Background
Opinions regarding NHS Trust Inductions represent marked divergences between ‘medical management’ and junior doctors. For the Department of Health, the NHSLA, and NHS Trusts, induction is crucial in ensuring that new starters are safe, confident and effective employees . In contrast, junior doctors often see the exercise as ineffective , irrelevant , an example of corporate ‘box-ticking’ and a waste of time . Despite induction’s importance, these impressions and the large quantities of salaried time spent delivering inductions suggest there is room for improvement in current practice .
Recently, several NHS trusts, deaneries and bodies such as e-Learning for Health have developed – or are in the process of developing – e-learning modules related to key induction learning goals. In many cases these have focussed on a small number of core skills, most notably prescribing. Such modules, designed by experts in the subject matter, have generally been well received . But with wholesale change to an e-induction, there is a risk that the main purpose of the implementation may become cost saving; the ‘e-learning’ merely replicating lecture-slide content without the lecturer. So far, the available evidence does suggest that junior doctors are uninspired by online inductions .
In 2008 The North Western Deanery’s Foundation School began a project to cover all key induction topics in a single Virtual Learning Environment (VLE) package, in an attempt to deliver a comprehensive, standardised, and high-fidelity e-induction program to all new F1s in the region. The following is a descriptive account of this venture.
Initial implementation and feedback
The North West VLE (NWVLE) was developed by the Deanery’s NWVLE workin...
... middle of paper ...
...rs. BMJ 2006:7568, Supp p106
Maxwell SR, McQueen DS, Ellaway R. eDrug: a dynamic interactive electronic drug formulary for medical students. Br J Clin Pharmacol. 2006 Dec; 62(6):673-81
Stanton E, Lerner C. The art of NHS induction. BMJ 2010. Vol 340 Suppl Career Focus
Smith B & Congdon G. Evaluation of the North West Virtual Learning Environment (NWVLE) for the North Western Deanery Foundation e-learning doctor induction project [PDF Summary Document]. NHS e-Learning Toolkit, 2009 [Updated 9 Jun 09, Cited Feb 18 2010] Available from: http://www.elearningreadiness.org/file_download.php?ts=1244575790&id=46
Wong G, Greenhalgh P, Pawson R. Internet-based medical education: a realist review of what works, for whom and in what circumstances. BMC Medical Education 2010, 10:12
Prensky, M. Digital natives, Digital immigrants. On the Horizon 2001, 9:5
In October 1998 the new European Working Time Directive was implemented. Its purpose was to prevent employers from expecting their employees to work excessively long hours. This meant that doctors were only allowed to work an average of 48 hours a week. As a result Registered Nurses had to take on tasks that were previously only performed by doctors taking them away from the patient’s bedside. In March 2000 the government launched a new paper. The NHS Plan. Its purpose was to modernise and reform the NHS and its practices and for it to be more patient centred. This put even more pressure on Registered Nurses to take on ever increasing number the doctors roles therefore removing them yet further away from the bedside. Lord, M. NT (2002) describes the effect that Project 2000 was to have on the education of nurses. The project changed nurse training from an “In house” style of teaching to University based education. This led to the abolishment of the State Enrolled Nurse (SEN) leaving a large skill gap in the workforce. The Royal College of Nursing’s General Secretary, Dr. Peter Carter stated RCN (2007) that 180 000 Registered Nurses (RN’s) were due to retire over the next decade. Combined with ever tightening budgets putting an increased strain on the Health Service it also meant there would be a huge skill shortage. These three events have conspired to introduce and further develop the role of th...
Physician engagement - Physicians often resist acceptance of new technology and complain about lack of hands on interaction with patients with Telehealth. According to Gustke et al (2000), fear of malpractice suites is another consideration for physicians. Lack of staff with appropriate skills for telehealth also poses a
The result of the Francis Report means that the NHS is at a turning point in how all Health Care is delivered, as suggested by NHS employers “28 of Robert Francis' QC's recommendations are for changes to nursing regulation or delivery”.
Taylor & Crisp. (2006). Fundamental of Nursing. Sydney , New south wales, Australia: Vaughn Curtis.
In his article, “Can You Be Education from a Distance?”, James Barszcz effectively weighs the pros and cons of online education compared to the traditional method, while effectively supporting his position with factual information and statistics. While distance education proves to be convenient for students, Barszcz asserts that it eliminates valuable experiences necessary in order to get the most out of the material being learned.
