Clinical Teaching in Education - single page view

As the name suggests, clinical teaching in education draws on models of decision-making processes used by medical practitioners, and on models of educating medical interns to support the development of their knowledge and clinical judgement. While there are limits to the degree to which models transfer fully across different fields, medical models have some key features that can usefully inform our understanding of teaching practice and teacher education.

There are some key aspects that we can learn by adapting and rethinking medical models in the context of education. These are that professionals make decisions by drawing on evidence from a range of sources, relating that evidence to the findings from a contemporary body of research, integrating into this their knowledge of the current situation, seeking further evidence if necessary, and deciding on actions (Burn & Mutton, 2013). Central to the professional’s thinking is that all decisions must be made with an overriding concern for the best interests of the person whose learning, health or wellbeing is charged to their care.

In education, this translates into a clinical model of teaching that has the following features:

The teacher uses evidence about the student, what they have learnt and what they are ready to learn to make decisions about subsequent teaching;
The teacher draws on current research evidence about effective practice in making decisions about how to work with a student or group of students
The teacher integrates knowledge about who the student is, including knowledge of their characteristics, circumstances and prior experiences into decision-making about the student and their own teaching;
The teacher evaluates their own impact on student learning on a regular basis;
The teacher exercises professional judgement involving all these elements; and
The student and their learning needs are pivotal to all decision-making about what, when and how to teach (Alter & Coggshall, 2009; Kriewaldt & Turnidge, 2013).

There are also implications for teacher preparation. Clinical models of teacher education, while incorporating the above elements, also draw on medical models of doctor preparation in which universities, current practitioners and those studying to become a practitioner work together to support the application of knowledge and the development of clinical judgement. Such models are additionally characterised by the following:

Close partnerships between schools and universities that inform practice in both sites (Grossman, 2010; Conroy et al., 2013);
Strong articulation between coursework and professional practice founded on a shared understanding and commitment to clinical reasoning and practice;
Professional conversations between novice and mentor that pose questions and probe to make reasoning explicit (Kriewaldt & Turnidge, 2013); and
A shared community of practice who are committed to a clinical approach.

References:

Alter, J. & Coggshall, J. (2009). Teaching as a Clinical Practice Profession: Implications for Teacher Education and State Policy. N.Y.: National Comprehensive Center for Teacher Quality.

Burn, K., and Mutton, T. (2013) Review of research informed clinical practice’ in initial teacher education. British Education Research Association (BERA).

Conroy, J. Hulme, M. & Menter, I. (2013) ‘Developing a ‘clinical’ model for teacher education’, Journal of Education for Teaching: International research and pedagogy,39:5, 557-573, DOI: 10.1080/02607476.2013.836339

Grossman, P. (2010). Learning to practice: The design of clinical experience in teacher preparation. Washington DC: American Association of Colleges for Teacher Education & National Education Association.

Kriewaldt, J., & Turnidge, D. (2013). Conceptualising an approach to clinical reasoning in the education profession. Australian Journal of Teacher Education, 38(6). doi: 10.14221/ajte.2013v38n6.9.

Conceptualising clinical teaching in education

In education, this translates into a clinical model of teaching that has the following features:

The teacher uses evidence about the student, what they have learnt and what they are ready to learn to make decisions about subsequent teaching;
The teacher draws on current research evidence about effective practice in making decisions about how to work with a student or group of students
The teacher integrates knowledge about who the student is, including knowledge of their characteristics, circumstances and prior experiences into decision-making about the student and their own teaching;
The teacher evaluates their own impact on student learning on a regular basis;
The teacher exercises professional judgement involving all these elements; and
The student and their learning needs are pivotal to all decision-making about what, when and how to teach (Alter & Coggshall, 2009; Kriewaldt & Turnidge, 2013).

Close partnerships between schools and universities that inform practice in both sites (Grossman, 2010; Conroy et al., 2013);
Strong articulation between coursework and professional practice founded on a shared understanding and commitment to clinical reasoning and practice;
Professional conversations between novice and mentor that pose questions and probe to make reasoning explicit (Kriewaldt & Turnidge, 2013); and
A shared community of practice who are committed to a clinical approach.

References:

Alter, J. & Coggshall, J. (2009). Teaching as a Clinical Practice Profession: Implications for Teacher Education and State Policy. N.Y.: National Comprehensive Center for Teacher Quality.

Burn, K., and Mutton, T. (2013) Review of research informed clinical practice’ in initial teacher education. British Education Research Association (BERA).

