Rola Ajjawi

Bio: Rola Ajjawi is an academic researcher from Deakin University. The author has contributed to research in topics: Medicine & Psychology. The author has an hindex of 24, co-authored 123 publications receiving 2927 citations. Previous affiliations of Rola Ajjawi include Geelong Football Club & Monash University.

Shedding the cobra effect: problematising thematic emergence, triangulation, saturation and member checking.

Abstract: Context Qualitative research is widely accepted as a legitimate approach to inquiry in health professions education (HPE). To secure this status, qualitative researchers have developed a variety of strategies (e.g. reliance on post-positivist qualitative methodologies, use of different rhetorical techniques, etc.) to facilitate the acceptance of their research methodologies and methods by the HPE community. Although these strategies have supported the acceptance of qualitative research in HPE, they have also brought about some unintended consequences. One of these consequences is that some HPE scholars have begun to use terms in qualitative publications without critically reflecting on: (i) their ontological and epistemological roots; (ii) their definitions, or (iii) their implications. Objectives In this paper, we share our critical reflections on four qualitative terms popularly used in the HPE literature: thematic emergence; triangulation; saturation, and member checking. Methods We discuss the methodological origins of these terms and the applications supported by these origins. We reflect critically on how these four terms became expected of qualitative research in HPE, and we reconsider their meanings and use by drawing on the broader qualitative methodology literature. Conclusions Through this examination, we hope to encourage qualitative scholars in HPE to avoid using qualitative terms uncritically and non-reflexively.

Using Hermeneutic Phenomenology to Investigate How Experienced Practitioners Learn to Communicate Clinical Reasoning

Abstract: This paper is primarily targeted at doctoral students and other researchers considering using hermeneutic phenomenology as a research strategy. We present interpretive paradigm research designed to investigate how experienced practitioners learn to communicate their clinical reasoning in professional practice. Twelve experienced physiotherapy practitioners participated in this research. Using hermeneutic phenomenology enabled access to a phenomenon that is often subconscious and provided a means of interpreting participants' experiences of personal learning journeys. Within the philosophy underpinning hermeneutic phenomenology, researchers need to design a research strategy that flows directly from the research question and goals of the research project. This paper explores such a strategy. Key Words: Hermeneutic Phenomenology, Clinical Reasoning, Designing Research, and Professional Practice Introduction This paper explores the value of hermeneutic phenomenology as a credible and rigorous research approach to investigate learning of clinical reasoning and its communication in health professional practice. The research was part of Rola's doctoral research, with Joy as the principal supervisor. We have primarily targeted the paper at doctoral students and others considering hermeneutic phenomenology as a research strategy. In this paper we present the design of a research approach that encompasses a research paradigm and its philosophical assumptions and framework, the methodology, and the strategies used to gather data and derive meaning from these data. This is underpinned by criteria chosen to ensure quality in interpretive research; rigor (Lincoln & Guba, 2000) and credibility (Denzin & Lincoln, 2000; Koch & Harrington, 1998). In addition, attention is given to the ethical conduct of the research. Research findings are presented to enable readers to contextualize the research approach and to understand the connection between research design and outcome. The Research Phenomenon and Questions The researchers explored how experienced physiotherapists learn to communicate their reasoning within the complex context of health care settings in Sydney, Australia. The purpose was to uncover the practice and professional craft knowledge embedded in practitioners' practices, related to communication of clinical reasoning with patients and novice physiotherapists. In addition, the researchers sought to interpret participants' learning journeys and experiences. We have used the term "learning journey" to refer to the participants' learning experiences and the events, people, and situations that impacted on participants' learning of clinical reasoning and its communication. Clinical reasoning was defined in this research as the thinking and decision making associated with clinical practice (based on Higgs & Jones, 2000). Communicating reasoning includes explaining, articulating, or teaching the actual decisions and the thinking leading to the decisions (this includes decisions negotiated with the patient). Clinical reasoning is a complex phenomenon. This complexity is related to reasoning processes within individuals that are both cognitive and interactive processes; are predominantly unobservable; at times automatic and subconscious; and always multifaceted and context-dependent (Higgs & Jones, 2000). Communication of clinical reasoning, while it is much more observable, is also embedded and enmeshed in practice, multifaceted, and is context-dependent. Learning in practice is situated and mostly implicit (Billett, 1996). Therefore, investigating the phenomenon of learning to communicate clinical reasoning required the participants to raise their level of awareness of their reasoning, their learning, and their communication, hence sub-questions related to each of these areas were explored. The principal question of this research was: How do experienced physiotherapists learn to communicate clinical reasoning with patients and with novice physiotherapists? …

The "educational alliance" as a framework for reconceptualizing feedback in medical education.

