Demographic questions and confirmation of consent.
*****
TA: Thank you. Can I start by asking you what was the context that you've been asked to use e-learning?
What was the context that you’ve been asked to use e-learning?

P8: We do a lot of our mandatory training modules on, online, as e-learning.  I've also done a module that was for my [clinical procedure] update training, which is every 3 years.  Most of them are annually, but that one’s a 3 yearly one, I think.  I think that's the 2 distinct separate ones that I know I've done fairly recently.

TA: Thank you. And then, how do you describe what Internet learning is? What would be the words you would use to describe Internet based learning?

P8: Well, you log into a, programme, and it's questions. You have a course and you have to click your way through it. You have to prove that you've read things, or played a video, that kind of thing, various different bits and pieces. And then the questionnaire's at the end, usually multiple choice of what's true and false. They're simple enough to make mouse clicks and things like that, and then, get your certificates.  You can print off certificates to hand to your manager to make sure they've got it as proof. You have to sort of show that you've done all the bits and pieces. 

TA: Yeah. In my participant information sheet I refer to open education resources.  Have you ever heard of those? 

P8: No, I don't think so.

TA: Okay. What would you call the learning you have described?

P8: E-learning. 

TA: Okay. So, maybe then just start by telling me a little bit what it's been like then to use these e-learning, or computer based programmes.

P8: I much prefer face to face. I’m this person that will not go to the self serve check outs in the supermarket because I'd rather have a person that is there doing that job. I'm not a cashier so I don't want to be doing the thing with the bar code, so e-learning was a bit of a cheap way of doing it, or something like that. But it is efficient. It's obviously going to be cheaper than getting someone in to teach. Certain things we do still have someone who comes in. It's quite funny, because we've had the same guy coming in to do our face to face group sessions for CPR, life support and advanced life support. Basic life support actually, because we do it with all the team [names team members by professiona or role], all of us mixed together to do basic life support. It's getting a bit monotonous now. Every year it's the same, and it's like okay, where is thelearning? I can see that online. Everyone does it in their own time. We're always under pressure at this time year to get them all done, and so we get protected learning time, and I manage to rattle through them on that, chunk my way through, so I prefer people, but I get that it's efficient.  

TA: So, why is it that you prefer people?  Tell me a little bit more about that? Why is it you prefer face to face? 

P8; Because I'm a people person and interaction, you can bounce ideas. It's not so clunky as just this, is it? You can discuss things. You can question things a bit more. Just nicer. I just like people.

TA: Okay.  So, you referred there to questioning things and things like that. Is there any of the e-learning in particular, you think doesn't sit so well as e-learning, that you might want to question people, or talk about a bit more, or anything?

P8: I know one of the one of the ones I don't like doing at all anyway is child protection, child safeguarding. It's an uncomfortable subject to have to talk about. Obviously I have to, and I just remember going to a face-to-face session and it was just much more supportive. It was recognising that this was, you know an unpleasant thing to talk about, and it just felt a bit more supported I would say. Acknowledged that it was uncomfortable, rather than tell us this, tell us that, da da da da, boom, there you go!  

TA: So, if you were doing say children’s safeguarding, and you were doing it as e-learning, if there was something like child safeguarding there was an issue that you want to discuss, how would you deal with that?  Would you take that back to work to discuss, or what would you do?

P8: Yeah, if there was something on the, on the e-learning, you mean?  Yeah, if there was something on the e-learning that I was unsure about, or questioned I guess I would probably speak to our [clinical service] safeguarding lead. It's unlikely that I would need to speak to my manager, because she's more management rather than clinical, and I would feel it's far more likely to be a clinical type query. Yeah, I think that, that'd be the route, I’d go to our safeguarding lead and they would probably know more about it. I always find, I've always hated having to do that at home, because I don't want to invite the horrible side of life into my own home, into my house. It's bad enough having it in my brain and acknowledging that it happens, but obviously I know, I've needed to know some of it, because obviously I'm dealing with babies and children, and sometimes there's something a bit suspicious, or something that you, I don't know, the hairs on the back of your neck, and that kind of thing. Then I obviously escalate it, and the thing with the e-learning I think, as well, is in some ways that’s quite good is that I know I can go on to it at any point and I can go through the module if I needed to, to sort of revise things because it's all there. I don't need a manual and I don't have to remember everything because it's there with questions to prompt your answers and make sure you've understood things. Knowing that that information is locked into that thing, it's in a cupboard kind of thing, I can go to that information, but in general, my first port of call for any questions would be my clinical team, whoever I’m working with.