Kriewaldt, J., & Turnidge, D. (2013). Conceptualising an approach to clinical reasoning in the education profession. Australian Journal of Teacher Education, 38(6). doi: 10.14221/ajte.2013v38n6.9.

The origins of clinical teaching in education

Clinical approaches to teacher education have gained increasing prominence in the past decade largely lead by initial teacher education programs in England, Scotland, The United States, the the Netherlands, Finland and Australia adopting research informed clinical practice models of teacher preparation (Burn and Mutton, 2013). However, with the exception of Finland, these initiatives are often within a single teacher education program.

An initial clinical teaching conceptual model of pre-service teacher preparation can be found arising in one of its earliest forms in Oxford, England, in the 1960s, (Redman, 2014). Harry Judge introduced a new initiative for pre-service teachers into education courses and which has been described as making a difference (Phillips, 2008). Judge employed classroom teachers from the Department of Education within the University of Oxford. The Teachers' roles were to liaise between the university and the school, and to work both within schools and the university with the pre-service teachers.

This new partnership model evolved and by 1987 it was termed the Oxford Internship Scheme, and involved academics, teachers, schools, the university and the Local Education Authority communicating together to meet the needs of the pre-service teachers, the school and its students. New terms were now being utilised in education, and with clear intent, as Interns and Internships were embedded into the educational system. Judge made an intentional and explicit reference to the medical model with its longer history of internship models. Introducing the concept of the internship into a teacher education program was a direct reference to the medical internship model of educating trainee doctors.

The incorporation of this type of internship into education acknowledged the value of learning on-site with an experienced other, and with the potential for more meaningful and authentic experiences alongside the theoretical and content-focused university programs. In retrospect, this can now be viewed as perhaps the beginning of an international response to a need for theories of professional learning to be implemented into school sites, which included more structured approaches that would assist to analyse student learning (Darling-Hammond & Bransford, 2005). In turn, beginning teachers would then be better informed when designing suitable curriculum responses appropriate for a range of learners.

More recently Scotland’s Glasgow West Teacher Education Initiative has built a clinical teacher education program in which ‘school settings are critical sites for sustained professional deliberation and co-enquiry’ (Conroy et al, 2013, p. 564). This In this Scottish example they do not adopt a medical model, rather they constructed a program in which important concepts that are arise from a medical model of professional education inform their program architecture.

Across the Atlantic in 2002, the Teachers for a New Era (TNE) initiative saw Bank Street College of Education selected as a site for researching high quality teacher education, again a model built on principles of school-university partnerships. The Curry School of Education at the University of Virginia constructed a teacher education program grounded in partnerships and evidence-based clinical teaching. Stanford University’s Teacher Education Program has also led in the development of teaching as a clinical practice profession. Their approach was acclaimed by Arthur Levine’s 2006 report on exemplary teaching programs (2006).

Burn, K., and Mutton, T. (2013) Review of research informed clinical practice’ in initial teacher education. British Education Research Association (BERA).

Conroy, J., Hulme, M. & Menter, I. (2013) Developing a ‘Clinical’ Model for Teacher Education, Journal of Education for Teaching, 39(5). P. 557-573, DOI: 10.1080/02607476.2013.836339

Darling-Hammond, L., & Bransford, J. (2005). Preparing teachers for a changing world, what teachers should learn and be able to do. San Francisco: Jossey-Bass.

Levine, A. (2006). Educating school teachers. Washington DC: The Education Schools Project.

Phillips, D. (2008). Making a difference: Harry Judge, teacher education, the university, and the schools. Oxford Review of Education, 34,3, p 271-274.

Redman, C. (2014). The Melbourne Graduate School of Education Master of Teaching; A Clinical Practice Model, in Successful Teacher Education: Partnerships, Reflective Practice and the Place of Technology, Sense Publishers, Rotterdam, p11-29.

Evidence- and research-informed practice

Teacher practice has often only been relatively loosely coupled with both evidence of student learning, and the current research base around what we know on effective teaching and learning. Pre-service education often exposed pre-service teachers to educational research, but there was little to support them to link this to their experiences in schools, and few requirements for teachers to remain connected to developments in knowledge around effective teaching and learning following graduation (Mclean-Davies et. al., 2013). Within a clinical model of teaching, the teacher bases their decisions on what, when and how to teach around current research on teaching and learning, and on evidence about the student. Tiers of interlocking evidence that clinical teachers integrate to support student learning are as follows:

classroom based-evidence – the data gathered in the classroom context and as a result of verifiable observations, and formal and informal assessments;
para-classroom evidence – data about the student’s out-of-classroom life that impact on their capacity to undertake tasks, meet learning outcomes;
external assessment evidence – summative assessment measures determined by governments and fed-back to school leadership and teachers; and,
research evidence – knowledge about learning drawn from reputable research that informs teacher understandings of the efficacy of various interventions and suitability for their context.

