VIRCLASS: the Virtual Classroom for Social Work in Europe - a toolkit for innovation?
Grete Oline Hole [goh@hib.no],
Anne Karin Larsen [akl@hib.no],
Centre for Evidence Based Practice, Faculty of Health and Social
Sciences
Høgskolen i Bergen, Haugeveien 28, N 5005 Bergen, Norway
[http://www.hib.no/english/index.html]
Abstract
English
Through a student-centred virtual learning environment students and teachers in Europe cooperate, exchange information of social work in their own country, and increase their digital literacy. In VIRCLASS students from 15 countries collaborated in their learning process by sharing knowledge with peer-students. Teachers from eight European countries were involved in the course. With a common curriculum, a study-program rewarded with 15 ECTS credits and using A-F marks many of the elements from the Bologna-process are met.
Norsk
Ved hjelp av et studentsentrert virtuelt klasserom samarbeider studenter og lærerer over hele Europa, utveksler kunnskap om sosialt arbeid i eget land og utvikler sin digitale kompetanse. I VIRCLASS hjalp studenter fra 15 land hverandre i læreprosessen ved å dele informasjon med medstudenter. Lærere fra åtte land var involvert i kurset denne første gangen. Med en felles fagplan, et studieprogram som gav 15 studiepoeng (ECTS) og karakterer i skalaen fra A-F, imøtekommer VIRCLASS mange av elementene fra Bologna-prosessen.
Keywords
Virtual Learning Environment, Social Work Education, Life Long Learning, Digital Literacy, International Collaboration, Bologna Process.
Topics
Findings
The new way of learning
Digital literacy
Curriculum and reading list
Teachers experiences
Introduction
This article explains how VIRCLASS, the Virtual Classroom for Social Work in Europe can contribute to fulfil the goals of European Higher Education. Through a student-centred virtual learning environment students and teachers from Europe cooperated, exchanged information about social work and increased their digital literacy. VIRCLASS also emphasised student-centred learning activities, focusing on sharing knowledge and exchanging information from the different participating countries; thus promoting increased understanding among Social Workers in a rapidly changing Europe. Therefore, VIRCLASS could be seen as a tool for innovation in the educational field as a consequence of the demands from a modern society.
New demands for professional education and work force training stemming from societies' need for competencies has led to considerable challenges for Higher Education Institutions (HEI). From 1999 the Bologna Declaration laid down the goals for the HE development in Europe. By defining 6 action lines towards the achievement of a European Higher Education Arena by 2010, the overall goal is to restructure the European HE system in a coherent and cohesive way (The Bologna Declaration). As a consequence, a European Credit Transfer System (ECTS-credits) together with a common European system for marks, graded A-F, and the 3+2 years Bachelor and Master Programmes were introduced. Another important goal is to eliminate obstacles to mobility over national borders, with increased opportunities for student & teacher mobility and an emphasis on academic cooperation at all levels.
The Bologna Process continued with the Prague (2001) & Berlin (2003) Communiqués focusing on Life Long Learning (LLL) and the synergy between the European Higher Education Area and the European Research area (Summit Bologna Bergen 2005, p 4). As a consequence of these processes there have been considerable re-adjustments in the framework of academic work in Europe over the last few years.
In Norway, the government White Papers "The Competence Reform" (1997/98)
and "The Quality Reform" (2000/01) laid down guidelines for how the
Norwegian HEI should meet these challenges. The White Papers were followed
by a new Parliamentary Act (2003) regulating the conditions for HE in Norway.
In accordance with these, all the Norwegian HEI have restructured their degree
programmes to 3 + 2 years, introduced A-F grading and ECTS credits (Michelsen & Aamodt,
2006). Similar adjustment has taken place in Europe, in many ways all over
the world, but owing to the White Papers and the new Act, Norway has completed
adjustment of the structure of HE to the Bologna process, and are in the forefront
of this transformation process. As a consequence of this, teachers from Høgskolen
i Bergen have been central in developing VIRCLASS together with partners
from: University of Wales, Swansea, UK, School of Health Sciences, Jønkøping
University, Sweden, Vytautas Magnus University, Kaunas, Lithuania, University
of Applied Science Vorarlberg, Austria, Complutense University Madrid, Spain,
University of Parma, Italy, Miguel Torga University College, Coimbra, Portugal;
University of Warmia and Mazury, Olsztyn,Poland and the City of Bergen, Norway.
