Introduction
The European Higher Education Area
1 has radically transformed university studies by placing the student at the centre of the educational process (Esteve,
2016). The new paradigm and the implicit assessment of acquired skills has forced teachers to rethink classical learning objectives (Correa & de Pablos,
2009). Therefore, recent years have seen a revolution in the classroom, with a large number of teachers striving to develop forms of active learning that seek to promote critical thinking and a high degree of autonomous learning (Initiative,
2004).
In this context of shifting pedagogical trends, one aspect referred to by some authors as the “digital revolution” stands out (Kaplan & Haenlein,
2016). This is the process adopted by those teachers who have been attracted by the possibilities of Information and Communication Technologies (ICT), which have great potential when it comes to transferring knowledge and allowing students to develop the necessary broad-spectrum skills (Zayer, Beran, & Alcaide-Pulido,
2017). In principle, wikis, blogs and social networks, to name just a few of the best-known examples, allow students to work on the proposed content in a participatory and collaborative way, thereby acquiring the necessary skills in an asynchronous and delocalised manner (Aguilar Martínez, Medina, Pons Albalat, & Saigí Rubió,
2013; Camacho, Carrión, Chayah, & Campos,
2016; Hamm, Klassen, Scott, Moher, & Hartling,
2013), as well as giving the subject matter a certain attractive aesthetic aspect. In the words of Bruns and Humphreys, these tools are capable of generating suitable communication spaces for the development of the desired skills, allowing a new model of critical, collaborative and creative technological literacy that opens a new pedagogical horizon unknown until recently (Bruns & Humphreys,
2005).
For the more specific case of the use of blogs (an abbreviation of the term web log
2 first coined in 1997 by Jon Barger (Blood,
2000)) -that was boosted in higher education by activities at Harvard University in the early years of the twentieth century (Lara,
2005)-, the literature has underlined the advantages of the incorporation of blogs into the university education toolkit: versatility when creating, updating and using different types of resources (videos, press releases, tweets, audio content, links to other blogs and websites, etc.) with no requirement for prior technical knowledge (Bonus, Wright, Scheidt, & Herring,
2005); the possibility of collaboration and involvement on the part of the student body as a consequence of the fact that all posts invite conversation and thus combine receptive skills (reading) with productive skills (writing); the ability to arrange posts by chronological order; and the possibilities this type of tool enables to disseminate teaching and research activity not only among students, but also among those professionals with an interest in continuing education (Soto, Senra, & Neira,
2009). All of these elements mean blogs should be considered as a means to support curricular content, especially since the available literature emphasises the positive results that have previously been obtained in a good number of similar initiatives in higher education (Alventosa, Peris, & Guerrero,
2016; Chun, Skinner, & Rosewall,
2019; Du & Wagner,
2007; Ferdig & Trammell,
2005; Molina, Valencia-Peris, & Gómez-Gonzalvo,
2016; Pérez-Nevado et al.,
2012; Williams & Jacobs,
2004). Other voices have been more pessimistic, highlighting the fact that the use of this type of tool has been more a myth than a reality, since students ultimately prefer more conventional, passive and linear forms of learning (Margaryan, Littlejohn, & Vojt,
2011).
In the specific realm of Health Sciences education, the available evidence points to a noticeable increase in the use of this type of media (Kala, Isaramalai, & Pohthong,
2010; Myrick, Caplan, Smitten, & Rusk,
2011; Vogt, Schaffner, Ribar, & Chavez,
2010; Zinger & Sinclair,
2013). These works have suggested that the use of blogs can have a significant impact on the formative development of students, since the reflections and discussions that the blogs enable are very helpful (Churchill,
2009). Furthermore, looking at professional practice, teaching biomedical students to use blogs also has its merits, especially given the importance such publication routes may have in the future for disseminating medical scientific research and supporting the health education of patients (Boulos, Maramba, & Wheeler,
2006). In this sense, this medium represents a unique opportunity to improve the transmission of knowledge in the field of health, due to the interactive communication it facilitates between health professionals and citizens (Bissonnette-Maheux et al.,
2015). This is reflected in the current growth of what some authors have referred to as the “medical blogosphere” (Kovic, Lulic, & Brumini,
2008): a large collection of blogs dealing with all kinds of health-related issues, from general aspects to such specific issues as Palliative Care (Ngwenya & Mills,
2014) or Diabetes (Kaufman,
2010). Blogs are even used in training biomedical students, frequently to engage learners and enhance education, because students may still achieve benefits by engaging in emotional disclosure and personal reflection (Becker & Freberg,
2014; Garrity, Jones, VanderZwan, de la Rocha, & Epstein,
2014; Sterling, Leung, Wright, & Bishop,
2017). For all these reasons, the boom in the use of blogs in university training programmes in Health Sciences seems to be just starting, especially as more and more teachers recognise that if this is to be a commonly-used tool in the future, its management must be standardised during the years of university learning.
