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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 22  |  Issue : 2  |  Page : 105-117

Use of the quality function deployment to transfer the physical therapy students’ perception regarding effective lecture into operational requirements


Department of Physical Therapy for Cardiopulmonary Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt

Date of Web Publication6-Mar-2018

Correspondence Address:
Salwa B El-Sobkey
Department of Physical Therapy for Cardiopulmonary Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Zahraa Al Maadi, Cairo, 11742
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bfpt.bfpt_8_17

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  Abstract 

Objective Quality is the most important factor of competition worldwide. Quality of education means meeting or exceeding costumers’ expectations from education.
Aim This study aimed to use the quality function deployment (QFD) to transfer the physical therapy students’ perception regarding effective lecture into operational requirements. The study used the technique of Bernal L (2009) to apply the QFD to transfer the Physical Therapy students’ voice regarding effective lecture into operational requirements. Results showed that the students perceived the following items as the most important items; “Teacher communicates with the students through a bridge of trust”, “Teacher gets attention to all students, disseminates the care to all students, provides them with positive energy by encouraging them and is not giving too many orders to the students as orders have negative impact on the students’’, “Teacher provides the students with feedback during and after the lecture” and “Active teacher”. The operational requirement of “Effective internal and external quality audit” got the first priorities rank.
Conclusion The study concluded that students’ perspective is important source of information regarding the effectiveness of educational activities including lectures. The implementation of the operational requirements would result in achieving the effective lectures and satisfying the students.

Keywords: effective lecture, physical therapy students’ perception, quality function deployment


How to cite this article:
El-Sobkey SB. Use of the quality function deployment to transfer the physical therapy students’ perception regarding effective lecture into operational requirements. Bull Fac Phys Ther 2017;22:105-17

How to cite this URL:
El-Sobkey SB. Use of the quality function deployment to transfer the physical therapy students’ perception regarding effective lecture into operational requirements. Bull Fac Phys Ther [serial online] 2017 [cited 2018 Jul 21];22:105-17. Available from: http://www.bfpt.eg.net/text.asp?2017/22/2/105/226693


  Introduction Top


Quality is the most important factor of competition worldwide, which intensifies the demand for products and services quality [1]. Different definitions for quality in education has been introduced, including excellence in education [2], fitness of educational outcome for use [3], conformance of education output to planned goals, specifications, and requirements [4], defect avoidance in education process [5], and meeting or exceeding costumers’ expectations from education [6]. Application of quality in the service sector, such as education, turns its definition to customer-centered, in which customer’s satisfaction is considered as a function of perceived quality [1]. Universities are the main source of provision of higher education, so they are very concerned about the quality of their services [1] and they strive to improve the quality of their educational systems, which makes them distinctive from the rest [7],[8]. This is particularly true for private universities especially in the current fast, dynamic, and continuously changeable competitive environment. Lecture is a major part of the educational process system and is the main service introduced by the university. Effective lecture is the term usually used to describe the quality of the lecture. Effective lecture is the lecture that creates an enhancing environment for deep learning and it also characterized with its well organization, clear presentation, variation in teaching methodology, enthusiasm, and involvement of students [9],[10].

In the education system, students are categorized as customers [1]. This raises the necessity for universities to identify customers’ (students) requirements in order to better satisfy them. The costumers’ requirements are referred to the expectations made by students from the educational system [1]. When the universities use these students’ requirements to determine design characteristics to make an educational system, the requirements made by students should be met easily and the educational system would provide satisfaction [1]. Applying this concept on effective lecture, educational institutions can only be responsive to students’ needs and improve the effectiveness of student outcomes if they first establish what the students believe to be effective lectures [11]. Students’ perceptions are important to be examined as adopting learning approaches should be determined by the students’ views [12].

Total quality management (TQM) is one of the quality approaches commonly used in education and it is multifaceted, including quality of inputs in the form of students, faculty, support staff, and infrastructure; quality of processes in the form of the learning and teaching activities; and quality of outputs in the form of graduates [1]. Quality function deployment (QFD) is one of the important tools of TQM techniques [1]. The QFD is most often used for process and design improvement [13-15]. It is a structured method for listening to the customers; transform their demands into design quality; and optimizing designs, materials, and processes to ensure the customers’ satisfaction [1]. It has been successfully used for both product and service design by many organizations, and researchers have used it mainly for service sectors (like education) to transfer the voice of customers (VOCs) (students) in stages into operations requirements [1],[16]. In other words, the main purpose of QFD is to visualize the cause-and-effect relationships, starting from the customer needs and then all the way down to the production process [1]. Many benefits are proved for the QFD, including focusing design on customer requirements, prioritizing design activities, reducing the design cycle, and help the decision-makers to make the design decisions and predict the right one through the QFD matrix, which is also called house of quality [1]. The process of QFD is composed of (a) identifying and ranking the relative importance of customer requirements; (b) identifying design parameters that contribute to the customer requirements; (c) estimating the relationship between design parameters and customer requirements; and (d) setting target values for the design parameters to best satisfy customer requirements [1]. It can be said that the need for this study is justified with the fact that the lecture is the main integral business of the universities, and with the incremental increase in importance of quality in higher education it becomes markedly important to design the effective lecture with quality technique, QFD. To the best of the researcher’s knowledge, this study is a pioneer one in using the QFD to transfer the physical therapy students’ perception regarding effective lecture into operational requirements in Egypt and Middle East.


