great because it tells us so much more. And I so appreciate that that you’ve already said it’s the why, the what and the how of learning is also important. So we’re already deep into our UDL journey so far. So I get a lot of questions as a podcaster person or as a UDL person, and and there are a lot of folks who are weary of UDL in STEM fields, especially, and yeah. And then also, let’s do, let’s double that, and say, What about very practical fields like nursing, and so, when and so. And they’re like, Well, how do you even do UDL in nursing? You we have this big test that they have to study for. You have to study for the test. How can you even use UDL? And so when I heard of your presentation and what you’re doing, I said, Well, absolutely, we need to talk, because more people need to know about UDL in STEM fields, in practical fields, and specifically in nursing. So my first question about this will be to John, and wanted to know what brought you to include UDL in this nursing education program at UCD. So
John Gilmore 06:29
I think the first thing to say is the institution which freed, and I work in UCD is, is an institution which was founded based on a philosophy of social justice and accessibility. And it was the, it was the first higher education institution that Catholics could attend in Ireland. Prior to that, it was only Protestants who could attend higher education. So there’s, there’s a real drive around social justice, widening participation, accessibility, emancipatory pedagogy within the institution as a whole, and our school in particular, you know, and prior to Frida and I even being in the school, had a long history of trying to push forward, you know, less visible groups within our programs. We had a higher proportion of students with disabilities than other areas, and did a lot of support for students with disabilities within our school. And UDL then was introduced as an institute at an institution level, as a way to really kind of map on, capture good practice and really build that accessibility and inclusivity across for everybody. So I think, from my perspective, I did a lot of work when I worked in the UK around, you know, anti racist pedagogy, queer pedagogy, really identity focused kind of curriculum developments. But then was also very involved in building kind of accessibility for disabled students in and UDL provided a perfect package for us to kind of bring those things together, think in a framework way, rather than an all or nothing, and building step by step. So we’ve been really lucky. I mean, Frida and I are part of a faculty partnership program where we were selected through a competitive process to build and lead UDL within the institution, particularly within our school, and compared to maybe some other colleagues, we really were knocking on an open door here. Our colleagues really wanted to build inclusivity within their system. So we have a national in Ireland, a national digital badge for Universal Design for Learning. Freedom, and I facilitate that at a local and national level, so we’ve been able to build kind of on that and support colleagues to embed universal design within their learning. We wrote a couple years ago, myself for Frida and our and our other colleague, Phil, who was also a faculty partner, who has retired since Dr Phil Halligan, wrote a piece around how universal design for learning is really about social justice within the curriculum and within the pedagogy. So we teach a lot about social justice because we’re nurses, and social justice is part of what we need to do. But actually, by building it into the curriculum in the way in which we teach and offer our programs has been really important for us. And you know, nursing, what we often hear about nursing in a global level is nursing shortages. And there is a real shortage of nursing. That is real. We’re about 1 million nurses short across the globe. Ireland is no different, but part of adding to the nursing numbers is also insurance. Diversity of those nurses, a more diverse workforce leads to better better patient outcomes for diverse patients. So I think all of that together made UDL a perfect package for us to go forward.
Lillian Nave 09:52
Wow. What a fantastic package. Yes, exactly for for your students and for UCD and I. I The more I learn about what Ireland is doing with those digital badges, and really the ingraining of UDL in your all of your programs, it is such a wonderful blueprint for others. So that’s why I do interview quite a few people in Ireland who are using UDL, because you are really showing the rest of the world what what you can do, or what one can do if, yeah, all of these systems are working together. So this sounds fantastic. So my follow up question is, how does this work? So Freda, what’s the context of your program? Who attends? Who are your students?
