Combining research and storytelling: Using personal experiences as research data

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Dr Lynette Pretorius

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Dr Lynette Pretorius is an award-winning educator and researcher in the fields of academic language, literacy, research skills, and research methodologies. 

I find it quite amusing that I would be writing this blog post to advocate for a research methodology as emotional and subjective as autoethnography. For over a decade, I was trained to conduct scientific research where objective answers were sought to solve problems. My research focused on examining a gene activated in athletes’ hearts to see if it could be a potential treatment for patients with heart failure. In this scientific lab-based environment, I had to ensure objectivity in my research so that I could help find a cure for heart failure. After completing my PhD, however, I ventured into humanities and social sciences and found that the research approach I had previously used would not work. In my new research space, I was interested in understanding people’s experiences, which meant embracing subjectivity.

Through my journey into qualitative research, I discovered the value of stories. As I have recently noted, I now believe that stories matter and that individual experiences should be valued. I also now advocate for researchers to allow individuals to tell their own stories, as they are the experts in their own experiences.

Researching personal experiences is becoming increasingly important as individuals’ stories are recognised as important sources of knowledge. Personal experiences can provide unique insights into social, cultural, and historical contexts and highlight the complexities of human experience. By researching personal experiences, we can uncover previously ignored or marginalised perspectives, challenge dominant narratives, and gain a deeper understanding of individual and collective identities. By valuing personal experiences as sources of knowledge, we can build more inclusive and diverse understandings of the world around us.

As I started researching personal experiences, I discovered a qualitative research method called autoethnography and soon realised its power. I now regularly recommend autoethnography to researchers. In particular, I often recommend it to PhD students to help them establish their research motivation and positionality in their thesis and more effectively engage in reflexivity during their research project. A well-written autoethnography can also be published, which helps these early career researchers by giving them the opportunity to build their publication record.

The rest of this blog post will explore autoethnography as a methodology. The information in this blog comes from my recently published book chapter, “A Harmony of Voices”. This book chapter was the methodology for our book Research and Teaching in a Pandemic World, where we used a form of autoethnography to allow PhD students, early career researchers, and more established researchers to tell the stories of their experiences during the COVID-19 pandemic. Using this methodology helped us show that the pandemic significantly affected the academic identity development of students and staff in higher education.

There are five main reasons why I think autoethnography is such a powerful qualitative research methodology.

1. Autoethnography requires researchers to purposely explore personal experiences to understand a particular culture or society. For example, I was recently able to use autoethnography to delve into a doctoral student’s journey as she discovered she was mentally unwell and link this with my experiences as a doctoral educator. By valuing the student’s knowledge of her mental illness and my understanding of the doctoral education system as a cultural insider, I was able to show how the culture of academia can contribute to the academic mental health crisis. Consequently, using autoethnography helped me demonstrate how educators can create more welcoming environments that help foster doctoral students’ wellbeing.

2. Autoethnography allows researchers to use personal experiences as data sources, narrating evocative stories and interpreting their significance. Researchers are also participants in their own studies, thereby valuing insider knowledge. The stories which are told often explore transformative experiences for the researcher, frequently taking the form of epiphanies that significantly influenced the author’s worldview. I believe that this allows researchers to provide more meaningful insights into complex phenomena compared with more traditional objective research methods. For example, I recently used Zoom to have a conversation with myself as I reflected on my past experiences (see Figure 1). During this reflexive Zoom conversation, I was able to delve into my personal experiences throughout my PhD, analyse my emotions and thoughts during that period, reflect on them presently, and determine how my previous experiences have impacted my current teaching philosophy and practice.

Figure 1. Screen capture of me having a conversation with myself on Zoom to collect data about my past experiences and how these influenced my current teaching philosophy and practice.

3. Autoethnography allows the researcher to use writing as a form of therapy for themselves and society more broadly. Researchers can give others hope and insight by engaging in this form of therapeutic writing. This can be seen, for example, in our book Wellbeing in Doctoral Education. In this book, several individuals used autoethnography to tell their stories of mental illness during their doctoral journey. Through their explorations of their own journeys, they were able to provide strategies for future students to maintain their wellbeing during their PhD.

