Demographic questions and confirmation of consent.
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TA: And then, what was the context that you've used these e-learning materials?

P7: Mostly for, like, mandatory, updates, I needed to do for my job.

TA: Okay, Thank you. And then, in relation to that type of e-learning, what would you generally call Internet based learning?

P7: I generally call it online, yeah.

TA: Okay.  

P7: Is that alright?

TA: Yeah.  Well, it's, I’m just trying to use your language throughout the interview, that’s all. So, have you ever heard of open education resources?

P7: Yeah, online or e-learning.  

TA: You haven’t heard of oers.

P7: Not till you started doing your work.

TA: Okay, so, what do you understand online learning to mean, then?

P7: Learning that we need to do, that can be done online, so, you don't have to go in and do it face to face.

TA: Okay. And what kind of experiences then have you had around online learning, and that could be anything from finding them, logging into them, completing them, recording your learning, sort of anything, just like to start talking about what it's been like. 

P7: So, sometimes. It's been varied. Some have been really good, and I've been quite sort of captivated by it, and really engaged, and others, I've just found it so dull, and I've just tried to skip, skip, skip, skip.  And then, if there's like a test at the end, I just hope that I’ll get it right.

TA: Okay. So, do you want to tell me a little bit more about that then, the skip, skip, skip. Is that only for the dull, the dull learning, or?

P7: Yeah, that, that tends to be more dull learning, and that's often when you've got, say, you've got a slide in front of you, and it's really, really, wordy. And then the person is doing a voice over, and is basically just reading the slide, and I just, actually I can read it quicker than they can. So, often I’ll either mute their sound, like press pause, and then I’ll just kind of skim read it, and then skip.  And sometimes, if it's a topic that I think I know fairly well, and I will just keep skipping.  And I always find it really demoralising, I think, when you start and it says this package will take 45 minutes, I think, 45 minutes! or, you know, however long. So, I always, I prefer if it doesn't, tell me that.

TA: Okay. that's interesting. Thank you. Can you tell me a little bit more about the time that it takes, where might you do your learning and when you do this learning that's online?

P7: Oh, So, I tend to do it when I’m at home.  Usually, kind of in the evenings. Often, I do it when I've had reminder emails, that it’s due, like you've got one day left. I don't know what's going to happen if I don’t do it. I’ve never got to, you know, you’ll explode. So, I usually do it because I have to do it, rather than thinking, oh, I'd like to do that.

P7: Okay. Thank you. So, the stuff that you mentioned, there’s some stuff that's had you captivated. Tell me a little bit more about that kind of learning, an example, or?

P7: So, often they’re ones, there was one the other week, that I did, that had like, it was almost like a, it had actors in it, and it was, you know, and I thought that was quite interesting. It was so much better than just stills with lots of words. And there was one I did with Health Education England, and that one, I was looking at it, to embed it in the unit, for the students to do, and I thought that was really interesting. It kind of it, you had to listen to it, because not everything that was on the screen, what it was saying. There was lots more information than was on the screen.  And it had lots of pictures and examples, so, and that was about NEWS, and there were lots of examples, and you had to see if you could get it right as it was going along, and I thought that was quite good.

TA: Okay, and were you happy with all that content? That's a bit of an open question, but did you have any questions about the reliability, or anything like that of that content?

P7: Do you know I didn't even question it.  I just assumed it would be right.  Yeah, no.

TA: Okay. If you have problems accessing it, what would you do? Have you? Have you ever had problems accessing any of the e-learning or any issues with the learning recording your progress, or anything like that?

P7: I had problems when the University first started using, I can't remember what it's called, is it Know, Know4You, or whatever it's called Know [university name].  And because I was clicking in the wrong place, so, I had to speak to IT.  And what I don't like.  So, there's one that's just come through at the moment that I need to do, which is, I think, on diversity, but it's coming from not a xxxxx.ac.uk account, so I didn't want to click on the link, because I thought it might be.  And then I asked somebody at work, and they said, oh, no, no, that is a real e-learning thing.  So, I think, maybe, I don't know we could be sent an email to say, an email will be arriving from this address.  Please click on it.  But other than that, I haven't had problems engaging and doing it.

TA: Okay.  Thank you. And you, you obviously went to IT, and they resolved that for you, so that was good.

P7: And I've also done mandatory kind of training through my bank contract at the hospital.  So, you have to have a, you've got like a brain on, on screen, and you have to make your brain green. So, you have to do all of these training packages. So, I've done some online ones through the hospital as well as through the university.

TA: Okay, and what have been your experiences of using those ones then?

