Demographic questions and confirmation of consent.
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TA: Okay, thank you. My first question is have you ever heard the term open education resources?

P12: No. Not professionally, no.

TA: Thank you. So, what would you call online learning that you do, any computer-based learning, what would be the name that you would use for that?

P12: E-learning, I suppose.

TA: Okay. That's the language I'll use for the purposes of this interview then. So, thinking about e-learning that you’ve used, can you tell me about why you were directed to use them in the first place?

P12:  I think some of our mandatory training converted to e-learning prior to the pandemic, and I think from the pandemic to March 2020 onwards, the majority of our training, or at least over those two years, was done online. E-learning via the [Trust name] e-learning website.

TA: Okay. And, has all the training that you've done been mandatory training, or have you done some things that you've gone off and found for yourself, or that you've been recommended to do, but that's not mandatory?

P12:  Some of it was in line with a new job role I took on, which wasn't mandatory training but was job specific training. I went from [demographic group] services, inpatient services to [demographic group] in the community, so there were a few modules that were recommended but not mandatory. I was recommended to complete them..

TA: Okay, thank you. So, thinking about those e-learning resources that you've used, can you tell me about how you've gone about using them? What was your approach to doing them?

P12: As in physically doing them as a online?

TA: In terms of process, yes.

P12: The process is access the Trust intranet. Its on a website which you have to log into with your details, and then there's a bar down the side which lists mandatory training and other training that is specific to different areas and roles. With mandatory training it tends to come up at the top with a bit of a warning to say that you’re out of date, but that's usually preceded by emails to say that you need to update this training as well. That's typically how it works really. There is the option of scrolling through the task bar to see courses that you might want to take which are online but not mandatory. I think people are free to do them.

TA: Thank you. So when you open up these training modules, whether it's the mandatory ones or the ones that you might choose to do yourself, how do you then proceed through those?

P12: Literally, it's a fairly bureaucratic process, but it's not a simple process. It's not straightforward or intuitive, especially if you're coming from using computers or apps, or phones or things like that where user experience tends to be optimised for the user experience. I don't think that's necessarily a consideration with some of the training that the NHS provides. So you click on a button to access the course, then you have to register on the course and then another page will come up saying here's a link to the course, and then you click on the link and it comes to another page. Typically there’s two or three links to press in order. I think the final one is to get your certificate but you can't get the certificate until you’ve completed the other mandatory, the other training, as such.

TA: Yeah. And is there typically a test?

P12: Typically, it's a mixture really. A mixture of reading online, pop ups and pages. At the end of a section or module completing this questionnaire, really, and usually there’s a test at the end to wrap it all up.

TA: Okay. And you work through those logically do you, generally?

P12: I try to work through it as quick as I can because some of it is not necessarily, it's. It's testing a lot of the time. It's mandatory, or if it’s not mandatory it's fairly sort of simplistic. I think that's to cover all bases isn’t it and also levels and abilities. I think part of that as well is it's not necessarily conducive to learning as such. I think it's conducive to ensure that that information has been imparted on a screen and you've then clicked a button to say you've seen that screen, and at the end of it you've got a 50/50 chance of passing the test just by basically being in the job role you're in.

TA: Okay. So, you talked about using the Intranet system. Does that mean that you have to be at work to do that training or have you done it elsewhere?

P12: I’ve done it at home. You can access it through a work laptop, so yeah, you can do it at home as long as you’ve got Internet access. A work laptop with that functioning, a proxy.

TA: Okay. What's your experience of managing your time around doing the learning?  Do you manage to do it in work’s time and get paid for it?

P12: Yeah, absolutely.  Always works time, unless it’s something that's gone seriously wrong. If I'm doing mandatory training or any sort of training outside of work and getting paid for it. To be fair I did a course that was on [clinical procedure]. I’m train the trainer for [clinical procedure] and part of my role was doing online training, online group work with a trainer, and as part of that I actually had to do some research, some homework prior to the course and during the course as well. I suppose that’s sort of adjacent to that isn’t it. So, it's not basically a hard and fast rule that I won’t ever do it. If necessity demands, I will.

