Author: Carolyn Gibbon (cjgibbon@uclan.ac.uk), Lindsay McPhail (lmcphail@uclan.ac.uk)
JISC e-Learning Activity Area: learning resources and activities
Higher Education Academy Subject Centre: health sciences and practice
Case study tags: online learning, staff satisfaction with e-learning, a positive effect on recruitment, use of resources, an effect on social equality, tangible benefits of e-learning, university of central lancashire, learning resources and activities, health sciences and practice
Background & Context
Why did you use this e-learning approach?
Diabetes Education Online (DEOL) has been established in partnership with local Trusts to provide accessible diabetes training for health care professionals. The principle aim of DEOL is to facilitate, at local level, the implementation of national policy, in the form of the National Service Framework (NSF) for Diabetes. The philosophy that we have adopted encompasses primarily those theories associated with constructivism. This approach takes into consideration the personal interpretation involved in learning, recognising that experience, past and present, will have an impact, as individuals develop their own understanding of a concept. Yet the very nature of the module dictates that comprehensive access to both literature and policy is made available, providing a framework within which discourse can take place.
What was the context in which you used this e-learning approach?
Diabetes Education On-Line (DEOL) has been designed to assist Health Care Practitioners (HCP) in the implementation of the NSF for diabetes. The course is delivered completely at a distance over the Internet, with WebCT providing the Managed Learning Environment (MLE) within which delivery of the training package occurs. Originally developed to facilitate implementation of the NSF at local level, the program is now accessed by students from across the globe. International students are attracted by the instant access to materials and good communication channels, as they find it difficult and expensive to physically attend this type of course. Whilst the content focuses on the NSF, the international students appreciate the clinical content and its applicability to their situation.
Average numbers of students are between 10-15 for each cohort. One Lecturer provides module leadership and teaching with additional support from a lecturer/practitioner (36 and 18 hours each per module). However, in reality, lecturers may spend up to 60-70 hours in support because of reading the responses in the chat rooms and commenting on posted work.
In response to the increased need for diabetes education for HCPs from the National Health Service, the Department of Nursing within the University of Central Lancashire has developed an educational package addressing the issues identified in the NSF. Key skills for health competencies for diabetes were identified and DEOL content is mapped against these competencies. This classroom delivered module is available to all HCPs and is particularly relevant to practice nurses in their role as key providers of diabetes care in the community.
Subsequently, an increase in demand for diabetes training as a result of the NSF, together with the need to provide broader access to training has prompted the development of an on-line version of the course in conjunction with local trusts. Currently, 20 practitioners, supported by their employer, complete the course each year.
Anticipation of problems- institutional systems of online enrolment and administration were not fully developed at the time of first delivery and some of these systems were developed in response to DEOL delivery as this was the first fully online distance learning course delivered.
What was the design?
The design of the e-learning approach was to build a distance learning course, based on 8 units of learning delivered on a weekly, time released basis. Each unit contains 4 case studies so that when a student completes the module 32 case studies will have been completed. In turn, in a cohort of 10-15 students, there will be at least 320-360 postings that require attention by the lecturer. Yet this design of the use of critical reflection exercises and case study work through discussion board sharing of work by students and responses by the tutor is crucial to the success of the module. The course was structured and designed specifically to enable interaction and learning via asynchronous and synchronous forums. This design utilises the problem-based learning approach and lessons learnt here have helped to inform the development of the B.Sc. Nursing Studies, by e-learning, course.
How did you implement and embed this e-learning approach?
The design was initially discussed with a steering group made up of key stakeholders curriculum development groups and following department procedure for development and validation of courses. Once the learning outcomes and units were agreed, content was finalised, the design was applied to a building process in Dreamweaver and uploaded to WebCT, utilising various University resources, sourced via a Learning Development Unit.
The personnel were a Senior Lecturer in Adult Nursing, a Senior Lecturer in Electronic Learning Technology, a Project Manager, and Associate Head for supervision and executive decisions.
DEOL was delivered to students enrolled after staff WebCT training. The students first completed a specially produced online induction unit and had e-mail and telephone support from the library (distance learning unit), module leader and information system support staff of the University.
Technology Used
What technologies and/or e-tools were available to you?
The technology available is Web CT version 4 (now going to version 6), and this included access to Flash animations to support some of the concepts. The course was built in Dreamweaver. The choice was down to Institutional policy, largely because the software is easy to use, and there was in-house developer expertise. Updating and training continues, with software programmes available, e.g. Course Genie, Breeze.
Tangible Benefits
What tangible benefits did this e-learning approach produce?