4. Autoethnography empowers researchers as it allows them to embrace emotionality and uncertainty and highlight topics that may be considered hidden or taboo. Autoethnography allows researchers to connect with their own emotions and experiences and, in doing so, find their voice. It allows them to challenge the dominant narratives that often dominate research and to tell their own stories in their own words. It also allows them to connect with their research participants more authentically and meaningfully. By sharing their own experiences, they can create a space for others to share theirs, fostering a more equitable and inclusive research process. In this way, autoethnographers can advocate for social change to address perceived societal wrongs.

5. Autoethnography is a more accessible type of research for those outside of academia because it is written from personal experience in easy-to-understand language. The autoethnographer also does not merely narrate an experience for their audience. Instead, they try to engage the audience in the conversation so that the audience can understand experiences which may be different from their own.

Autoethnography, however, is not without its challenges. Some researchers critique it as a methodology because it is not scientific enough, while others say it is not artistic enough. I believe, however, that these critiques fail to see the value of combining both science and art when exploring complex phenomena. Autoethnography has allowed me to combine my scientific understanding of the research process with the ability to tell stories – both my own stories and those of my participants. In this way, I now see research writing as a way of communicating my findings to better understand myself and change the society in which I reside.

In conclusion, autoethnography has become an increasingly popular research methodology, particularly within the humanities and social sciences. Its emphasis on personal experiences, reflexivity, and storytelling allows for a deeper exploration of complex experiences and societies. While it may be a departure from more traditional scientific research methods, autoethnography allows researchers to learn about broader cultural and societal issues by exploring their personal experiences. As a researcher who was initially trained in a scientific environment, I can attest to the value of this approach, particularly when seeking to understand individuals’ experiences. Ultimately, by embracing the methodology of autoethnography, researchers can gain a deeper appreciation for the lived experiences of the individuals they are studying, leading to more nuanced and insightful research findings.

I want to thank Dr Jennifer Cutri for introducing me to autoethnography as a research methodology.

Questions to ponder

How do you think the inclusion of personal stories and experiences can enhance the validity and depth of research in fields traditionally dominated by objective methodologies? Can you think of any specific areas or topics where this approach would be particularly beneficial?

In your opinion, what are the potential benefits and drawbacks of blurring the lines between scientific research and personal storytelling? How can researchers balance the need for scientific rigour with the richness that personal narratives bring to understanding complex phenomena?

I found my PhD journey extremely stressful and mentally exhausting

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Dr Lynette Pretorius

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Dr Lynette Pretorius is an award-winning educator and researcher in the fields of academic language, literacy, research skills, and research methodologies. 

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Dr Luke Macaulay

Dr Luke Macaulay is a research fellow, researching the education and employment experiences of people from refugee and asylum seeking backgrounds.

Credit: Main text republished from EduResearch Matters,

The secret lives of doctoral students and how academics can help Every year, thousands of students enrol into doctoral programs across Australia and around the world. New PhD students enter an environment characterised by the persistent pursuit for knowledge – there is always something more to learn. They also hear advice about academia from all and sundry. When we spoke to students in 2021, one final year PhD student noted,

“There are so many different aspects to learn about and it’s difficult to know what you don’t know. This leaves you always wondering whether you are missing something. There are also many different perspectives offered by others – everyone’s experience is so different that it’s hard to work out what advice applies to you and what does not.” Given that each person’s experience in a PhD program is unique, how does a PhD student come to know what their identity as a researcher is?

When someone asks you to describe yourself, on which area of your life do you focus? Perhaps you highlight your job or education, listing your interests and achievements. Maybe you highlight your religion and/or ethnicity, highlighting how these shape your approach to life. You may explore your family and personal life, showcasing the impact these areas have on your life satisfaction. The stories we tell ourselves and others about who we are, who we are not, and who we ‘should’ be in our context, can be defined as our identity.

Identity is multifaceted and continuously shaped through our experiences. It is also significantly influenced by the context in which we find ourselves – the implicit practices within our context tell us what is expected of us. As researchers, we are particularly interested in the concept of academic identity – the stories people tell themselves and others about who they are or are not within the context of academia. A PhD student’s academic identity is, therefore, largely shaped through the narratives and practices they experience within academia as they conduct their research.

