A Conceptual Framework for Educational Design at Modular Level to

Promote Transfer of Learning

Botma Y

School of Nursing, University of the Free State, Bloemfontein, South Africa

Van Rensburg, G. H.

Department of Health Studies, UNISA, Pretoria, South Africa

Coetzee, I. M.

Department of Nursing, University of Pretoria, Pretoria, South Africa

Heyns, T.

Department of Nursing, University of Pretoria, Pretoria, South Africa

Yvonne Botma, School of Nursing (99), P.O. Box 339, University of the Free State,
Bloemfontein, South Africa, 9300. [email protected]

Y Botma (PhD) is an associate professor and lead researcher in innovative teaching and learning
strategies in order to promote transfer of learning.

Gisela van Rensburg (D. Litt. et Phil) is a professor in nursing and lead researcher in support of
students.

Isabel Coetzee (D. Litt. et Phil) does practice development in critical care nursing.

Tanya Heyns (D. Litt. et Phil) is the lead researcher in practice development.

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Abstract

Students bridge the theory-practice gap when they apply in practice what they
have learned in class. A conceptual framework was developed that can serve as
foundation to design for learning transfer at modular level. The framework is
based on an adopted and adapted systemic model of transfer of learning,
existing learning theories, constructive alignment, and the elements of effective
learning opportunities. A convergent consensus-seeking process, which is
typical of a qualitative approach, was used for expert review. The final
conceptual framework consists of two principles: establishing a community of
learning and the primacy of a learning outcome. The four steps entail: 1)
activation of existing knowledge; 2) engaging with new information; 3)
demonstrating competence; and 4) application in the real world. It is envisaged
that by applying the framework educators in health care will design for transfer
of learning, resulting in quality of care and optimal patient outcomes.

Keywords: conceptual framework; modular design; theory-practice gap; transfer

of learning

Introduction

The unifying aim of all educators in health care is to enable students to render quality
health care and to apply what they have learned in the classroom and simulation
laboratories to real-world situations (Lauder, Sharkey, & Booth, 2004). This process of
application in the real world is known as “transfer of learning” or “theory-practice
integration”. Holton, Bates, Bookter and Yamkovenko (2007) state that transfer of
learning is the degree to which students apply to their jobs the knowledge, skills,
behaviors, and attitudes they have gained in training. Transfer of learning is
demonstrated by a competent student. Goudreau et al. (2009) summarise competency as
follows “… thus allows one to deal with different situations by drawing on concepts,
knowledge, information, procedures, and methods. It incorporates many elements,
mobilizes knowledge, and strategically marshals capabilities in accordance with the
specific nature of the situation” (p.3). Facilitation of problem solving, reflection,
decision making, critical reasoning and relevant other skills is necessary to give students
the opportunities to become competent (Jerlock, Falk, & Severinsson, 2003). However,

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transfer of learning does not always occur. Many organisations have found that about
10% to 20% of training is ever applied in the real world (Ford, 2009; Kirwan &
Birchall, 2006). Failure to transfer learning occurs for several reasons and these may be
grouped as factors within the student, design of the learning sessions, and organisational
climate or workplace environment. The relationship of these factors is illustrated in
Figure 1. Student characteristics, educational design, and workplace culture influence
students’ motivation to learn and to transfer learning and, in this way, performance in
the clinical environment.

Student
characteristics

Motivation to
learn

Transfer of Student Workplace

Educational learning performance environment
design

Motivation to
transfer

Learning climate

Figure 1: Systemic model of transfer of learning, adopted and adapted from Donovan and Darcy (2011)

In order to promote transfer of learning the educator must consider these factors
when designing at modular level. For many educators it becomes a daunting task and
they do not know where to start. It is the purpose of this article, therefore, to provide the
conceptual framework that could serve as the foundation to design module themes in
such a manner that it will promote transfer of learning.

Methodology

Developing conceptual frameworks involves identifying specific concepts, defining

these concepts and then linking, integrating and aligning these to form a framework
(Brink, Van Der Walt, & Van Rensburg, 2006; Rycroft-Malone & Bucknall, 2010).