Freda Browne 10:41
I suppose there’s two contexts we have as an undergraduate program. We’ve national standards and requirements by our regulator. So we have certain content that has to be delivered with certain standards to meet. But also within our university, as John said, UCD is a university for all, and we have university strategies in relation to inclusion. So our context, I suppose, very specific for the university, in that we have protected entry routes for our students. So across our undergraduate programs, we have four different entry routes, but we have a target across the university that all undergraduate programs would have at least 35% protected places for entry routes. And in our school, across our Nursing Midwifery programs, we reach and exceed our targets every year. So we’ve four different entry routes which are recognized entry routes in Ireland. So we’ve protected places for students on the scheme called here. So higher education access route, dare disability access route. Education, we have a qqI, which is post school like like a post leaving search post final school exam program, which, if you complete, allows you access to it. And we have a mature entry pathway as well for students over 23 years of age. So our here scheme is for students who are so socio economically disadvantaged, and there’s certain criteria, our dares for students who are registered with disabilities. And again, there’s certain criteria. Our qqI are students who complete this two programs, so they’re like introduction to nursing programs. And then our mature entry is over 23 so across our undergraduate programs, we have between 35 and 50% entry from those routes, however. So our University, University for all, is very good, and our admissions for collating that data, protecting those places and collating our actual entry however, it doesn’t get students who may enter through mature student but who may be so socioeconomically disadvantaged, you may have students with disabilities who don’t enter through the dare route. So our classrooms are hugely changed. We’ve very large program numbers within the university, for example, the undergraduate general nursing program. We have numbers of 164 in that. So it’s a large number of students. So I suppose we’re very fortunate. Their university really pushes towards our access routes. We generally always fill our access route placements. Our admissions will work. If you don’t fill in there, they’ll go and fill here, you know, so they’re very rarely will fill an access route place with the leaving search or someone out of school place, and they’ll always come back and check with us in school in relation to that admissions. So like our data shows that we were very diverse, but we actually are even more diverse than what our data is currently showing us. And university for all are trying to collate more data in relation to the socio economic conditions of our students as well, and we would find that, again, it’s just from discussion with colleagues and people like John that we find our classrooms are changing hugely. We would have a lot of first and family students as well, and a lot of them, it would be the first opportunity to attend university, to develop come a professional to obtain professional registration. So that’s a huge challenge. And John spoke about traditionally, I suppose you’re expected to look a certain way, do a certain thing, learn a certain way in nursing, so it is a challenge trying to push those boundaries, but everybody is really eager to help and to support we’re very fortunate in that.
Lillian Nave 14:36
Wow. So already you know that you have an incredible variability of students, and so having this UDL practice is absolutely perfect, yeah, because it is a methodology. It is, it is a whole paradigm of all of our students are different. Let’s design for that difference. So wow, that’s and. And how many did you say? I don’t know if I got the full number. How many students are in this program, kind of yearly.
Freda Browne 15:07
So on the general program, we would have 164 but sometimes that may go higher, sometimes we may not fill so at least 35% are coming from those access routes,
John Gilmore 15:19
and many of our classrooms are are multi program classrooms. So within our school, we have almost 1000 undergraduate students studying a bachelor’s in a nursing or midwifery program, and they have almost 1000 post graduate students on top programs as well. So we’re a very big school, so a very diverse school.
Lillian Nave 15:42
Yeah, wow. Okay, so that can be quite daunting, but it wasn’t for you, because you all took this UDL framework and decided you were going to put it to use. So the next question that I have is, what’s the process, Frida, can you explain the process you used to infuse UDL into your program, and especially like this? How did you incorporate using student collaborators?
Freda Browne 16:09
Well, I suppose there’s multiple ways, like as a team myself, John and our colleague Phil, originally would have started to promote it at our school meetings and promote it with other staff. But really, I suppose where we got most buy in is when we started using it ourselves in our modules, when students started becoming familiar with it. And now I hear and I even had a conversation with John this morning, students are now looking for it from people who aren’t providing it. In the very early days, when I started using UDL as part of our faculty partnership program within UCD, we were asked to write up a case study of how we used it. So an example, in one of my large modules, I had a registration of about 190 students quite often. This is where people who implement UDL say it’s difficult when you have such large students group. My initial idea was to offer an alternative assessment so, again, traditionally in nursing, it tends to be exams or paper assignments. So I wanted to offer students an alternative assessment method, but to also offer them a choice in that alternative assessment method. So I was teaching a unit I had about eight hours in relation to skin dermatology, skin assessment. And I wanted to offer students a choice of doing the short, written assessment or preparing a PowerPoint presentation for us. I also wanted to offer them a choice of topic. And this is going back to 2021 I think spring 2021 so I thought it would be wonderful. But as I was designing, I also was very careful in how I delivered it. So I wanted students to provide an evidence base. I had to ensure my lectures were evidence based. I had to support them finding that evidence. So my reading lists, students had a choice of topic and that. So I didn’t have, like, a list of eight topics, and they could pick one, they could pick the topic themselves from the content covered, and students struggled hugely with that. So I had to support that through use of a discussion board. We’ve always had the discussion board on our virtual environment, but normally it’s like a questions and answers. You know, the word limit, 600 words. Can I write? 