A clinical teacher draws heavily on evidence about the student in determining action within the classroom. This includes detailed information on what the student has learnt and what they are ready to learn next, together with an understanding about what may be driving particular patterns of response – for example, what do the student’s responses indicate about their understanding of a particular mathematical concept? Implicit in a clinical model of teaching is the need for ongoing formative assessment based on developmental approaches that highlight next steps in the learning progression. In addition, evidence also comprises the broad range of knowledge teachers bring to their work about who the student is, and factors that may be impacting on their learning. So a teacher using a clinical approach will not only make judgements about what the student has learnt and is ready to learn, but will also take into consideration in making judgements about how to work with the student information about the student’s personality, their home life, their cultural background and any current issues they may be experiencing. A deep and nuanced understanding of the interplay between cultural, personal and social elements connected to student trajectories within schools is an essential part of the clinical teacher’s knowledge.

In determining how best to advance the learning of a student or group of students, the clinical teacher also makes ongoing reference to our current research-based knowledge about effective teaching practices. Clinical teachers have a broad understanding around what the research literature says about effective teaching and learning, and use this knowledge to decide how to proceed in the classroom. The clinical teacher adopts a stance of openness to new research evidence about quality teaching and student learning, and a commitment to maintain and refresh their knowledge around this (Cochran-Smith et al., 2009).

Finally, the commitment to evidence also means that the clinical teacher collects evidence around the impact of their own teaching and uses this to inform future teaching and their own professional learning. Clinical teachers monitor and evaluate their impact regularly, seek to understand the reasons behind what the evidence suggests, and make plans to maintain, change or learn further about their practice based on these evaluations.

Evidence base and references

McLean-Davies, L., Anderson, M., Deans, J, Dinham, S., Griffin, P., Kameniar, B., Page, J., Reid, C., Rickards, F., Tayler, C and Tyler, D. (2013). Masterly preparation: Embedding clinical practice in a graduate pre-service teacher education programme. Journal of Education for Teaching, 39(1), 93-106.

Davies, P. (1999). What is evidence-based education? British Journal of Educational Studies, 47(2), 108-121.

Cochran-Smith, M., & the Boston College Evidence Team (2009). “Re-culturing” teacher education: Inquiry, evidence, and action. Journal of Teacher Education, 60(5), 458-468. doi: 10.1177/0022487109347206

Processes of reasoning

Teachers use a range of specific and broader reasoning processes to decide how to improve student learning, before, during and after teaching episodes and these processes are described in various terms, including problem solving and critical thinking.

Clinical teaching uses clinical reasoning processes. Clinical reasoning describes ‘the analytical processes that professionals use to arrive at a best judged ethical response in a specific practice-based context’ (Kriewaldt & Turnidge, 2013). Teachers integrate knowledge of student characteristics, curriculum frameworks, school and broader policy to frame their clinical reasoning. Clinical reasoning is sometimes used interchangeably with clinical judgment or decision-making, though reasoning describes the process and judgement describes the result.

Clinical teaching use processes of clinical reasoning to identify collect and analyse evidence to determine student’s learning needs to plan and implement teaching interventions. Subsequent clinical reasoning is employed to evaluate the outcomes of teacher action using evidence and to initiate a new cycle of clinical reasoning. Therefore clinical reasoning is situated in practice in which teacher actions are the result of critical deliberations of options and predicted effects. Clinical teaching is learner-focussed and requires a culture of evidence (Cochran-Smith et al., 2009).

Teachers employing clinical reasoning seek and use evidence to guide their practice by asking and integrating these questions into their thinking processes:

What does the student already know and what can they do?
What does each individual student need to advance their learning?
What are effective practices according to the evidence base from research?
What evidence of learning can be gathered during and after each teaching intervention?
What happened and how can this be interpreted, or what does it show?
What does this mean for future interventions?