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Initially, the first author of this article developed a conceptual framework of how to
seamlessly incorporate simulation as a teaching and learning technique because the
higher education institution she is affiliated with acquired authentic learning spaces with
a number of human simulators.
Conceptual frameworks can be abstract, broad or skeletal in order to provide
tapered information on a specific theme (Rycroft-Malone & Bucknall 2010:27). An in-
depth literature review was conducted with regard to learning theories, competence,
educational design and simulation. The literature review was later extended to include
transfer of learning and/or learning and the theory-practice gap. In other words, the
focus of the initial conceptual framework was changed from simulation to transfer of
learning, because simulation is but one technique to promote transfer of learning. This
framework provides a frame of reference to organise the thinking, problem solving and
application needed in the clinical and non-clinical educational modules or themes.
The efficiency and usefulness of the conceptual framework is to assist and guide
educators to describe the principles of a particular field to enhance the transfer of
learning in a context. The use of the conceptual framework is set out in a systematic
manner, which leads to the potential to explore and investigate the transfer of learning
in different contexts (Smyth, 2004).

Influential Theories

Learning theories have reshaped themselves from behaviourism to information

processing to constructivism. Recognising that context and culture influence memory
and cognition forced researchers to explain personal meaning and the nature of reality
and its representations (Doolittle & Camp, 1999). Consequently social and radical
constructivism developed with the following four principles:
 Learning is an active process according to which learners construct their own
knowledge;
 Cognition is an adaptive process;
 Meaning making is a subjective process and does not render an accurate
representation of reality; and
 Social, cultural, language, and biological/neurological processes influence
knowing (Yilmaz, 2008).

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Educators usually have an eclectic approach to learning theories because they seldom
support only one theory but consider instead what each has to offer. Therefore Piaget’s
view of learning, Vygotsky’s theory of interactional learning, and Ausubel’s concept of
meaningful learning may all be considered relevant by an educator. Cognitive science
and cognitive psychology confirm that the process of constructing knowledge is
dependent on existing knowledge, the context or situation, and internalisation of
information in an organised cognitive structure (Bruce, Klopper, & Mellish, 2011). This
constructivistic approach interrelates well with Kolb’s experiential learning theory,
which postulates that knowledge is created from understanding and transforming
experience (Kolb & Boyatzis, 2000). Kolb’s model postulates that observations and
reflections occur upon concrete experiences. These reflections are internalised and
abstract concepts are formed with associated possible consequences of action. The
possible associated consequences can be actively tested for validity and inform future
actions in similar situations (Kolb & Boyatzis, 2000). On the basis of these viewpoints
of learning it is clear that the focus of learning outcomes has shifted from content to
competence (Braband, 2008; Brandon & All, 2010).
With the constructivist approach the educator becomes a facilitator of learning.
For this reason the responsibility of the educator-facilitator is to create learning
opportunities for students to process new information and link it to existing mental
frameworks through individual or social activity. However, prior knowledge needs to be
retrieved before the student is able to link the new knowledge to it. Through this process
the new information is comprehended and meaning making occurs or knowledge is
constructed.
Learning opportunities are created within a complex system that consists of the
educator, student, teaching context, teaching and learning activities, outcomes, and
student assessment tasks (Biggs, 1996) and should take the clinical environment into
consideration. The starting point for creating learning opportunities is to clarify the
learning outcome or competence (Biggs, 1996) that the professional person must
demonstrate. Kouwenhoven defines competence as the capacity to demonstrate up to a
predetermined standard the key occupational tasks that characterise a profession
(Kouwenhoven, 2010.). According to Braband (2008), students are competent when
they have the capacity to apply their knowledge and skills with an appropriate attitude
in various environments and circumstances. In other words, when foundational

