TA: OK. Thank you [P13], for agreeing to meet me again. My first question is how do you think that using open education resources as CPD is different to doing mandatory and statutory training using them?

P13: How is using open education resources different to doing mandatory training?

TA: Yeah, because it's all e-learning isn’t it? It's all online.

P13:  Yeah. So, I suppose with mandatory training and I think somebody was talking about it the other day in the [team meeting]. You kind of skip, skip, skip, skip, skip and you just want to get to the assessment bit. Just want to pass it because it's just got to be done. Whereas actually, when you engage with open education resources particularly something that you're interested in I think you've just got a different mentality, so you're not skipping through and just trying to get to the assessment. You're actually hoping that you're going to be learning from it.

TA: Okay. So, can you tell me a little bit more about that mentality that you refer to, about learning from it?

P13:  I think you want to develop skills. I'm just thinking of the mandatory fire training that we do. You know, you like to think the chances of us actually being in a fire are pretty minimal. If I was in a fire I'd just be guided by somebody else about what to do, so I just want to tick that box and get it over with. Whereas when I'm not doing mandatory, when I'm doing an open resource about say something in nursing that I'm interested in I genuinely want to learn that skill or develop that knowledge. I think my mindset is very I want to do it rather than it being imposed on me.

TA: Thank you. What do you hope to gain from that? You said you want to develop, you want to gain more knowledge. What's the purpose? Do you have a specific thing in mind about an area of practice for instance?

P13:  I think to be a better practitioner, be that to do with teaching or something related to nursing skills, it's just to be a better practitioner. To just continually strive to be better. To advance your knowledge, your skills, everything.

TA:  Okay. Thank you. I know that you've used free online learning before. There was a unit that you specifically did from e-learning for health. You chose to do it because the students were going to be doing it. Maybe you could just, thinking back to that time, tell me a little bit more about it because we only briefly talked about it last time.

P13:  So, that was I think that was the one that was produced by Health Education England about doing a NEWS assessment. So, to get the NEWS score, we cover that in the unit and you know doing a NEWS assessment, but it was produced by Health Education England during COVID so that students could learn online how to carry out those skills. But it had lots of practical so I went through and I did the package myself and it was useful. Where I see the benefit of it is when you're sitting in a classroom with second year students and you're talking about doing a blood pressure or resps or whatever, there's going to be some students in the room that aren't. They don't really fully understand what blood pressure is or they don't really, but they don't feel that they're at a stage of their learning where they should know that. So actually, having that resource for them to dip into to develop that knowledge or fill in those gaps, I think it's really useful.

TA: Yeah. So, you found that useful for yourself as well, even as a practitioner. How did you know about where to find that resource?

P13:  I was told by the clinical skills team. One of the clinical skills members of staff joined our unit and she said ‘oh, we've got this in skills’, and I had a look at it and asked if we could put it on our unit.

TA:  Were you aware before that of any of the other e-learning for health, HEE learning or any of the things that are on the screen [referring to list on room background] like the LinkedIn learning, or anything else?

P13:  The e-learning for health. Yeah, I'm aware of that and obviously I do that myself when I do my bank shifts. So, I've got to do that every year myself and obviously mark the students that I have, that are doing e-learning for health. It’s been quite predominant sort of, for years for me. TED talks, yeah. I'm not a massive fan of TED talks. I would say there’s a couple that I really like. Some of them, I think quite often the talk's not really what the talk’s about, or what the learning’s about, and it's a bit too abstract. I need it to be a little bit more obvious.  RCN resources. Yes, use them. Do you want me to go through these, which ones I know of?

TA: You can if there's anything that jumps out at you that you've been aware of, but I'm really interested in how we, as nurses should find out about these things because there's a lot on the screen isn't there, actually? 

P13:  There is a lot on the screen and actually for some things we have to subscribe to stuff, to then know about it. Then I think sometimes we get bombarded. I know that sometimes I'm bombarded with e-mails from different places so often I will just delete it, where actually the RCN or the International Council of Nurses might actually send me something that's useful. But because I'm so bombarded with different groups sending me stuff, I don't spend enough time. I found a lot of stuff on Twitter actually that I really, you know when people share good resources on Twitter, I've found that really useful, and they come from a whole variety.  I don't know if you're seeing at the moment there's a doctor and he puts a picture up and asks for a diagnosis. Often the comments are really good, where they then share and I just think that's amazing really. I think it's that move, isn't it, to that kind of quick learning?

TA:  Yeah. I suppose again the question is how do we actually educate people, or student nurses maybe about where they can find all these things or what their purpose is?

P13:  We knew that there was a university that was doing a lot of. I want to say York, but I might have made that up. They were doing a lot of open education stuff that was really good.  I think it was York. That was really good and sometimes I've used their resources for students. I suppose with students it's that kind of. So, I've had a student before who sent me an e-mail and said that what I taught her in class was incorrect. I did question myself, I thought there was a chance that I've got it wrong. So then I spoke to her the next time I saw her in class and she had watched a YouTube video, so I said ‘well, can you send me the YouTube video’? She sent me the YouTube video and I looked at it and then I went back and told her that actually the YouTube video was wrong. He was wrong in what he was saying. I think therefore that you’ve sort of got to be wary of maybe directing students to the right sources for learning stuff, as well for them to understand that sometimes it's people's opinions as opposed to actual research and evidence based stuff that is being shared.  