In this approach teachers view their practice from an inquiring stance (Cochran-Smith & Lytle, 2001) in conjunction with student evidence generated by observing, questioning and formatively and summatively assessing student performance. By giving emphasis to clinical reasoning this drives a forward-thinking orientation to teaching in which each student’s development is brought sharply into focus and this drives powerful planning. It works hand in hand with reflective practice which focuses on learning from teaching episodes.

Evidence base and references

Cochran-Smith, M., & Lytle, S. L. (2001). Beyond certainty: taking an inquiry stance on practice. In A. Liebermann & L. Miller (Eds.), Teachers caught in the action: Professional development that matters (pp. 45-58). New York: Teachers' College Press.

Kriewaldt, J., & Turnidge, D. (2013). Conceptualising an approach to clinical reasoning in the education profession. Australian Journal of Teacher Education, 38(6). doi: 10.14221/ajte.2013v38n6.9.

Focus on student learning and development

An important characteristic of clinical teaching is the focus on student learning and development. As with other clinical professions; understanding and interpreting the needs of each client is fundamental (Alter & Coggshall, 2009; Burn & Mutton, 2013) in deciding on the best course of action. Teaching requires teachers to not only have a deep understanding of subject content, but be able to identify and address the diverse needs of their students.

By understanding how students learn (Darling-Hammond, 2006), teachers are able to determine what stage of the developmental continuum they are at, and adapt their teaching accordingly. What is important to note here, is that a clinical model of teaching recognises that each child is able to be successful but in order to do this teaching must centre on individual student needs in setting meaningful learning goals to advance learning.

Central to interpreting student learning and development, is a teacher’s ability to collect various forms of data in order to determine what a student is able to do in relation to where the teacher wants them to reach. Examples of data may include assessment and observations of a student’s context, knowledge, skills or dispositions which serve to inform the teacher’s clinical judgement about how best to plan in order to assist the student to achieve their next set of learning goals. Through careful observation, record keeping and analysis, teachers can ascertain current levels of student knowledge and understanding from which to build on.

A focus on student learning and development also relies on developing productive pedagogical relationships with students. Building these relationships requires teachers to comprehensively know their subject and how to teach it, to understand the abilities and needs of their students and to create high quality learning environments (Alter & Coggshall, 2009). Positive interpersonal relationships between teacher and students make a significant contribution to advancing students learning. Clinical teaching fosters relational aspects of teaching in conjunction with developmental goals for each student.

Evidence base and references

Alter, J. & Coggshall, J. (2009) Teaching as a clinical practice profession: Implications for teacher preparation and state policy. New York: National Comprehensive Centre for Teacher Quality.

Burn, K. & Mutton, T. (2013) Review of research informed clinical practice in initial teacher education. Research and Teacher Education: the BERA-RSA Inquiry. https://www.bera.ac.uk/wp-content/uploads/2014/02/BERA-Paper-4-Research-informed-clinical-practice.pdf?noredirect=1

Darling-Hammond, L. (2006) Powerful teacher education: Lessons from exemplary programs. San Francisco: Jossey Bass.

Integration of theory and practice through university-school partnership

In the past, teacher education programs have typically involved the university providing theoretical perspectives of curriculum and pedagogy, and schools providing contexts for professional practice placements; the lack of integration between these two components has often resulted in decontextualized learning (Darling-Hammond & Bransford, 2005). In order to prepare teachers who are clinical practitioners, strong partnerships between the university and schools is crucial. A number of factors contribute to effective university-school partnerships, including: understanding and use of a shared language about teaching and learning; course design that facilitates meaningful links between academic studies and professional practice; the development of coursework tasks framed around the collection and analysis of authentic classroom data; and close collaborations and exchanges between university- and school-based staff.

A key feature of effective university-school partnerships is shared language in relation to concepts such as ‘clinical teaching’, ‘interventionist practice’ and ‘data’, and the genuine integration of this language across both university and school contexts. Central to this integration are the collaborations between university- and school-based staff, course design and program scheduling. To enable pre-service teachers to constantly enact and reflect on the links between theory and practice, requires extended and sustained periods in schools that are ‘interlaced with coursework’ (Darling-Hammond & Bransford, 2005, p. 411). This ‘interlacing’ of coursework and practice enables coursework tasks to be authentically situated in practice and based on the collection and analysis of school data, rather than decontexualised, remote and contrived.