In addition to the partners teachers from Germany, Belgium and others universities
in Spain and Italy have also participated in the course, and in the development
of the learning material.
The changes in the educational field coincide with major adjustments of conditions in the workforce. The Lisbon Strategy (2005), which among other elements emphasises LLL and the Learning Economy as a central agent for change in the European Economy, is another influential force for the HEI and Work Life Training in Europe (ODL- Liaison paper May 2006). The emphasis on LLL has led to a global growth in Further and Continuing Education, giving the HEI a new role in the transmission of knowledge. HEI's are not only responsible for students on their campuses, but have a commitment to the society as well (ibid). All together, these factors support demands for extensive use of Open and Distance Learning (ODL) in meeting the demands for continuing education.
An extra challenge for HEI in educating professionals working in the Health and Social Work arena stems from the Pan-European work market, with the Internal Market focusing on free movement of goods, trade and workforce. Meeting clients from different countries demands new skills and knowledge in their culture, history and language. This requires new skills among the Social Workers throughout Europe and VIRCLASS is intended to be one of the tools for meeting these demands.
Background
In 2002, the European Social Work Thematic Network (EUSW-TN) started as an EU funded project. With 45 organizations, both academic and professional bodies from 30 different European countries as members, the objective was to contribute towards the improvement of social work, raise important questions in the discussion of social work issues, and gain knowledge about social work, service users, policy, practice and education from a comparative perspective in Europe. One of the means to reach this goal was a Summer School in Parma, Italy in 2005, and the idea of VIRCLASS was launched as a consequence. Through VIRCLASS the students could prepare for the summer school by an e-learning course, gain knowledge about social work in different countries in Europe, and simultaneously be rewarded with more ECTS-credits. The teachers would develop e-learning courses for an international group of students, in collaboration with other teachers from Europe, with a common curriculum plan and readings. In this way they would meet the goal of using ODL in their programmes, increase the opportunities for internationalisation among both students and teachers, and get innovative experience with use of ICT as a tool for delivering the learning materials. Before outlining how VIRCLASS was carried through this first time, the underlying learning perspective will be clarified and elaborated, as a backdrop for further discussion,
Theoretical Perspectives
A review of literature demonstrates that there is a new understanding about the process of "learning", which emphasises student-centred learning activities and collaboration between the students as a tool for gaining new knowledge (Biggs 1999, Bransford et al, 2000, Bruner 1996). Before pointing out how this influences HEI, some of the main features regarding these learning theories will be briefly outlined.
Sociocultural learning theory, where learning is seen as integrated in complex practices, and emerges during a fusion of practice experiences, theoretical knowledge and discussions among peer-students and supervisors, has influenced the organisation of the teaching and learning arena. With a focus not on the 'single learner', but on the learners' activities in a community of practice, rooted in theories of situated learning (Lave & Wenger 1991, Nielsen & Kvale 1997, Wenger 1998), the emphasis is on communication and cooperation in the students' learning activities. Knowledge of how situated, reflective practice is developed, (Bruner 1996, Schön 1987), what promotes student activity (Biggs 1999) and encourages communication and cooperation (Brown et al 1989) is central. Problem-based/project-based learning is a widespread way of fulfilling these goals. The students work with the learning material connected to theory-practice knowledge, related to empirical workplace experiences, dialogue and collaboration.
The aim of the educators is that the students will become reflective practitioners, where theory and practice, thoughts and actions are integrated (Schön 1987). An important tool here is to challenge the students reflection on learning, with the goal of promoting a meta-perspective on the learning process to emphasise the students' own ways of learning (Thorpe 2000)
Due to the underlying theories of the teaching /learning-process, there is a shift towards portfolio assessment, where different products documenting learning processes are collected in the student's portfolio (Paulson et al 1991, Cooper & Emden 2001). Through this the assessment will guide the learning process, not only test what the students' recall of the tutors' lectures. A learner-oriented assessment will focus on controlling the amount of knowledge the students have gained where the main issues are more on the formative rather than the summative assessments (Birenbaum 2003, Ramsden 2002). In Module 2 in VIRCLASS the assessment was by portfolio, where all the assignments were collected as a part of the final evaluation, to strengthen a "learning as participation" perspective (Sfard 1998, p 6).