660 words? Yeah, it was new to students, actually engaging. And I’m thinking of writing or doing my presentation on, say, assessment of a basal cell carcinoma. Does this sound all right? Freda, and like I’d reply back to them, Go, yes, book, where’s your nursing interventions there? And how can you evaluate that? So for a lot of students at that time, it was kind of their first engagement with actually discussion on a discussion board at an undergraduate level. So one of my scaffolding strategies was the discussion board. I was really busy, phenomenally busy, and I had never that letter of student interaction before with students, either inside the classroom or outside of the classroom. And that is a challenge, because if you have the discussion board available, you have to answer it if you want to get students using it. And then students had a choice, so they could pick their topic without a choice to do a written piece or advice over PowerPoint presentation. Most students, I think, my first year, I had seven students out of 180 something who did a voiceover presentation. The next year it increased to 11. So the actual picking a different method of assessment was so new for students that they struggled with it. They just went for the old reliable, even students who I know would be much better off doing a presentation, but the discussion board was huge learning and them actually picking a topic, a suitable topic, and being able to go through the steps required of the assessment. After a number of years, I changed it to just how students do the vice Dover PowerPoint presentation, and the students get on phenomenally well. With that assessment method, it’s a huge change in grades, improvements in grades from what it would be if it was just a written assessment. And they still have to have the knowledge, because they have to explain over it why they’ve picked something. I have very specific guidelines for them, though, as well to help to support them, but those so that was very early. Think maybe it was spring 20 even. But since then, across the school, our assessments hugely diversified. As more people, as more faculty have done the UDL digital badge, as we’ve shared, we’ve had a lot of opportunities in the school and in the university to share our redesigns. Both John and my case studies have been published by the University. There’s a lovely booklet on it. There’s many case studies. We might give you the reference afterwards, if anyone wants to look at them. I think that it’s wonderful to see the worked examples of it. But more and more people are doing it. Students are much more familiar with things like the discussion board now. They’re not as afraid to do presentations, and students start looking for these elements now, and like you do help feedback. Of course, feedback is hugely important. We have our module feedbacks, and students do report very, very positively on things like the discussion board and even things like the speed that you answer their questions on on a discussion board. And I suppose that was something that I learned very quickly when using the discussion boards. If I say I’m going to answer them every day, Monday to Friday, I need to answer them every day, Monday to Friday. Yeah, students even like to know that you’re going to answer them at three o’clock every day or structured like that, but there is a lot of work, and it can be, I suppose, one of the challenges that can be unseen work. I don’t think there’s anything that our workloads that talk about the amount of hours you spent on the discussion boards can be a lot more than I would do in face to face, teaching on the module, actually, but it’s very important for students, scaffolding and engagement. I feel,
John Gilmore 22:07
I think one of the things as well that is quite specific around the type of programs that we teach in Ireland and many other jurisdictions, nursing, midwifery, medicine programs have the practical component. So in Ireland for us, 50% of the teaching and learning that goes on happens in a clinical practice environment, not with the lecturer teaching in a classroom. And so this really drove us to think about, hold on a second. We’re doing amazing work within our school, within the classroom, within discussion boards, all of these other areas where we’re supporting diverse learners, but what about when they go on to a clinical placement? They’re in a community clinic, they’re in a ward, they’re in a critical care environment and operating theater? How are we supporting diversity of learning there? Because they are learning environments. They’re not just practicing, they’re learning through work. So that drove us to think a little bit around, hold on a second. When we were developing our case studies in the classroom, we were looking at our colleagues across the university, there’s nothing really speaking to clinical practice environments. So Fareed and I got together and we had a look, and there was really nothing out there specific to clinical practice environments similar to what we would be dealing with in nursing and midwifery. So we came together, and we were supported by further funding, through that University Partnership Fund, through our access and lifelong learning unit, and we got some funding to recruit a number of student collaborators as CO designers, research collaborators, and we recruited them through a competitive process where we had nine nursing students from across our different disciplines. So we have a children’s in general, integrated program. We have our general program and a mental health program. So those students came together from across the three of the four years of study to talk, to look at how universal design for learning could be inbuilt into clinical practice. So the way in which we did that is we partnered with them. They had training on universal design, which was provided by the University, an introduction to universal design, and then they came together to look at what were the big issues for their learning. Many of these students were students who were registered with a disability. I knew them through doing assessments, etc, with them, but many weren’t, and that wasn’t a criteria. So they came together to talk about, what were their barriers to learning within a clinical practice environment, what were their suggestions around how learning could be better? And then essentially, what we did is we translated the then universal design for learning guidelines, which have since been updated, so we may have to look at them again. And they looked at, well, okay, what does what does this mean? You know, what does it mean to provide alternatives for symbols and signs? What does it mean? What does this mean in a practical environment? Yeah, and they were really able to take each one of those guidelines, each of the principles and the checkpoints, and start thinking about clinical practice, and essentially translated Universal Design for Learning, which would take place in the classroom, around multiple means of engagement, multiple means of representation, multiple means of expression and action, and actually translate those into clinical practice from their experience. So each week, over a period of time, we would meet, we would revise what we did the last week, and we would look at the guidelines and talk about those. It was an iterative process. The students would come back, I would do the initial draft, and then we came back, and Frida was very helpful as kind of another pair of eyes to kind of pull things together, streamline, ensure our language was in line with standards and requirements. I think that’s always the big concern for us is that UDL is not about reducing standards. It is not about reducing competency. It’s about providing multiple ways for the students to acquire the knowledge, demonstrate the knowledge and reflect the knowledge in their practice. So we got a chance to develop these guidelines, which we have now. And then the next step was we actually worked with the practice educators. Frieda and I are nurses, but we don’t work in clinical practice full time, so we don’t work at the bedside. So we engaged with the people who support their learning in the hospitals in the community areas, to get them to have a look at the feasibility of these guidelines. So those practice educators came together in a workshop, and we had some really interesting, good discussion and debate around what was feasible what wasn’t feasible. And actually what we found was a lot of the variance in kind of how to teach and learn in a clinical environment were already happening in various spots. So we’re able to already do that. Oh, you don’t do that. Oh, how this is how we just and actually that sharing was really useful. So again, we’re continually to look around, innovating, around how we can in build universal design as a way of learn, as a way of designing the clinical learning environment. And we’re in an exciting time now in Ireland, as we’re developing a new new standards for undergraduate education. So Frieda and I have been beating the drum around universal design and accessibility and diversity within those curricula.