In order for the links between the university and schools and coursework and practice to be integrated, strong collaboration and dedicated roles for both university and school-based staff are crucial (Burn & Mutton, 2013). Ideally, these roles involve exchanges whereby school-based staff have opportunities to teach and assess within the university coursework program, and university staff are involved in professional development and research in schools. Central to this collaborations is the mentoring of pre-service teachers in school placements, during which the contextual knowledge and expertise of the school-based staff is integrated with the theoretical perspectives brought by university staff (McLean Davies et al 2013).

Evidence base and references

Burn, K., & Mutton, T. (2013). Review of Research Informed Clinical Practice in Initial Teacher Education. British Education Research Association (BERA). http://www.bera.ac.uk/wp-content/uploads/2014/02/BERA-Paper-4-Research-informed-clinical-practice.pdf

DarlingHammond, L. & Bransford, J (Eds.) (2005). Preparing Teachers for a changing world: what teachers should learn and be able to do, San Francisco: Jossey Bass

McLean Davies, L., Anderson, M., Deans, J., Dinham, S., Griffin, P. , Kameniar, B. , Page, J., Reid, C., Rickards, F., Tayler, C., & Tyler, D. 2013. “Masterly preparation: Embedding clinical practice in a graduate pre-service teacher education programme.” Journal of Education for Teaching: International research and pedagogy 39 (1): 93-106. DOI:10.1080/02607476.2012.733193

Integrated curriculum, pedagogy and assessment

To successfully prepare pre-service teachers for their classrooms, teacher educators need to understand the ways in which the various knowledge they are learning fits together and impacts on the students that they teach. In order for a teaching model to be ‘clinical’ it must allow students to combine the practical with the theoretical, the content with the policy, and the learning needs with the student.

In the 1970s Bernstein (1971) spoke about the three message systems of pedagogies, curriculum and assessment. Bernstein sought to understand both the connections and disconnections between these three components. Historically, teaching institutions have often separated the various components of knowledge as a way of dealing with all three of these components. While this may allow pre-service teachers to access each component, it can mean that they never see the larger picture. Aspects of the various fields are added iteratively, rather than considered holistically. However, pre-service teachers do not have the luxury of considering these three components separately. The immediate nature of classroom teaching means that all aspects are considered at once, as they all form part of the learning needs of the students in their classrooms.

Traditionally, teacher education has not explicitly role modelled this holistic integration process for pre-service teachers.

In order to solve the issues of disconnections between subjects and a lack of conceptual coherence, further attention needs to be paid to an integrated approach to curriculum, pedagogy and engagement. Linda-Darling Hammond states:

“…effective teacher education programs... include tight coherence and integration among courses and between course work and clinical work in schools, extensive and intensely supervised clinical work integrated with course work using pedagogies that link theory and practice, and closer, proactive relationships with schools that serve diverse learners effectively and develop and model good teaching”. (Darling Hammond, 2006, p.300)

Integration of curriculum, pedagogy and assessment can lead to a number of benefits for pre-service teachers including consistency of ideas (Hammerness, 2006), stronger impact of theory on pre-service teachers, conceptual coherence (Darling-Hammond, 2006) and an alignment of ideas across the teacher education institution. There are also opportunities for interventions if misconceptions are formed.

Evidence base and references

Bernstein, B. (1971). On the classification and framing of educational knowledge. In M.F.D. Young (Ed.), Knowledge and control: New directions for the sociology of education (pp. 47–69). London: Collier-Macmillan.

Darling-Hammond, L. (2006). Constructing 21st Century Teacher Education. Journal of Teacher Education 57 (3) pp. 300-314.

Hammerness, K. (2006). From Coherence in Theory to Coherence in Practice. Teachers College Record, 108(7) pp. 1241-1265

Collaborative approaches to teacher education

Collaboration is central to the work of a teacher; however, in traditional teacher education programs, there has been a tendency, particularly in the subject disciplines, for each academic to view their area as discrete from other course components. In order for pre-service teachers to see the value of collaboration, not only within but across disciplines, collaborative approaches should be modelled in teacher education programs. Examples of collaborations include the integration of literacy across coursework subjects, interdisciplinary workshops and combined assessment tasks.

The inclusion of specific literacy intervention across the disciplines has been mandated in some jurisdictions; this aims to assist students to develop awareness that language and discourse differ across the curriculum and that there is a need to learn literacies involved in each subject they undertake The capacity of teachers to support their students to address the language and literacy demands of specific disciplines is crucial to the clinical model. Key questions that guide literacy inclusion are:

What are the student’s existing skills in relation to listening, speaking, reading, viewing, writing and creating?
What evidence supports this?
What are the language and literacy demands of this task/topic/discipline?
What does the student need to know/do to address these demands?
How will the teacher support the student to develop the required skills and knowledge?
What theoretical and pedagogical approaches support this approach?
How will the student’s discipline- specific language and literacy development be measured?

