Demographic questions and confirmation of consent.
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TA: Thank you very much. Okay. I'm really looking to see how nurses can be prepared, effectively, to use open education resources, or e-learning, or online learning, as CPD. Just before we start, have you ever heard of the term open education resources before?

P22: Yeah, I've heard about it, many times.

TA: That's good. Most people I've spoken to haven't heard that term at all. So, we generally talk about free online learning, or Internet-based learning. So, just thinking then about some of these resources, that you've accessed yourself, how have you come to find them? Has somebody signposted you, or have you found them through yourself, through searching for information?

P22: Yeah, I was introduced to it, by my fellow workmate, so.

TA: Okay.

P22: He is the one that introduced me to it, so, and I searched into it, and got interested in it.

TA: Okay. And was that when you started your clinical place, your clinical job after you qualified? Was that where the introduction was made, or was it back in your training?

P22: It was after.

TA: After. When you were introduced to the information, why did they make that recommendation? Were you looking to get yourself up to speed about the clinical area you were working in, or was it something else?

P22: Yeah. So, while like, engaging my friend. So, he had a lot of expertise in his job, and had a lot of experience in some informed knowledge, that we didn't learn in the training. So, I joined it so that I can be more experienced, and more knowledgeable about my career.

TA: Brilliant. Thank you. And was that a specific platform? Was it e-learning for health, or was it something else?

P22: Yeah, it was just e-learning for health. I wasn't using it before, so currently started using it just recently.

TA: Okay. So, I don't need to know where you trained, but I'm imagining you didn't train in [town name], because at [university town name], we do use e-learning for health, for some of the training, during the students’ programme as well.

P22: No.

TA: So, it was new to you. Have you also done mandatory training online?

P22: I’ve signed up for a few.

TA: Yeah. So, things like health and safety and things like that, have you done those? Have you done that kind of training online, as well?

P22: Yeah, I’ve done some of them, like emergency, safety. Yeah.

TA: So, when you're thinking about the training that you went to after your fellow colleague introduced you to e-learning for health, how's that different, to what you've done, for health and safety, lifting, fire safety, that kind of thing? How's it different, engaging in that learning?

P22: I think, very unique. It's a very unique way of like, learning, especially online. And I think, first, it was cost effective. I think, the, one of the most advantage, significant like, of engaging with the OER, is that, some of them is freely accessible to users, so, that’s one of the differences that I encountered.

TA: Yes.

P22: I think the other one is, it is easy to adapt in the materials. It's adaptability makes changes very fast and easy, and gives you up to date information.

TA: Okay. Can you just tell me a little bit more about the adaptivity? Is that something that you see being built into the OER, or is that something that you as a practitioner looks at the OER and thinks I'm going to adapt this, to match my clinical context of?

P22: You know all OER materials are like, often are licenced under open licence, like some form of Creative Commons. Yeah, I think this allows some users to modify, and it's not like they force you into something, they just give you the ability to modify, and adapt to the customised, and customise to the content that suits my needs, so it wasn't like forced into it. I was able to modify and customise it, to meet my adaptability.

TA: Okay. Do you want to just tell me a little bit more about that, maybe thinking of an example where you have adapted something, because it's, not quite met your needs, and how you've adapted that?

P22: I think like, their teaching style is different from their curriculum. I think, and they meet some form of, they meet diverse needs of their students. They like, give space for, not a specific group of health student, but a diverse group, so anyone can choose from what he or she thinks that she needs to learn at that time.

TA: And if you find something that you don't want to learn, at that time, it's in the middle of an OER, what do you do?

P22: I learn it.

TA: You still learn it?

P22: Yeah, I still learn it. But you know, in this world, it's a changing world, so you know, you have to like, be competitive, so as much as it's not something I wanted to learn, I try to learn and maybe try to understand some newer things. So, I don't know it may end, but try to learn new things as much as possible.

TA: Yeah, okay. And obviously you're understanding about OERs is quite in depth. Did you know about actual OERs and what they are before you started using e-learning for health and things? Or, did you learn, after you'd accessed those free resources?

P22: So, before, there wasn't someone to like. There wasn't someone to like show me, or tell me the advantages of OERs. So, before I heard about OER, but I wasn't like. There wasn't any one, helping me show, helping me understand the advantages of OER, but after like during the training, after getting some work, it's where like, I started, giving it more attention, and like while maintaining the programme.

TA: Yeah. And the platforms that you've talked about, going to e-learning for health, have you looked at any other platforms? There are some on the board, behind my picture, I don't know if you can see those, but have you looked at any other resources, or have you really just stuck with e-Learning for Health?

P22: Not really. Not really like, looked deeply into it, because of, I'm still in my first year. So, I'm giving it time, though I think there are other courses. I think, as much as I would like to look at it, I think I have a really big problem, with the time, and creating time for other, for learning, which has been really difficult, but with the help of OER, I think I can create some time, so I've not really engaged with other, these other type of resources, but I've engaged with the TED talks. I've engaged with TED talks and some, free courses in England, and some LinkedIn learning.