TA: But on the whole, and especially mandatory training, that should be done in work time.

P12: Absolutely. Yeah.

TA: Thank you. You talked about the Trust listing the training that you need to do. Have you got any thoughts or feelings about the relevance of that learning that you get asked to do?

P12: I would say that I understand the necessity of ensuring that all staff have looked at the training. But to be clear, I think some of it is fairly irrelevant in terms of, it seems like it's more of a bureaucratic process you know that has been done so they can receive funding from [funding body] in order to say look, most of the staff have attended their certain level based on the funding. So I don’t think it's necessary or relevant a lot of the time, the majority of the time.

TA: Thank you. Despite the relevance of what you're doing your approach is always the same is it, or does it differ?

P12: If it's a subject I’m quite well versed in I will try and complete the training as quickly as possible because I think some of it, the information that’s being imparted isn't necessarily new information or information that would be unavailable to somebody with a level of understanding, comprehension of their job role. So, some of the things are fairly straightforward and fairly obvious, but obviously you can't assume that everybody knows everything can you? And that's the purpose of those sort of trainings I suppose, it has to cover quite a broad range of people, and abilities doesn't it.

TA: Yeah. You said you moved from one job role to another. Did your training carry across with you at all?

P12: Well, the relevance of it, or the actual training?  

TA: The actual training that you’d already done and completed. The evidence of having done training. Did that carry across with you into your new role?

P12: Yeah. It’s the same platform, within the same Trust. 

TA: Okay. Thank you. Going back to where you said that the learning platform is not really optimised to make things very easy or intuitive, have you ever experienced any kind of technical glitches or issues that have stopped you doing your training, or prevented you doing it in a timely way?

P12: Yeah. Typically, it's usually, people in HR tend to laugh when I say this, it’s usually when you've gone to complete the exam and you've definitely completed it, 100% pass and it says you haven’t! If they ever didn't say you passed it, you’ve got to do it again. That has happened a few times, believe or not.

TA: Yeah. How does that make you feel when stuff like that happens?

P12: It’s pretty irritating, especially if you spend a couple of hours perhaps doing [mandatory] training which you can't skip and you have to go through the process and get to the end of it and you even have to do the test again.

TA: Thank you. So you have to provide evidence for your employers. Do you ever print off the certificates or anything like that? Do you need to provide paper evidence or is there another way that they’re provided? 

P12: Yeah, the certificates are stored on the same platform, or they theoretically are!  Sometimes there's a bit of disconnect between you completing the course and the main servers being updated. So, sometimes you have the certificate but it hasn’t been updated elsewhere so you can still get an e-mail to tell you that you need to do the course and then have to show them the certificate which is on the platform that they're telling you you haven’t, you know. Do you see what I mean? You have to show them their own evidence in order to prove that you've done something they're not aware that you've done.

TA: Yeah. But they can access that can they? They can see what you have done and what you haven't done?

P12: Yeah, I just think it's two different departments that aren’t talking to each other, or whatever reason it hasn’t uploaded as well.

TA: Have you ever gone to find learning on your own, like e-learning and undertaken any e-learning outside of the system from work?

P12: What, in relation to work or work adjacent?

TA: Well, they could be things that you’ve chosen to do yourself really. So, you’ve suddenly thought I’d like to learn a little bit about this so gone and found something somewhere.

P12: I've accessed online e-learning with regards to writing code, computer code, free. I don’t know if it was Government backed or not, a free website that teaches you how to write basic code and certain things like that. So, I’ve done that just because at some point it might come in useful. It was interesting.

TA: Yeah. Has it been useful? 

P12: It has in one sense. Theoretically it has because I understand things slightly better. It’s especially useful about IT sort of things but it will come in useful at some point I'm sure. I'm sure computers are going to be massive.