Collaboration between literacy specialists and discipline-based academics facilitates all pre-service teachers to identify and understand discourse-specific literacies and genres, and to develop strategies to integrate explicit teaching of these into discipline content (Billman & Pearson 2013). One such interdisciplinary collaboration involves pre-service teachers of Physical Education undertaking literacy-based workshops utilising artworks. These workshops are collaborations between the Physical Education lecturer and literacy and art specialists. In these workshops, the pre-service teachers are asked to respond to artworks and associate their responses to their own professional and personal identities. The key outcomes of these workshops were the deepening of the pre-service teachers’ own visual, oral and written literacy skills, and the development of their own interdisciplinary approaches to teaching (Nash et al., 2015).

The collaboration of staff across core subject and discipline-based subjects can result in ‘combined’ assessment tasks that show the integration of subject content, pedagogy, literacy and considerations of contextual factors. In one such example at the Melbourne Graduate School of Education, the Clinical Praxis Exam (CPE) requires all pre-service teachers completing the Master of Teaching to report on their teaching in a particular subject area, and to discuss their pedagogical approaches given the students’ existing skills, the language and literacy demands of the specific task, the contextual factors impacting on the student, and relevant theory and research. This task requires teaching staff from across the program to become familiar with subjects outside their own specialised fields, and to be involved in assessment panels comprising a range of staff from both the university and partnerships schools (McLean Davies et al, 2013).

Collaborations such as those outlined model good practice for pre-service teachers, and also provide academic staff with holistic learning experiences leading to understandings that enable them to approach their work as clinical educators.

Evidence base and references

Billman, A. and Pearson, P.D (2013). Literacy in the disciplines. In Literacy Learning: the Middle Years, 21(1).

McLean Davies, L., Anderson, M., Deans, J., Dinham, S., Griffin, P , Kameniar, B. , Page, J., Reid, C., Rickards, F., Tayler, C., & Tyler, D. (2013). Masterly preparation: Embedding clinical practice in a graduate pre-service teacher education programme. Journal of Education for Teaching: International research and pedagogy 39 (1): 93-106. DOI:10.1080/02607476.2012.733193

Nash. M., Kent, H. and Reid, C. (In press – accepted March 2015). Learning across figured worlds. In The Arts Collection.

Integrated Assessment Practices

A key feature of clinical teaching models is the integration of theory and practice, this approach is also reflected in assessment practices in programs which identify as ‘clinical’. Clinical models of teaching make it possible for new and more integrated assessment practices which focus on student learning to be undertaken by pre-service teachers. Three examples of integrated assessment practices are the use of teaching portfolios, learning rounds and combined assessment tasks.

In clinical teaching models, integrated assessment is evident both in formative and summative assessment tasks. Key to these approaches is the ways that formative assessment not only requires pre-service teachers to integrate theory and practice, but also supports pre-service teachers to undertake summative assessment.

Perhaps the most widespread example of this kind of assessment is the teaching portfolio of practice, which pre-service teachers collect throughout their professional preparation for the purpose of final assessment and, in the United States, for professional accreditation (see Darling-Hammond et al., 2010).

Another more context specific example is the Learning Rounds approach developed at the University of Glasgow drawing on the work of City et al. (2009). These Learning Rounds enable pre-service teachers at the site of practice to observe their peers teaching, and then, with the support of mentor teachers and University staff, pre-service teachers reflect on the implications of the example of teaching they have seen for their own practice. This then contributes to their summative performance assessment (see Conroy et al., 2013).

A promising practice is the “Clinical Praxis Exam” at the University of Melbourne, an inquiry which requires pre-service teachers to design a learning intervention for a school student within a classroom context and report on and explain the ways in which they utilised classroom data and research evidence to support learning for this student (see McLean Davies et al., 2013).

Evidence base and references

City, E. A., R. F. Elmore, S.E. Fiarman and L.Teitel. 2009. Instructional Rounds in Education: a network approach to improving teaching and learning. Cambridge, MA: Harvard Educational Press.