TA: Right. Okay. So, you're obviously, you sound as if you're quite forward thinking and a really interested and engaged learner, in that you're still doing all these things, despite not having very much time.

P22: Yeah.

TA: Do you get any time back from your clinical area at all, if you do this kind of learning, or do you take the learning, or do you take some evidence of having done this to your manager, and tell them that you've done the learning? How does that work?

P22: I create the time for myself. 

TA: Okay. Does your does your clinical area really give you any reimbursement for the time, or any recognition of the learning that you've done?

P22: Yeah, yeah. I think, I really got recognition in the emergency room, after learning some good safety measures. I think, while starting working, I didn't like, do this type of thing, so. Nowadays I can really engage with a lot of things, showing what I've learnt to my bosses, has really kind of exposed me to my work, so, I think they really recognise it, and really, really appreciate, by giving me some work in the areas that I’ve learned.

TA: Okay, so they don't necessarily give you time for the learning, but they then maximise, your potential, by giving you opportunities to use that learning and practise.

P22: Yeah, they don't give me time. They just recognise it. They tell me it's my responsibility, so I cannot take it positively, and try to create time for myself.

TA: So, you've talked about how you still continue with the learning even if it's not something that you really wanted to learn, if it's in the middle of a package, but have you ever found any open education resources that you think are inaccurate, or that are really, irrelevant for you? And what did you do if you find those?

P22: I believe the OER is built for diverse learning. I don't believe that the resources that are put there, you must like, it's a must that you that you learn. I think when getting these type of resources, that seem not useful, I just scroll and look for resources that may be useful for me, so I just brush it off and like scroll to look what suits me.

TA: Okay. So, you're obviously using some judgement there, about the relevance. Was that through skills that you developed in your training, would you say, or was that skills you already had about finding things which are relevant?

P22: So, I think, from my area of expertise, I think there's some things that I know. When I come across some things that I know, sometimes, since I know it, I may not like, take the course again. I may see them as irrelevant. So, those are some of the things that I like, subjects from learning.

TA: Yeah. So, when you go to the resources that are saying, it sounds like e-Learning for Health is the main place you go, so when you go there, what questions are you asking yourself, as you're checking whether something's relevant?

P22: First. I see, first I look for the availability, or like, the abundance of the expertise in our facility.

TA: Yeah.

P22: So, the more the evidence, the more likely I would like to do it, so that I may be competitive.

TA: Yep.

P22: So, apart from that, I also look at the time spent to like, finish this course.

TA: Yeah.

P22: So, the time is also a factor, to consider. And maybe my area of expertise, so if it's not under my area, under adult nurse, I will not consider it.

TA: OK, when you're looking at the resources, are you looking at who's produced them, or what their provenance is, or where they've come from or who's written them? Do you take that into account, and maybe choose one provider, of the OER, over another?

P22: I really don't like, try to judge the course by the writer, because it will limit me. I feel like it will limit me, because I believe there is, there are a lot of brilliant people out there, with the different diversity and different places. So, I really don't consider them, but I try to look at their achievement, you know. By understanding their achievement, I understand how far this guy can go, or she can go, so I really don't try to maybe, diverse my content from the writer of something that.

TA: OK. When you go to e-learning for health, how much do you trust the materials that are on there?

P22: I really trust them a lot. I believe, I've seen a lot of colleagues, have been, recognised through the OER by, by our personnel, by our top personnel in the organisation, so, if the top group of the management are recognising like, students who are recognising, workers who are from the facility who are learning some form of experience from the OER. I believe like, if the top one are, they're appreciating the effort from personnel, from the OER, I think, I don't like, need to like, question, this material, so I really don't do that.

TA: Okay, that's fine. They obviously authenticate or validate it, then, don't they by knowing the people who are presenting the materials and knowing they're going to be good quality materials.

P22: Yep.

TA: Okay. And there is some assumption, isn't there, that if something's in e-learning for health, it will have gone through some checks, or something, to be able to be on there?

P22: Yeah. like peer review. 

TA: So, people talk about peer reviewing, and when they look for OERs, they might look for things which are peer reviewed, like it would be, if it was in e-LfH.

P22: Yeah.

TA: Okay, so when we're thinking then about what skills you need, to use OERs, do you think you need any special skills? Just maybe tell me a bit about that. Is there anything that you wish you'd known about OERs, before you started using them?

P22: I think there's no specific like, skills. I think the fact that we were born in a generation where most of us know how to navigate this online platform, I really don't think I needed some skills to update for OERs, you know. 

TA: Okay. And what about knowledge? Do you think you needed any special knowledge or anything, to be able to use OERs effectively?

P22: No, I don't think so. I just got, some direction, and after navigating through some OERs I think I was like, ready to, handle the whole platform, so I don't think I need some special skills or something to navigate. I think everybody can do it in a particular time or period.