Use of ICT in learning processes
As stated earlier, there is a demand for optimal flexibility in all learning arenas, not only in the institutions offering formal learning, but also in the field of vocational, continuous and further education. ICT, particularly the Learning Management Systems (LMS)[1] has become a central agent for fulfilling these goals (Paulsen et al 2003). LMS is an obvious tool for administration of students in e-learning courses, delivering learning material, as well as an arena for communication, problem-solving and a providing common workplace for teachers and students.
Online learning is a major force giving optimal flexibility due to the time and place of the learners' study activities, and with the latest technological development there are vast opportunities for both synchronous and asynchronous cooperation both between students and teacher and between the students. These new communication tools facilitate dialogue and collaboration between the participants, even with the use of low-technological and low-cost computer tools (Salmon, 2004).
However there are challenges when using ICT to educate professionals in a complete on-line environment. Some claim that the development of LMS has been driven more by the technological possibilities than by educational purposes (Koschmann 1996), others claim that there is a 'didactic lag' towards the pedagogical use of ICT (Laurillard 2002). Computers are well suited to deliver learning materials in different forms, checking what activities the students has undertaken, testing through quizzes and multiple-choice-tests the amount of 'acquired knowledge' the students possess. But the main findings from many studies indicate that without careful planning and painstaking efforts towards creating a learning environment enhancing student activity, promoting and rewarding collaboration and experience-sharing, the LMS carries out an instrumental form of teaching and learning. In accordance with Biggs, good pedagogical design requires consistency between curriculum, teaching methods, environments and assessment (Biggs 1999). In a virtual learning environment attention must be given to the choice of mediating artefacts, (Conole 2005), the assignments and assessment (Thorpe 2002) and the teaching and tutoring supplied during the course.
There is still a lack of knowledge of how ICT can support student-centred, problem-based flexible learning, particularly in the education of health and social workers. More knowledge of how ICT can support activities that create productive learning arenas is needed, and it is important to gain more insight in the consequences for the learning community to make sure that learning is enhanced among European students (ODL- Liaison Policy Paper May 2006), to fulfil important European goals. As the following discussion reveals, VIRCLASS undertakes to give the participating HEI such information.
VIRCLASS
As a preparation for a summer school, VIRCLASS had a group of partners who wanted to "Create and establish an e-learning platform for comparative studies of social work in a European perspective" (http://www.virclass.net). The first time VIRCLASS was carried through, the educational programme consisted of three modules. Module 1: "Social Work in Europe. Commonalities and Differences", credited with 5 ECTS-credits could be either a self-directed study or as an e-learning course. Module 2: "Comparative Social Work. A European Perspective on Core Issues of Social Work" at 10 ECTS-credits was only offered as an e-learning course. Module 3, the summer school "Social Work as a Subject and Profession in Europe" with a preparatory period first and the assignment period at the end as self-directed study, was rewarded with 10 ECTS-credits. Module 1 was a pre-requisite for modules 2 and 3, and the students could combine these 3 modules in different ways, earning from 5 to 20 ECTS-credits.
Figure 1. The structure of VIRCLASS courses spring 2005 (http://www.virclass.net)
120 students applied for Module 1, 108 were accepted and sixty two students from fifteen European countries completed one or more of the modules and received their ETCS-credits. Eleven teachers from eight countries were teaching and tutoring and still more teachers from the EUSW-TN were involved as assessors. Even though there were many drop-outs, there were in total 745 ECTS-credits earned during these 3 modules.
The Virtual Learning Environment
VIRCLASS uses the LMS "it's learning"[2], a standard commercial e-learning platform. There are discussions about the pros and cons of standardised platforms (Hoem 2005), but the project-group decided using a LMS like this would be the easiest way to include newcomers, both students and teachers in an ODL environment. The teachers were trained to use the LMS and taught how to create and deliver the necessary learning materials before VIRCLASS started, with special attention to challenges delivering ODL with a student-centred approach. Resting on socio-cultural learning theory where learning is seen as integrated in social, historical, cultural and institutional practices, knowledge of how situated, reflective practice is developed is central. Learning occurs in the interaction between actors and learning resources available in a community of practice, and it became evident that the underlying desire to fulfil the goals from the Bologna Declaration demanded extra efforts from both students and teachers.