Conroy, J., M. Hulme and I. Menter. 2013. “Developing a ‘clinical’ model for teacher education.” Journal of Education for Teaching: International research and pedagogy 39(5): 557-573. DOI: 10.1080/02607476.2013.836339

Darling-Hammond, L., Newton, X., and Chung Wei , R. (2010) Evaluating

teacher education outcomes: a study of the Stanford Teacher Education Programme, Journal of Education for Teaching: International research and pedagogy, 36:4, 369-388 http://dx.doi.org/10.1080/02607476.2010.513844

Features of existing models of clinical teaching in initial teacher education

Clinical models of initial teacher education (CMPSTE) are those that prioritise and facilitate close alignment between sites of practice—the school—and the University in order to integrate theory and practice in initial teacher education. In these models, schools are an integral part of the design and delivery of the initial teacher education program, and contribute to the evolution and design of these programs. Clinical teacher education programs have gained traction in the United States, The United Kingdom and Australia (Burn & Mutton 2013).

Clinical models of Teacher Education recognise that practices in medicine, in which Universities are closely aligned with teaching hospitals, and the ‘theory’ learnt is contextualised in practice have value for teacher preparation, and this approach is adapted for an educational context (Kriewaldt & Turnidge, 2013; McLean Davies et al., 2015). Clinical programs allocate significant resources to the integration of theory and practice, and to leveraging teacher learning across the sites of learning and practice. To this end, they are often resource intensive, and require funding to become established and maintained (Conroy, 2013, McLean Davies et al., 2013). This results in some universities offering two kinds of programs, a regular program, and a more intensive clinical program.

Features of Clinical Models of Pre-service Teacher education:

Architecture

CMITE enable pre-service teachers to spend significant time in schools alongside the classes they undertake at university. Programs either have students in schools for part of each day, or for a significant proportion of the week. This enables pre-service teachers to connect learning that is initiated in different institutional contexts.

Staffing

Clinical programs have dedicated staff who work for a substantive time with pre-service teachers in schools, and school staff that are also involved in the university component of the program. These staff will facilitate the connection between theory and practice, and can also serve to provide additional support to schools (see Conroy et al., 2013; McLean Davies et al., 2013).

Assessment

The focus on the integration of theory and practice in clinical teaching programs results in integrated assessment. A key feature of these clinical assessment tasks is the way in which they require academic and school-based staff work closely together to support the pre-service teacher’s development and ability to critically reflect on their practice. New assessment processes and protocols (such as the Clinical Practice Exam at the University of Melbourne, and the Learning Rounds at the University of Glasgow - see McLean Davies et al., 2013; Conroy et al., 2013) have been developed to meet both the need to integrate theory and practice, and in response to the possibilities of the close partnerships that are a feature of these programs.

References

Burn, K., & Mutton, T. (2013). Review of 'research-informed clinical practice' in initial teacher education. Paper commissioned by BERA, presented at BERA-RSA Inquiry (London, BERA/RSA).

McLean Davies, L., Dickson, B., Rickards, F., Dinham, S., Conroy, J., Davis, R. (In Press - Accepted February 2015). Teaching as a clinical profession: translational practices in initial teacher education – an international perspective. Journal of Education for Teaching: International research and pedagogy.

McLean Davies, L. M. Anderson, J. Deans, S. Dinham, P. Griffin, B. Kameniar, J. Page, C.Reid, F.Rickards, C.Tayler and D. Tyler 2013. “Masterly preparation: Embedding clinical practice in a graduate pre-service teacher education programme.” Journal of Education for Teaching: International research and pedagogy 39 (1): 93-106. DOI:10.1080/02607476.2012.733193

Developing clinical judgement: the mentor perspective

Clinical judgement develops from processes of gathering and analysing data to diagnose learning needs in order to undertake an intervention (Kriewaldt & Turnidge, 2013). School-based mentor teachers play a vital role as teacher educators in teacher preparation. In initial teacher education the school mentor specifically develops clinical judgement by taking an inquiring stance with the pre-service teacher to encourage the iterative use of data and evidence to answer questions of practice. Mentors use respectful and reciprocal dialogue in which personal assumptions and theories are probed.

At the core of mentoring that develops clinical judgement is a focus on articulating reasoning, which can equally be described as visible thinking. This happens when mentors:

think out loud as they work through a situation
rehearse judgments with the pre-service teacher “what will you do if…” before a lesson episode
ask the pre-service teacher to articulate their reasons for actions after a lesson episode

By articulating their thinking with reference to evidence, both mentor teachers and pre-service teachers learn to hone their capacity to make clinical judgements. Such judgements are examined and compared with evidence from university studies (Burn & Mutton, 2013).