  Participants and methods Top


The current study was conducted at Faculty of Physical Therapy (PT), Modern University for Information and Technology (MTI), Cairo, Egypt, in the duration from March to June 2016. The MTI is a private university, and the faculty of PT offers one educational program, bachelors degree of physical therapy. The program is composed of 5 years with 10 educational levels. The program is offered in English language and is recently running with the highest opened level, which is level 6. The proposal of the study was approved by the faculty council. Convenient sampling method was used to recruit volunteer students to participate in the study. The students who participated were recruited from different educational levels (2-6). Level one was closed during the spring semester while the study was conducted. The study used the technique of Bernal et al. [17] to apply the QFD to transfer the PT students’ voice regarding effective lecture into operational requirements. The technique of Bernal and colleagues was selected because it is rigorous and simple. The following flowchart summarizes the steps of the study followed by the steps of study.



Generation of the voice of students (voice of customer) (students’ requirements)

  1. The researcher facilitated two focus-group brainstorming sessions with 15 students from levels 2, 4, and 6 to generate voice of the students regarding the requirements for effective lecture (students’ requirements). The recruited students are known with their objectivity, ability to represent their ideas in a clear way, ability to work in groups, and volunteered to participate. Students’ perspective regarding effective lecture was represented in nine themes with underlying 36 items. Themes for effective lecture were as follows:
    1. Lecture management theme (four items).
    2. Language theme (four items).
    3. Teaching methodology theme (eight items).
    4. Communication theme (four items).
    5. Teacher behavioral theme (four items).
    6. Curriculum theme (two items).
    7. Teacher’s qualifications theme (five items).
    8. Infrastructure and facilities theme (two items).
    9. References, resources, and educational material (three items).
  2. The researcher designed a draft version of the questionnaire with those nine themes and 36 items. In the instruction section of the questionnaire, students were asked to select the most important 15 items for effective lecture from their point of view and then to rate the importance of each of these items using a scale from 1 to 5 where 1 means the least important and 5 means most important. The student’s level and cummulative grade point average (CGPA) were requested, whereas the student’s name was optional.
  3. The draft questionnaire version was introduced in the pilot study to 20 students. It is to be noted that students who participated in the pilot study were different from students who participated in the brainstorming sessions. The researcher asked the students to report about the clarity of instructions to reply to the questionnaire, the statements, and language, as well as the time taken to reply. They were asked to report whether there were any redundant statements.
  4. The researcher modified the draft version according to the students’ feedback. There were redundant statements and three words were replaced to be clearer. The time range to complete the questionnaire was 10-12 min, which was acceptable by the students.
  5. The final version of the questionnaire was introduced to 60 students [500 (12%) of the total number of the enrolled students in the program]. It was written in the questionnaire that fulfillment of the questionnaire is considered as agreement to participate in the study and that the information in the questionnaire will only be used for improvement of the faculty and for research and publication purposes. The completed questionnaires that were used in the study were 53.
  6. The researcher used an excel sheet to record the students’ rating for the 36 items of the questionnaire according to the importance of the items from students’ perspective (customer importance rating). Then, the means for rating scores were calculated ([Table 1]).
    Table 1 Mean rating score of students’ requirements items

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  7. Because the researcher was concerned about the most important items to the students, items with mean score less than 4 were excluded. The items with a mean rating score of 4 or above were 30 items. For better allocation of the college resources and concentration, the researcher decided to divide these 30 items into three phases. The first stage included the first 10 items with the highest rating score. After implementation of the first stage, the next 10 items with the highest rating score would be selected for phase 2 and the last 10 items would be included in phase 3.