Students worked with tasks that provided useful learning situations, stimulating extended knowledge-building and 'scaffolding' (Bruner 1996) within the field of social work. When learning professional knowledge moves from apprentice style learning-in-practice to the student centred learning in the HEI, the learning is re-contextualized in a pedagogical frame. The teacher's challenge is to provide examples that help the learners to develop professional knowledge and different assignments can be a bridge between the 'reality in practice' and the theoretical world of schooling (Säljö 1999, 2001). There were students from many countries, with different backgrounds and on different educational levels[3] who participated and completed in the first VIRCLASS course. Developing the course to take advantage of this by encouraging the students to exchange experiences also encouraged the students to guide each other towards being 'reflective practitioners'.
Cooperation
The work tasks for the students were developed in such a way as to ensure that the students had to cooperate when fulfilling them. When people with different experiences work together to solve a problem, their effort provides both individual learning and increased knowledge in the group (Koschmann et al 1996). The students collaborated through the LMS, and all the lectures and work tasks were given in the 'classroom' located in this learning arena. Students carried out various assignments, which received grades; they were supervised during the process and received comments on content and solutions, as well as their academic writing. During the course, each student had their own 'space', their own working-place and storage-room at the LMS. The groups, sharing and commenting on each others' work, also had their own working area at the LMS. As a supplement in the learning process the students could participate in asynchronous discussions-forums.
As different social systems have diverse structuring resources, which people use for evaluating the situation and deciding what to do (Goffman 1974), this adds to individual differences when participants from different cultures meet (Biggs 1999, Marton et al 1984/1997). This makes problem-solving more complicated in a multi-cultural learning environment as the participants enter the learning environment with different understanding of both the teaching and learning processes. Enhancing student collaboration like this entails a new role for the teacher; who does not transmit a given amount of knowledge. Rather knowledge is constructed in a dialogue between the partners. Even though the teacher is central in this 'scaffolding' process, the learners themselves will help each other to gain new insights into the problem.
There was extensive cooperation between teachers in the preparation and planning of the course, where they communicated by Face-to-Face (F2F) meetings, web-conferences, e-mail and telephones. A 'teacher-room' was created at the LMS, with bulletin-board, files storing different drafts and comment upon these, synchronous and a-synchronous discussions forums. Simultaneously, there was an area for planning, and a place for exercise in using the platform. This was supplemented with a lecture and guidance to this particular LMS during the F2F meetings before the start of the course. One teacher was responsible for each course, but was professionally and practically supported by at least one other teacher.
In the following section the challenges of using ODL as an international collaboration between students and teachers from different countries will be further raised and some of the answers to these questions will be outlined and discussed.
ICT supported ODL
During the project period, experiences were gained towards the challenges of enhancing ODL as a European collaboration. Knowledge about the delivery of learning materials in a LMS, the use of "triggers and teasers" to enhance the learning arena, and how to integrate a common curriculum-plan, reading-list, assessments and workload, which were credited with ECTS in a trans-European course, were obtained. During the first VIRCLASS there was an extensive collection of data to evaluate the courses, in order to further develop and refine them. In-depth research of how to exploit the pedagogical opportunities in a knowledge-building collaboration in a learning community mediated through a virtual learning environment was carried out. The emphasis on student-centred learning, collaboration and cooperation in a completely virtual environment made new demands on the students' learning processes.
Findings
The target group was students from the undergraduate BA, but students from both diploma and MA programmes and PhD students (often professional social workers with work experience) participated in the course this first time. The basic idea was that the students should work with tasks that provided good leaning situations, stimulated knowledge-building and scaffolding within the field of social work, sharing their knowledge with each other[4]. Social Work students with different kinds of professional knowledge from 15 European countries have a lot to learn from each other if they make the most of the opportunities.
The participants were dependent on their peer-students guided by the course aim of giving the students a 'comparative European perspective' of social work. They had to help each other by supplementing each other in fulfilling the assignments; one would not find knowledge of this kind in ordinary textbooks. When learning is seen as participating rather than acquisition (Sfard 1998), the teachers' role changes. The teachers support the students in their learning process by being a 'guide-on-the side' without taking the 'sage-on-stage' position (Horton 2000).
The "new way" of learning
The task- centred approach, which emphasised the students' activities in creating knowledge, was a new way of learning for many of the participants. As the assignments required collaboration to be finished, the students had to share their knowledge and experiences to fulfil the tasks, and this made the groups vulnerable. If someone did not do as expected, the others in the group had problems with finishing their own assignments. This was a problem during Module 2, when many students left the course, leading some of the groups to be reallocated.