Probing questions that mentors use that show promise in developing clinical judgment include:

What evidence supports this? or How do we know?
How does this help to improve learning?
Explain why you say that?
How does that follow?
What were /might be any unintended consequences of the action?

This approach to clinical judgement is designed to inform and challenge teachers to think critically about their practice as is equally relevant at all career stages. It can be applied to the dialogue that occurs between a mentor teachers and their mentee during professional practice, in professional learning communities and in quality teaching rounds (Gore & Bowe, 2015).

Evidence Base and references

Kriewaldt, J., & Turnidge, D. (2013). Conceptualising an approach to clinical reasoning in the education profession. Australian Journal of Teacher Education, 38(6). doi: 10.14221/ajte.2013v38n6.9.

Burn, K., & Mutton, T. (2013). Review of 'research-informed clinical practice' in initial teacher education. Paper commissioned by BERA, presented at BERA-RSA Inquiry (London, BERA/RSA).

Gore, J. M., & Bowe, J. M. (2015). Interrupting attrition? Re-shaping the transition from preservice to inservice teaching through Quality Teaching Rounds. International Journal of Educational Research. Advance online publication. doi:10.1016/j.ijer.2015.05.006

Significance of professional standards of practice

A clinically based approach to teacher education enables aspiring teachers to understand and integrate the standards of practice (NCATE, 2010) to which professionals are held accountable (Darling-Hammond, 2006). ‘Clinical communities of practice’ model professional standards and provide opportunities for aspiring teachers to develop competencies in clinical settings with clinical supervision. They also support teachers to gain recognition as professionals in their communities.

Professional standards of practice provide top-down support for bottom-up reform (Darling-Hammond & McLaughlin, 1995) and facilitate the development, dissemination and reinforcement of a shared view of effective teaching (NCATE, 2010). They can be constructed for use as a framework for benchmarking the high quality teaching practice that is needed to achieve strong learning outcomes for all students. This framework of professional standards of practice enables a series of discrete and separate standards to be viewed holistically (NCATE, 2010). It enables communities of practice to monitor quality of teaching (Alter & Coggshall, 2009) and guide teaching day-to-day teaching practice and promote strong performance (Darling-Hammond & Baratz-Snowden, 2005).

Most significantly, the framework of professional standards of practice, guides professional development at every stage of a teacher’s career and provides a basis for the assessment of clinical teaching and the evaluation of professional development programs. An important design principle of a clinical approach to teacher education is to build pre-service teachers’ capacity to know what to teach and how to teach (NCATE, 2010). To assist teacher education providers, the American National Academy of Education Committee on Teacher Education, adopted a framework of professional standards of practice that is organised around three intersecting areas of knowledge that are evident in statements of standards for teaching:

“Knowledge of learners and how they learn and develop within social contexts, including knowledge of language development

Understanding of curriculum content and goals, including the subject matter and skills to be taught in light of disciplinary demands, student needs, and the social purposes of education

Understanding of and skills for teaching, including content pedagogical knowledge and knowledge for teaching diverse learners, as these are informed by an understanding of assessment and of how to construct and manage a productive classroom” (Darling-Hammond 2006, p. 4).

The content of clinical based approaches to teacher education courses and clinical experiences should “cumulatively add up to set of knowledge, skills and dispositions that determine what teachers actually do in a classroom” (Darling-Hammond, 2006, p. 4) and build pre-service teachers’ capacity for continuous learning and development.

Evidence Base and references

Alter, J. & Coggshall, J. (2009). Teaching as a Clinical Practice Profession: Implications for Teacher Education and State Policy. N.Y.: National Comprehensive Center for Teacher Quality.

Darling-Hammond, L. (2006). Constructing 21st-century teacher education. Journal of Teacher Education, Vol. 57, No. X, 1-15.

Darling-Hammond, L. & Baratz-Snowden, J., (eds) (2005) A Good Teacher in Every Classroom: Preparing the Highly Qualified Teachers Our Children Deserve. San Francisco, CA: The Jossey-Bass education Series.

Darling-Hammond, L. & McLaughlin, M.W. (1995) Policies that support professional in an era of reform, Phi Delta Kappan,76(8), 597-604.

National Council for Accreditation of Teacher Education (2010) Transforming Teacher Education Through Clinical Practice: A National Strategy to Prepare Effective Teachers, www.ncate.org.

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