TA: Yeah. So, you said you get protected learning time. Do you want to tell me a little bit more about that? How does that work? 

P8:  Someone in management would know what our allocation is, and how often we do it, but every so often we get told we've got that. So, it's Tuesday afternoon or something, one week, is going to be PLT, so we're blocked out from half one to half four or something like that. Anyone who works around those hours would have clinical up to those hours, and then potentially afterwards, unless you’re due to finish, then you can finish when you go. We shut the [clinical service] and there’s notices go up on the on the doors, saying we're closed for staff training. Either it's a group session, sometimes we'll have meetings, sort of team meetings like [names members of the team/roles] team meetings, that kind of thing. But often, it is where management tell us you can do your [learning system] training now. So, some things that's group and stuff that we have to be taught. Some of it is a chance to do your own learning. The trouble is, we all say I don't know how they think we're going to do this during our work time, because we're all super busy. We don't get spare time to do modules in between patients or anything like that, and the [names team members] are certainly bombarded all the time. So, it's either use the protected time or you do it in your own time and claim it back. But then I don't have much spare time when I’m at home, because I’m always dashing off to [names activity] or something other else, or [names activity] or whatever, so I don't. Again, I don't like to do it in my own time. What I have done in the past is quite often in February half term, we've spent one of the days, it just happens to be around that time, that we've gone to the [names museum] and we've been there so many times. I've been there and done it, and it's very interesting, obviously, to a point. Then it might be that [husband] and [son] will go off and do their thing, and I'll go to the cafe, get a coffee, and sit with my tablet, doing my e-learning in the cafe. So, we're all having a day out together, but if I get a bit bored I can do a couple of modules, sat in the café, and then I'd need to log it, and I can claim it back. But, I still think I do enough hours as it is, I don't really want to do it. So, protected learning time is useful. It's one of those eye roll moments sometimes, but it's also a bit of an oh, thank goodness!  A bit of reprieve from the constant onslaught. It is protected. It's good. 

TA: Yeah.  So, have you ever done any e-learning at, at home, as well?  Have you needed to do any at home? 

P8:  Yeah, and I have ended up doing like child safeguarding one, and I just feel unclean afterwards. It's horrible, I don't like it. It’s just that they’re the bigger ones. I remember coming out of the bedroom one time and go ‘well, I've learned all about COSSH’, and it was like I don't think I’ll ever need to know about that! And I did one about cleaning. It wasn’t about infection control but I did something that was about cleaning, and I was thinking, ‘to be honest, I don't really know that I need to know what colour mop you use in the kitchen, and what colour mop you use in the clinical environment, because that's not my job!’ I got cross, thinking this is ridiculous! It's a waste of my time, but it's because they're almost like blanket across. You have to do all of these, because we need to know that you've had that training, but some of it is a bit, really. Some of it is very, there's the ones that are very PC, and there are some that are just, yeah, we need to know about this. We know, but I can understand, in certain working environments, people would definitely need to know that there is a whistleblowing policy, or bullying in the workplace is not to happen. I’m thinking well, learning all that is usually, it’s not in one ear and out the other but it's just, I've done it, tick. But, I’m very comfortable in my work environment. I've got a really good team around me. I know these things exist and I need to know, but it's sort of sometimes, it's not speaking to me. It feels like it's talking to a much bigger organisation, with much more 
complex staffing and all that sort of thing. It's not really aimed at my practice, but you know it's got to done. As I say, some of it’s spot on, some of it’s a bit irrelevant, yeah. 

TA: Would you ever challenge about the stuff that seems more irrelevant, or would you just get on with it? 

P8: Oh, I think I sort of jokingly said to my boss, somehow I’ve managed to learn about the mops, and then she sort of said, you know, they've got targets, obviously. It's more sort of gentle feedback. I'm not objecting to it in strong terms. It's just more, ‘well, that was fun. I don't know why I needed that, but I've ticked your box for you. There you go, another certificate, thank you very much’ sort of thing. And because they've got to, some of it's box ticking. Some of it’s absolutely relevant and absolutely necessary, and totally on the case. It's such a mixture.