Generation of the design (functional/ operational) requirements

A brainstorming sessionwas conducted to generate the operations or critical to quality required for achieving the students’ requirements (design requirements, functional requirements, or operational requirements). The criticals to quality are the key measurable characteristics of a product or process whose performance standards or specification limits must be met in order to satisfy the customer [17]. In addition to the researcher, brainstorming group included expertise in physical therapy from the institution, consultant in physical therapy and quality from outside the institution, and expertise in physical therapy and medical education from the institution. For each students’ requirement (each item), the brainstorming group brainstormed together, discussed, and agreed upon the operational requirements to achieve this students’ requirement ([Table 2]).
Table 2 Operational requirements for each item of the students’ requirement

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Preparation of relation matrix

The relation matrix is a matrix representing the relation between the customer requirements (VOC) and the operational requirements. The strength of the relation is expressed with three numbers: 9 for strong relation, 3 for moderate relation, and 1 for weak relation. However, 0 means no relation. The relation matrix was conducted to the items of the three phases using an electronic template of Microsoft excel document [18]. This template is available for noncommercial use at continuous improvement toolkit: http://www.citoolkit.com. The above-mentioned brainstorming group was the group that expressed the strength of the relation for the relation matrix. Once the relation matrix is completed, the template calculated the following measures:
  1. The weight score: This represents the relative importance of the requirement. It represents the summation of customer importance rating of the item times each expressed relationship. For example, in item number one, the customer importance rating was 4.75 and there were two strong relations with the functional requirement expressed with 9, so the weight score is (4.75×9)+(4.75×9)=85.5.
  2. Technical importance score: It is calculated through summation of the customer importance times the expressed number of the relation for each functional requirement column.
  3. Prioritize rank: It ranks the priority of each functional requirement where 1 represents the first priority, whereas 5 represents the least priority.
  4. Difficulty: It indicates the level of difficulty of the functional requirement. Very easy level is represented with 1 and very difficult is represented with 5.
  5. Cost and time: It indicates the cost and time required for each functional requirement. Low cost and time is shown with 1, whereas high cost and time is shown with 5.


Preparation of the interrelationship matrix

This is a triangular correlation matrix that describes the strength of the interrelationships between the design requirements. It is represented as follows: (++) strong positive, (+) positive, (−) negative, and (−−) strong negative. The interrelationship matrix was conducted to the three phases by the brainstorming group.


  Results Top


Results revealed that the item with the highest weighted score (167.4) was ‘Teacher communicates with the students through a bridge of trust’, as shown in [Table 3], which represents the QFD for phase I. The item with the highest weighted score (112.05) in phase II was ‘Teacher gets attention to all students, disseminates the care to all students, provides them with positive energy by encouraging them and is not giving too many orders to the students as orders have negative impact on the students’ ([Table 4]). Two items shared the highest weighted score (110.7) in phase III ‘Teacher provides the students with feedback during and after the lecture’ and ‘Active teacher, who moves in the class, writes on board, asks students and improves the students understanding, with good level of written and spoken English, and shows the students the proper way to study the course’ ([Table 5]).
Table 3 Quality function deployment of phase I

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Table 4 Quality function deployment of phase II

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Table 5 Quality function deployment of phase III

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For the three phases, the operational requirement of ‘Effective internal and external quality audit’ was with the highest technical importance score and importance and got the first priorities rank ([Table 6]).
Table 6 Characters of operational requirements in the three phases

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  Discussion Top


Higher education is a crucial element for the development of nations. Higher-education institutions are characterized with high diversity in their nature, missions, size, and rank. Regardless of this diversity, teaching and learning is still the core business of higher-education institutions. In spite of modern techniques of teaching, lecturing is still the gold-standard teaching methodology and is the most commonly used method for transferring information in medical and healthcare education [19]. Medical education introduced the characters of effective lecture while quality assurance for education managed evaluation and assessment of lecture through surveys, interviews, and even observation. Usually students participate in this evaluation and the output is used for quality improvement planning. Mostly, the higher institution management body, decision-makers, and quality assurance consultants cooperate to develop this improvement plan. A majority of the improvement plans are based on planners’ experience, benchmarking with best practices and guidance of manuals and standards of the accrediting bodies. The students are the direct consumers of teaching and learning in the classroom and they can provide valid and reliable information about effectiveness of lectures [19]. They are also the main stakeholders, number one customers, and core partners for the education process of teaching and learning, which is why this work aimed to study the effective lecture from students’ perspective. Students perceived the item of ‘Teacher communicates with the students through a bridge of trust’ as the most important item. This indicates the humanities of the educational process and that the teacher-students relationship is very important for the students. Trust is the very basic core for any humanity relation, especially if one side of this relation is youth − in this case the university students. Students need to feel secure with their teachers and that the teachers are providing them with the most qualified educational service and effective lecture. This is especially true for students in a private university. In Egypt and many of the Middle East countries, higher education is introduced through public universities in which the students feel that they are in safe hands as the government and ministry of higher education are directly responsible for these universities. The private universities started in Egypt since early 1990s, and although the ministry of higher education is supervising these universities and many of these universities have excellent reputation, the students perceived that the culture is still looking to the private universities with some doubt. Therefore, trust is the number one customer (students) requirement. In addition, because the students can be enrolled in the private universities with high-school grades lower than that what is accepted in the public universities, students are afraid that the teacher might underestimate their academic abilities and consider them as low-quality students. That is why an item such as ‘Teacher is not treating the student of a private university as a low-quality student’ is included in phase I items.