The request in the assignment of sharing their own experiences was novel for many students, and some did not know what was expected of them. They withdrew from the discussions, gave their answers too late, and a few gave the impression of not being comfortable with this way of working. Still, in the final evaluation many were really positive towards this way of learning by sharing knowledge (Larsen & Hole 2007).
There were quite considerable differences in the students' accuracy in writing, while some were comfortable in using the Harvard Style of referencing and evidence-based writing; other students met these demands for the first time. This caused problems when the students tried to use their peers' assignment in their own work. To what extent could they trust their information, and how should they reference them, were questions frequently addressed.
Reflection over their own learning process was an important part in the education of reflective practitioners, with assignments aimed towards this. But this was obviously new for many of the students, as they did not dare to reveal their thoughts and feelings during the course. While some of the students[5] in their final evaluation of the course gave enthusiastic credit to how this assignment really had opened their eyes and widened their ways of thinking over their work attitude, others were undoubtedly just submitting answers directed by what they believed the teachers wanted to be told (Larsen & Hole, 2007).
Digital literacy
In a pan-European course like this, there are huge differences in which equipment is available for the students. Both ICT literacy and access to resources delivered by this medium were a common problem for many students. To be an e-student was a novel experience for most of the students, and very few of the students were familiar with e-learning before VIRCLASS started. There were tutorials available, and the first assignments were tailored to let the participant become familiar with the tools available in the LMS. But problems with access to computers and the use of those as a learning tool led to withdrawal from the course. Even though all the students who completed the course evaluated the LMS very well in the surveys at the end, we don't know what the students who left thought about the LMS. However, we know that many students had problems with access to the learning material which caused a 'struggle' for most of them to submit their assignments in due time. Another problem was that these courses were voluntary, not compulsory, and thus competed with the students' tasks in their ordinary campus study. These were mentioned as the biggest problems both among the students completing the course and from those who left without completion.
Curriculum and reading list
The curriculum reading list was another challenge in delivering a course through a LMS. To gain access to actual, relevant literature in English was a huge problem for all students. There were very few Native- English speakers[6]; and the literature from their own SW education was in the national language. Translating idiom and professional terms were not easy for students giving an overview of this to their peer-students, and when 3 students from countries with diverse infrastructure regulating the social work field tried to tell each other of the core elements in social work in their own country, there were misunderstandings.
Not all students had access to relevant international journals, papers and books through their own university, and there are strict copyright limitations to what extent one can copy book chapters and papers and make them electronically available in an LMS. The solution to these problems was to give all VIRCLASS students access to the databases Høgskolen i Bergen subscribe to, through "its learning".
Teacher's experiences
The teachers also had obstacles to overcome in order to fulfil the aims of VIRCLASS. In spite of careful planning at the preparation stage, there was a wide variety in how the teachers delivered their 'lessons' and gave their tutorials during the course. During the work with the curriculum there were many meetings, both physical and virtual, but when the courses started, there were hardly any opportunities for cooperation among the teachers. They did not have time to discuss the best way of doing things, such as comparing ways of giving assignments and responses to those in a virtual environment. As a consequence, there were differences in the ways each teacher planned the course, how they carried through the tutoring, took care of the portfolio assessment and so on. Different knowledge of e-learning and various views of the art of teaching led to a diversity of ways of implementing the courses.
The work load of the teaching and tutoring in VIRCLASS was added to the teachers' ordinary duties, and many of them had to use evenings and week-ends to meet their obligations to the project. Being an 'e-teacher' for the first time, many of them put in an enormous effort, were available for the students any time they were contacted[7], gave long individual tutoring for the portfolio-assignments, supervised the discussion-forums and so on. Even though there were problems, VIRCLASS promoted innovation and collaboration in the educational field.
Lessons learned
During the years of planning and carrying thorough the VIRCLASS project, many useful and important possibilities for Life Long Learning in the Education of Social Workers in Europe emerged. VIRCLASS fulfilled the main objectives of the project; to develop different e-Learning courses in Social Work in a comparative perspective for an international group of students with an international group of teachers. A common curriculum plan and readings were made, which can be integrated in BA and MA programmes at the universities educating social workers. The courses were also of interest for many professional social workers who wanted to get an international perspective on social work, and this added to competence development from a LLL perspective. The curriculum plan included ECTS- credits and a common grading system.