The use of blogs has also become popular in aspects of Health Science as important as food, nutrition and diet
3. Many of the advantages of blogs are indispensable here in making content development more dynamic and the dissemination process more versatile in these times of so-called
fake news. Evidence on the use of blogs in teaching subjects in these areas reveals the wide variety of possibilities, including their use as tools for a better understanding of food systems, work on cultural aspects, narratives of students’ own experiences in implementing sustainable practices, and regular training in nutritional assessment instruments (Leveritt, Ball, & Desbrow,
2013; Maher & Burkhart,
2017; Paulus & Spence,
2010; Romero, Espinoza, & Hernández,
2019). Other articles have analysed the use of blogs in the teaching of nutrition in the field of Nursing, where a good number of previous approaches focussed on factors such as the good reception by students (Lin & Shen,
2013; Reed & Edmunds,
2015) provided the factors influencing low participation are addressed (Moule, Ward, & Lockyer,
2010), the possibilities they offer to improve the standard of training (Garrity et al.,
2014; Maag,
2005), and the advantages of being able to reach a greater number of people interested in health care and food given the potential of blogs to share knowledge and inform (Almeida, Christovam, & Correia,
2018).
It is in precisely this context that the experience we shall examine here is framed. In the following, we will present results obtained from research into the advantages and disadvantages of, and attitudes of students to, the use of blogs as a pedagogical tool in the Nutrition and Dietetics module of the undergraduate course in Nursing at the University of Castilla-La Mancha (Spain).
Discussion
The analysis of this experience of the use of a blog as a component of a health education teaching strategy shows a notable degree of heterogeneity. On the one hand, the evaluation of the teaching staff is very positive, and it is in line with the advantages and usefulness of blogs and other web applications that the existing literature has identified (Boulos et al.,
2006; Chawinga,
2017) but, on the other hand, a poor level of participation and a significant workload for the teaching staff has been also reported. Among the positive aspects, beyond offering a complementary and successful model for the dissemination of content and answering student questions, these technologies represent a suitable tool for the acquisition and development of skills essential for nurses who can think critically. For example, this experience has allowed students to delve deeper into questions such as the way the scientific process operates, the distinction between science and
bad science (Goldacre,
2014), and the need to adopt a critical attitude toward the production and presentation of facts (Kala et al.,
2010; Oravec,
2003; Zinger & Sinclair,
2013). In addition, these skills are crucial to keep up with the rapid pace of scientific output in health, particularly in the field of food and nutrition, in which much misinformation frequently circulates, yet has the potential to directly impact consumer habits
6. Therefore, if nursing students acquire the skills necessary to develop critical thinking they could be more aware about how the world is changing and the way they are developing their practice and, as a result, those skills may help to improve the quality and safety of care (Jefferies et al.,
2018).
The negative outcomes of this experience must be also underlined, in particular the low participation rate of the students (an average just 24.4 visits to the blog per student), beyond the collaborative work that formed part of the assessment of the module. The low response rate to the questionnaire (14.1% of students responded), and the lack of any comments on the posts are no coincidence. We would suggest that a large proportion of students tend to express a preference for more linear methodologies, with more “solid” content, which are less open to interpretation and discussion. There is one recurring question virtually every university professor has heard repeated in every course – “will this be on the exam?” – which shows a greater tendency toward the evaluation of content than of skills.
It is also important to point out that the use of blogging as pedagogical tool in health education entails a significant workload for the instructor, which takes away time from other activities and could possibly hamper performance in an increasingly-demanding role which includes duties in disparate areas such as teaching, management, bureaucracy and research. This time commitment did not go unnoticed by students, who tend to value positively initiatives such as the one presented here, where the visual aesthetics of this form of dissemination particularly stand out.
Despite the ethical consequences of not publishing negative results (Kaplan & Irvin,
2015; Mlinarić, Horvat, & Šupak Smolčić,
2017), although negative/null results are not negative for science, the existence of a publication bias toward the selective reporting of positive outcomes in the literature has previously been recognised and extensively discussed (Dwan, Gamble, Williamson, Kirkham,, & Reporting Bias Group,
2013; Hopewell, Loudon, Clarke, Oxman, & Dickersin,
2009; Wayant et al.,
2017). A global analysis of the present experience, taking into account the increased workload for educators and the low participation of students in this type of activity, seems to support the idea that publication is biased toward successful experiences, which emphasises the attractive end product of the project (the blog itself) and the positive evaluation of the students’ experiences. Future research must elucidate how strongly publication bias affects scientific literature in this field (van Aert, Wicherts, & van Assen,
2019).
Beyond this somewhat pessimistic view, we can identify certain elements that may present barriers to greater participation. We start from the premise that there are no socioeconomic barriers here, since all students have the means to access the resources. On the one hand, our project involves first-year students whose previous learning experiences have, as a general rule, employed teaching methods that are more vertical than dialogical, embodying a model that places more value on the memorisation of facts than on the process of producing and questioning them. It is left for the future to repeat the experiment with students at different stages of their university education and also whether or not they will continue using blogs to learn (Ifinedo,
2018). On the other hand, students tend to cite the “overwhelming” or “excessive” amount of time demanded by the way in which study courses are organised. This results in them allocating the time that they do have to mandatory and classical activities (which they are already familiar with and know how to handle), which take priority over new learning experiences such as those proposed here, which are perceived as “extra” effort. We do not know if the high number of students in the class also limits the effectiveness of initiatives such as these, just as it is difficult for us to measure the real effectiveness of this type of proposal (Boulos et al.,
2006).
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