Out of the 36 items perceived by students as the most important items for effective lecture, 29 (80.55%) items were concerned about teachers. This result should not be interpreted that the students are passive and rely more on the teachers. This is because of two reasons: the first reason is that the students required teachers of highly qualified characters, which indicate remarkable awareness of the students. The second reason is that the students valued the active teacher who uses questions, group activity, and other interactive class activities to motivate the students participation and make them concentrate in the lecture. What the students are describing is very close to the interactive learning in classroom, in which the students are actively participating in the teaching and learning process and in which the teacher is acting more as a facilitator. Interactive learning in the classroom makes learning and teaching more effective and adds to the human intelligence and experience, as well as communication and atmosphere, to the lectures [20]. In a very close study, medical students perceived lecture as a poor teaching method when it is a one way of transferring information without discussion or questioning [19]. Students in the current study required characters of teachers similar to other studies that took place in different countries. Barnes and Lock [11], in China; Oregbeyen [21], in South Korea; Lee et al. [22], in UK; Mohidin et al. [12], in Malaysia; Wright [23], in America; Chen [24], in China; and Ramsden [25], in Australia, mentioned the following characters of teachers as required by the students: teachers who deliver their lectures well, give clear explanations, give handouts, involve the students in class discussion, allow students to ask questions and make class presentations, friendliness, helpful, respecting students, preparedness, fair especially in grading and examinations, knowledgeable, and motivating students.

Another very impressive result shown by this study is that the students are perceiving elements of teaching and learning process such as teachers, curriculum, and educational materials to be more important than elements such as infrastructure. The students recorded only two items in the customer requirements related to infrastructure out of the 36 (5.55%) questionnaire items. All the students need is a well-equipped lecture room with fresh air. Many of the private universities invest a lot of money in the infrastructure to make luxury buildings to attract students and their parents. With the previous results, the owners of the private universities need to rethink and consider that the students are more mature than they may think and they are special customers with more concern about the qualification of the educational service than the luxury of the infrastructure.

For the three phases, the effective internal and external quality audit was the first priority of the operational requirement. Haakstad [26] stated that quality auditing in higher education is an evaluation of the quality mechanisms established by an institution itself to continuously monitor and improve the activities and services. He added that it could be internal or external auditing through quality agencies and that the scope of the quality audit includes the quality assurance of the educational activities, research, and interactions with the society. He claimed that if the quality audit in the educational institution is expected to improve the quality management system of the institution, it would by default improve the performance of that institution and its activities. If we adopted this concept, we can say that the auditing system, internal or external, would enhance the effectiveness of the lecture as one of the educational institution activities. Quality audit results in effective lectures is a very logical assumption, as audit includes activities such as collecting and analyzing data for monitoring purpose and then taking the corrective decisions and implementing the corrective actions for continual improvement and development. As the physical therapy program in the current study has faculty quality assurance unit, it may conduct and arrange for internal and external quality auditing activities such as peer evaluation, periodic revision, student-course evaluation, benchmarking, and peer external quality auditing. By peer evaluation activity, each teacher can act as a mirror for his/her colleague, and perfect aid for teaching skills improvement can be provided. Periodic revision managed by the faculty quality assurance unit can also play a great role in improving the effectiveness of lecture. Revision of the program specification and reports, curriculum matrix, courses’ portfolios especially courses’ specifications and reports, benchmarking reports, previous student-course evaluation surveys’ reports, and progression of remedy plans and actions should be included in this periodic revision. Most important outcome of this revision is the correction plans and their activation. Peer external quality auditing can also work as an external expertise eyes that help the program to detect areas requiring improvement and areas of strengths for further improvement.