P7: Varied. I'd say the hospital ones are varied.  So, some look like they are, almost national packages or something, you know. They're very professionally put together, and others look like, they may be more in-house, packages that aren't quite as sophisticated.

TA: Okay. Do any of them match the learning that you've done for your other post, that you work in, your established post?
P7: So, did some of their hospital ones match the ones that I've done?  Yeah, so, ones about data. I think the hospital call it more sort of clinical governance. The uni call it more kind of data, stuff. So, that's sort of similar. I haven't, diversity, done the university diversity one to say whether that's, but a lot of the hospital ones are more sort of like clinical, you know, and fire safety.  You get fire safety at both.  But there’s slight differences. I think.

TA: Okay, so would you think they were transferable at all?

P7: Yeah, I think there's lots that we have to do, that I think a, are transferable, and b, aren’t needed, maybe is quite as regularly.

TA: Q11. Tell me a bit about those ones that you feel are not needed as regularly then, thinking about either your trust role as a bank nurse, or your academic role.

P7: Well, I think in my academic role, like fire safety ones. I’m not a fire steward, so, I think all I need to know is, get out of the building. And, I suppose maybe some of the confidentiality ones, you know, and the data ones.  And I don't know if that's because we do kind of data management alongside, say our [academic programme] stuff.  So, I’m not sure then I need a generic thing.  And also because we’ve, the confidentiality has been drummed into us in our nursing, I’m not sure.  So, do you? I think, and I suppose as well, because, maybe, you know, been qualified for 20 years or something, and, that maybe because you're repeating stuff, I think I've done this.  But maybe the first like 10 years it would have been worth it. But, I don’t know.

TA: So, you talked about there being quite a lot to do.  Is that in relation to the Trust, that they give you quite a lot of learning modules that you have to do?

P7: Yeah, and definitely, when you, first kind of start, and then you have to, some you have to update yearly, some that you have to update twice yearly. But actually, XX University stand out quite a lot.  And [university name] I kind of, I’m not convinced always that, like, we all need to know this.

TA: Okay, so that learning for the Trust.  Do you do that in your own time as well and at home.

P7: Yeah.

TA: And do could you get recompense for that, at all?

P7: No, the only ones that you, get, are the ones, the mandatory ones that you have to go in for. So, like basic life support and manual handling.  But you have to go in and do those face to face. 

TA: Okay.

P7: I was going to say, any of your extended skills, as a nurse, so, like IV updates, or anything like that, you don't get paid for, because it's an extended skill, not a mandatory one.

TA: So, you could choose not to do those then and end up just not doing that skill in practice? 

P7: Yeah.

TA: Okay. Okay, that's interesting. So, I’m going to talk a little about what do you feel you've learned from using some of these online learning? You might think about the e-learning for Health one that you were reviewing for the students, or perhaps some of the Trust ones, because again, they're probably a bit more relevant to practice than

P7: Yeah.  Do you know, it was interesting because the, Health Education England one, was actually something that I teach.  And, it's clarified a point.  It sort of, do you want me to go into detail about what it was about? 

TA: You can do.

P7: So, it was about NEWS scoring.  And it clarified at the end, about agitation, and that you can score for agitation, rather than, so you know the ACVPU, alert, confused, and it said that agitation was, kind of an early sign of confusion, so, you could score 3.  So, then, after I had done that, I went back to, the Royal College of Physicians documentation to find where it had said that, so that I could add that into my teaching.

TA: Q17. But you wouldn't have done that without going back to the evidence first? 

P7: No.  No, I wouldn't have just taught it just based from that, because I wanted to be able to reference it, to, for the students, to show where it, you know, is said.

TA: Okay. So, you've discussed that kind of learning with your students then?

P7: Yeah.

TA: In a way, as teaching it.

P7: Mmm. So, I mean the reason I was doing that was I’m hoping to do a bit of research, just to see whether this online package enhances the students’ ability to do NEWS, or if it is just, whether we need it or not, or can they just have the sessions with us.

TA: Okay.  I’m just interested that. Do you think that online learning module would ever replace the taught sessions, with the, with you, what you're doing now?

P7: Well, it was used during Covid.  That's how it came about. So, it was used by the skills team and it was free from Health Education England, during Covid, for student nurses, and then BU has continued to purchase the package.  Although it's being delivered in skills, and then I deliver it as part my academic unit, so, we're just seeing really, we’re going to put it in with my unit to see if it does enhance the students’ knowledge of NEWS, or if they are getting enough with the teaching, and then actually we might not need to purchase the package.  And do I think it would?  I’m not sure it would be good enough on its own, because students have lots of questions, and actually you can't, the package doesn't answer the questions.  So, when I teach it, students will often ask, oh what about you know, this, to do with blood pressure, or you know, why does this happen, or.  So, like with that package, so, it talks about, if you've got a NEWS score above whatever, then you must consider sepsis, but it doesn't relate why, you know, whereas when I’m teaching it, I’ll say that's because, or they might ask something, you know, why does your blood pressure drop, or you, you know.  So, I think that's probably a real limit with e-learning packages, or they're probably good if it's just you know, like your data protection, and you know, when you haven't got any questions.  You just need to know the facts and follow them.  But when it's maybe deeper learning, I’m not sure the packages are good enough.

