Online Learning: Preparing For The Future
Professor Morag Gray, Head of Curriculum Development, Faculty of Health & Life Sciences, Napier University highlights some of the workforce development benefits that online learning affords…
The NHS in Scotland is facing unprecedented change and as a result is aiming to transform the existing models of healthcare (Scottish Executive 2004a). The transformation of the current models of healthcare delivery will involve the creation of new roles and new ways of working.
In order to meet the above needs and demands it is imperative that not only existing services are redesigned and delivered in new ways but also that there are sufficient numbers of appropriately trained and educated healthcare professionals (RCN 2004; Scottish Executive 2004a, Scottish Executive 2004b, Scottish Executive 2004c, Scottish Executive 2004d).
Education is crucial to any role development and is a continuous process. Indeed Malcolm Chisholm, the Minister for Health & Community Care stated in the forward to the Scottish National Workforce Plan 2004 Baseline (Scottish Executive 2004b) “one of the key issues is the way healthcare professional roles are changing and developing. This questions the way we have traditionally thought of the healthcare professions and the boundaries between them. The challenge is to reconceptualise how we think of clinical teams, support people adequately and safely to fulfil new roles and continue to value core skills and contributions of individual professions.”
There are a number of factors acting as drivers for role development. These include the working time directive reducing the length of the working week ending the resident on call system; a reduction in junior doctors’ hours; skill shortages; remote and rural issues, the Out of Hours and Hospitals at Night agendas (Mahon et al. 2005). To comply with the working time directive regulations by 2009, there will be insufficient doctors across all grades to provide care 24 hours a day, 365 days a year in every locality and unit that is in operation today (Scottish Executive 2004c).
With the reducing in junior doctors’ hours and the new consultant contract, there is a also a shift towards all professional groups and healthcare agencies working much more collaboratively (NES 2004). Moreover, from the 1st of April 2004 the way in which Primary Medical services changed allowing the development of ‘Out of Hours’ care. This too requires new and challenging ways of working and effects in particular, Nurses, Midwives, Paramedics, Pharmacists and Allied Health professionals (NES 2004). {mospagebreak}
Healthcare professionals operating in integrated multi-professional teams are now increasingly undertaking work that was once the sole province of medical staff or doctors in training. With the Scottish Executive’s plans to promote new ways of working to deliver more effective patient centred care which is better value for money there is an obvious and urgent need for healthcare professionals to be educated and trained so that they can fulfil these new roles safely and efficiently.
Again this is acknowledged by the Scottish Executive (2004b: 56) when they state, “these shifts in responsibilities and duties must be reinforced and supported by the professions, regulatory developments, suitable training and development and ongoing clinical governance.” Since the largest group of healthcare professionals are made up of nurses, midwives and health visitors, the impact of new ways of working and new role developments will be on these groups.
It is therefore strongly evident that education, training and career development are crucial to meet the health needs of Scotland’s population. Indeed research has demonstrated that high patient: qualified nurse ratios and adequate levels of professional education preparation has positive effects on patient outcomes (Scottish Executive Health Department 2004). Whilst the thrust of the Scottish Executive’s polices highlight new ways or working and new role development, it is also acknowledged that all healthcare professionals have a duty to remain up to date and therefore engage in lifelong learning. All professionals must undertake some form of continuing professional development in order to maintain their registration with their respective professional body.
Challenges of meeting learning needs
There are however a number of challenges associated with meeting the learning needs of healthcare professionals. Due to staff shortages and increasing work pressures it is very difficult for staff to be released from the workplace to attend traditionally classroom-based courses. Therefore education opportunities for staff must be flexible and accessible to all. For the last 8 years the Faculty of Health & Life Sciences at Napier University have increasing been offering undergraduate and postgraduate learning opportunities in a paper-based and online format to allow students to access and pace their learning at a time, place and pace that suits them as an individual and their own personal and professional commitments. This mode of delivery particularly benefits those who would otherwise find difficulty in accessing learning opportunities because of employment, time, location, family or other constraints on participation in full-time post-graduate education.
Online, blended of e-learning?
In recent years, the Scottish Executive, the UK Government Department for Education and Skills (DFES), and the Scottish Further and Higher Education Funding Councils have instigated strategies to support the provision of life long learning through eLearning initiatives. The consequent need to provide continuing professional development opportunities in eLearning has been documented in a number of recent industry, education and Government reports and policy initiatives. Agencies such as the Scottish Executive Health Department; Scottish Executive; Royal College of Nursing; NHS Education for Scotland; and the Department of Health have determined to transform healthcare delivery through the creation of new roles and new ways of working which is premised by the fundamental requirement for suitable training, education and professional development.