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knowledge (content), procedural knowledge (how to do), and conditional knowledge
(when to do) become functional knowledge (Biggs, 1996).
The elements of learning opportunities that promote competence are activation of
existing knowledge to serve as a foundation for new knowledge; application of
knowledge in real-world settings; active engagement of students in real time and real-
world situations; practicing of assessment, critical thinking, communication, and
leadership skills through collaborative learning processes; multiple authentic formative
assessments to ensure mastery of the complete competence; and objective assessment
measures that are clearly aligned with expected competencies (Carraccio, Wolfsthal,
Englander, Ferentz, & Martin, 2002; Merrill, 2002). It is the responsibility of the
educator to ensure that all teaching and learning activities are aligned with the outcome,
reality, and assessment tasks while it is students’ responsibility to actively engage with
the learning material in order to internalise the theory and skills and in this way
construct new knowledge (Reaburn & Strategy, 2009).

Development, Evaluation and Refinement of Conceptual Framework

From an extensive literature review a conceptual framework was drafted by the first
author, who is a member of a community of practice with a focus on scholarship of
teaching and learning. This first author of this article presented the initial conceptual
framework and supporting literature exploration to the rest of the team for a purposive
review. In an attempt to refine and finalise the conceptual framework a process of
expert review was utilised. The community of practice consists of educators in health
care that have experience in: personal research, supervising postgraduate students,
developing guidelines, and being active practitioners who facilitate learning.
The purpose of the critical review was to assess whether the framework could be:
accepted as it was described; found acceptable but with recommendations for change or
improvement; or found not to be acceptable at all. The group entered into a process of
expert evaluation by critiquing the conceptual framework based on criteria set by Tastle,
Wierman, and Dundum (2005). These criteria entailed:
 Clarity, simplicity and consistency – are constructs concrete and precise with
clear descriptions?
 Appropriateness, relevance and comprehensiveness – are all aspects of transfer
of learning addressed?

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  Applicability, practicality and usability – are there potential barriers in terms of
implementation- and cost implications?
 Adaptability and transferability – are constructs transferable to various contexts
and circumstances?
 Credibility – is the framework based on an extensive and critical literature
review?
 Importance for research, practice and education – is the scientific value and
contribution of the framework evident?
 Trustworthiness/validity – has a correct interpretation of the available evidence
been drawn up to support the implementation of the framework?

To facilitate a well-informed review, a process was followed that involved reading, re-
reading and internalising the initial framework and supportive literature, followed by
academic debate. The criteria listed immediately above were kept in mind. Agreement
and consensus building are complex processes that require a thorough understanding of
what is to be reviewed or assessed. The review was approached in a qualitative manner
through a convergent process. Convergent processes include consensus formation
regarding topics or aspects of topics that need to be addressed, their significance and the
most effective means to address them. Tastle, Wierman and Dundum (2005) describe
consensus as a function of shared team feelings towards an issue. Although these
authors suggest a rating scale to capture these feelings [views] and to measure the extent
to which a person agrees or disagrees with the issues put forward, the principle of
consensus formation could also be applied to a qualitative approach to the review
process.
The review discussions were based on an understanding of convergence among
the members as experts and focused on the key constructs of a well-structured
conceptual framework. These constructs were regarded as clear, appropriate, applicable,
adaptable, practical, and credible and have value as proposed by Polit and Beck (2008).
Polit and Beck’s (2008) criteria are in accordance with those of Tastle, Wierman and
Dundum (2005) that were initially used for review.The review process enabled the
members of the community of practice to refine and finalise the conceptual framework.
Changes were made to the extent of the framework so as not to limit it to the clinical
environment. Focus was placed more on principles of transfer of learning rather than

7
specific activities. It was agreed that these changes would make the framework more
useful in a broader context of teaching and learning.

Conceptual Framework

On the basis of the principles of constructivism as a learning theory, constructive

alignment and the elements of effective learning opportunities a conceptual framework
was developed to guide educators on how to design themes for modules that would
promote transfer of learning.
The conceptual framework consists of four steps – the activation of existing
knowledge, engagement with new information, demonstration of competence, and
application in real-world practice. (Refer to inner circle in Figure 2.) Criteria for
successful implementation can be identified for each of these steps. (Refer to the four
squares in Figure 2.) These four steps or phases are dependent on two principles – the
primacy of learning outcomes and the demand that learning takes place within a
community of learning. The four steps have as their objective the transfer of learning.

