I haven’t been to an NHS conference for many years, but I was surprised by the lack on online activity at the NHS E-learning conference. Is the NHS still in the dark ages? Compared to a higher or further education conference, there was hardly any online activity around the conference. An archive of tweets using the hashtag #NHSel, such as they are, may be found on TwapperKeeper at http://twapperkeeper.com/hashtag/NHSel
Perhaps more seriously, when I returned to work, I found that so many of the projects and tools demonstrated wouldn’t work. I cannot access the National Learning Management System (NLMS) nor the e-learning repository. I suspect that this lack of access is actually very widespread.
The agenda for the day and most of the presenters’ slides are available at: http://www.londonlinks.nhs.uk/2011-events/feb/london-nhs-elearning-conference-2011/
Welcoming delegates, Richard Osborn, Strategic Library Services Development Manager for NHS London, announced that the London ten-point e-learning strategic direction, which at the time of writing only exists currently in paper form, but will be online soon, was out for consultation, and included in delegates' packs . He also mentioned the London e-learning SharePoint site https://www.portal.nss.cfh.nhs.uk/sites/connlearn/eldev/london. The themes of the day were to be promoting national initiatives, collaborative working and sharing good practice and innovation and he promised us an exciting announcement in the afternoon from the National Strategy for Technology Enhanced Learning.
Julia Moore, the keynote speaker from eLearning for Healthcare, http://www.e-lfh.org.uk/index.html, was delayed by a road accident so the first presentation was Kate Lomax on the Elearning portal at http://www.e-learning.nhs.uk, which replaces an old repository. Kate won support for a proposal to Strategic Health Authorities for a new gateway to national and local resources and showed us mock-ups of the new site, which should be live in a couple of weeks. She showed us a slide, traditional in any presentation about repositories, of the street name sign of Repository Road in Woolwich. One can browse the repository by Mesh and by NHS Knowledge and Skills Framework (KSF) headings. It will also link to Sharable Content Object Reference Model (SCORM)-compliant material on the National Learning Management System (NLMS), and Creative Commons licensing material is given for each resource. There is also an e-readiness toolkit http://www.elearningreadiness.org/ and a developers’ network at https://www.portal.nss.cfh.nhs.uk/sites/connlearn/eldev/default.aspx. Kate announced a workshop in the near future on intellectual property rights and e-learning. The e-learning team are on Twitter as @nhselearning
Kim Churchman and Jo Sidebottom from Chelsea and Westminster presented a case study of implementing OLM e-learning (as far as I can tell this seems to be synonymous with the National Learning Management System). They went through the way they mange the project and made an intriguing mention of subject matter experts; I wondered if she meant librarians here, speculation encouraged by Richard Osborne’s exhortation, after questions to Kim and Jo, to involve librarians in e-learning projects. They rebranded their system as Learn Online. With hindsight, they felt that they needed a larger and longer pilot phase. I would have liked to have known more about the use made of the e-learning tools and what sort of levels of take-up they had. In fact, it was hard to tell exactly what stage in the project they had reached.
After coffee Julia Moore gave her keynote speech, on the Mitfordian theme of E-learning in a cold climate, and quoting Dylan and Harold McMillan. I’m not sure I entirely accept her version of recent African historiography, but she gave a good overview of where e-learning is going in the NHS. E-learning needs to be grasped very quickly, she said, which indicated to me that take-up so far hasn’t been that successful or widespread, in contrast to higher education. She mentioned the drivers of patient safety, quality and above all, enormous pressure on budgets and the consequent strain on care, services and training. She showed the effective learning pyramid (a rather over-schematic view of learning in my view) and suggested that e-learning could support learning at four of its seven levels, by reading, audio-visual materials, demonstration and simulation, and discussion.
E-learning for healthcare started in 2007 as a partnership: the Department of Health funds, and professionals lead the projects, building syllabi, validating and maintaining courses. Fifty-three projects have had approximately 3,500 sessions. All tools are reviewed on a four year cycle (a period she justified by analogy with textbook development, though I would like to see some evidence that textbooks are, on average reviewed with that sort of frequencies). Julia made the point that e-learning educates trainers too: preparing and managing materials requires them to review, and possibly improve, their own skills and knowledge. The powerful in trusts and in commissioning bodies need to be convinced that e-learning must be embedded everywhere.
Then she showed us clips from some of the learning tools, including a dental consultation and an extract from a session on putting on an eye drape from the Royal College of Ophthalmologists e-learning site, Eye Sight http://www.e-lfh.org.uk/projects/eyesite/index.html
Case studies show real savings to trusts, for example a sexual and reproductive health module on long-lasting contraception at http://www.e-lfh.org.uk/projects/e-srh/index.html is estimated to have saved the NHS £7.9 million a year by abolishing a four day face to face course for an investment of £250,000, and won a national e-government award.
Finally she showed us a video from the medical leadership module of a patient talking about a situation where everyone knew his diagnosis but him. She suggested that take-up might be a generational issue. I have to disagree; there are ancient enthusiasts for e-learning and youthful technophobes and no even distribution by generation. As someone suggested in the tweets, the generational argument can sometimes be an excuse for inaction.
In questions, people raised issues of access to these materials, and asked whether they were available with Creative Commons licences? I think the answer was that they are freely available through the NLMS but, given the access problems I mention below, this is far from universal, and certainly doesn’t work for users in higher and further education. Other questions included whether employers could see an individual's data (the answer is no).