By introducing e-learning as a tool, both students and teachers gained necessary experience in this new learning environment. Due to their VIRCLASS participation, the students were better prepared for being an e-learning citizen of Europe, and the teachers developed skills which enabled them to be 'a virtual teacher'. All the learning materials, the teasers and triggers etc, can be used next time VIRCLASS is carried through. Thereby, the participating institutions have gained tools to use in future, offering e-learning for both their campus students and future ODL-courses.
Conclusions
VIRCLASS will be carried through a second time as a project with funding from Høgskolen i Bergen, from the Norway Opening University and some of the participating partners. The project partners have undertaken a considerable effort to establish VIRCLASS as an optional course in the European undergraduate Social Work education; and simultaneously be a course available for postgraduate students and professional social workers wanting enhanced knowledge of an united Europe going through rapid transformation. Even though there were some obstacles during the project, VIRCLASS was in all parts successfully finished the first time.
The participating students became aware of the challenges in social work throughout Europe, increased their digital literacy and experienced international collaboration though an e-Learning course. The teachers developed international courses with a comparative perspective, in collaboration with other teachers from Europe, making a common curriculum plan and readings. In this way they met the goal of using ODL in their programmes, increased the opportunities for internationalisation among students and teachers, and tried out innovative use of ICT as a tool for delivering learning materials.
VIRCLASS is an effective tool for fulfilling the goals in the Bologna Declaration and the Lisboan Strategy, and can be a flexible, open and innovative educational opportunity both for students and for Social Workers, thus giving new competencies in a changing Europe.
[1]Or Virtual Learning Environment.
[2] Delivered by the company its learning AS in Bergen, Norway
[3]From first year Bachelor studies to PhD students with work experiences after graduating,
[4]The first assignment was to introduce oneself, followed by giving an overview of own county's social work education, before discussions and comparisons between three peer-students. Thereby the students could reflect on their own practice and contrast this with experiences from other countries.
[5] Especially among the students which were participating in all 3 modules.
[6] One teacher and a few of the students taking Module 1 as a self-study; none of the e-learning students.
[7] Being available "24 hours/7 days per week/365 days a year".
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[29] The Bologna Process (http://europa.eu.int/comm/education/policies/educ/bologna/bologna.pdf) (retrieved 12Nov 2006)
[30] Life-Long Learning (http://europa.eu.int/comm/education/policies/lll/lll_en.html) (retrieved 12Nov 2006)
[31] ODL- Liason
Committee: Learning Innovation for the Adapted Lisbon Agenda. Policy
paper of the ODL Liason Commite; Released on 3 May 2006.
http://www.odl-liaison.org/pages.php?PN=policy-paper_2006 (retrieved
12Nov 2006)
[32] The Lisbon Strategy http://ec.europa.eu/growthandjobs/pdf/COM2005_330_en.pdf (retrieved 12 Nov 2006)
[33] The Norwegian Competence Reform http://odin.dep.no/kd/norsk/dok/regpubl/stmeld/014005-040016/dok-bn.html (retrieved 12Nov 2006)
[34] The Norwegian Quality Reform http://odin.dep.no/kd/english/doc/white_paper/014071-120002/dok-bn.html (retrieved 12Nov 2006)
[35] The EUSW Network website (http://www.eusw.unipr.it) (retrieved 12Nov 2006)
[36] The VIRCLASS website http://home.hib.no/ahs/VIRCLASS (retrieved 12Nov 2006)
[37] The
Norwegian Ministry of Educational and Research Departments Summit
http://www.bologna-bergen2005.no/Docs/Norway/041014Fact_Sheet_Bologna-Process.pdf (Retrieved
12Nov 2006)
Acknowledgements
The authors gratefully acknowledge organisations and people who contributed to this project: EUSW-TN and Norway Opening University for financial support in the planning and further development of VIRCLASS; Høgskolen i Bergen made it possible to undertake VIRCLASS the first time and the revised version starting autumn 2006; and the support from all VIRCLASS partners in carrying through this project.
And finally a heartfelt thanks for support in writing this paper from our colleagues and the supervisors from the Centre for Evidence Based Practice (earlier Dept of Health and Social Research) at Høgskolen i Bergen.