An area of special interest for us is the doctoral education environment in higher education institutions. As higher education researchers, we experience the daily influence of academia on our own sense of who we are. We have seen PhD students try to navigate the often implicit knowledges and practices of academia during their studies. These implicit knowledges and practices are rarely taught and can cause an environment of exclusiveness – a space where some are privileged while others are marginalised. We were interested in exploring how PhD students’ experiences influence their perception of their place within the context of academia.

We believe that, to understand the experiences of PhD students as they navigate this complex environment, you have to highlight their voices. By listening to their stories, we believe we can better understand their journeys and, consequently, design improved educational experiences. We have used this approach in the past, which allowed us to explore the personal journeys of several doctoral students as they reflected on their own studies. The autobiographical narratives that the PhD students wrote highlighted that the PhD significantly influenced their wellbeing, sense of identity, and intercultural competence. For example, one student noted:

“I understand the PhD as an office-like job; however, your job has a lack of clarity regarding how you are supposed to achieve your goals. You get to decide what you need to do each day, but your plans change all the time as your research results take your study in a new direction. This of course means that you have a great deal of flexibility, but it also means there is a lot of uncertainty during your PhD journey. Personally, this meant that I found my PhD journey extremely stressful and mentally exhausting.”

To explore PhD students’ academic identity development, we conducted a large-scale research project exploring the experiences and lived realities of 29 PhD students at an Australian university. We used a creative approach that was designed to highlight the voices of the students through narratives and poems, allowing us to explore academic identity development from their points of view. The first findings from this project was recently published in The Journal of Higher Education and has since received significant attention from the academic community. An open access post-print version of this article is available here.

To start our research, we wanted to know why students committed the time and energy to pursue a PhD degree. We found our participants pursued a PhD as a stepping stone for future career success, to learn more about themselves or a particular academic topic, and to solve a problem in their local context. The students believed that the PhD was an all-consuming endeavour, something that should only be attempted by someone if they could fully dedicate themselves to the pursuit.

Further exploration of our participants’ experiences helped us to discover that PhD students experience significant pressure to build their personal brand. They felt that there was considerable tension between developing disciplinary knowledge and building professional skills (also sometimes termed “soft skills” or “transferable skills”). Yet they also felt that both these forms of personal knowledge were essential for later career success. Importantly, our study showed that several of our participants felt marginalised in their ability to develop these different forms of personal knowledge. They felt that their agency to take control of their own learning was hindered by various institutions that influenced the context of academia including the universities themselves, government agencies, and scholarship funding agencies. As a result, several students felt disempowered during their educational journey which adversely affected their academic identity. As noted by one participant,

“This has been taxing intellectually but VERY taxing on my sense of self and my sense of self worth as a scholar.”

The tension students experience highlights that the links between disciplinary knowledge and professional skills are not made clear to students. We believe that professional skills actually increase the applicability of disciplinary knowledge. For example, if PhD students do not have the ability to communicate their research to a wider audience, it is likely that their disciplinary knowledge will linger in relative obscurity. We also believe that the act of doing disciplinary research teaches a range of professional skills as a consequence. For example, conducting literature research to identify a research project for study necessitates the use of a variety of analytical skills. It is, therefore, our responsibility as educators to help PhD students reflect on the knowledge and skills they already possess. This reflective approach can help students develop an understanding of the variety of skills they have already developed during their studies, giving them the agency to seek targeted professional development approaches for future career success. Importantly, our research should act as a clarion call for those in academia. We implore educators to value different forms of knowledge and skills. This approach will help the scholars and problem-solvers of the future develop a strong sense of who they are and where they fit within their respective fields.

Questions to ponder

How do the varying experiences and advice received by PhD students impact their development of an academic identity? Do you think this diversity of perspectives is more beneficial or detrimental to their journey?

Considering the importance of balancing disciplinary knowledge with professional skills, how can PhD programs be structured to better integrate these two aspects?

Learning how to evaluate the reliability of online sources

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Dr Lynette Pretorius

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Dr Lynette Pretorius is an award-winning educator and researcher in the fields of academic language, literacy, research skills, and research methodologies. 

