Barriers to E-learning for Health Professionals and Students: Identifying Solutions Dr Graham Walton, Research Fellow Human Information Behaviour & Competences For Digital Libraries Libraries in the Digital Age: 25 th -29th May 2004, Dubrovnik and Island of Mljet, Croatia

Introduction E-learning and evidence Various roles of learning resources in e-learning HeXL project Illuminations from HeXL Conclusion

What is e-learning? E-learning is concerned with using digital technology to provide- learning content and support services. By making learning more accessible, and freeing learners at all levels to study in their own time and at their own pace, e-learning can enhance and add value to more traditional forms of learning. E-learning is not just about online courses. It can provide a wide range of services for both learners and tutors, including access to resources, information and advice. E-learning can cut down on administration, and help plan, record and track learning and development activities (NHS University, 2004)

E-learning and evidence ‘Learning and teaching strategies …will some need to be re-written and will need to give much greater attention to e-development and support. We need much more research on all of this’ Time Higher Education Supplement, 23 rd April 2004, p. 16

Importance of evidence in e-learning Need to make informed decisions In Western cultures, move to link policy, research and practice (to ensure accountability and validity) Need answers to questions (is it cheaper, is it more effective, what’s it like for the student?)

Characterizing the evidence in e- learning Influence of ‘evidence-based medicine’ on ‘evidence based practice’ Cultural impact of rigid hierarchies where experimentation/ randomised control trial is at top Need for qualitative approach Implications of the evaluators of e-learning also being the people who ‘do’ e-learning (Oliver, M. and Conole, G. (2003) Evidence based practice and e-learning in higher education: can we and should we?)

Various roles of learning resources (and learning resources providers) in e-learning Skills development Resource provider Study environment Support Intellectual property Multi-disciplinary team member Evaluator

HeXL project Funded by the NHS Tyne and Wear and Northumberland Strategic Health Authority Overall aim to identify barriers to effective e-learning in NHS and process to overcome barriers Look at e-learners at all levels and in various locations Project ran from May 2003 to May 2004

HeXL project: methodology Semi-systematic review of the literature on barriers to e-learning (161 references) Barriers grouped under 8 broad areas (organisational, economic, hardware, software, support, pedagogical, psychological, skills) Literature used to generate questionnaire for health e-learners Semi-structured interviews (based in questionnaire focus) with 13 key informants at national level

Total number of questionnaire respondents Medical 11 (7%) Nursing and Midwifery 17 (12%) Allied health professional 17 (12%) Health care scientist 1 (1%) Admin and clerical 27 (18%) Ancillary 65 (44%) Estates 0 (0%) Paramedic 0 (0%) Other 9 (6%) Non responses 2 (%) N 149

Workplace for questionnaire respondents

Study details of respondents

Effectiveness of e learning Key: 1 = Strongly Agree 2 = Agree 3 = Disagree 4 = Strongly Disagree (n 149)

Role of learning resources in skills development Survey: My e-learning would be improved if I had training on how to use IT effectively (16% strongly agreed, 62% agreed) Survey: My e-learning would be improved if I had training on being an effective e-learner (19% strongly agreed, 62% agreed) Survey: I have had training on how to be an e- learner (60% disagreed, 18% strongly disagreed) Quote: ‘It’s the study skills that underpin the success of any e-learning’

Role of learning resources in resource provision Quote: ‘There is a need to make sure that the links and the pdf files are all updated and, the links are working’ Quote: ‘One of the challenges is that you’ve got learning platform A, you’ve got learning platform B and potentially C is developing its own platform. That’s not helping the end user at all’ Survey: My e-learning would be improved if my e- learning was mixed with other learning methods (20% strongly agreed, 62% agreed)

Role of learning resources in support Quote: ‘We have something called ‘Fearless Friday’ so they can come in and have a supported practice test’ Quote: ‘Residential and domiciliary staff tend to be older, they tend to be part time, they tend to be people who aren’t traditional computer users’ Quote: ‘ If they don’t have skills, they’re not left on their own…we do have someone who can help’ Quote: ‘ e-learning is improved when there is a named person who can help when I have problems with the software’ Survey: Some people are resistant to using computers (14% strongly agreed, 64% agreed)

Role of learning resources in multi- disciplinary team Quote: ‘Often an IT department has its own strategy and that may not blend well with the training department’s strategy’ Quote: ‘I think it is necessary for some people that I work with who do need face to face teaching, who do need pastoral support’’ Quote: I think you’ve got to have both staff that are delivering it, staff who are supporting the-learning and committed students that are undertaking it’

Role of learning resources in evaluation Learning resources staff have long experience in ‘blended delivery’ and its impact e-learning management information systems have been part of decision making process in learning resources for many years Qualitative evaluations have high status in learning resources (e.g. impact studies) Learning resources are in close proximity to the e- learner

Conclusion HeXL gives some evidence on role of learning resources in e learning HeXL indicates that e-learning is seen positively as learning method by health workers Still many questions regarding learning resources where answers are needed What are the the range of e sources used by an e learner? To what extent is group e-learning valued as well as individual e-learning? What will be the impact of e books and how will they be used? How are e-learning skills best acquired and delivered?

URL for HeXL project