TA: You talk about certificates.  

P8: Yes.

TA: Do you print the certificates out and get them as evidence, or?

P8:  Yeah, I did this time. I said, I've done them and she said ‘can you give me the certificates’. I thought seriously, you actually now want pieces of paper?  But, I thought fair enough, and I need some for my CPD, my practice profile, for evidence obviously, to show my assessor, or whatever else, that I've done all the bits and pieces. I thought that was quite amusing, that despite the fact that they must have some kind of access to the computer thing, to see all the ticks, they still like to have the pieces of paper, printed. A4 as well, you know, what a waste of paper!  

TA: Yeah.

P8: I did think that was a little bit, considering I'm old and clunky and I like that side of things, I like pieces of paper generally. I thought that seemed to be a bit, backward almost. But we’re gradually moving on. There won't need to be, I can just email it to them or something instead soon. I did it because I was asked for it.

TA: Yeah. They seem to want evidence, don't they.  

P8: Yeah. And solid paper. Yeah, weird.

TA: Yeah. And how do you think that fits in with our accountability as nurses?
P8: Having that evidence, you've got that to stand up for things with your practice profil. When that first came in, I remember feeling absolutely terrified, that, how are we gonna do this? What, prove all this? We’ve got to get evidence, reflective practice models. Actually, the first one I did, it was so much easier than I thought, because you're doing it, anyway. I definitely do the hours, because I'm not full time, but I’m not here and there. You have lots of study days, lots of study sessions, the ones we have to do, and then lots of additional ones that you choose to do, or opt to do. It's just a way of proving that you’re doing what you're doing.  

TA: Yeah. 

P8: So it's because we have to. If I want to do things I have to prove I’m capable of them, so I would want someone that was doing that for me, to be proven that they’re capable.

TA: Okay. You said about not being so ofay with IT that you're really comfortable with it.  Have you ever experienced any glitches or tech issues when you've been trying to do your e-learning or anything?

P8: Quite probably. I can't remember, but someone would have come and helped me. We recently, obviously I must have learned something because I’m flying through them now. I can just do them, making sure you get the password correct, with the right upper and lower case. I mean, usually there's someone around that's way techier than me that can help. I haven't had any calamities.

TA: Okay. When you open up these things, you said you did your one on [clinical procedure].  How do you work through it?  Do you want to just talk me through how you work through it?

P8: That one, I mean it was fairly straightforward commands. It told you what you what the pattern was like, how it was going to work at the beginning, and showed you where you have to click and all this kind of thing. Then it was. I'm getting muddled up, because there was another one that I’ve just remembered that was about being a practice assessor. We've had a student nurse recently, and we did a thing on being a supervisor. And we had to do some training for that as well, and that was similar to the [clinical procedure] one, in the way you worked through it.

TA: Yeah. Talk about that one if you want to.

P8: Certainly the student one was lots of little videos, and they weren't always in sync, but they were subtitled. They were acted, ugh, ugh. So, it was a little bit, yeah, okay, just trying to labour the point. Obviously, the way that she's hesitant when she's interviewed, and the one that's going off looking at her phone, not looking after the patient who's being sick or something like that. It was about failure to fail, they were on about that a lot, and making sure also, how important students are. Students are vital. I thought, I know this. It was all quite obvious. I suppose it was appealing to some things they’ve found before. But you had to play the video, then click next or whatever, to go on to the next bit, and it was all a bit clunky and awkward. But, I did it, and I've got it.

TA: Yeah. 

P8: I’m trying to think of the [clinical procedure] one, because that was a little bit before it. I’m trying to remember. I'll have to do it again at some point, so I'll remember again. It'll come back round again. But, the previous ones I've done have been with lots of people having their reassessment. Lots of slides, lots of information, all about the new way that they're doing [clinical procedure] and everything. And then to do it all online in my room at the computer just seemed a bit, distant. It did the trick. I had the information, I just didn't have the interaction, which was what I miss. 

TA: So, from your memory, you sort of just work through every single page, and just get to the end.  Do you ever do the the quiz first, or anything like that, or have you found any other ways to do it?