This post is based on an article I recently published.

It is commonly thought that contemporary students are digital natives who are naturally able to use sophisticated digital literacy in their daily practices because they have been immersed in the digital age their entire lives. Research, though, shows that the concept of being a digital native is a myth. For example, studies have shown that students born in the digital age use technology frequently, but that this often requires only basic technology knowledge (e.g., how to type a search into an internet browser or how to send and receive emails or instant messages).

It is clear from the research that students require significant support to learn how to use specific technologies for learning. Students entering university are not necessarily familiar with the skills needed to access information at a university level. For example, many have never had to search for or read academic journal articles before. It is, therefore, incumbent upon us to teach students how to find this type of information on the internet, while also assessing the reliability of the information they obtain.

There is clear evidence that, while students are able to use technology to find information (i.e., search engines), little attention is given to evaluating the quality of information. As educators, we need to help students learn how to effectively evaluate information for relevance, accuracy, or authority so that they can enter the online information landscape and resolve conflicts between online media and scholarly content.

I explicitly teach students how to evaluate the reliability of sources during my orientation workshops each semester. This is done in a two-hour workshop focused on how to read academic sources effectively. A key component of this workshop is an online interactive tutorial which I developed several years ago. I have recently made the tutorial freely available for other educators to use in their classrooms.

The tutorial incorporates case-based learning and self-discovery to encourage learning through experience. After completing each case, the students are provided with an expert evaluation of the reliability of the source. There are five cases, as outlined below:

  • Blog Post
    • Students are presented with a blog post discussing the science of salt lamps and how it can be used to treat asthma. Students are asked to decide whether the source is reliable or unreliable for use in their assignment. Students are also asked to provide a reason for their evaluation. After submitting their answers for each question, students are provided with a video explaining how to evaluate the reliability of sources.
  • Wikipedia
    • Students are presented with a Wikipedia entry for the Opium War. Students are asked whether they think Wikipedia is an appropriate first step in research. They are given three options from which to choose:
      • Yes, you should research a topic on Wikipedia first, as it gives you a broad understanding of the ideas important to the topic.
      • Sometimes, as you can gain some useful information and Wikipedia can provide links to other resources such as journal articles, books, and academic websites.
      • No, as Wikipedia can be edited by anyone, the reliability of the information is suspect.
  • History Website
    • Students are presented with a history website discussing the Opium War. Students are asked to select items they think make the source reliable from the following list: the author is a historian, the author has written several articles on the website, the article uses historical dates and Chinese names, the author lived and worked in Asia, and the article is easy to understand. Students are also asked to select items they think make the source unreliable from the following list: there are no references, the article does not indicate to which institution the author is affiliated, the website sounds unreliable, and the links to further information redirects to other pages on the same website. Students are then asked to provide an overall evaluation of the source’s reliability.
  • Newspaper Article
    • Students are presented with a newspaper article discussing a new medical treatment for heart disease. Students are asked whether this source can be used in an assignment by choosing from one of the following options:
      • Yes. This article clearly describes a new pharmaceutical treatment for heart disease, quotes a respected professor in the field, and highlights the key research findings.
      • Sometimes. These types of articles can be useful as they provide information in an easy to understand language, and can provide the links to the original research.
      • No. You should never use these types of articles in an academic assignment
  • Journal Article
    • Students are presented with a journal article presenting qualitative data from an educational research paper about self-discovery learning at university. Students are asked to select items they think make the source reliable from the following list: the article is published in an international education journal, the authors work at an academic institution and have qualifications in the field, the article describes original research, the authors use data to support their claims, and the article uses technical terms. Students are also asked to provide an overall evaluation of the source’s reliability and to provide a reason for their evaluation.

In my research paper, I evaluated my teaching strategy and found that this approach can effectively teach students how to discern the reliability of sources. It helps students deepen their personal understanding of what makes sources reliable or not. By analysing the responses students provided to the blog post, I discovered that students had not previously considered that evaluating the reliability of a source would be an important consideration for writing assignments. I also found that students’ evaluations of sources were dependent on their personal opinions about the topic, rather than any verifiable evidence provided in the source. Then, as they moved through the tutorial, students started to discover which aspects were most important in establishing the credibility and reliability of research. By the time they reached the final source, they were much more cautious when assessing the research, often asking for further details about the source.