TA: So, thinking about the e-learning that you've done that was relevant to your role but wasn't mandatory. Have you applied any of the learning from that in your practice?

P12: Yeah, I’d say in regards to very specific training around the [clinical protocol] I’m trained in, it was more like an update really for the new job role. From that it did remind me of a few process things that come in useful. I think it's very specific though to [clinical procedure]. I don't think it's a 
general rule that that's the case. 

TA: Yeah. I'm thinking about working with your colleagues. Do you ever discuss the learning from any e-learning that you've done or the mandatory training or anything, through discussion? 

P12: It's usually discussions saying I've thought I've done that already. Why are you asking me to do it again? Pease don’t make me do it again. It's not usually a discussion around how wonderful the course was or how informative it was. It's usually complaining.

TA: Yeah. And since you've qualified, had you experienced any different ways of doing CPD, rather than using e-learning?

P12:  Yeah, back in the day. It was 2015 or thereabouts.  Even then I think the process was transitioning more towards e-learning. But I think some of the [mandatory training] was done in person, but it's now done online. Things like that were done in person but the majority of that seems to have transitioned across to e-learning.

TA: Yeah. Thinking about differences between the face to face and the e-learning, what are your thoughts about the two different platforms for say [mandatory training]? 

P12:  Pros and cons to both, I suppose. A lot of it is dependent on if you prefer talking in general, talking to people in person or face to face like this, and I think that in terms of training, I think a lot is dependent on the quality of the training being provided, the quality of the person doing the teaching. But in person that's sort of counted against the fact that you can a lot of people the room and actually that affects how much you can. I don’t know, it affects the ability of a trainer and that sort of stuff, but I know it depends obviously on the pros of e-learning is more often than not it’s at home and sometimes it's quicker, but if it's just the interface it's just you and a basic algorithm, you know sort of repeating pages, and there isn't much nuance to that is there! So, it's learning in one sense isn’t it, but it's a very sort of systematic, functional way of learning.

TA: Yeah. 

P12: I think from a managerial, you know. I’ve managed teams before and services and things like that and I think from the perspective of staff learning something, I don't think it's always the case that you learn something. You might have done the course, you might have completed it, you might have got a certificate, but that doesn’t necessarily mean that you’ve learned anything. That surely must be the point of e-learning, for people to learn things that they can apply to their jobs, which I don’t think is always the case.

TA: Yeah. You referred earlier to people having viewed the screen but that doesn't mean to say that they’ve learned anything from it, or that they've even read it.

P12: No, not at all. I know, even thinking to disciplinary processes I've been involved in when I was a manager, and people would say I didn't know that and you’d say well, actually, you've got the certificate. It says you’ve completed the course, the e-learning course. And they’d go oh, did I? You’d go, yeah, you did. So, you know, there we go.

TA: Yeah. So do you think people understand better if they can talk about the learning with other people, like the [mandatory training] thinking again about the face to face.

P12: Yeah. It's easier, being in person, but then equally, I think it's dependent on the person doing it as well. I can only speak for myself, and some people might prefer online learning because you don’t have to talk to people, and actually for whatever reason, neurodiverse or whatever, it might be easier for them. So you know just because I think that doesn't mean that it is true or good. I want to say it's a straightforward answer, but it's my preference I suppose.  My preference is in person.

TA: Okay. You did refer to e-learning being quite simplistic and based at a level which doesn't really look at people's abilities. 

P12: Yeah.

TA: I just wondered what was it that, brought you to that?

P12: I think it's just the nature of the information being imparted isn’t it. I don't think it's necessarily meant to be of a high level. I'm going to rephrase that. It’s is not necessarily a criticism, the quality of the information or what's been imparted. I think that's probably the level it needs to be at. I don’t think it needs necessarily to be really super complicated, or if we understand for it to be necessary, but I think it's proof of my intolerances around the sort of fact that it is. I suppose it’s a balance between doing things I find interesting and challenging and the other stuff, which I suppose more often than not it's not very interesting, it's not very challenging. I find it quite tedious and then if I find something tedious I’ll then lose interest and I will try and avoid doing it. That's the point I was trying to get at.