Lillian Nave 27:19
Wow. The student, collaborator part is so important. I’ve found, especially in my practice, that I learned so much more when the students are sort of re explaining, or they’re like, they’re making that learning visible. And yeah, it’s the thing that I didn’t realize. I was able to I didn’t actually understand how I was teaching them until they’re kind of mirroring it back, and then they’ll say, yeah, something new or different, and it’s a completely much more rich and nuanced understanding, right?
John Gilmore 27:50
One of my biggest learning from those workshops were students were already being boundaried in terms of what they could around what could happen. They already had inflexible thinking within the process. You couldn’t possibly do that, and it wasn’t till if we just talk clearly about the why, tell me exactly why you couldn’t have flexibility in kind of shift patterns. Tell me exactly why you couldn’t set some of your own learning outcomes. Tell me exactly why, and even just that, you could see the transformation of students, you know, come back to, okay, I still need to be a nurse. I still need to meet these standards. But why couldn’t I do this demonstrate that standard in a different way? Now, there are limitations and free to alluded to earlier. We do have currently quite restrictive standards and requirements for undergraduate nursing in Ireland, that is changing. We are seeing kind of more flexibility, recognizing that nurses aren’t this kind of single entity like not every nurse needs to have the same knowledge or approach the same knowledge in the same way. We do have to have a standard. But if you’re working in a community clinical environment, or if you’re working in a public health area, or you’re working in an acute hospital, the skills are going to be different. The ways and approaches to that knowledge and how you use it is going to be different. So actually, by building a flexible curriculum through universal design, there may still be, we will still have to have competencies. There will still be tasks and skills that students would have to demonstrate because they’re core to effective nursing, but actually how we build them in are going to be interesting. And we recently did an audit of our of our colleagues, and what we saw was there was so much commitment to Universal Design for Learning within our faculty colleagues. But also in that workshop, we had placement areas coming up asking, Could they be the pilot? Could they be the pilot? Please? We would love to implement it, because they’re really, they know. I mean, we as we’re because we’re all nurses. We are deeply committed to nursing as a profession. Discussion, I often will say, our students are like any other student in the University, plus a little bit more. We have maybe an extra level of commitment to our students succeeding, because we know how much we need more nurses. We are very proud of our students. I think, you know, a huge amount of emotion goes into our work at graduation day, or when students come back from their first clinical placement, or students first day, we get really excited because they’re not only students that we’re providing education for. They’re becoming part of our nursing family, which I think is really lovely and special for us within our programs.
Lillian Nave 30:41
Again, it just makes it so much more meaningful, too. As students are learning, they’re also learning how they’re best going to be part of this community, right, or what their strengths are, and maybe that’s going to tell them which sort of setting they need to go into as well, or, you know, where their strengths lie. So what are these results so far? I’d love to have some examples of the UDL implementations and engagement and representation and action and expression. And John, I’ll start with you, and then Frida can join in.