Through my research, I was able to demonstrate that the students in my study had changed their way of looking at online information. They had crossed a threshold in understanding which permanently transformed their way of thinking. This demonstrates the value of explicit instruction through self-discovery learning as a pedagogical tool for teachers.

Questions to ponder

How do you personally evaluate the credibility of information you find online? What specific criteria or strategies do you use, and how do these align with or differ from the methods outlined in the tutorial described in the study?

How has the skill of evaluating digital sources impacted your academic work or research? Can you recall a situation where discerning the reliability of a source significantly influenced the outcome of your project or research? How did this experience shape your approach to digital literacy?

Building a sense of belonging for students who do not live on campus

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Dr Lynette Pretorius

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Dr Lynette Pretorius is an award-winning educator and researcher in the fields of academic language, literacy, research skills, and research methodologies. 

Students who do not live on campus and commute to university (often termed commuter students) can experience a sense of detachment from the university community, which can adversely affect their student experience. Juggling travel, studies, and other commitments means that these students can feel like they are visitors to their own campus. In a recent paper, my colleagues and I describe and evaluate the non-residential colleges (NRC) program at Monash University, an initiative designed to specifically foster a greater sense of connection for commuter students.

The NRC program creates a space where commuter students can experience similar support programs and campus activities as those who live in the residences on campus. Students are assigned a college mentor (a student who has already studied at the university for a while). These mentors are each responsible for providing mentoring and pastoral support for a small group of students. They also organise social events for their mentees and larger events for the whole college. Each college also has a college head and deputy head, who are members of staff with an interest in student engagement and belonging. There are also administrative staff who oversee the program to ensure an equitable experience for all students. In this way, NRC provides extra-curricular support for commuter students, aiming to emulate the community feel of traditional residential colleges, thereby building students’ sense of belonging.

It is important to note that “sense of belonging” is not just a feel-good term. Research consistently demonstrates that a sense of belonging plays a critical role in the academic and personal development of students. Some of the benefits of feeling connected to your place of study include:

  1. Academic success: Numerous studies have shown a strong connection between a sense of belonging and academic achievement. When students feel like they are a part of their university community, they are more likely to be motivated, engaged, and committed to their studies.
  2. Mental health and wellbeing: The transition to university life can be challenging, often marked by a sense of isolation and disconnection. Feeling connected to the university community can provide emotional support, reduce stress and anxiety, and improve mental health.
  3. Retention rates: When students feel valued and connected, they are less likely to drop out and more likely to complete their degrees.
  4. Personal development: University is a time for personal growth and development. A sense of belonging can facilitate this by providing a safe environment where students can explore their identities, build confidence, and develop interpersonal skills.

We wanted to evaluate the effectiveness of the NRC program, so we surveyed students who were part of the NRC program and students who were not, focusing on their sense of belonging, campus engagement, and overall student experience. We found that NRC students had a more positive university experience compared to non-NRC students. There were four key insights from the study:

  1. The NRC program was effective in enhancing students’ sense of belonging to the university community. This was achieved through increased interaction with peers and staff, along with more frequent campus attendance.
  2. Participants in the NRC program reported a more positive university experience compared to non-NRC students. This was reflected in their choice of words describing their experience, with a higher selection of positive terms like “friendly”, “community”, “comfortable”, and “supportive”.
  3. The study showed that NRC students were more likely to remain on campus after classes and interact more with their peers and teaching staff, indicating an increased engagement in both social and academic aspects of university life.
  4. Interestingly, NRC students were also more likely to have contemplated ways to enhance their employability, suggesting a broader impact of the program beyond just academic and social engagement. This was despite the NRC program not focusing on employability. We think this benefit comes from discussions students have with their mentors, who may be considering employability as they are further along in their course of study.