TA:  Yeah. You talked about the TED talks being a bit too, something.

P13:  A bit too subtle aren't they, sometimes? You know, we're going to talk about frogs but actually the real learning is going to be about how you attach, you know. Do you know what I mean, that kind of thing? Yeah.

TA:  Yeah. So maybe then it's not explicit what the learning is going to be about is it really, so we're expecting our student nurses to become practitioners and go out and look for oers. The NMC are advocating it and everybody else is advocating it, so I just wondered what sort of skills do you think they need to be able to use them effectively? That links in to another question which is what sort of technical, technology skills and what sort of other higher level skills do you think nurses need to be able to work in today's health service, NHS environment? I think that links to accessing oers because they're probably similar.

P13:   I think they need to be IT savvy. There are different platforms that you use within say a hospital or community setting, so there's lots of different sort of IT stuff that they need to be able to navigate and be confident in. But I think probably one of the skills that they need is to be able to sift the wheat from the chaff. That this isn't relevant or true or where has this come from, and to go to recognised sources and things that are maybe endorsed by the RCN or the ICN or something like that, so that they're not picking up whatever his name is from down the road who’s just decided to put something together.

TA:  Yeah. And that links to your point about relevance. You talked earlier about something being not 100% relevant. How do you know an oer is going to be relevant for your context or how might you make it relevant for your context do you think?

P13:  I think I've probably fallen foul of, not fallen foul but I've started using an oer and then kind of halfway through thought either this is more basic than I thought it was going to be, so I kind of don't continue, or this isn't actually what I thought it was going to be so I'll discontinue. I think for students it's about, I would only recommend an oer to them that I had used myself and not vetted it, but you know. Also, I think it's really good, so where we've got the research units in the Uni and I don't know if those units do cover oers and how they can sift through and work out which are good ones, that are relevant and useful and correct, but that might be something. So, we tell them about how to review articles and make sure that they're correct and actually to add that skill.

TA:  Yeah, the skill set is similar isn't it, in fact, about critical appraisal. Putting words into your mouth like critical appraisal skills, do you think that even if an oer not quite 100% context relevant, is there value in using it?

P13:  If it's not context relevant yeah, but if it's incorrect context then no. Sometimes you know you'll go in and sometimes it's just interesting isn't it, as opposed to necessarily being what you thought it was going to be, but it might still be interesting.

TA:  Yeah, yeah. Are you aware of any changes that you can make to oers if they are in the wrong context, or incorrect?

P13:  That I can make?

TA:  Yeah. 

P13:  No. No, I’m not.

TA:  Okay, so I'm referring to things like Creative Commons licences. Have you heard of Creative Commons licences?

P13:  No. Should I've done?

TA:  Not necessarily.  

P13:  Okay. Alright.

TA:  I think we're still early days in using oers and the stage one data showed me that that was true. Really it's mandatory training and statutory training that most people are doing, which is why I want to focus on people who've done a bit more really.

P13:  Okay.

TA:  But, without overstating it, if it's got a Creative Commons licence you can adapt it to your own context, so you don't have to deliver the material as it's set. You can actually make changes to make it context relevant .

P13:  Oh right. Okay. That would be useful wouldn’t it, with students.

TA:  Yeah, but you can't do that with everything. So, often if there's a university course on FutureLearn you can't change it. It is what it is. But if it's somewhere else, in an open education resource repository, then you can.

P13:   And they’re happy for that to be used at unis? That's sort of a stupid question to ask, but I feel I should ask.

TA:  Yeah, they can. I suppose my question. How would you quality assess that resource in the first place?

P13:   If it was an open education resource that I was going to share with the students like that one from Health Education England, I knew the content inside out so, by going through it myself, that package, I was quality assuring it, although it had obviously gone through lots of quality assurance because it was about skills from Health Education England. I suppose if I’m going to use other resources then I would probably quality check it with what my knowledge base was.

TA:  Yeah.

P13:  Well, Tanya, possibly I haven't linked open educational resources into other units or other bits of teaching that I've been doing because, it's a bit like when you source photos, you've got to go to shutter stock or whatever it's called, where they're not copyrighted. I get so panicked when they go on about copyrighting but yeah. Maybe if we knew that there was this copyright thing that you're saying that we can change content and then add it without getting into trouble. Yeah, that'd be great.

TA:  Yeah. What are your thoughts about us sharing and giving guidance about oers to students that are externally produced?

P13:  We should, shouldn’t we? It’s something I've always thought was really odd, why you’ve got have a university account to be able to really search for articles and things. But actually, surely when people are producing new knowledge they want to get it out there and people to share it. As long as if it's something I produced, it's got my name on it, then it shouldn't matter if someone at Bournemouth is using it or someone in New Zealand is using it. That's surely a great thing that we're sharing. Also, if you know somebody like Health Education England produces this great resource with great graphics and all of that. Well, I wouldn't be able to produce anything that good, so why not share them? It's a bit like the NHS produced a little sort of team video about how the NHS is structured and we could try and explain that in class, but we’d never produce something as good as that. So yeah, I think definitely share it.