P8: With our mandatory annual stuff, there is a way that you can get straight to the questions, and because it's stuff we do, like the cleaning one and all that, the ones we do every year, you can cut straight to the chase. I know the information is there because I've done it so many times. You can go to the, tick the policies and procedures bit, and you can go straight to the questionnaires, and it cuts out a lot of time. The thing is that it is a crazy system really! You can go straight to questionnaire. You can go for the questions and if you get some wrong, if you get too many wrong it gives you the chance to go back and answer them again. I don't necessarily get 100% on every single one. To be honest, I swear there are trick questions in there sometimes, the wording. I think, that was sneaky, because you worded it just slightly different, and/or there are options to tick as many as you want, and I just missed one, so I get it wrong. But if you were to discuss it or something, you know, it’s different ways of learning.  It’s flawed in a way, but you can go through, and then if you get 16 out of 20 and the pass rate is 18, you can go back, do the questions and you get 20. I wouldn't, if I'd have got 18 out of 20, I’d still pass, but when I get it wrong, I get it better. It's a little bit mad. You can sort of cheat, but I’m not cheating in a way because I’m still answering the questions. I'm not, I'm still answering the questions, and I’m reading the questions and having to give the right answer, but because I've done the module so many times before, some of it I can remember, because it's not that long ago that I did it, and I’m doing it again.

TA: Yeah. When we were going through Covid, you were in practice at that time, weren’t you. 

P8: Yeah.

TA: So, did you find any extra e-learning that you thought would be interesting to do, or do anything extra yourself, or did you have extra stuff to do that was allocated to you by your managers?

P8: Not that I recall. I deliberately stayed away from doing the Covid vaccination training, because the hours I do, and what I do, I thought ‘well, that's enough’. They still need me to do the backbone bits, lists clinical procedures]. We paused for a while, and re-established what was urgent and necessary, and what could be done else in other ways, but then gradually got back into things. People still needed to have their [clinical procedures] because life goes on. We had to sort of work around it. So we were all garbed up with everything and we did it all that way. The only thing I know that would have been another learning thing that I would have done would be COVID vaccinations, and I deliberately declined to do that. I thought if I do that, that's just another thing they'll have me doing, and I really haven't got time because I’m too busy doing all the other stuff I've got to. I know there were modules about that, that I opted not to do. I can't remember anything else specific. A lot more things moved on to being e-learning, rather than classroom based, and I know things like BLS remained face to face. We still had the guy coming in because he said about things that changed with COVID, the recommendations for mouth to mouth and things like that radically changed. You can choose not to, and all that. That was obviously post or during COVID times. I can't recall anything else particularly.

TA: Yeah.  So, you've been qualified long enough to know what CPD was like at the beginning, and how we used to be supported to go off and do courses and all sorts of things.  Have you got any sort of thoughts about how e-learning is changing things?

P8: It's that mix. I can see it's benefits. It's efficient. It's got to be cheaper. It can be updated very quickly, rolled out very quickly, but it's still not as nice as seeing a person. Not just someone talking at you, but that interaction. Obviously, things like this, like Teams and Zoom and that kind of thing, I've done a [clinical procedure] update on Teams, and I've done various different [clinical condition] updates and things, that were done on Teams when we couldn't get together for meetings. They're a little bit interactive, you could put in the chat box and obviously one person at a time can speak. Its still not anywhere near that. We still love, now that we can get back to meetings and see each other and chat, and we get to interact with the person that’s discussing. Getting together in a room and bouncing ideas off each other is still nicer than just sitting at a computer screen and ticking boxes, because I’m old school.

TA: Yeah. What are those sort of ideas that you bounce around?

P8: Experiences. I mean, when you’re taught something and you go, yeah, but in real life I tried to that, but this patient said ‘blah, blah de blah’. I had a patient that did so and so, and it's that real life experiences and peer support, because you don't get any, well very much of that anymore. That's really missing, especially in the sort of role that I’m in. The 2 other nurses that work with me, I very, very rarely see them face to face. We might message each other if we’re on the same shift. We've got a WhatsApp group that we'll chat to each other on there if we need to, but I don't see them in person, from one week, to the next, to the next. We do not work. We’ve got 2 sites and even if we're on the same shift, we're at opposite ends of town. 