Lisa Gilks and Alison Pope told us abut the West Midlands Mandatory Training Passport, which covers ten core subject areas and, having been taken up outside the West Midlands, in NHS South Central, NHS London and NHS Cheshire and Merseyside, allows all staff to move from employer to employer, taking with them an electronic record of their learning. They have found some lacunae in national content, or some areas where nation content was unsuitable for local needs. It is also integrated with NHS local: http://nhslocal.nhs.uk/ in what they call an ecosystem, which seems to mean they can embed content from Facebook, etc. They will be running junior doctors’ induction with this in August 2011, and the content will be uploaded to Electronic Staff Records. Is it a physical passport, they were asked? No, but staff can print-out certificates. Again, the lack of universal take-up of the Electronic Staff Record renders the passport less portable.
Nancy Davies from the University of Leeds ALPS (Assessment and Learning in Practice Settings) http://www.leeds.ac.uk/medicine/alps.html project was, for me, the most interesting and engaging presentation of the day. ALPS takes off where the mobile learning project I was involved in at Brighton and Sussex Medical School (BSMS) finished. The BSMS project used Palms; Leeds, after a redesign of their medical curriculum to include technology enhanced learning, are using iPhones to help students become better doctors and support their learning while on placements. The content comes through the same intermediary we used at BSMS, Medhand, and includes Oxford Handbooks and the BNF. Students are given unlimited broadband, and pay-as-you-go voice and text; they can port their existing mobile number to the iPhone. They need no longer print thousands of pages of assessment forms.
A big advantage is that the iPhone is perceived by students as a highly desirable object; moreover, there’s lots of high-quality medical content in the App Store, the handhelds are easy to use and pose less of an infection risk than other mobiles. The use of an e-portfolio accustoms tomorrow’s doctors to recording their CPD. The project has experienced some resistance. Some student fear they will be perceived as using it for frivolous purposes, that supervising consultants or GPs might think they were texting when using them for educational purposes. The future of the smartphone market is uncertain, but ALPS’s next step will be to develop content in iTunesU and build an interface with the Leeds VLE, Blackboard.
As the last act before lunch., Suzanne Hardy and Lindsay Wood of MEDEV presented the PORSCHE project Pathways for Open Resource Sharing through Convergence in Healthcare Education, http://www.medev.ac.uk/ourwork/oer/, an engaging reminder of Medev’s inimitable way with acronyms Suzanne pointed us to a recent blog post form Nottingham http://blogs.nottingham.ac.uk/learningtechnology/2011/02/08/it-turns-out-that-oer-does-save-time-and-students-do-use-them/
One of the advantages of sharing resources for students on placement is that it helps ensure quality of access to materials for students on placement. Please, Suzanne asked, make permissions clear and explicit. Lack of clarity is a major barrier to reuse. In HE, the way it works is well-understood, with an example of Suzanne’s rather handsome cat. They are working on ways of storing consent with a learning object, which MEDEV dub the Consent Commons.
For further reading:
http://www.nottingham.ac.uk/xerte/
http://www.nottingham.ac.uk/xpert/attribution/
http://openattribute.com/
http://www.medev.ac.uk/oer/resource/add/
http://openeducationalresources.pbworks.com/
http://www.elearningreadiness.org/
http://stemoer.pbworks.com/w/page/6799480/User-Guide-to-OER
http://www.timeshighereducation.co.uk/story.asp?sectioncode=26&storycode=415115&c=1
http://blogs.unbc.ca/open/2011/02/03/finding-and-using-open-educational-resources/
Lindsay then presented their OER good practice self-assessment toolkit, covering consent, pedagogy and technology, and allowing content creators to put materials in many places, for example Picasa and YouTube. They’re looking for beta testers: contact Lindsay to enrol.
Questions centred on consent and the difficulties of the NHS, where someone cited the problem of establishing the ownership of the intellectual property in X-rays and MRI scans,
After lunch Stuart Carney, the Technology Enhanced Learning strategy lead at the Department of Health by day, and a psychiatrist by night, spoke on the national strategy for technology enhanced learning, due to be published in June or July, postponed from April. He drew our attention to paragraph 5.9 of Equity and Excellence: Liberating the NHS which proposes that ‘NHS services will increasingly be empowered to be the customers of a more plural system of IT and other suppliers’.
The principles of the strategy will mean, among other things, that there will be a great use of simulation, that there needs to be research into the effectiveness of e-learning and that local initiatives like those of NHS London need to be maintained, as will the national repository. Stuart was keen that there should be equity of access and that groups of staff who may not normally have access to computers should be able to benefit from TEL. He quoted the figure of eighty different videos on hand-washing in trusts up and down the country. One tweet questioned whether there was any evidence for this figure. The TEL strategy will inform Health Education England’s funding allocations for education and training. I looked in vain for the strategy consultation online at the Department of Health and at Connecting for Health.
Peter Milford gave a progress report from the Core Learning Unit, again something I don’t seem to have access to locally. They have twenty-one packages and make up 50% of NLMS completions; they include packages on literacy and numeracy as well as infection control, child protection, immunisation and trips and falls. Curiously, in response to a question about releasing SCORM files, he told us that the DoH forbids any work on interoperability
Finally, a series of lightning presentations:
- John Ashton presented on NAMDET, the National Association of Medical Device Educators and Trainers
- Cat Oxley showed us GOLD, Great Ormond Street’s e-learning platform using social media https://www.goshgold.org/
- Sian Aynsley of the Clinical Librarians and Information Skills Trainers (CLIST) showed us their website
- Rajah Habib, like me a former sufferer under the South Thames College yoke, showed us what he’s doing with e-learning for the London Ambulance Service. No one, he told us, can agree on how to stick a plaster
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