As universities continue to evolve and adapt to the diverse needs of their student populations, initiatives like the NRC program can play a pivotal role in shaping a more inclusive and supportive educational environment. A strong sense of belonging is linked to the creation of an inclusive environment that respects and values diversity. It is important to ensure that all students, regardless of their background, feel welcomed and accepted. This is particularly important in university settings, where students from various identities, cultures, and backgrounds come together. The NRC programs’ success in fostering community, engagement, and a sense of belonging is a compelling argument for the adoption of similar initiatives in tertiary institutions worldwide.

Importantly, this study underscores the importance of acknowledging that the goal of a university education is not just academic achievement. As educators, we should encourage the holistic development of our students by encouraging students to engage with initiatives such as the NRC program. In this way, we can encourage them to seek out and engage with opportunities to have a more fulfilling university experience.

Questions to ponder

  1. In your opinion, how important is building a sense of community within a university? Can online platforms and social media complement initiatives like the NRC program?
  2. What role can technology play in enhancing the sense of belonging and community for commuter students?

Embracing flexibility in assessment to enhance higher-order thinking

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Dr Lynette Pretorius

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Dr Lynette Pretorius is an award-winning educator and researcher in the fields of academic language, literacy, research skills, and research methodologies. 

Innovations in assessment task design are essential if we as educators are to encourage our students to see assessment as a learning process, rather than just a means towards a grade. In a recent study I did with some of my colleagues from accounting, we developed a flexible assessment regime designed to bolster students’ higher-order thinking skills, particularly critical thinking, reflection, and self-directed learning. We did this by giving students the option to choose how to complete their assessment during the semester, kind of like a “choose your own adventure” assessment regime.

In the paper we wrote, we describe how we developed optional critical thinking tasks for a core second-year undergraduate accounting unit. Our assessment regime gave students autonomy to choose whether to invest time and effort into optional tasks. In this way, students were allowed to take control of their learning trajectory throughout the semester. Their choice affected the way the assessments were weighted in the unit, as shown below. It is important to note that we wanted to ensure that students were not deterred from choosing to attempt the optional tasks because of any perceived risks. As such, students’ final overall grades depended either on just the two compulsory tasks or on all four assessments, whichever was higher.

Choice 1 (completion of all four tasks)Choice 2 (completion of only the two compulsory tasks)
Answering teacher-developed pre-lecture quiz questions10%Not applicable
Students developing their own critical thinking questions for the tutorial sessions15%Not applicable
Compulsory coursework tasks15%20%
Compulsory exam60%80%
Flexible assessment regime

The design of the optional assessment tasks encouraged students to reflect on their learning needs, question their existing knowledge, and identify gaps in their understanding. In this way, we hoped to promote a deeper level of engagement with the content and foster a more active learning experience. The critical thinking questions were used in tutorials in a peer-learning environment, allowing students to work together in groups to find answers to the questions they had generated. This helped to foster shared learning.

A large proportion of the cohort in our study chose to complete the optional tasks, with two-thirds of the cohort thinking that a flexible assessment regime was a “very good” or “good” idea by the end of the semester. Students who completed the optional tasks had a 12% higher grade than those who chose to only complete the compulsory tasks. Qualitative data from the students also highlighted that students realised they had improved their higher-order thinking, particularly their critical thinking ability and their reflection skills.

It was interesting to see that several students complained that it would be better if the teacher just gave them the answers to the questions, instead of encouraging students to discover the answers for themselves. In particular, they thought that critical thinking was not necessary in accounting. Students also thought that the flexible assessment regime did not affect the grades they ultimately received, despite the clear quantitative difference in grades mentioned earlier. This indicates that students may not have yet made the connection that improved higher-order thinking such as critical thinking helped them in other tasks such as the final exam. It also highlights that students could not necessarily make the connection that critical thinking can enhance the applicability of their content knowledge in accounting. For accounting students, higher-order thinking such as critical thinking is important for several reasons, including:

  • It helps students solve accounting problems by enabling them to analyse problems, identify causes, and come up with effective solutions. The discipline content taught in the unit we adapted, for example, includes cost-volume-profit analysis, necessitating critical thinking and problem-solving skills.
  • It encourages informed decision-making. Effective graduates from this unit would need higher-order thinking to be able to make thoughtful and reasoned management decisions related to cost behaviours and projections.
  • It fosters students’ capacity to adapt and innovate in constantly evolving contexts. Using higher-order thinking allows students to learn how to critically think about a situation, assess their knowledge, and creatively apply their skills in an environment where variables related to things such as costs, cost behaviours, and cost allocations are constantly changing.

