E-learning

Reducing cost in the delivery of statutory learning

The UK health service (we refrain from calling it the NHS, as it decomposes into smaller component parts) employs approximately 1.3 million professionals, of which around half are clinically qualified in some form or other. Regardless of individual focus, there are growing requirements for mandatory or statutory training in vast numbers of staff, with increasing pressure on training budgets. As statutory or mandatory training grows, it has the potential to block provision of specialised training designed specifically to enhance individual performance. In truth, regardless of the idealist position that we should provide all of the mandatory, statutory and individualised training necessary to enable a person to be both compliant and effective, cold hard financial reality dictates that we must make choices. As the statutory and mandatory burden grows, so the specialist training must dwindle in order to balance both books and time.

Understanding the statutory/ mandatory burden

Employers are required to provide certain training, mainly driven by the Health & Safety at Work Act 1974 and aimed at ensuring that all employees are fully aware of issues related to safety of both themselves and others. Table 1 is an example analysis of requirements (based on an actual analysis).

All of that training requires time to be devoted, budgets to be expended and stringent records to be kept and this is before the job specific training requirements are addressed, such as maintaining clinical knowledge and skills.

Key challenges in training

Traditionally, there has been a heavy reliance on classroom-based training. Regardless of effectiveness, this form does have inherent problems, predominantly a disproportionately high cost of delivery and significant time away from the workplace coalface. Reduced hours and tighter clinical commitments result in doctors particularly struggling to be released for learning. Trying to co-ordinate groups of doctors is a significant challenge in its own right. However, the problem is not just medical. Nurses have even more limited budgets and just as many scheduling problems. The continuous nature of healthcare means that it is almost impossible to train a whole team at the same time, resulting in fragmented training across multiple sessions, increasing cost and reducing effectiveness.

Financial constraints have had other detrimental effects on training, especially in the growth of in-house programmes. In the interests of providing training, many Trusts run low cost in-house programmes using internal staff as the key deliverers. Although migration of internal expertise throughout a team is to be commended and vital, there is a danger that training quality is limited to the knowledge base of the person delivering and any gaps therefore remain within the system. Furthermore, bringing external knowledge, skills and perspectives into the workplace is an important component of a strong development process.

Reducing the financial burden of statutory & mandatory training has a two-fold benefit:

Improved financial stability
Greater resources to devote to performance enhancing training

The carrot is clearly there but the question remains as to whether we have the right pot to cook it in.

Naturally, great interest has been expressed in the use of e-learning. E-learning certainly has the potential to overcome many challenges facing training departments in an era of financial famine. However, benefits go much further than simply reducing cost.

The e-learning era

Jim attends a 1-hour classroom-based training session on aseptic techniques. He needs to conduct this training annually as a statutory training requirement of the job he fulfils. On arrival, he registers and then sits for the hour session, particularly interested in a police helicopter that seems to be circling the local area. At the end he collects a certificate, signs the register again to show he stayed throughout and goes about his way for another 12 months. Both Jim and the Trust have complied with their statutory requirements but the outcome is not a good one. The Trust can only establish that Jim was there, not that he learned anything. E-learning can improve this in three ways:

A forced process can ensure that Jim moves through all of the necessary content
An evaluation can assess whether Jim learned and can apply his new knowledge
Feedback based on the evaluation answers can fill in the gaps, even then re-testing until such times as Jim has passed the acceptable standards set

The key difference here is in the true goal of the statutory training. The Trust seems to have made ‘compliance’ their goal whereas the true goal is safety. The e-learning approach is likely to lead to much greater safety, as well as meeting compliance requirements.

E-learning needs to improve

E-learning is not without its own challenges. Much e-learning is based on pages of text on screen and this does not constitute good adult learning practice. Consequently, e-learning has earned itself a poor reputation for impact and led many to believe that it simply can’t replace good classroom teaching. We’d certainly agree that bad e-learning is no substitute for good teaching. However, modern technology allows us to deliver classroom-quality learning in an e-learning format. By videoing a good classroom presentation, learners can engage in a classroom-like experience, by viewing slides with a video narrative. This allows the learner to both look and listen to content whilst enabling the teacher to point out the key bits of information to enable learners to get a clear picture of what’s important and what’s not.

Furthermore, e-learning can now be delivered in a blended format, involving downloadable or viewable workbooks, video, podcasts, slides, text documents, tests & exercises and more. The ability to create sensory rich learning improves the ability of e-learning to take on much of the burden of statutory and mandatory training without any loss of impact. In fact, structured correctly, it delivers on impact, timeliness, access and cost-effectiveness goals, allowing Trust and learner to remain compliant whilst also ensuring that the desired outcome of statutory and mandatory training remains the key driver.

Author: Andy Wells BEng Head of IT & Technical Support, Medicology Ltd

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E-learning

Reducing cost in the delivery of statutory learning