John Gilmore 31:14
Yeah. So we’re just in the process of developing the implementation. Obviously, we want to do this really well. Because, as you brought up earlier on, that, you know, sometimes in STEM and particularly practice focused stem subject, there’s a How could you possibly do that? Right? So for us, it’s really important that we properly implement and evaluate this. So we have sought some more funding to allow us to actually do that and to ensure that we don’t, you know, we we are, again, we’re very committed to patient safety, to public health. We’re registrants. We are, we’re, you know, in Ireland, you have to maintain your registration as a nursing education, as a nursing educator. So we have that responsibility to public health. So we are testing and teasing. But as I said, most of, not, most of many of the intervention students suggested so things like students suggested things like that their previous knowledge should be brought through. So students should have a have a initial meeting with their clinical mentor preceptors, the term we use currently, and they should have an initial meeting where they identify their own learning outcomes for that placement, look at where their strengths are, and acknowledgement of prior learning and prior knowledge, which is your standard UDL practice. And we’ve created a guideline around that, however, in reality, that’s being done all the time, maybe not all across the board, maybe not with every clinical mentor and Preceptor, but by putting it in the guidelines, it’s allowing students to sign posts as well. And as Frida said, what I really like, because I can be a little bit radical and I’m a bit of an activist, I like students to push back. And if I set a module and I say, you have to write a 5000 word essay for it, for it, for the student to come back and say, Why? Why can’t I have an alternative assessment? And similarly, in the practice area, for students to say, Well, I really want to focus on this area of knowledge. And if their preceptor says, Well, no, we want to do this, that the student can say why? That’s sometimes a difficult thing to happen. So there’s a lot of support was around that. But I think what we’re finding as well, we recently with that audit of faculty, we found that there was actually activity, if we think about the three principles of universal design, one of the things, one of the questions we had before we audited our colleagues, that sounds bad, before we audited the practice within the field, we kind of thought, oh, maybe there’ll be a lot on assessment, and there won’t be a lot on on the other areas. But actually, we found there was, I think, free. We found a nice spread that people were engaging in lots of different ways. So we’re going to share that and publish that so to ensure, again, that cross pollination of good practice and learning.
Lillian Nave 33:55
Frida, did you have some additions for that one?
Freda Browne 33:59
Yeah, I suppose, across the university, just at the end of last year, at the end of 24 they did a university for all survey where they looked at demonstrating the impact of UDL within the university, and just very lucky, Lillian, they shared it on Saturday with me, the data from our school, so they were able to break it down into the schools. So in our school now there was a poor response rate. There was only 61 students, so out of around 2000 students, not a strong response rate. But from the last time it was completed in 2020 to 2024 our positive responses and our positive approach to inclusion, it greatly increased. I mean, we were good in 2020 but we hugely increased in 2020 up to 2024 for elements such as alternative formats, inclusive assessments, all those principles that I suppose myself and John would be really strong and really powerful. Passionate about. However, I was disappointed one of the things the students are made as positive, but there was additional comments that faculty are still not always sharing their slides before classes. Now we do run a diverse range of programs, from undergraduate to postgraduate, and that data wasn’t broken down. Sometimes we do have external clinical experts coming in. Perhaps those comments relate to that, but it was that was, I suppose, the main thing I was disappointed with. We still do have student comments about the built environment, you know, and the university has worked hard the building that we’re in, and Health Sciences is pretty good from an accessibility perspective, but some of the buildings in the university are very old, something we’re still struggling with, and it’s our geographical location of the university is accommodation and affordability of accommodation. And I know when I think of UDL and John thinks we’re always thinking of curriculum, but that’s a huge influence on who comes to the program and whether they attend or not? Lot of our students are commuting and traveling long distances. So I suppose when the other negative comments that came back from students is that we don’t record our lectures and have them online for students, I think, and I know it’s the next question, I don’t want to preempt it. Perhaps I’ll hold it. You know, that’s something that we could perhaps work on a whole curriculum redesign, but some wonderful and from doing the UDL digital badge for a number of years, we’ve seen some wonderful examples shared. I’ve recently with two of my colleagues are also UDL facilitators. We ran a workshop for people in simulation so how to incorporate UDL as an inclusive design process for simulation, and we had nurses, but a lot of other healthcare professionals attending the workshops as well. And it’s wonderful to get out there and to push it. And again, we’re fortunate in Ireland in that we have the National Digital Badge, so really, we’re able to promote that. I I hope we can get more people, from the simulation perspective, into Universal Design. There is a lot of push, and I’m sure it’s the same for you in relation to simulation and nursing. But like, we need to make sure that the simulations are inclusive as well. And, you know, and that design, and it’s all the core values of simulation is that it’s inclusive. So we need to ensure that we’re designing according to inclusive principles. So I suppose we’re trying to continue with that work as well and continue to spread that message.
Lillian Nave 37:34
Yeah, I noticed that it’s really a lot of accessibility is the thing where we could maybe improve. And that’s, you know, worldwide and coming up in the next year or two, depending on where you are in the world, that accessibility for all websites, for all higher ed for all learning management systems, is going to be the law across the land. But what you bring up too is that that doesn’t include the something like, Well, do you get the slides ahead of time? Like, that’s not in that accessibility law. It’s just that when you have a when you have slides and they are posted, they need to be accessible. But now we’re also talking about, what are our practices that we can engender in a program that says, You know what, we want everyone to have access to all things. Because maybe they can’t make it in, maybe there’s construction and they can’t make it into right into the class that day, or or whatever it is. How can we make sure that all of that information is available, and it’s context dependent too, right? Because you’ve got students who aren’t coming to the program because it’s so expensive, although that is very common here in the United States, too, very expensive accommodations. But yeah, what is that mindset that we can we can do, we can create, right, so that it’s more accessible.