'I have enjoyed it very much, it is a lot of new information and is intensive but I have got a lot out of it.' This comment typifies the satisfaction felt by students about the module content, and they were impressed with the level of information and resources and stated they have learnt much about diabetes care (some very good assignments were received which demonstrated meeting the learning outcomes). One student stated that they were very impressed by the web site itself and the way it was constructed and how it encouraged them to think, read and learn. They liked the systems of interaction via discussion board and e-mail and enjoyed the chat room events particularly on a social level. All students found the module challenging to their existing knowledge of diabetes care and practice. Another student noted 'the unit materials were very thorough, the diagrams and graphics were very interesting; I could complete it in my own time.'
Developing animations to explain visually, physiological processes, enhanced student learning and also aided further work in other e-learning courses. This has included the establishment of an 'animation repository', in collaboration with the Learning Development Unit. The processes of development and the animations themselves have been used in SONIC - a FDTL4 funded project.
External examiners, validation panels and service user forums have all commented positively on the e-learning courses and highlighted some as examples of best practice (B.Sc. Nursing Studies, online). Other outcomes have included the development of a Steering Group and subsequent University Strategy for e-learning, engaging other departments including Computer Services, the Library, and Business School. Now there is online library access, and Banner links to WebCT.
Students who have completed the course, indicated in their evaluation forms, that their IT and communication skills had improved, which adds to personal development and transferable skills. One student stated 'as online I could access when convenient to myself as and when I wanted. This benefited me as I had no travelling to UCLan on a day off and hence more time to devote to study'. It is hoped to assess imminently the influence the international students may have on their local practice e.g. the development of strategies at local and national level.
Did implementation of this e-learning approach have any disadvantages or drawbacks?
In the development phase, gaining understanding between academic and technological staff, on occasions was time consuming.
It required extra time of lecturers, more than allocated to module, particularly in chat room sessions (see above). Students were accessing the helpdesk, but not always with success. This has been referred to Library Services.
The module leader observed that the students were not using the discussion board. The module leader decided to re-name the case study exercises with more explanation of discussion boards in the introductory sessions.
Not all the students attended the Chat room events. The Module leader set chat room events in advance of module start and renamed the rooms.
The formative quiz not used, so more explanation of its use and the help available was given by the module leader.
The module leader observed the lack of contact by struggling students. So more explanation of the help available was made, as well as an explanation of in-classroom help.
Student feedback and module leader observation demonstrated that the video streaming server was not working externally (if not got broadband connection and PC spec). Referred to Learning Development Unit and Information Support Services.
How did this e-learning approach accord with or differ from any relevant departmental and/or institutional strategies?
UCLan has a committed e-learning strategy which has been in place since 2004.
http://www.uclan.ac.uk/old/ldu/theldu/ELearningLeaflet.pdf
DEOL has run for 4 years to date and numbers are increasing and is an integral part of the diabetes teaching and learning strategy.
Lessons Learned
Summary and reflection
The Internet does provide fantastic potential for educational innovation, but fundamental to the attainment of this potential is the employment of learning theory appropriate to the medium together with continued evaluation of all aspects of the program. For an educational course to be effective over a period of time, it is essential that it evolve, responding not only to changes in relevant policy and evidence base, but also to findings from evaluation.
Continual evaluation provides feedback that can direct future development of the program and provide insight into the relative strengths and weaknesses of the facilitator. This iterative process of course development is considered to be fundamental in the production of an effective learning package.
'I have found this to be a thoroughly enjoyable course, and feel I have learnt a huge amount, which I hope to utilise within my practice to benefit my patients.' Implementation of the National Service Framework is paramount in the treatment and management of diabetes in England. Education will be a fundamental aspect of the implementation strategy, providing HCPs with the skills necessary to empower patients to manage their diabetes effectively. Employment of the Internet to provide accessible, timely education together with ongoing support via an associated network could help in achieving this goal. Having synchronous and asynchronous discussions of case study work and critical reflection exercises has proved very useful for student learning, knowledge transfer and student/tutor communication.
Further training and resources including staff allocated time may be needed for the future continued delivery, especially in addressing issues such as wider access university strategies.
A final student comment 'I have been at this computer most of the day, I am loving the course but there is so little time'.
Further Evidence
'I have enjoyed it very much, it is a lot of new information and is intensive but I have got a lot out of it'
'As online I could access when convenient to myself as and when I wanted. This benefited me as I had no travelling to UCLan on a day off and hence more time to devote to study.'
'One student stated that they were very impressed by the web site itself and the way it was constructed and how it encouraged them to think, read and learn.'
'External examiners, validation panels and service user forums have all commented positively on the e-learning courses and highlighted some as examples of best practice.'