TA: Okay.  So that point about the deeper learning you've talked about in the context of discussion with other people really.  So, some of the e-learning that you've done, has there been any opportunities for any interaction with other people, or not? 

P7: No.  No.

TA: And what your thoughts or views about that from the learning that you've done.  Was there ever any situations where you kind of thought that you might like discussion, or?

P7: I don't think so.  Or maybe that, that NEWS package.  But at the time I didn't.  I went away and kind of looked up stuff.  I can't recall any e-learning that I've done that I thought I really wanted to talk to somebody about that.

TA: Yeah.  That's interesting, that you went away and looked up.  I know you looked up that reference, but you just looked up other stuff as well just to develop your learning, so you recognise maybe you wanted to know more. 

P7: Yeah.

TA: Okay. So, I want to come back to another point you said actually.  You talked about lots of questions and needing support.  So, you were from a generation where CPD was different wasn't it, in in the days when you qualified.  So, this move to online learning and your experiences of using online learning.  Have you got any thoughts about your experiences of how things have changed, or the impact that has had?

P7: What?  So for doing CPD stuff? 

TA: Yeah. 

P7: I don't know if it's because a, I haven't really done any CPD type stuff with e-learning, or b, because I’m from a generation where, it, it wasn't kind of done in my day, so therefore it's the wrong way to do it.  But I can't imagine how as you go up higher levels, e-learning would allow you, to really develop and delve kind of deeper into stuff.  I would worry that, it would be a bit surfacey, and because you've got that ability to kind of skip stuff, and.  Well, I suppose you could skip stuff in lessons couldn’t you.  You could not turn up.  But yeah, I don’t know. I mean, there's something very nice isn't there, about being able to discuss stuff with a real person, and, understand their opinion on something, their take on something, if you don't understand something, sometimes.  Somebody says it in a certain way, you think I still don’t get it, and then they'll explain it in another way, and then you get it.  So, I would worry that if I were doing lots of sort of CPD stuff and maybe I did it in one way, would I then never understand it, because I wouldn't have the opportunity to discuss.  But this is just me guessing, because I haven't.  I can't think of any CPD, you know, stuff.  I think all my stuff has been kind of mandatory type, training.

TA: Yeah.  Okay.  But that is interesting.  That's in the context of that, you know, e-Learning for Health is exactly what you did, though, isn’t it.  You went and found out more. 

P7: Yeah.  Yeah, yeah.

TA: For whatever reason.

P7: Yeah.

TA: Just, have you got any more thoughts about the skipping stuff, because you've talked about that a few times.  Any thoughts or feelings about, or your experiences about the skipping stuff, I mean, why do you choose to skip stuff?

P7: I choose to skip stuff primarily when it's boring.  It's not even, so it could be that it's brand new stuff to me. I don't know it, but it is so boring, that I just have to skip because I’m going to lose the will to live, and I did it on, I did it recently on, there is, did you do the marketing one from [university name]?

TA: I think I did. Yeah.

P7: Oh God, it was the most boring thing I've ever done.  It was like so wordy.  It also had a transcription of the bloke chatting, so I'd scroll down this transcript.  I just realised that he was going to be talking for hours.  So, I just kept skipping, and then I think it was like a test at the end.  And then I nearly kicked myself because I did get one of the questions wrong, and because I do, you’ve just got that thing, I need to get 100% at the end, and so I got a question wrong, and I thought that was because I skipped it.  But it was so boring, and I, I did wonder who, and it was kind of a bit of a boring content.  I get that it was all about that kind of contract stuff, and you know.  But there was a hundred and one other ways that could have been delivered, other than just wordy.  And, and I think that kind of knowing what he was going to be saying, seeing his transcript, I just thought I can't take this.  I've got to skip it, so I just, kept skipping.  Yeah.

TA: So, seeing the transcript could be helpful, or it could?  Well, in 2 ways, it could help you read it,

P7: Yeah

TA: Or it could help you judge the importance or relevance, or whatever.