Figure 2. Conceptual framework for educational design at modular level to promote transfer of learning

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Principles

Establish a community of learning

Fellow students, facilitator(s), and experts in the field constitute a community of
learning that assists in developing students’ communication, critical thinking skills and
the ability to elaborate and defend their views to others of different opinions
(McLoughlin, 2001). Interaction amongst members of the learning community may
occur face to face or through the use of electronic media (Reaburn & Strategy, 2009;
Kala, Isaramalai, & Pohthong, 2010) and helps to build cognitive bridges (Brandon &
All, 2010). The quality and quantity of engagement and interaction are among other
factors dependent on the degree of the presence of the facilitator (Raeburn, Muldoon, &
Bookallil, 2009).

The primacy of learning outcomes

Researchers in cognitive psychology have shown that deep learning occurs when
learners solve authentic problems, in such a way realizing the relevance of what they
have learned (Merrill, 2002). For this reason, the educator should identify what a
person at entry level into a profession should be able to do. Once that has been
identified, it becomes the completion of the following stem sentence: “On completion of
this module/theme the student will be able to …”

Four Steps

Step 1: activate existing knowledge

As stated earlier, knowledge construction occurs when new information is integrated
into existing mental schemas. Clark and Harrelson (2002) state that instructional events
that activate relevant prior knowledge in long-term memory and stimulate
internalisation in working memory supports knowledge construction. However, in
practice many educators immediately start with new learning material without
identifying the students existing knowledge. It is therefore essential to determine if the
students have had any relevant experience and what that experience entailed.
Information-orientated pre-tests are unproductive in activating prior experience (Merrill,
2002). In order to incorporate new information, existing schemas need to be recalled
and modified. Existing knowledge and its related schema is often activated through

9
story telling of lived experiences and guided reflection (Biggs, 1996). Doolittle and
Camp (1999) state that it may be necessary to deconstruct an existing “incorrect”
concept and then to (re)construct the appropriate concept before continuing with the
desired teaching and learning activities (Doolittle & Camp, 1999). This description fits
with Mezirow’s transformative learning as cited by Clapper (2010:e10); namely, that “it
is a process of using a prior interpretation to construe a new or revised interpretation of
one’s experience in order to guide future action” (Clapper, 2010). The motivation to
learn increases when students realise the relevance of the theoretical content.

Step 2: engage with new information

Learning is enhanced when the learning activities are aligned with the outcome or
expected competence (Biggs, 1996). The engagement phase is student centered and
outcome focussed because deep learning is promoted when students are actively
engaged with the aim of making sense of the information by seeking integration
between content and tasks (Pascoe & Singh, 2008; Rust, 2002; Sefton, 2006). Students
demonstrate engagement when they discuss information, think about it, or use and apply
the information to solve real-life problems or challenges. Sefton (2006) recommends
that students develop these skills progressively throughout the educational programme.
Furthermore, students should know their learning style and preferred learning
techniques to become life-long learners (Biggs, 1996; Pascoe & Singh 2008; Boud &
Falchikov, 2006; Fink, 2003).
Content and skills should be pared down to what is essential to meet the learning
outcome (Brandon & All, 2010; Pascoe & Singh., 2008). Forbes and Hicky (2009)
advise that educators should ask themselves if the information will be used in the
majority of situations in the specified context. When planning engaging learning
activities, the facilitator should take into consideration that learning occurs best when
more than one sense is involved – for example, when students see and hear (Clark &
Harrelson, 2002). Engagement should occur in all domains of learning and students
should be offered opportunities to observe and practice how to perform certain skills
correctly, because personal experiences are necessary for enhanced functioning within
one’s professional environment (Doolittle & Camp, 1999). The emphasis during the
engagement phase is on mastering content, becoming proficient in certain tasks and
being actively engaged in the process of learning through various student-centered

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teaching methods. After the engagement phase students should be given the opportunity
to demonstrate what they have learned.