John Gilmore 38:57
And there’s something that’s rather illuring For me, where I’m at at the minute in terms of wanting to move, is, is moving from that point of university design for learning as this framework we’re going to use to really moving into a mindset of justice and design justice, and thinking about the ways in which we do this. So like, rather than just think about, you know, well, how, how, you know, how do we create accessibility for these particular groups, actually. How do we transfer power to groups to ensure they get that knowledge to do more co creation and collaboration? I mean, it’s hard. You know, we were moving from this view of, we’re the experts, you’re the student, we’ll fill your heads, to actually recognizing, wow. What are the skills you bring to nursing? What are the ways I know how to apply those skills, how do we bring those together and kind of really thinking about, I suppose, through that structural change of, rather than just this intervention around assessment, intervention around curriculum, actually having approaches like, how do we embed justice within our curriculum? That includes making sure that. Anybody who wants to access a nursing program and use their skills, their body, their mind, all these wonderful things that you can do in nursing and apply that, because I think still we have quite a normative approach to nursing. One of the beautiful things that I consistently say to my students about my profession is that you bring so much of you into nursing. It’s a real profession where no two nurses provide the same practice of therapy. Like everything different, everything we have a standard. The ask, the jobs might be the same, it might be the approach might be the same, but the personality comes in so much. Students sometimes are a little bit frightened by that. They just want to tell me how to do it was like, No, you show me how you’re doing this. And I mean, that’s really beautiful. And I think getting ourselves to question all the time, are there barriers we’re creating to, you know, certain students who might might be brilliant nurses but haven’t had that opportunity yet, they’re the kind of conversations I want to really encourage through universal design or design justice talk class.
Lillian Nave 41:03
Wow, like we’re already getting into, yeah, that last question about the next steps. And it seems like you’re, you are thinking about really expanding UDL, not just in the the teaching part, but it’s almost like the the being, how is it that you’re really trying to empower these students to take control of their profession? And we do say for UDL, you’re creating expert learners or creating active, engaged participants, and that they’re really learning how to learn to continue to do that, because, again, they’re going to be learning nursing practice their whole lives, right? You have to have continuous education, right? So, yeah, it’s how you’re building these students to be comfortable and confident, to be really great nurses that will keep learning any more steps or what you’re hoping that you’re furthering what you’re already doing. I know you said you had maybe a publication that will be coming out, or at some point you want to write those things down. And yes, also any publications that case studies you’ve already done will put in the resources here. But yeah, what other next steps might there be?
Freda Browne 42:15
I think we we have huge opportunities now in Ireland, with the new curriculum, new, well, new standards and requirements coming out. Inclusive pedagogies at the moment are specifically mentioned in our draft standards. So that’s wonderful news for us. So we think we have, like we have been retrofitting UDL into modules, and we’re trying to look at it across a program, but it has never been designed into our current program, if that makes sense. So I think we’ve huge opportunities now, when we’re designing a program, that we can look at it from the whole I’m hoping. I’m not saying that it’s all good to be online, but perhaps we can meet some of those access needs by providing and it’s not just about online lectures, it’s developing a curriculum that is blended. You can’t just transfer a face to face lecture in one of our large lecture halls into a recording and put it up there for students like that. Isn’t how it works, and I don’t blame students for asking. They don’t know we’re the educators. We’re the people that need to be aware of that. So I think we’ve an opportunity to design and offer more elements of online learning now, but blended with other pedagogies and other ways of I suppose supporting students, as well as with huge opportunities in that. And again, with the new with the new standards and requirements, they are going to allow adaptation. So, you know, we will be able to do a certain amount of adaptation in our university based on our cohort of students. Think that offers us huge opportunities. I think, I suppose, from a nursing perspective, we’re doing really well in our university, but across, actually, Ireland as well, I’m coming across more and more nurses and nurse educators who are doing UDL. And I’m sure, John, you’d agree with that as well. Our clinical partners have very much supporting, buying into it. A lot of our clinical partners at our site have done the universal or the digital badge for universal design for learning. I mean, I started the conversation in relation to simulation, and it is one of the values. It was wonderful. When we did that workshop, we met a lot of nurses, but a lot of non nurses as well. Some of the professions are hugely open to it. Others, not so much. They’ll take a bit more work, but we’ll get there. We have huge opportunities in our new curriculum as well for inter professional learning. So that’s another way of kind of influencing that piece as well. I think it’s from my perspective. It’s just to continue the drive and continue to push it, name it. But it is wonderful. And I was saying this to. On this morning, when I hear students looking for things that haven’t been provided, that I may have provided other people are doing it, or John is doing I’m not doing it, they’re asking that. Well, why can’t I?