Recruitment and training system for teachers and adherence to qualified teaching and learning internal policies and procedures (IPPs) are the two operational requirements competing for the second and third priorities of operational requirements. Regardless of the priority competition, these two requirements are much related to each other and to the first operational requirement as well. The qualified teaching and learning IPPs can be considered as the standards adopted by the educational institution. The presence of the standards is not a guarantee for effective lecture, but it is the adherence of the teachers to the standards and implementing them in each lecture. The IPPs may be presented in the form of manual of teacher guide for effective lecture, and it may include following the course specification regarding the lecture intended learning outcomes, educational materials, and teaching methodology, and also include lecture time and duration, preparation of audiovisual devices, and any tools or devices used for demonstration, application of class activities, providing the students with feedback, dealing with any circumstances, reporting, documenting the lecturer, and so on. Teachers will not be able to comply and be adherent to these IPPs unless they are well trained. This gives reason to the importance of the training system for teachers. Training system must be arranged and organized in a way to provide teachers, especially the newcomers and juniors teachers, with the required training to enhance the effective lecture. According to the students’ VOC, the training program may include seminars and workshops related to presentation skills, communication skills, teaching strategies and methodology, feedback construction, discussion and debate monitoring, management of lecture and class discipline, educational material preparation, courses integration, and so on. Recruitment of the highly qualified teachers will play a remarkable role toward effective lecture. Partly because lecturing process is a teacher-dependent process to a great extent and partly because qualified teachers will engage more perfectly in the training programs and easily be adherent to the institution IPPs. It could be said that for continual improvement of lecture effectiveness an institution must have its standards (IPPs), teachers who are qualified and periodically trained and are adherent to the IPPs, and an auditing system that regularly checks and monitors the lecture effectiveness and takes the corrective actions whenever needed. These three operational requirements can be considered as the cycle of continual improvement for effective lectures and can be repeated in annual or even semester basis.

This continual improvement cycle needs umbrella of administration support. Therefore, it is very logical to find that the administration support is the priority number 4 in the operational requirements. Administration support is required to approve the previously mentioned cycle for continual improvement and to provide the required resources to activate and implement this cycle. Administration support is also important to disseminate culture of quality and excellency in all institution activities including lectures. Sometimes reward and punishment is required to guarantee effective performance (including lectures) of teachers and this is one of the authorities of the administration. Administration support is required to make all the above-mentioned design requirements come to real-life day-to-day practice. It is the administration’s role to provide the students and teachers with safe educational environment that enhances the achievement of effective lecture. Administration of the university and faculty is responsible for determining hiring and contract renewal criteria that recruit and keep only qualified teachers, establish and activate students’ complain system, and open effective channel of communication with the students to keep updated with their satisfaction and achieving the effective lecture they are requiring, availability, and effectiveness of teaching and learning infrastructures, and support the auditing activities of quality unit and monitoring the effectiveness of corrective plans.

Controversial to the concept of private universities owners, infrastructure and resources came in the last priority of operational requirements. It could not be claimed that infrastructure and resources are totally least important. Properly lightened and well-ventilated classrooms with comfortable seats, internet access, and suitable audiovisual tools are with no doubt tools that can play a role in effective lecture. Physical therapy program resources such as models, mannequins, and devices are extremely important for an effective lecture. What could be said is that infrastructure and resources are secondary important requirements for effective lecture, whereas other factors such as the qualification and training of teachers, adherence of teachers to IPPs, and quality auditing system are primary requirements.


  Conclusion Top


Students’ perspective is an important source of information regarding the effectiveness of educational activities including lectures. The main students’ requirement, as main customer and to the lecture, is qualified teachers who communicate with students through a bridge of trust. Application of QFD showed the following five operational requirements, arranged in descending order according to the priority of importance: effective internal and external quality audit, adherence to qualified teaching and learning IPPs, recruitment and training system for teachers, supportive administration, and availability of proper infrastructure and resources. The implementation of these five operational requirements would result in achieving the effective lectures and satisfying the students.

Limitation of the study

Because the study topic is linking between the quality tools in higher education and effective lecture, which belongs to medical education issue, the available references were limited, especially those related to studies in Egypt or Arab universities.

Recommendation

The researcher recommends that the administrative body of the physical therapy program at MTI University adopt the results of this study and start to implement the first phase as continual improvement plane and measure its effectiveness to improve the lecture and satisfy the students.

Acknowledgements

Researcher expresses great thanks for the professional diploma of quality and accreditation management systems in educational institutions, Ain Shams University, which offered the researcher with the scientific knowledge and information that enabled the researcher to conduct this study. The researcher also thanks the students who participated in the study and inspired me to complete the study. Great thanks for the consultants who kindly participated in the brainstorming group.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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