Dougherty, L. & Lister, s. (2006) ‘The Royal Marsden Hospital manual of Clinical Nursing Procedures: Communication 6th Edition Oxford: Blackwell Publishing Ltd
Pee B, Woodman T, Fry H, and Davenport E. (2000) Practice-based learning: views on the development of a reflective learning tool. Medical Education, 34, 754 – 761.
Siviter, B. (2008) The Newly Qualified Nurses Handbook. A Survival Guide. Edinburgh: Balliere Tindall Elsevier
Even though EM is a highly attractive specialty, according to my experiences, the service pressures and budgetary constraints are real and I feel that junior doctors in EM don’t get structured and supervised teaching on the shop floor. We have teaching programme for junior doctors where once a week they get lectures on various topics covering their curriculum. This type of traditional teaching in the form of lectures or skill stations in the emergency department is particularly unsatisfying and unproductive for adult learners. (Kilroy, 2004)
The popularity and availability of online schooling, also referred to as virtual schools, cyber schools, e-learning, and distance learning, is growing rapidly throughout the U.S. I think the idea of virtual schools is wonderful, especially for those who are home bound or have medical conditions. Students at virtual schools can learn at any time and any place about any number of subjects, which is quite convenient. Students from rural areas can have the wide selection of courses usually only available to students in large suburban or urban schools.
. Most of my career has been in community nursing providing care in the patient’s home. This opportunity has allowed me to be a teacher and encourage health promotion. This can be very challenging due to issues with literacy and the patient’s readiness for change. This course has exposed me to the many different learning theories that have been developed and how to effectively assess the in order to develop and implement an effective teaching plan. Teaching strategies and plans must be specific to the learner and barriers need to be identified early so they can be overcome to promote better outcomes
Before the Internet medical information of any kind was very difficult for the average person to find. Patients had to rely fully on the knowledge of their doctors to make the most accurate diagnosis, and find the most effective treatment plans to meet their overall health care needs. Medical information was once only available in medical textbooks, and journals that were not accessible to the general public. Now, however things have changed. With the Internet, the general public now have access to citations of more then 12 million medical articles online. Which has lead to many patients being an active part of their own medical treatment as well was their physician’s continuing education on new medical advances. The Internet has changed the kind of relationship that is experienced between Doctors and patients. Previously, patients would, for the most part, follow doctor’s orders blindly as they were the experts and therefore to be trusted. Now, however, patients consider themselves somewhat of an expert after a few Google searches. They enter into appointments; armed with information and want to be an active part of the decision making process with regards their treatment plans. The Internet has changed the way the health care system currently functions, patients have becomes more and more like clients, information has been made accessible to more people, and has created more support for patients and more way to become informed about medical options, and a much wider medical community both for physicians, as well as patients.
Furthermore, some may suggest that online learning is benefiting our students in society. There has been a breakthrough in time and geographical limitations of education via online courses (Ho, 2009). Online education is cost-effective, efficient, and easily accessible (Schmeeckle, 2003). Online classes are used for individual and independent learning in which the student can learn at their own pace (Gonzalez, 2009). Not only is online education beneficial for breaking down barriers, online education has the potential to help students learn material more efficiently. Students are more likely to seek help from their instructors when the material is taught online (Whipp & Lorentz, 2009). Computer use in statistical classes could help decrease math anxiety (Gundy, Morton, Liu, & Kline, 2006). In a study that measured online students’ ability to achieve the same efficiency of course material as face-to-face students, at least 98% of students reported that they had, so one may be lead to believe that online learning is just as efficient as face-to-face courses (Liebowitz, 2003). With all of the positive aspects of online education, one may wonder why there is any debate as to whether or not online education is beneficial for
Today’s generation is like no other. The nation as a whole has completely evolved from past times, with technology being one of the greatest improvements. Traditionally, schooling takes place in a classroom setting, but, with the many modifications in our world’s system, we are able to assimilate more modern means of education, such as online learning. However, with many changes comes differences and requires adjustments. The online learning system has proven to be just as effective as traditional learning, with some minor differences, however, nothing of great significance. A few of those insignificant differences include online learning being convenient, especially for the non-traditional students,
With the advent of modern technology, a forceful impact of this technology has been observed in nearly all walks of modern day life. With the increasing access to these facilities, the lives of modern-day human beings have changed so dramatically that in many cases a reversal towards the old ways of life seems apparently impossible. Similar is the case with the process of education. In general the concept of e-learning has modified learning modes and behaviors to a much greater extent. It has...