Our study, therefore, highlights that it is important for educators to explain the relevance of the higher-order thinking skills they are fostering in their classrooms to the disciplinary field more broadly.

In summary, the flexible assessment regime in our study was carefully crafted to not only assess students’ understanding but also to actively engage them in the process of learning. By requiring students to generate questions and seek answers collaboratively, these tasks were instrumental in promoting self-reflection, problem-solving, and critical thinking, which are key components of higher-order thinking​​. Other educators may choose to use a similar strategy and encourage their students to choose their own assessment adventure, thereby fostering deeper learning and student engagement.

Questions to ponder

How can flexible assessment be adapted to different disciplinary fields?

In what ways can educators ensure that flexible assessment regimes are equitable and inclusive for all students, regardless of their backgrounds?

Developing students’ critical thinking and clinical reasoning through problem-based assessment

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Dr Lynette Pretorius

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Dr Lynette Pretorius is an award-winning educator and researcher in the fields of academic language, literacy, research skills, and research methodologies. 

In clinical education, the challenge is to not just impart content knowledge, but also help students develop critical real-world clinical skills. This is particularly true when it comes to critical thinking and clinical reasoning skills. In a paper I recently wrote with colleagues from a midwifery unit, we demonstrate how constructive alignment of a course’s graduate attributes and a unit’s learning experiences and assessment tasks can help students develop clinical reasoning skills.

Critical thinking and clinical reasoning are foundational skills in midwifery for several reasons:

  • Complex decision-making: Midwifery involves making decisions in complex, often unpredictable situations. Critical thinking and clinical reasoning enable midwives to assess and interpret patient data, consider various options, and make informed decisions that ensure the best outcomes for their patients.
  • Adapting to diverse scenarios: Every childbirth is unique, and midwives encounter a wide range of scenarios. Critical thinking and clinical reasoning equip them with the ability to adapt their knowledge to different contexts and provide tailored care based on individual needs and circumstances.
  • Safety and quality of care: Good critical thinking and clinical reasoning are key to patient safety and the quality of care. It allows midwives to identify and respond to potential complications promptly and effectively, which is vital in a field where situations can change rapidly and have critical consequences.
  • Holistic patient care: Midwifery is not just about the physical aspects of childbirth; it encompasses the emotional, psychological, and social well-being of the patient and their family. Critical thinking and clinical reasoning help midwives to consider all these aspects in their care, leading to more comprehensive and personalised support.
  • Lifelong learning and professional development: Midwifery, like all healthcare professions, is constantly evolving. Critical thinking and clinical reasoning are essential for midwives to engage in continuous learning, keep up with the latest evidence and practices, and refine their skills over time.
  • Collaborative practice: Midwifery often involves working in teams with other healthcare professionals. Critical thinking and clinical reasoning are important for effective communication and collaboration, ensuring that all team members are aligned in their approach to patient care.

Consequently, midwifery educators need to develop curricula which balance academic content with skills development. This is also true for assessment tasks. Traditionally, assessment tasks in midwifery have revolved around essay questions, which often fail to test students’ clinical reasoning and decision-making skills. Recognising this gap, we embarked on a curriculum redesign journey, aiming to make our assessment task more clinically relevant using problem-based learning.

We wanted to make our assignment more problem-based, as there is ample evidence that real-world scenarios can make students’ education more clinically relevant. We believe real-world scenarios are useful for several reasons:

  • Bridging theory and practice: Assessments that mirror real-world scenarios enable students to apply theoretical knowledge in practical contexts. This helps to bridge the gap between what they learn in the classroom and what they will encounter in their professional lives, making their education more relevant and effective.
  • Developing critical thinking: Real-world-focused assessments often require critical thinking, problem-solving, decision-making, and other key skills that are essential in professional settings. By incorporating these elements into assessments, educators ensure that students are not just learning information, but are also developing the skills they need to use that information effectively.
  • Encouraging active learning: Real-world assessments often involve active, experiential learning, which is typically more engaging and effective than passive learning methods. This can lead to a deeper understanding of the subject matter and a more enjoyable learning experience for students.
  • Fostering lifelong learning: In the rapidly changing modern world, the ability to learn and adapt is crucial. Real-world assessments encourage students to be self-directed learners who can seek out information, analyse problems, and find solutions independently.
  • Preparing for professional challenges: The workplace presents challenges that are often complex and unpredictable. Assessments that simulate real-world situations prepare students for these challenges, equipping them with the experience and confidence to handle similar situations in their future careers.