Lillian Nave 45:11
Yeah, our students are great teachers too, about how we can teach better.
John Gilmore 45:16
And I think opening up the system to more diversity, to diversity, not only in the people who are accessing the system, but are delivering the system, but also diversity in the way in which we’re thinking to do stuff. I mean, that’s how we started off. We started off by not talking about our deficits as learners, the things we find difficult. We start talking about the things we like, the realization for us as educators that we like lots of different ways of learning. We can learn in many different ways. We’re lucky enough to have that adaptability. You know, some are easier than others, but actually having choice is so important. And we talk to our students all the time about autonomy, and don’t tell your patient that they have to do. Give them options, give them choice, and then we often don’t give them options and choice. So I think by building in that and creating these learners that are, you know, sometimes more difficult to teach because they’re asking for more, but it’s a really nice kind of shift in the power dynamic where you can critically discuss. These are all the skills I have as an educator and as a clinician. Want to bring them to the room. You tell me what you need as a student and a student clinician, and we’ll try to marry up in some ways. There are challenges in terms of, you know, as I said, nursing. We have over a million shortage of nurses across the world, so we’re trying to, we’re trying to, kind of build up that workforce, but we also have a shortage of nurse educators along the same time, and trying to create time within a university system as well. I think where we’re, you know, a global research, intensive growth, global leading institution, we’re in the top 50 Qs ranked institutions for nursing. So that brings its own pressures as well. And unfortunately, in higher education, sometimes teaching and learning initiatives can take a second or third row to clinical research or other types of research. So you know, Frida and I are trying to be those that kind of all rounded academic with a real commitment to teaching and learning, but we’re also researchers, so trying to balance that all the time is a challenge for us, but I think having a team is helpful as well. So there was the three of us, there’s now two of us, but we have actually a lot of colleagues around who are deeply committed. So I think that’s helping us, as well as knowing there are people who think not exactly the same all the time, but around that kind of shared wavelength, around building inclusivity, building accessibility, trying to create change, and not being afraid of change.
Freda Browne 47:46
And I suppose Lillian, just when we come to that, like John had said, it’s the system that we come from as well. We have to mention, like UCD for all and Dr, Barbara Fleming, dr, Lisa Patton and Daniel Elliot and Lisa and Daniel, really, they kind of build you up and leave you off to do your piece. You influence your profession, you roll it in your school. We’ll support you in what you need. And I mean, that’s been hugely beneficial. And I think our network of faculty partners as well across different schools, where you can bounce ideas off what works what doesn’t work. It’s been hugely beneficial. However, we probably still have a bit of work to do, as all higher education facilities do. I mean, we spoke about student collaboration. The ideal is students would design outcomes and assessment with you, but you work in university structures, your module descriptor has to be completed before the students sit in the classroom. So, yes, you know, yeah, it’s not, ideal.
John Gilmore 48:49
And when you come from a system like one of the things I thought was really interesting when I presented at the International Research Network for UDL a couple of years ago, and one of the things I found really interesting was like, I was coming from Ireland, where UDL is starting to be embedded as a third level higher education system, and a lot of the people who are working there were working at kindergarten tier 12. So it was really interesting how we’re actually not doing a huge amount of UDL in our primary and secondary education system. We’re at tertiary, and in the US, they’re not doing so much in third level, they’re doing more. And so actually, with a huge amount to learn from global engagement and learning, our school system is very didactic. Right now they, you know, it’s, as Rita said at the start, it’s that fill their head full of content and they’ll regurgitate that at an end of, you know, end of program exam, and then, and that, then they come into our classrooms, and I’m in first year, I’m trying to do discursive learning, and here’s your six part staged assessment. It’s formative. And they’re just like, just tell me what to write down, right? But again, in nursing, in the US, everything is geared towards. Licensure exams. We have a licensing exam, Frieda and I at the well Frida, at the end of the program, determines as the as the academic responsible, that this many students have successfully attained their degree, and therefore they can practice as a nurse. So there are different contexts, but I think learning together and recognizing if you have a licensing exam, you you do need to focus on the content for that licensing exam. We maybe have a little bit more flexibility here. But then, on the flip side, the pressure is on for us, because as nurses, we need to make sure that the at the end of the day there is no exam. So every single classroom encounter counts, every assessment counts, because it’s part of that journey towards becoming a nurse. There’s no safeguard at the end. There’s no finals at the end to to find students that may have difficulty practicing safely. So there’s lots of, I think, learning and and it’s really good, and we hopefully will see more nurses in in, you know, take on Universal Design for Learning. Take on design, just as you know, hopefully in a couple of years, we won’t be going to UDL conferences. We’ll be going to Universal Design for nursing conferences, and it’ll be really useful if that happens.
