Demographic questions and confirmation of consent.
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TA: Can you just tell me what name you would use for Internet based learning?  What would you call it? 

P9: I'd say e-learning.

TA: Okay.  Have you ever heard of the term open education resources?

P9: No.

TA: I'll use e-learning for the interview.  And then, can you tell me about how or why you were directed to use e-learning then, in the first place, and when you've used it?

P9: Why I'd use it at the moment?

TA: Yeah.

P9: So, I would need e-learning for my professional development.  Now, there are certain, so there's, so.  There's e-learning modules I need to do either every year, or sort of 2 years, 3 years.  So, there's that mandatory.  I would use e-learning as my role changes, and I've got other responsibilities, so for example, doing venepuncture and ECGs, so I'm now looking at that that particular e-learning.  So, that is very much.  I suppose those ones are practice based.  Within the university setting there are again mandatory ones that, I have to undertake.  Now, there's also e-learning, because I'm a [clinical speciality] nurse, I also have to. We've got a new [protocol] that starts tomorrow. I've done lots of mandatory e-learning from that. I would also do e-learning for just my own personal interest, in regards to there's an area I'm not sure about.  And, you know, there's, there's, you know, when you look on Google, or whatever, or when you, different organisations might be NIHR, they have courses.  I know that I have to raise my game, so I will look at those particular resources as well.

TA: You  talked about finding some learning on Google or things like that.  Have you ever actually gone and done any kind of learning like that?

P9: Yeah, when I’m trying to learn something and I’m not that familiar with it, then actually, like I'd say to learners ‘well, find out the level you are, and then use that, to be familiar with it, then build up because there's no point trying to understand something that's more complex, if you don't understand the basics. Definitely and in my job, for example, medication?  I've been out of practice, for years. I am watching, because being new, I got to shadow people, including giving drugs. Because it's a speciality you have to know in more depth than a general nurse, so definitely I would seek those e-learning resources, because I don't want to look daft. As an autonomous practitioner, you make phone calls to patients and when you call them, you just don't know what they're going to ask you. I need to make sure that I am competent and understand what they're talking about, so I've definitely had to raise my game and I've had to seek those e-learning resources.  Yeah.

TA: Okay.  So, you talked about being autonomous?

P9: Yeah. Although everybody works within a team, as a [clinical speciality] nurse, I contact the patients. That dialogue could be on the phone, or could be meeting them. It could be just me, or sometimes I might have what a team member with me. Different [clinical protocols] require different input from me, but I do enjoy it when I am on my own. I forgot to say I'm also a vaccinator. I can come to that one in a minute. 

TA: Okay. Well, do you want to tell me a little bit more about that now?

P9: Yes, I'm a vaccinator, so that also meant to say I had to do a load of e-learning to be able to undertake that role. It's not challenging, but it's just another way for me to engage with patients, and it was a lovely introduction to get me back into practice.

TA: Okay. And you said it's a load of learning. So, in terms of it being a load of learning, have you got any thoughts about how that learning was given to you, or set out for you, or?

P9: I think the NHS are, as a nurse you are accountable, but an organisation is also accountable, so they have to prove that they are employing, and they have given the resources to that employee, to be competent and safe. They have responsibilities as an organisation, and then myself as an employee, I have responsibilities. E-learning ticks the box. In the past we would have done a lot, like a week in induction for example, whereas now it was just a one day induction. Obviously, there are advantages to both parties doing it. I understand that. It depends on how engaging the material is. I must say I think that the way that the [clinical protocols] do the e-learning, they're much better, much better than doing the e-learning. To give you an example of why I think they're better, is they’re smarter. When you are watching something for example, every now and then they have a code at the bottom and if you haven't been watching it and you haven't put the code in within a minute, it goes right back to the start! Okay, that's to make sure that we're listening isn't it and thinking about it. E-learning is e-learning, isn’t it. Some of the e-learning as in e-learning for health that we mandatorily have to do, or some of the e-learning that [Trust name] put up. It's far more engaging when you have to watch videos, when it's different. It is that multi-dimensional effect, rather than a slide where somebody talks over it, and then you go on again. Like anything, there's a variety. There's a richness about that e-learning, and that richness can mean it's more engaging, or it it's not engaging. It's just like a text box exercise. The more variety they can do, the better it is. And don't make it too long. Some of them make it too long.

TA: Yeah. Have you got an example?

P9: I can't think of any specific topic, but it goes back to our attention doesn't it. Nowadays, we want things much quicker, in bite size, and e-learning isn't necessarily that, so it's good when they break it down, and they've got say 6 sections. I've done one, and you can physically see one, then 2, and it sort of motivates you. You're down to the fifth and you’re going ‘oh, my God’, but it's okay, it's fine, I've just got one more to do. There are times in which that e-learning, isn't broken down and you just feel as if you're on a wheel, that, how, when am I going to get off it? It's not pleasurable. When am I going to get off it?  When am I going to get off it?

TA: Okay. So, that gives a sense of time in there as well. Have you got any thoughts or experiences about time, when and where you do the e-learning, or anything like that? 

