Elearning

Elearning: the solution to the NHS’s training shortfall?

A recent study, conducted by researchers at the University of Nottingham and the School of Pharmacy at the University of London, revealed massive gaps in the consistency of training that junior doctors receive on the correct procedures for safely administering drugs to children.

The study, Co-operative of Safety of Medicines in Children (COSMIC), found that children were estimated to be three times more likely to suffer a prescription error in hospitals than adult patients. This is due, in large part, to dosage guides being based on adults, whereas children’s dosages have to be calculated individually. But that’s not the only problem.

The study discovered that the most common training method in use at hospitals is a brief 30-60 minute presentation to junior doctors during their induction, usually in a lecture style format, with little to no hands-on training. Moreover, only three of the 319 medical institutions who responded to the questionnaire actually test doctors before allowing them to prescribe to children. Beyond that, few centres assess competency, let alone test it.

This is an extremely disturbing discovery and one that raises a number of issues. Not only should more comprehensive training be given, but doctors should have to demonstrate competence before dosing children.

Much of the problem lies in the fact that our doctors and nurses are already stretched and it is difficult for them to find the time to keep up to date with the latest thinking and techniques. It is especially difficult to find the time to get off-site or to lengthy training courses. The challenge is to ensure that medical practitioners are receiving all the training they need and, more importantly, have understood it and can put it into practice to a high standard.

That being said, the NHS has initiated a programme to embrace learning and development technologies; and this revelation about lack of training in the prescription of drugs to children certainly provides evidence of the importance of this initiative. In fact, a 2007 report prepared by the National Director of Education and Training for the NHS (eLearning and NHS Connecting for Health: an Overview) recognised the importance of embracing and developing elearning solutions as imperative to the future of the NHS, its staff, and ultimately its patients.

Elearning is no longer in the experimental stage and it has been proven to be an excellent way of rapidly and efficiently delivering a high level of training to dispersed workforces. Furthermore, the considerable advancements made to elearning solutions in recent years means that this training gap can be addressed quickly and efficiently using tools already in practice within the NHS

In the past, one of the biggest barriers to successful elearning was that the output was typically very flat, unengaging, and thus ineffective. Today, by contrast, anyone can put together content rich programs that captivate users. And, more importantly, allows users to interact with the lesson, be assessed by the program, and provide feedback. All of which can be done on-site or remotely, at relatively low cost.

Part of the reason the new wave of elearning has become so successful is because of the general acceptance of certain file formats, especially online, such as Adobe’s Acrobat Reader and the ubiquity of the Flash Player, which already is installed on 99% of web browsers worldwide. This allows managers (or anyone) to build lessons with the confidence that employees will be able to participate in them from wherever they are and whenever they can.

But quite apart from the overall accessibility of elearning, the new software that is available for authoring content is the most powerful and easiest to use yet. And, herein lies the real opportunity for the future of elearning in the NHS: being able to tailor lessons to specific groups, or even individuals, then tracking their progress, and updating content as often as is necessary, which provides total control throughout the entire process.

The technology is so simple and intuitive to use that you do not need technical expertise to put an effective curriculum together; all you need are some basic PowerPoint skills, a microphone (should you choose), and some time. Elearning packages will take care of everything else: publishing your lesson, training course or update on impending legislation for live or on-demand access by whomever within your trust or practice should require it.

These developments have been noted in the elearning overview by the NHS Connecting for Health report. It recognises that face-to-face training is time and place restrictive, often requiring problematic rearranging of staff work schedules, and argues that elearning offers the solution by allowing people to access the material they need when it is more convenient for them, which has the added benefit of making it a more personal process from the very beginning.

The potential cost savings to the NHS makes elearning a very compelling option for training staff. While there is an initial cost of setting up training schemes, the overall savings from virtually free maintenance and updating, and reduced redundancy across the system, make it a more viable training solution than most traditional methods, especially when considering the scale on which the NHS has to support.

This strategy is already in use at the British Dental Association (BDA), who employed an elearning program to train dental nurses at their place of work. The nature of their jobs, like that of junior doctors in hospitals, is such that they can’t set aside large blocks of time for out-of-office training. But with elearning programs, the BDA has been able to rapidly increase the number of nurses trained to take x-rays.

The new generation of elearning technologies will enable the health service to create and deploy truly engaging and interactive content that transforms passive viewers into active participants and maximises the learning experience, wherever they are. Moreover, they provide for immediate assessment and follow-up, enabling the NHS to ensure that medical staff have truly understood the content and are competent to practice.

In light of recent reports concerning the lack of training given to young doctors on the dangers of prescribing to children, and given the potential of a comprehensive elearning, it would appear as though the NHS has already found the solution to its problem. The tools and resources are there; all that remains is for the NHS to put this plan into action.

Ian Cockerill, Director, Public Sector, Adobe Systems