In the last two to three years there has been an increased demand for online learning or blended learning opportunities. There are a number of terms used which could usefully be defined here. {mospagebreak}
Online learning is the use of the Internet, particularly the World Wide Web, to support teaching, learning and assessment. Blended learning uses of a combination of online, flexible and face-to-face teaching methods to provide learning materials, student support and assessment. By e-learning we mean the use of communication and information technology to support teaching, learning and assessment.
By using information technology, healthcare professionals’ learning experience will be enhanced and furthermore it will ensure equity of access of educational opportunities to all regardless of geography; work and shift commitments or home circumstances. Access to education and training will increase the knowledge and skills of healthcare professionals so that they remain fit for purpose in the rapidly changing environment of the NHS and healthcare generally.
Being able to access high quality learning experiences regardless of location or time is imperative to the needs of both healthcare providers and the recipients of their care. Recognising the difficulties in healthcare professionals accessing traditional classroom based education the Scottish Executive (2004a:24) have stated that “education programmes to support role development should be flexible, cumulative, largely work-based and give academic credit for learning gained in practice.” Time, family commitments and shift patterns are all significant barriers.
Online learning is one of the most accessible and allows students to access and pace their learning at a time, place and pace that suits them as an individual. Modules delivered in this way should be interactive so as to allow students to work through problem-solving scenarios so that they can learn from the consequences of their decision making in a safe environment. In this way learning is enhanced without adversely affecting an organisation or its patients.{mospagebreak}
The added advantage of engaging in online or blended learning is that transferable skills are also be developed and in particular information technology skills. This is especially important in healthcare as the national programme for IT (NpfIT) (DoH 2004) aims to improve the quality and effectiveness of care by ensuring the right information is available at the right time and in the right place. This means that healthcare professionals require fundamental skills in accessing information using information technology. Nurses in particular lag behind others in these skills so by providing quality learning experiences online they will be supported whilst they not only learn new knowledge and skills directly related to their role, they will also improve their IT skills experientially.
Conclusion
The largest employer in Scotland is the NHS. The nursing and midwifery workforce in Scotland is vital to the delivery of effective care to the people of Scotland. Nurses and Midwives are ‘front-line’ practitioners, delivering services designed to meet people’s health and healthcare needs across the spectrum and in all communities of Scotland” (Scottish Executive Health Department 2004:2). “Improving the health of Scotland and reforming how healthcare is delivered depends on effective leadership at all levels of NHS Scotland. Developing the leaders of today and tomorrow will be crucial in delivering the ambitious goals that have been set for the health service” (Scottish Executive 2004d:3).
The provision of learning opportunities through online and or blended delivery methods benefits individual practitioners, and recipients of healthcare (patients and clients) and organisations seeking to acquire and develop skills in the workforce who are delivering healthcare. Education designed to meet expressed learning needs facilitates individuals to extend their body of skills, knowledge and understanding thereby their development as highly competent and reflective professionals, so that through their lifelong learning they remain fit for purpose in the rapidly changing environment of the NHS and healthcare generally.
References and Further Reading
– DoH (2004) National Programme for Information Technology: Making IT Happen. London, Department of Health.
– Mahon, A., Carr, S., Lowson, K., Carr, L., Chaplin, S., Wright, D. (2005) The Implementation and Impact of Hospital at Night Pilot Projects: An Evaluation Report. London, Department of Health.
– NHS Education for Scotland (2004) Out of Hours: Mapping and supporting new roles for practitioners in unscheduled care. Edinburgh, NHS Education for Scotland
– Royal College of Nursing (2004) The Future Nurse: The RCN Vision. London, Royal College of Nursing
– Scottish Executive (2004a) Framework for Developing Nursing Roles: A Consultation. Edinburgh, Scottish Executive.
– Scottish Executive (2004b) Securing Future Practice: Shaping the New Medical Workforce for Scotland. Edinburgh, Scottish Executive.
– Scottish Executive (2004c) Scottish Workforce Plan 2004 Baseline. Edinburgh Scottish Executive.
– Scottish Executive (2004d) NHS Scotland Leadership Framework: Consultation Draft for NHS Scotland and Partner Organisations. Edinburgh Scottish Executive.
– Scottish Executive Health Department (2004) Nursing & Midwifery Workload and Workforce Planning Project Edinburgh, Scottish Executive.
