An e-learning tool, funded by NHS South Central and written by medicines information pharmacists, was launched in March 2009. We take a look at how it came about
In recent years the internet has opened up new and convenient ways of delivering education and training. The NHS is starting to pick up on this trend, with strategic health authorities — and individual NHS trusts — developing their own approaches to “e-learning” as a means of training staff, with varying degrees of innovation and success.
But as with much in the health service there is a danger that good work will be duplicated by colleagues in nearby trusts.
NHS South Central has been trying to prevent such replication of effort by developing e-learning that all trusts on its turf can use. An e-learning tool looking at compatibility of injectable medicines has gone live.
The pathfinder project has been managed by NHS Education South Central (NESC) — the SHA’s education and training arm — and the tool itself, written by a pharmacist and tested by nurses, is the kind of collaboration that gives multidisciplinary working a good name.
Designed primarily for nurses, it provides interactive education on the basic concepts around compatibility of injectable medicines — and finishes with a set of eight randomly selected multiple-choice questions to test participants’ knowledge.
Planning
“We are in our infancy at South Central in terms of developing and supporting e-learning on a region-wide basis,” says Alison Wright, NESC e-learning programme manager. “Many of the other SHAs have been doing it for some time.”
She started looking around a year ago at what sort of e-learning was available, or being developed, locally and “identified opportunities to co-ordinate such work at a regional level”.
“One of the outcomes of that work,” she explains, “was a recommendation that NESC should look at a content management approach to e-learning for the region — to see whether we could maximise use of resources.”
When Simon Wills, head of medicines information at Southampton University Hospitals NHS Trust, heard about the SHA’s plans for a pathfinder project he was quick to offer some ideas that he thought pharmacy could help deliver.
“As MI pharmacists we get a lot of calls, mainly from nurses but sometimes from pharmacists and doctors, about mixing injections in the same syringe, the same bag, the same line,” Dr Wills explains.
He believes that many such queries are fairly straightforward for pharmacists but not necessarily for other colleagues.
His proposal of a module on IV compatibility was one of several ideas put forward for consideration and, along with a package on critical evaluation of clinical evidence (see Box below), it received funding as a pathfinder project late last year.
“We wanted something that’s short, practical and relevant that a relatively large number of people would want to use — not a niche subject,” Dr Wills adds.
Critical appraisal of clinical evidence
|
There was a lot of support for medicines management-related topics from the SHA’s e-learning task-group, Ms Wright points out. It also happened to link in with a peripheral line training project, led by Eleanor Guegan (née Woodford).
Dr Guegan, who is research fellow in healthcare-associated infections at NESC and formerly a hospital pharmacist, explains: “We are looking at improving the education of staff about peripheral line insertion and continuing care. I am also part of the NESC e-learning task group.”
She continues: “I think it is useful to have e-learning as part of a blended learning approach. It is good for multidisciplinary working as well.”
She expects the tool to be particularly handy for nurses to update their understanding before they attend study days or as part of IV training days.
“Although hospital pharmacists are usually available for advice,” Dr Guegan suggests, “it is also good for nurses to have a knowledge base, understanding and realisation of the clinical importance of incompatibility issues. This has important consequences for patient safety.”
Although the resource is designed primarily for nurses, she believes it is also suitable for e-learning by pharmacists and junior doctors.
“It is certainly useful for nurses on the ward because they can dip into an e-learning program for half an hour, rather than having to be absent from the ward for half a day.”
 |
| A screen shot of the e-learning tool |
 |
| A screen shot of an interactive activity within the e-learning tool |
Development
A lot of time and effort went into making sure the module was not only educational and factual, but also visually appealing (see Figures above), engaging and even (according to feedback from user testing) enjoyable.
“The program is eye catching and fun to use,” Dr Guegan enthuses. “It keeps your interest. Some forms of e-learning are not so captivating.”
There are many standards — for example technical, quality and branding — that need to be considered by the IT developer, explains Ms Wright. “There are many IT companies that produce e-learning,” she says.
“If you carefully select an e-learning provider, rather than just having the technical know-how they understand how best to design interactions and solutions that engage learners online — when to include interactive activities and whether the interaction is the right one for a particular piece of learning.”
Ms Wright explains the importance of making the tool relevant to the user: “You’ve got to know who your audience is in the first place, what learning outcomes you want them to be able to achieve.”
She says that the e-learning provider Sponge has very much delivered to NESC’s expectations.
Dr Wills wrote the material for the resource, which was reviewed by his MI colleagues for quality assurance. He is confident of the skills pharmacists can bring to such a project:
“I’ve thought for a long time that it’s important for pharmacists to try and share with other professions the knowledge they have about medicines.
“Pharmacists have knowledge that isn’t readily available from one source and which other professions — and hence the public, patients, carers — don’t have easy access to. A lot of the time it’s things that we as pharmacists just take for granted that we know.”
Dr Guegan concurs: “Pharmacists — especially MI pharmacists — are ideally suited to developing multidisciplinary educational tools because they have a wide knowledge base encompassing specialised knowledge in pharmaceutics, pharmacokinetics, pharmaceutical chemistry and pharmacology, as well as clinical skills.”
User testing
Dr Guegan arranged for the SHA’s peripheral line training group — a gathering of nurses who deliver IV training at trust level throughout the region — to “user-test” the resource. Feedback from these nurses was extremely helpful to fine-tune the content, she says.
Dr Wills agrees: “It gave us many practical tips around how to present what we had already done in a way that was more meaningful for nurses. For example, sometimes we used terminology that a pharmacist might use, and the nurses picked up on that.”
According to Dr Wills, one of the biggest challenges was understanding the level of knowledge that nurses have on the topic. “I think that coming from a medicines information background where we are answering questions from nurses about this sort of thing all the time, we were kind of in a privileged position and had some feeling for the right level to aim for.”
Nonetheless, Dr Wills had some butterflies: “Even right up to the point of user testing I was a bit concerned that we might not have addressed issues that nurses wanted us to address, or we’d pitched it at too high a level or too low.”
When aiming the training at all levels of nurse experience, from student through to senior nurses, it was difficult to find the right balance, he admits. “But the feedback from user testing is that we’ve positioned the content well.”