Abstract: Feedback has long been considered a vital component of training in the health professions. Nonetheless, it remains difficult to enact the feedback process effectively. In part, this may be because, historically, feedback has been framed in the medical education literature as a unidirectional content-delivery process with a focus on ensuring the learner's acceptance of the content. Thus, proposed solutions have been organized around mechanistic, educator-driven, and behavior-based best practices. Recently, some authors have begun to highlight the role of context and relationship in the feedback process, but no theoretical frameworks have yet been suggested for understanding or exploring this relational construction of feedback in medical education. The psychotherapeutic concept of the "therapeutic alliance" may be valuable in this regard.In this article, the authors propose that by reorganizing constructions of feedback around an "educational alliance" framework, medical educators may be able to develop a more meaningful understanding of the context-and, in particular, the relationship-in which feedback functions. Use of this framework may also help to reorient discussions of the feedback process from effective delivery and acceptance to negotiation in the environment of a supportive educational relationship.To explore and elaborate these issues and ideas, the authors review the medical education literature to excavate historical and evolving constructions of feedback in the field, review the origins of the therapeutic alliance and its demonstrated utility for psychotherapy practice, and consider implications regarding learners' perceptions of the supervisory relationship as a significant influence on feedback acceptance in medical education settings.

Developing evaluative judgement: enabling students to make decisions about the quality of work

Abstract: Evaluative judgement is the capability to make decisions about the quality of work of oneself and others. In this paper, we propose that developing students’ evaluative judgement should be a goal of higher education, to enable students to improve their work and to meet their future learning needs: a necessary capability of graduates. We explore evaluative judgement within a discourse of pedagogy rather than primarily within an assessment discourse, as a way of encompassing and integrating a range of pedagogical practices. We trace the origins and development of the term ‘evaluative judgement’ to form a concise definition then recommend refinements to existing higher education practices of self-assessment, peer assessment, feedback, rubrics, and use of exemplars to contribute to the development of evaluative judgement. Considering pedagogical practices in light of evaluative judgement may lead to fruitful methods of engendering the skills learners require both within and beyond higher education settings.

Researching feedback dialogue: an interactional analysis approach

Abstract: A variety of understandings of feedback exist in the literature, which can broadly be categorised as cognitivist information transmission and socio-constructivist. Understanding feedback as information transmission or ‘telling’ has until recently been dominant. However, a socio-constructivist perspective of feedback posits that feedback should be dialogic and help to develop students’ ability to monitor, evaluate and regulate their learning. This paper is positioned as part of the shift away from seeing feedback as input, to exploring feedback as a dialogical process focusing on effects, through presenting an innovative methodological approach to analysing feedback dialogues in situ. Interactional analysis adopts the premise that artefacts and technologies set up a social field, where understanding human–human and human–material activities and interactions is important. The paper suggests that this systematic approach to analysing dialogic feedback can enable insight into previously undocumented aspects of feedback, such as the interactional features that promote and sustain feedback dialogue. The paper discusses methodological issues in such analyses and implications for research on feedback.

Using Multivariate Statistics

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Thinking fast and slow.

Abstract: In 1974 an article appeared in Science magazine with the dry-sounding title “Judgment Under Uncertainty: Heuristics and Biases” by a pair of psychologists who were not well known outside their discipline of decision theory. In it Amos Tversky and Daniel Kahneman introduced the world to Prospect Theory, which mapped out how humans actually behave when faced with decisions about gains and losses, in contrast to how economists assumed that people behave. Prospect Theory turned Economics on its head by demonstrating through a series of ingenious experiments that people are much more concerned with losses than they are with gains, and that framing a choice from one perspective or the other will result in decisions that are exactly the opposite of each other, even if the outcomes are monetarily the same. Prospect Theory led cognitive psychology in a new direction that began to uncover other human biases in thinking that are probably not learned but are part of our brain’s wiring.

Speech Genres and Other Late Essays

Abstract: Note on Translation Introduction by Michael Holquist Response to a Question from the Novy Mir Editorial Staff The Bildungsroman and Its Significance in the History of Realism (Toward a Historical Typology of the Novel) The Problem of Speech Genres The Problem of the Text in Linguistics, Philology, and the Human Sciences: An Experiment in Philosophical Analysis From Notes Made in 1970-71 Toward a Methodology for the Human Sciences Index