Lillian Nave 51:09
Yeah, it sounds too like with the shortage, after our conversations, made me think of this, with the shortage of nursing and nursing educators, with a million worldwide, that what we should be doing, and what you are doing are building nurses. You’re creating nurses, rather than what often happens in STEM fields or in kind of that very didactic system is things like weed out courses. You’re not fit to be a nurse. You’re not going to make it right. And we think, or I’m not saying this is right, but that’s the the thought is okay, well, that’s how you make a rigorous curriculum, and that’s how you know people are good. But it’s not I’ve really coming to change my mind on those things. Is that That’s a lot of those structures that aren’t changing, that are not helpful. It’s that logistical rigor, like you have to learn it in this one way, but it’s not the intellectual rigor. It’s completely weeding out for no reason.
John Gilmore 52:07
And learning changes, and we change, and we become more physically disabled or more mentally in capacity throughout our career. My professional group is 90% women, many of those women still in their career, at the height of their careers, will go through physiological changes which may impact the way in which they can learn and apply that learning. Surely, having universally designed learner throughout helps that adaptation, because, again, we don’t want to have the learner at the end being like, as Greta said, with the alternative assessments. We find that funny. We laugh at that. We put so much work into designing multiple means of action and expression, and they write the essay because they’re conditioned. So again, bringing this idea around, building this into our program from the start, is really where we want to need to be. We mightn’t get there at this point because there might be kind of some hesitancy, but I think we can get there. I think we certainly can get there. And, yeah, and we’re very clear all the time. We have a commitment to safe, effective, expert clinicians at the end of our program. But how they get there can be multiple different ways, right?
Lillian Nave 53:17
Yeah, you’re building people that in this teaching, you’re building nurses. It’s just a completely different way of looking at our students, which I think there was one way is to say, Oh, this is, this is a nurse. This is a student who can be a nurse. We know they have the skills. We’re ready to just sort of finish them up, like a like chiseling away at the sculpture, right? Instead of really, all of these students have this option, this possibility, and we’re here to build to help that student to really gain the skills become the learner that they need to be in order to do it, rather than the fixed mindset of you are or you aren’t. And we’re going to determine how that, you know how that plays out because of how we teach this whole system.
John Gilmore 54:04
And we don’t know, we don’t know what the future needs to be. Because, you know, for all like freedom, I weren’t taught to use apps like technology was very limited in the programs we did. Because now you absolutely need digital competency to be a safe and effective tradition, because there’s so much digital you know. So again, what we need to build in is that information literacy that really would assess and problem solving skills and maybe try to shift away from the content, content, content, deliver it in one way. But we’re getting there. I think we are getting there at UCD. I think we’re not the only ones. We’re not We’re not claiming to be the best. We’re claiming the first ever clinical practice guidelines for UDL, just because we can’t find any others. But maybe there are better ones. Continue to claim until we find them and hopefully build more networks globally around this area.
Lillian Nave 54:58
That’s great. I hope so. Too. And you know, actually, in my little corner of the world neck, in 2026 we’re going to start a doctor of nurse practitioner program at our little University to serve our area. And I’m super excited. We are. In fact, can’t even get in the building today because of the construction, and we had to, like, turn the generator on. And so I’m from home, working from home, and they’re putting together all the simulation labs and all of those things. So I’m really glad that we can learn from you, and we can put that into practice, because we have a diverse set of learners that are coming in. And so I just want to say thank you. Thank you so much for the work that you’ve done over the years, this is a lot of work and time and passion to help transform what nursing education looks like. So thank you for infusing UDL and for taking the time to speak with me today on the podcast.
Freda Browne 55:56
Thank you, Lillian.
John Gilmore 55:57
Thanks, Lillian.
Lillian Nave 56:00
thank you for listening to this episode of The think UDL podcast. New episodes are posted on social media, on LinkedIn, Facebook, X and blue sky. You can find transcripts and resources pertaining to each episode on our website, think udl.org dot org. The music in each episode is created by the Odyssey quartet. Odyssey is spelled with two D’s, by the way, comprised of Rex Shepard, David Pate, Bill Falwell and Jose cochez. I’m your host, Lillian nave, and I want to thank Appalachian State University for helping to support this podcast. And if you call it Appalachian, I’ll throw an apple at you. Thank you for joining. I’m your host. Lillian nave, thanks for listening to the think UDL podcast. You