P7: Yeah. And I’m sure.  I’m sure, it was like already, and I've like said it a couple of times when I've been like in meetings, and going like, you know the marketing, learning package that we've just done, and everyone’s like mmm, mmm, mmm.  So, like there's a couple of bits of it that I think that are relevant, and I suppose it was relevant for kind of the role that I had with admissions and things.  But, I can't imagine that many people have retained a lot of what was in it, because it, it was delivered in such a dull way.  And I think that's probably one of the things about e-learning isn't it, that it must be really difficult, because it's got to be engaging.  It's all got to be correct, and up to date, and I suppose there needs some fool proof mechanism where you can't have people like me just skip, skip, skip, because you.  Yeah.  I can’t bear it.

TA: You talked about the importance of the 100%.  Do you want to talk a bit more about that?

P7: Yeah.  That’s just me Tanya.  I feel, I’m just a bit competitive, but I, especially when they’re like work ones and, you worry that, like the scores, people are going to see the scores, like 60, 60, 60% or something, and you've got to get 80% to pass.  But, in fact, now this is naughty, there was a group of us, a few years back who, when the mandatory packages came out, used to, one person would do it and share the answers with the other.  So, there is a way that you can do it. Do you know what I mean, you can cheat the system a bit.  

TA: Yeah.

P7: I don't do that anymore.  I’m very, a good girl.  But yeah, I suppose that's maybe partly because some of it, people don't value doing it, the mandatory stuff.  You know.

TA: So, why is that? Why is that, do you think?

P7: I don't know. I don't know if it's because sometimes mandatory stuff, we just get a bit bored with, or because, because our experience mandatory stuff has been boring in the past.  So, and I have noticed that lately some of it is different, and they are using actors.  And so it is more like a little TV show, not a TV show, but do you know what I mean, it's like you're watching something, and that's a bit more engaging.  So, I don't know if maybe, because when e-learning was first kind of introduced, it was all a bit clunky and boring, and you know, and so, you know.  But now things are getting better.

TA: Okay, that's interesting.  And how do you record your learning, then, for e-learning?  It’s simply on the system, is it, or?  

P7: Just on the system.  Yeah.

TA: In terms of the Trust as well? That's all on their system?

P7: Yeah. yeah.  We don’t record it anywhere else.  And then, when I do, you know when you have to do your revalidation, and you have to say, CPD hours, or hours of learning that you've done, and often I will go back to those places to note, and anything in my calendar of training that I had to go to.

TA: Right. But so far, you've not really reflected on any e-learning or online learning as such. It's really been from other?

P7: I think it's been from other.  I mean, I’ll check. I've revalidated 3 times I think, so, I can re-check my, I’ll re-check out my paperwork, and see if there's anything for e-learning. If there is, I can send it to you.

TA: But nothing that really springs to mind very quickly. So.

P7: No.

TA: Okay.  Now is an opportunity for you to tell me anything else you think about your experiences overall.  You know, whether they've been positive or negative, or mixed, or, you know how you felt about doing the e-learning?  If I was to show you the screen now, for [in house training system], how would it make you feel that kind of thing?

P7: I kind of accept that it's just part and parcel of what we have to do, and, but it's when you, it's that kind of, so, there's one that's come out, this diversity one, and when I asked, I was in a meeting, and I said, can I just ask, is this real?  And, it's something like, yeah.  And then somebody said, put an hour aside, it's going to take you an hour, and my heart kind of sank.  And then somebody else said oh no, it doesn't take that long, about 25 minutes to half an hour, and so I was like oh, okay.  But even then, I kind of, I like them short and sweet.  So, I like, you know, less than 10 minutes.

TA: Okay, and, maybe you could just say a little bit more about that being short and sweet in terms of fitting it in and managing it around, because obviously, you said you do them at home.  So, how do you manage them doing then at home? 

P7: Yeah. So, when they are, there was a series of 4 that came out not so long ago, and they, one said this will take you 3 minutes, one was maybe 7 minutes.  And that was great, because I did one of them, then went and stirred the dinner, or whatever I was doing, and then I’d come back, and I’d do the other one, and it, it just was less.  It just felt less onerous.  You know, it felt like, I can get 3 things, and I, you know.  Probably altogether, the time was over 25 minutes, but because there's one package someone's told me it's going to be 25 minutes, I've put off doing it.  So, I think, the shorter they are, you know, probably lots of short ones, are better than one big one, in my opinion.

TA: Yeah. So, with some of the long ones, you can save them, can't you, and come back to them?  Have you ever used strategies like that, or?

P7: No, I've never done that, because I’m not sure I'd remember to go back to it.  I’m sure I’d get a reminder, but no, once I’m in, I just think, you know, get it done, but it's usually the longer ones that I will be skipping stuff.

TA: Right, okay.  Thank you.