Step three: demonstrate competence

Benner (2009) states that all learners within a professional programme progress from a
novice- to competent practitioner. Novices are characterised by strict adherence to rules
or plans with little situational perception and little ability to make discretionary
judgments. At this level students need much guidance and support. At a competent level
students have a broader understanding of the situation and can make more intuitive
decisions (Roberts, Gustavs, & Mack, 2012). Expertise is acquired through extensive
involvement in activities that are specifically designed to improve performance (Ward,
Hodges, Starkes, & Williams, 2007). Educators should, however, recognise that this
involvement is still part of the learning cycle and students also learn through their
mistakes (Allan, Smith, & O’Driscoll, 2011). When students are not skilled in what they
need to do the specific incompetency should be identified and strategies implemented
that give the student the opportunity to deliberately practice to become competent in
those identifies areas (Clapper & Kardong-Edgren, 2012).

Step four: apply in real world

Health care systems are workforce- and service orientated rather than learning oriented
(Allan et al., 2011). Therefore, the workplace climate or organisational culture
influences learning and is not always conducive to learning. Maben, Latter, and Clark
(2006) describe the pressures and constraints of the system and professionals as
organisational and professional sabotage. The sabotage may be due to time pressure,
role constraints, staff shortage and poor skills mix, work overload, task orientation and
high patient turnover. It is therefore essential to plan during the educational design
phase how to support students in the workplace in order to enhance transfer of learning,
thus applying it in the real world.

Discussion
Following the principles and the steps in this conceptual framework may enable
students to apply what they have learned independently in different contexts over an
extended period of time. In other words, the students will demonstrate their functional

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knowledge when they know when and how to use the content and skills that they have
learned appropriately.
Known learning theories have been used to underpin the framework that could
assist educators to design at modular level in order to enhance transfer of learning or
bridge the well-described theory-practice gap (Allan, 2011; Maben et al., 2006).
Although the initial conceptual framework was widely used in the institution where the
first author works the refined conceptual framework needs to be applied outside that
institution in clinical and non-clinical contexts. The rigour of the review process was
enhanced by the fact that none of the experts are associated with the higher education
institution of the first author. Furthermore, an independent skilled moderator facilitated
the review process and thus reduced bias.
It is envisaged that by applying the framework, educators in health care will
design for transfer of learning, resulting in quality of care and optimal patient outcomes.
Furthermore, the principles and steps of the framework may culminate in a standardised
educational design template used during the design process. This conceptual framework
should become an integral part of curriculum development and could be applied in any
professional educational context.
It is recommended that the conceptual framework be evaluated once it has been
implemented to determine if transfer of learning occurred. Strategies to strengthen
educators and clinical facilitators in applying the principles underlying the framework
will become key to the value and contribution of this framework. Referring to the
publication of Goetz and LeCompte (1984), Smyth (2004:168) states the conceptual
framework can be utilised to guide and contribute to the methodological approach for
future research in the transfer of knowledge.

Conclusion
In order to address the challenge that educators face in designing for transfer of learning
the conceptual framework was developed that could serve as the foundation to
educational design. This framework provides principles and steps that could assist in
developing modular themes in such a manner that students are able to apply in practice
what they have learned in theory. Existing mental schemas are recalled in preparation
for the creation of new knowledge. Competence and expertise are developed within a
community of learning during the engagement phase during which students are actively
involved with learning activities that are well designed and aligned with the outcome

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and their learning needs. Students are afforded the opportunity to demonstrate their
competence through various techniques of which simulation is an example. The
framework further emphasises that learning in the workplace is part of the educational
design and educators must consider how to support students in the workplace. Student
support in the workplace can no longer be relegated to the service provider. The
approach described in this article could assists educators in health care in applying
overlapping principles of learning theories.
The principality of sound outcomes and a community of learning is emphasised in
this conceptual framework. A health care professional needs to demonstrate functional
knowledge which is the attainment of a sound learning outcome. As a result it is
envisaged that successful application of this framework could cultivate a culture of
lifelong learning that is a desired outcome for students studying for a professional
degree.

Financial disclosure
The authors declare no conflict of interest.

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