TA:  Yeah, and you talked there about maybe sharing some of your own work.  

P13:  Yeah. 

TA:  If you had a Creative Commons licence on that, that allowed people to adapt it? What are your thoughts about keeping track of how people use it? Do you think that's important or not really relevant? 

P13: I suppose, I don't know. If I produce something and then everybody went off and altered it. I suppose as long as there's always a link to the original that's there? Because what you'd hate is for it to be altered and altered and altered and then it is either wrong, or I don't know if somebody does something malicious to it or whatever, and for people to think that if it's got your name on it, that it's originated from me. So, I think if you can go back and see the original then yeah, it wouldn't bother me. 

TA:  You've talked several times about students maybe coming to you, or talking with students about oers in class because you've directed them to something. What are your thoughts about that kind of conversation aspect around them?

P13:   What, about them wanting then to discuss it?

TA:  Yeah, or having the opportunity to discuss it, rather than them doing it on their own particularly.

P13:  Yeah, I think they should discuss it. Years ago when everything was still quite clunky we did one for a [clinical process] unit. I produced a package and that did get good discussion going in class. We linked a test to it so you could see if somebody had worked through the package, they'd get 100% in the test, and then you could see if they haven't done the test or they'd score, you know, 2. So then you could ask ‘why didn't you engage with it?’, have those kind of conversations, but also some of the scenarios in there were quite thought provoking so just get discussions going. I think they're great.

TA:  Yeah. You did refer earlier to guiding students to resources and things in preparation for them being a qualified nurse. How do you think that fits with your professional responsibility for developing nurses who are fit to practice?

P13:  Yeah, I think it is part of our responsibility. We probably need to catch up at the university because we're still looking at guiding them on articles and I think when you look at it, actually there's some work on how children are learning and it's that kind of bite size, really quick videos and lots of TikTok. I speak to my kids and they're always like well, on TikTok it says. I'm not sure TikTok is right, but then I think we do need to, that is going to be the way forward. You know most people have got a smartphone, you know lots of these things you can access really quickly, so, a bit like that man on Twitter that's sharing just a picture, and then you can look at the discussion as much as you want, whereas sometimes going to a big hefty article that maybe is written in a way that isn't easy to read. You know, that's not maybe the future of nursing. You know when you're in practice and you want to look something up quickly, reading an article, lots of long words, may be not the best thing. 

TA:  Yeah.

P13:  I think we should be moving with the times.

TA:  Yeah. Do you think we have a responsibility as educators to make sure the students access specific stuff that's relevant for their programme or that they must tick a box about, or do you think there should be different freedoms?

P13:   We've got a responsibility to direct them, but I think we've also got a responsibility to direct them to things that they're going to engage in. I don't think we can do it the way that it was done for us because, you know. Yeah, put me with the times, you know, that's what nursing and our profession is all about, is actually about evolving and keeping up. That is the way in which we're learning, or our learners are learning. Stuff’s so much more acute now as well, that people are looking after in nursing, so sometimes people aren't going to retain all the knowledge or keep up to date with how fast paced things are moving. So, if they knew how to access good, reliable oers, then yeah.

TA:  Yeah, good and reliable, you spoke about there. Did you want to say anything more about that?

P13:   You know there are clearly from reputable sources, that they can see have been peer reviewed or, you know the equivalent that we would be asking them for when they're looking at articles. You know, just going to somebody doing a video in their kitchen as opposed to reputable, the RCN or Nursing Times. 

TA: Thank you. Okay, was there anything else that you wanted to just talk to me or tell me about, your thoughts about how we prepare our future nurses or how you use open education resources yourself?

P13:   I think it's a really exciting time. I think we're seeing this real shift with our students and the way that they're learning, and the way that they want to learn, the way that they want to engage. There's so much isn't there, because you can go down rabbit holes really quickly when you're searching for stuff. I think there being a known source to go to would be good, like a BrightSpace for nurses, that's a repository for all things nursing that you need to know about, or all things health related.

TA:  Yeah. There are some reputable repositories out there with healthcare science specific stuff.    

P13:  I'll tell you one thing that definitely puts me off when I'm looking for oer type things is when you start and you think oh, this looks really good, and then you can start watching something, or engaging with something, then if you want to go any further you've got to subscribe. You think well this isn’t an open resource then, is it, if you're asking me to pay for this. That becomes frustrating. And I don't know whether that's my ignorance in my searching for stuff, or if that is that people are trying to dupe you in, to hook you in and then you think oh, God, this looks really good. Okay, I will pay to subscribe to 
it, and actually.

TA: Thank you. Any other thoughts?

P13:  No, I think that's it.

TA: Thank you.

After the recording stopped there was some further brief conversation, where P13 raised concerns about potential for phishing when looking for open education resources, or on being subscribed to mailing lists/learning platforms/learning providers.