To achieve our goals, we needed to constructively align our assessment tasks, learning outcomes, and learning activities. This helped us ensure that the outcomes we hoped to achieve with our unit were effectively developed in our classroom activities and that our assessment tasks actually assessed the skills we taught. To help us constructively align our assessment task to the learning outcomes of the unit, we utilised the Research Skills Development (RSD) framework.

We changed the previous essay-based assessment task into a scenario-based question, requiring students to apply clinical reasoning to a specific case, as shown below.

Lola is a G1P0, EDC 16/4/2012, singleton pregnancy, positive blood group, currently taking pregnancy multivitamins, she has attended the routine schedule of antenatal care with no adverse issues identified. Lola presents to your maternity unit at 10:30hrs with a history of irregular contractions since 02:30hrs, with contractions now becoming regular at four minutely intervals. Lola’s membranes ruptured at 01:00hrs with clear liquor draining. On admission the abdominal palpation reveals a baby presenting in a right occipito-posterior position (ROP), with the fetal head 3/5ths above the pelvic brim. A vaginal examination is performed, with the cervix found to be posterior, 1-2cms long, 2cms dilated, station -2, and membranes are confirmed ruptured. Critically discuss the care required for the laboring woman with the fetus presenting in an occipito-posterior position, including possible outcomes this woman may expect.

This case was designed to test a broad range of competencies, including critical thinking and clinical reasoning in complex clinical situations. These students had not previously had a similar assignment in their course. By consulting the RSD framework, we decided to target the assessment at Level IV, encouraging students to research and analyse the scenario themselves, but with some structured guidance. As a result, an assignment preparation session was also conducted to examine the scenario-based question in a peer learning environment. Consequently, interactive group discussions were used to analyse the assessment task and decide how to best approach the assignment. The three discussion prompts used in the class are listed below:

“What are the key symptoms or features in this case?”

“What do the key symptoms mean?”

“How will I care for Lola?”

Students were encouraged to work in groups to decide on appropriate answers to these questions, and they were then asked to present their ideas to the class. Discussion between the groups was used to
foster the investigation of different opinions and ideas.

The implementation of this new assessment approach was met with positive feedback from both students and staff. The scenario-based question was appreciated for its clinical relevance, and the structured guidance helped students focus on critical aspects of midwifery care. This suggests that students were more concerned with understanding the implications of the case for clinical practice than simply answering the question, reflecting a deeper level of engagement and critical thinking​​.

The study also provided insights into the feedback process following the assessment. Students received extensive, focused feedback from the academics who marked the assignments. Several students also engaged with the optional opportunity to meet with the lecturers after receiving the feedback, seeking verbal insights into their performance. Students highlighted that the feedback they received was useful in helping them know how to improve in the future. Staff found that the feedback they provided on assignments indicated that the new approach led to a deeper engagement with the content and a better understanding of clinical reasoning.

A marking rubric was developed to accurately assess the research skills developed as part of this process. This marking rubric is freely available and can be used by other educators as needed. It can be found here (pages 386-387).

By shifting from traditional essay-based tasks to scenario-based questions aligned with the RSD framework and constructive alignment theory, we succeeded in enhancing student engagement, critical thinking, and clinical reasoning skills. Students benefit from an educational approach that prepares them for real-world challenges, fostering skills that are directly applicable to their future professional practice. This study also offers a framework for integrating educational theories into the design of practical assessment tasks and rubrics, which can be useful for other educators.

Questions to ponder

What are some of the key factors in assessment design that can encourage deeper learning and critical thinking in students?

In what ways could this approach to curriculum design impact the quality of healthcare provided by future graduates in clinical settings?