TA: Right.

P8: We're not even in the same building, and I can, you can feel very isolated, because it's very much yourself in a room with your patient. Other colleagues, I might not see for the whole shift. I think then being stuck at a computer screen, doing your all your training is just more and more isolating. I crave that interaction, and not just with the patients, or the [names other team members] that happen to be on that shift, it's peer support, and knowing that the problems I've had, someone else has had, and they've got an idea for it, or I can help them. It's more valuable than just ticking a box. So, there's the efficiency versus support, I suppose, and interaction.

TA: Yeah.  So, I imagined, when you said about your protected learning time, there might be all your team of nurses, sitting in a room, at the same time together. But clearly. 

P8: No. We’re all at our own screens doing it. For example, if it's on a Tuesday, like the last one is on a Tuesday afternoon when I’m working. I was on the Tuesday afternoon, sat in the room all on my own all afternoon, freezing cold. It’s cold in that room, doing my learning, just chunking my way through it, and maybe a couple of people might have popped in the room and said hello, or grabbed something out of my room, and that was it. I was just on my own.  My colleague, one of the colleagues doesn't work Tuesdays anyway, so she wouldn't have been in. She would not benefit from that because she works shorter hours. I'm guessing that she does it more in her own time and claims it back. If you're not on shift when they do it, you lose out really. You don't get that protected. You don't get your hours off otherwise, but I think yeah, you'd have to just claim it back. 

TA: Yeah, and can you manage to take hours back?  Say, when you've had to do it at home.  Does that work ok? 

P8: Yeah, we can put the claims in. You just put your honest hours down. I've never had a problem with that, but more recently I've been able to get it done in work time, partly because you can go to the questions. Yeah. I didn't do it if we didn't have protected learning time. I would really struggle to do it in work time and that would mean it has to be done in my own time, which is precious, and in fact, you know, there’s not, not a lot of it! 

TA: We've talked about evidence, employers wanting evidence, and things like that as well, so you know, just in summary, what, what are your own sort of thoughts or feelings about doing e-learning, as a summary, really.

P8: I understand the importance. Obviously, we have to evidence our learning. Our managers have to know that we've done certain types of training. That makes sense, and it's a quick, efficient, cost-effective and measurable way of doing it. But, I can't say it's my favourite way of learning. It does the job, but I’m a people person, so ultimately put me in a room, and they give me a certificate at the end of that. That'd be fine, you know. If I’m in a room doing a lesson, I'm involved. You can't shut me up, basically. I've got something to say, or I'm really loving, enjoying learning from my colleagues, and from asking them questions and things.  I’ve done several in-person sessions and I honestly think I get more from them, because we bounce ideas off each other. Everyone's got different experiences. Some people are there and they're green as grass, and they're asking us questions, with people that are long in the tooth and have been doing it a while, and I love that, rather than just sitting at a computer, which is not talking to you. It has a place definitely, but it can't replace human interaction in my way.  People first, because I’m a people person. Other people just avoid people at all cost, so if you can do it with a computer that's much better. It's. horses for courses I suppose, as well. 

TA: Yeah.

P8: Some people much prefer it. They don't have to talk to anyone then. Awful.

TA: Yeah. Okay, any other comments or thoughts for me?

P8: You learn off the patients. I'm not the most forward person when it comes to technology for the patients, either. I realise that because I know there's lots of apps and things that people can use, that they can have on their phone. A lot of my patients wouldn't have a clue. We've got patients ranging from people that are illiterate anyway, and even reading the numbers on a machine is beyond them. They have family members to read to them. Some just have an old button phone. They really don't like the idea of a mobile phone and it's switched off in their pocket most of the time, right up to people that are so much more techy than me that I said, you know, if you want to do this you can google it and you can find out more than I could teach you because I would have to look it up. So, if you're that way inclined, tech yourself out. You can just go for it. So, I’m aware of these things, but I’m probably not the most forward in promoting them, because it's not my way. I'm getting old, that's the trouble. I'm old generation now. Things have changed, and I’m rolling with some of the changes. Most of the time, the hardest thing is remembering your password, so it's having a system to make sure you get passwords, you know, somewhere nailed.
Okay. Thank you.