P9: It always takes me longer than I want it to be. Now, I don't know if that's me just being slow, but if I put a morning, I never get through what I want. Being quite experienced at this, it's 'well, why can't I get through it"? But, that's because you don't know how long that e-learning is. Sometimes they might say, oh, no they don't normally. It would be good if they said, well, this might take you an hour, then that would be more realistic. Where do I do it? It just depends on my schedule really. If it's work related, as in at [hospital name], then a lot of the e-learning, if it's the intranet, so it's from the hospital itself, I cannot access at home, so I have to do that, which is slightly annoying at times. Anyway, that makes sure that I work within the work hour times, rather than doing it at home, which I will tend to do at home, and actually that's not very good discipline. I need to do it more within the working hours. If it's at work then there's just 2 of us. It's quite quiet. I can put my headphones on and crack on with it. If it's at Uni then I will tend to do it late at night because I've got to do it, and I just can't find time to do it during the day, so I’m trying to get through it as fast as possible. It's, it's a chore. I must say uni e-learning is a chore. Why? I just find it boring, boring to do a security and emails training.  I know. I get it, but it's boring! The practice stuff, it's because I like learning, and because I like learning then that automatically engages me more. Yeah, definitely. Now, whether that's also because I've gone back into practice and I love the challenge. I love learning, and that's different learning than being in Uni, because you're the teacher. I'm not saying you don't learn something, but you do come at life differently.

TA: Okay. Thank you. You said it's annoying sometimes to have to access at work. Have you had any trouble with technical glitches, or anything like that in all of your e-learning?

P9: No, the only problem I had was vaccinating and making sure I had the right browser. Actually, yeah, you have to tick various things off and they said because I was in the wrong browser, I wasn't, but anyway, it wouldn't let me tick it. It's like anything, it's a process. You’ve got to go a to b, to c, to d, and so that was quite annoying. Actually, it was really annoying, really annoying! I can remember it now. But that's just life. Just got to get on with it. 

TA: Yeah.  Okay.  So, you've talked about it being a process.  How do you go about doing the learning, once you get into it?  Do you have the same strategy for all of it?  Or, do you do different things in different ways?

P9: I have to write it down, the information that they give me. I'm a kinaesthetic learner. I can use the other learning styles, but for me, to go into my brain, I have to write things down, stop, look at it, and then go on again. Especially if there's a quiz! I know I can't get away with it. I can also go back to those notes if I need to? If I can print off stuff, which isn't always possible, then I will. I look at it first, and then I'll go at the e-learning. That's me, because I need time to process information, so that's the best, if I could. It's a bit like going into a lecture, isn't it, or a seminar. Have the material, have a look at it, rather than being at zero on your knowledge. Then, okay, I'm on number 2, and then whatever it is that I'm exposing to myself, which in this case is e-learning, then I can move up that layering. That's the strategy I would use, if it's available to me, but I have to write because I'm more kinaesthetic.

TA: Yeah. How would that relate to the [university name] kind of e-learning.  Do you use the same kind of strategy?

P9: No.  

TA: Do you want to tell me about that, as well, then?

P9: I'm just trying to get through it, as quick as possible. Do they have questions at the end? Some of them do, some of them don't. If I know that I can only take it 3 times, then I have to be far more engaged with it, so, it depends on the stick, really.

TA: You talked about printing and evidence. What are your thoughts or your feelings about how you manage the evidence of completing the learning and the need for evidence?

P9: At [Trust name], they're very hot, and I don't know if it's because it's the [clinical speciality] department, and you have to have your certificates. You have to upload them. They're about to do an audit, so you must show that you've done your e-learning. Actually, they have audited again, something called ‘your green brain’. When you're at [Trust name], they assign you, a number of modules, topics that you must cover and if it's within 90 days then your brain goes orange, and if it is out of date or you haven't done it, it's red. So, your bosses will go, especially having been in the probationary period, ‘what colour’s your brain [P9]?’ Green. That's again about them. They have their responsibilities as an organisation, and I obviously have my responsibilities. So, the evidence is that, vaccinator, actually they're saying at the moment that my evidence is out of date. I've got to, as long as I can give them a screenshot  just to say, you're correct. When I use the [Trust name], it's out of date but they will happily accept a screenshot of [Trust name] to say this is the same e-learning and I am in date. So, they contact me. At [university name] you get these emails if you haven't done it. You get chased up if you haven't done it.

TA: Yeah. So, when, for instance, you take a screenshot of your [Trust name] learning, to pass to the other Trust, do they update their system to say that they've accepted it, then? 

P9: Yeah, because at the end of the day it's the same e-learning. So, this is the more mandatory ones, you know, like clinical governance, resus. It's ridiculous and a waste of time if it's the same. You should be transferable across.

TA: Okay. How do you feel about being assigned the learning? Maybe thinking about the vaccination learning. Did you think it was relevant? 

P9: Some of it was actually talking about the virus. So, when you're being asked about the vaccine, and is it live? Patients, especially at the start, had a lot of questions. Generally, when you were vaccinating people would generally ask questions. Is this the same? Is this whatever?  So, you did need to know that knowledge base. As time has gone on, people are more accepting, they just get on with it. The public were much more worried because of the media. They needed to have a lot more information about what you were doing, which is good. They did tailor the e-learning at that time. The vaccinations learning was very good. At some points I thought do I need to do so much detail?  But, actually it was really good, because every now and then you would get a very informed but very anxious patient, and you did need to know your stuff.

TA: Thank you. So, to finish I just want to ask if you have any things you want to tell me about e-learning in summary.

P9: I think it's definitely got a place, e-learning. I do like the fact that you can go back over it. For me, that's really important. Make it as varied as possible. It's really key for me, that you are able to print off information as that's really helpful for me. And for the people that are producing, developing, keep their eyes and ears open to the way that other people do it, because that's some really good practices out there. 

TA: Thank you.