TA: Okay. How do you assess the quality of the learning that you're doing? Have you ever been in a situation where you've questioned some of the content, or the answers to the test?

P12: Yeah, I think again some of it I find really, really simplistic, but again, interestingly from a management point of view, I'm not a manager, I'm a clinician, but I can understand the rationale behind it, because a lot of time if somebody doesn't know they shouldn't do something then you can't necessarily in the NHS be told off for not doing it. And so a lot of them they found it’s so broad because so much basis, that when it comes to things happening they can say well, at least we cover that in mandatory training.  In terms of the actual quality of it, it's fairly low level but I suppose that's it’s purpose isn’t it, so, yeah.

TA: Okay. In terms of that then, you talk about being a clinician and about need to provide evidence of your learning for your managers so that they can confirm that you've done everything. How do you think that fits with our autonomy as clinicians?

P12:  You know, to be honest I think it strikes me as you do it in order to avoid. It’s to make your manager’s life easy.  I think a lot of time again, from my perspective, getting the e-mails from HR to say that these staff members haven’t done this training, and can we make sure we do it before this point in time. There's always a rush towards in the financial year to get everybody up to a certain percentage. I think it's 90%, 95% of the workforce covered in whatever training so you can then get the money off the CCG, or not have to pay it back for example. So, I think there's an element of that involvement as well. A lot of time it feels to be the case that actually you're doing it in order to meet benchmarks that isn’t necessarily something you know of or agree with. It slightly undermines the process, I suppose. It undermines intention.  

TA: Okay, thinking about any additional learning that you've done, have you ever relayed that to your manager in appraisals, or anything like that?  Do you ever tell them about that?

P12: Yeah, I do. I’m fairly irritating. Any chance I get, I tend to talk about research and things like that. Handovers and in huddles and just in casual conversations too. I probably do that all the time actually, to be quite frank. Yeah.

TA: So, there is a possibility you have taken some of the learning back to practice in discussing it in those handovers and things, or not really?

P12: I would draw a distinction between training I probably access myself and training I've accessed because of my job role. I think, if you’re looking back at things like [clinical protocol] and things like that, and how you’re actually more often than not I think, especially the role I’m in now, it comes up more than anything else in terms of. Actually, thinking about that logically as well, training around the [legislation] and [legislation] and things like that as well. I think that tends to be highlighted and discussed more. But then, equally that training is very repetitive as well and actually I just wonder if you just know it because you've been heard it so many times, that actually it’s part of the structure within which you work.

TA: Yeah, thank you. Okay, I'm going to finish by asking of there is anything else that you want to tell me about your experiences of using e-learning as CPD.

P12: Yeah. I think that there is probably, if we're going to continue down that route and having the majority of our training done in that fashion, there definitely is greater scope in terms of making it better in terms of the quality of information, how it’s imparted, and also if it's interesting or not. I think 
it's fairly low level and fairly basic and fairly simplistic is the word I've been looking for. Actually, I don't see why it has to be so boring a lot of time and so process driven. I think there’s scope to make it a bit more interesting and challenging I suppose.

TA: Have you ever done any e-learning that has been more interesting because it's had different elements in it?

P12: No. The only thing I can think of is when I did the training around computers for myself.  I cannot think for the last for 4 or 5 years of any training that I’ve done, you know e-learning via working for the NHS that a, I have enjoyed, basically, and b, that I’ve found useful. I think it's just something I have to tolerate, in my job, to keep my registration.  

TA: To keep your registration. Okay. So, any other comments or thoughts?

P12: No, I think that’s probably it. 

TA: Thank you.
