Turning Learning into Purpose Through the COVA Approach
As I began developing my innovation plan and connected the coursework to my actual position within the Heme/Onc fellowship program, the shift to COVA approach challenged me to think differently. It was not just about learning, but about my role in it and the choices I would make. Instead of completing assignments just for a grade, I was creating materials and ideas that would be useful in real situations. My ePortfolio showcases some of my current work, which I’m incredibly proud of. Planning events, improving communication, or enhancing learner engagement, all within the workplace, it gave my work a deeper sense of purpose! Then came the realization that my work really had purpose beyond the classroom! This aligns with the idea that authentic, meaningful learning occurs when learners are engaged in real-world problem solving (Dewey, 1938; Jonassen, 1999).
In addition to theoretical foundations of meaningful learning, Hematology/Oncology fellowship programs demonstrate clear educational needs that make structured, learner-centered strategies especially relevant. Research assessing graduate medical education in Heme/Onc found that many programs lack comprehensive training in essential skills such as clinical trial communication, with program directors reporting variability in curricula and expressing interest in structured communication workshops for fellows. These gaps highlight that, even within accredited programs, fellows often rely on informal, experiential learning rather than intentional, guided instruction to develop critical professional competencies. This evidence underscores the importance of designing educational interventions, like the COVA approach, that are practical, workflow-integrated, and responsive to real learner needs (Parker et al., 2024).
Stepping out of my comfort zone, it was initially very uncomfortable. I was having to make decisions that I never envisioned. The freedom seemed to be more responsibility, and I was a little apprehensive in the beginning. After much thought, I convinced myself that I could do it! My media project explores my approach to faculty development—focusing on practical, workflow-integrated strategies that help educators become more effective teachers, because the future of our fellows depends on how well we support those who train them. I realized everything I had been learning was right in front of me. I began using my real-world responsibilities and my everyday work tasks, such as creating flyers, organizing events and supporting my fellows as the inspiration for my assignments. My work became more relevant and meaningful. This reflects constructivist learning principles, where learners actively create meaning through experience (Jonassen, 1999).
Adjusting to a new learning style required a shift in mindset. I learned to solve problems, rather than just completing tasks. I learned to make decisions, not being the one who just followed directions. Last, but certainly not least, I was no longer writing for my instructor, I was communicating with a real audience! This shift aligns with the development of learner ownership and voice, key components of meaningful learning environments (Harapnuik et al., 2018). I realized how important these steps were in giving me the confidence I needed. Looking back, I would have spent less time worrying about whether I was “doing it right” and more time applying ideas with my newly discovered confidence.
Developing my own voice came easier than I expected. I realized that my recent boost of confidence was now my voice! With increased confidence, I began to recognize my potential and contributions within my department. Traditionally, I have worked behind the scenes supporting others in my department. Through this program, I learned so much, as my eyes were open to all my new potentialities. However, through this program, I realized that my ideas and perspective have value. This growth reflects increased self-efficacy, which plays a critical role in an individual’s ability to take initiative and lead change (Bandura, 1986).
Initially, the idea of leading change felt intimidating, especially in a structured medical environment where policies and expectations are well established. In the beginning of the program, just the thought of leading change felt intimidating. Over time, I began to see how my perspective and ideas could influence positive improvements, all with my voice. Before, I worked just to meet expectations, although I’ve always done my job well, but more as a routine, day after day. Instead of creating work just to meet expectations, I began to create with intention! Designing materials to engage our learners and not just an article to read, enhancing my ability to communicate in different ways that resonate with busy, healthcare professionals align with the principles of significant learning, where intentional design leads to deeper engagement and understanding (Fink, 2013).
My attitude toward leading change has taken a dramatic transformation! As a leader, in general, I’ve always been intimidated. Working in a structured medical environment, policies are often well established, with rules already set in place. However, through this learning experience, I’ve become more confident in identifying opportunities for improvement and more forthcoming when it comes to contributing ideas. From enhancing communication, creating engaging learning materials, and supporting initiatives such as wellness events, I now see myself helping drive positive changes. I’ve even written a journal submission, Educating the Educator: Supporting Faculty in Time-Limited Clinical Environments While Improving Patient Care and Outcomes. I plan to submit this soon.
Both Professional Learning (PL) Plan Outline and coursework have been rooted in real needs within my organization. As outlined in my Faculty Development Action Plan for Clinical Educators, it was never about simply completing assignments –it has been about creating something meaningful. Something that would improve the experience for our fellows, faculty, and staff. The COVA approach emphasizes choice, ownership, voice, and authentic learning as essential elements of a significant learning environment (Harapnuik et al., 2018).
The COVA approach resonates deeply with how I now believe learning should materialize. Learning should be relevant, applicable, and empower learners. It should also be connected to real world experiences. In a healthcare setting, time is limited, and demands are high, so meaningful learning is essential. This perspective is also supported by adult learning theory, which emphasizes self-directed, relevant learning experiences (Knowles, 1984).
This program has shifted my perspective from viewing learning as structured and assigned, to seeing it as dynamic and purposeful. I’ve come to believe learning is most effective when learner driven, experience based and directly connected to real life applications. Additionally, learning is strengthened through collaboration and shared experiences within a community (Wenger, 1998).
Moving forward, I plan to incorporate the COVA approach into how we support fellows and faculty within our program. This includes creating opportunities for our learners to:
- Engage in real world problem solving
- Contribute ideas and feedback
- Take ownership of projects that impact their learning environment
In practice, this could include allowing fellows to lead or co-design educational sessions, creating interactive and visually engaging materials, and connecting learning activities to real clinical or operational challenges. To support this approach, I will provide flexibility in how learners engage with content, encourage innovation, and create opportunities for reflection and feedback. I have also updated my FINKS 3-Column Table to reflect how I have refined and redefined my approach to educating the educator.
To support COVA, I plan to: I recognize that not everyone will be immediately comfortable with less structure, especially in a fast-paced healthcare environment. To support this transition, I will clearly communicate expectations, provide examples of successful approaches, and offer guidance while still encouraging independence.
Implementing COVA in a healthcare setting does come with challenges, including time constraints, resistance to change, and a preference for traditional structures. To address these challenges, I will focus on demonstrating value through results, starting with small, manageable changes, and building trust over time; one step at a time.
In the field of Heme/Onc, where learning directly impacts patient care, it is critical that education be engaging and meaningful, as well as effective. Incorporating COVA and creating a significant learning environment, we can improve engagement and support a deeper understanding. This will also empower learners to take an active role in their own development. This approach also aligns with expectations for continuous learning and improvement in graduate medical education (Accreditation Council for Graduate Medical Education, n.d.).
This experience has changed how I approach both learning and my role within my organization. I am no longer just supporting processes; I am contributing to their improvement. The most important lesson I have learned and taken to heart is when people are given choice, ownership, and voice, they won’t just participate, they will invest, engage, when given meaningful opportunities to participate in real-world problem solving. In a fast-paced clinical environment where time is limited, creating learner-centered, practical, and workflow-integrated educational interventions address documented gaps in fellowship training and strengthen both professional competence and confidence. This approach also aligns with expectations for continuous learning and program improvement as outlined by the Accreditation Council for Graduate Medical Education (ACGME, n.d.), reinforcing that intentional, authentic learning benefits not only the individual learner but the entire clinical and educational community.
References
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
Dewey, J. (1938). Experience and education. New York, NY: Macmillan.
Fink, L. D. (2013). Creating significant learning experiences: An integrated approach to designing college courses. Jossey-Bass.
Harapnuik, D., Thibodeaux, T., & Cummings, C. (2018). Creating significant learning environments.
Knowles, M. (1984). Andragogy in action: Applying modern principles of adult learning. Jossey-Bass.
Jonassen, D. H. (1999). Designing constructivist learning environments. In C. Reigeluth (Ed.), Instructional-design theories and models (Vol. II). Lawrence Erlbaum Associates.
Parker, N. D., Murphy, M. C., Eggly, S., Weiss, E. S., Amin, T. B., Wollney, E. N., Wright, K. B., Friedman, D. R., Sae-Hau, M., Sitlinger, A., Staras, S. A. S., Szumita, L., & Cooks, E. (2024). Educating Hematology-Oncology fellows about how to communicate with patients about clinical trials: A needs assessment. Journal of Medical Education and Curricular Development, 11, Article 23821205241269376. https://doi.org/10.1177/23821205241269376
Wenger, E. (1998). Communities of practice: Learning, meaning, and identity. Cambridge University Press.
Accreditation Council for Graduate Medical Education. (n.d.). Common program requirements. https://www.acgme.org
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