TA: Yeah. And out of your colleagues and the people you work with, would you say that you're alone in understanding about OERs and the Creative Commons licences and things, or do you think that many of your colleagues understand these already?

P22: I think they understand. They understand, or most of them understand these things.

TA: Thank you. I'm just going to refer to my questions, if that's all right. Okay. And maybe just talk to me a little bit about what type of learning you've got from an OER and how you've actually taken that, and used it in practise. You've said that your managers have given you scope to practise your new knowledge. Could you just tell me a little bit about how you've shared that knowledge with them, and then how you've applied it in practice?

P22: So, I’ve really like, gained a lot of experience and some learning from OER. I think some of the things that I’ve really learnt and applied is some safety measures. How to handle some safety measures around the organisation, and how to like navigate and maybe safely handle emergency situations in the organisation. This has really helped me handle some difficult situations, which required some other personnel. So, the fact that I was there, was able to handle that situation at that time.

TA: Yeah. Could you think about a specific example, and are you able to tell me a little bit more?

P22: I’m trying to look for one.

TA: [Pause 23 seconds to allow response] It's okay if you can't think of something, but if something came to mind, obviously it would just, help me understand how you've taken that learning. So, have you recommended any OERs to other people?

P22: Yeah. Okay. So, some of the things I learned from OERs and how I used it. In the facility was I think, there was a time, there was a time I approached a person. I think, from OER I learned some cultural competence training.

TA: Okay.

P22: So, I was like, able to handle different type of groups in the organisation. In the facility there was a type of group that was coming, and they were really misunderstood. I think I was able to listen to them, and maybe interact with them in a positive manner that, they were able to disclose what they wanted, and how they may be helped, and I assisted them, so that's how we used kept cultural competence training in in our facility, to help these kind of clients.

TA: Excellent. And, was anybody else there, observing what you were doing? Did they learn from what you did, and find that helpful, and?
Some uncoded discussion removed for anonymity as disclosure of a clinical situation.

TA: Yeah. And, you obviously felt confident in that situation, by the sounds of it.

P22: Yeah, I felt confident and really learned a lot, and I was glad that something that I learned from the OER was able to help me in that kind of situation.

TA: Yeah, and did that link in then to your NMC Code and professional responsibilities? Do you think that learning helped you to apply your code, more easily or?

P22: It wasn't easy. It wasn't easy at first, but with time it came. It came easily with the experience.

TA: Okay. Thank you. My final question really is just to ask if there's anything else that you'd like to tell me about your experience of using OERs, and about how you might have been prepared better, or differently, or if there's anything educators perhaps could do, to make it easier for you to find and use OERs?

P22: I think some of the things that may hinder OER is maybe Internet access, which is. I don't think it's a thing that you guys may handle, but I think it's something that the users may like to have improved, so that it's easier to access this kind of information. 

TA: Was there anything else that you can think of, that you'd like to tell me, or?

P22: Yeah, I'm trying to think of one. I think, there's some form of limited interactivity, while using the OER. I think some of the OER may lack, interactive elements, or engage in multimedia features, commonly found in proprietary educational materials. I think, these things, this is something that can limit, and can impact the overall learning experience, I think, especially for students who benefit from interactive content, I think, introducing some interactive, features, in the OER, I think it's really helpful to, for like, some learners, to engage different learners, anywhere, around the world.

TA: Has that impacted on your own experience, would you say [P22], about the limited interactivity?

P22: It hasn't, but I think, if I could get more interaction, I think, I could explore it more, and maybe, learning. And maybe I'll be able to diversify my learning, because of the interaction I'm getting. It hasn't, but in case I could have had some form of interaction, while accessing the OER, I think it could have improved my ability to access more OER content.

P22: Yeah.

TA: Do you think the employers have any responsibility, or role, in supporting their staff to learn, things that are relevant for their role?

P22: Yeah, yeah, I think they are responsible. I think they should shed some light, on some expertise that some of the employees need to, improve on. I think they know, potentials of different employees in the facility, so, they should expose them and try to like give them direction, on how to like, improve on this, and on this, through the OER things.

TA: Yeah. And do you think that there's any possibility that employers, could use an open education resource, actually, in a setting, for their staff members, in order to make it more interactive or?

P22: Yeah, yeah, I think, they should introduce that in settings. I think some of us, some of us, instead of like spending some time, maybe. So, if they are free in their facility, they can spend their time there, which can, increase, the learning ability from the OER, and maybe improve the experience. Yeah I think so. I think they should introduce something like that, then it will improve the performance of the nurses, and improve the OER, how people are engaged in the OER, yeah.

TA: Yeah. And what's your impression of the value, that your employer puts on CPD? Do you think your employer places a big value, on CPD, or something different?

P22: I think they are the one who understands. I think them being on the top of the management, understands each, and every ones’ personal experience, I think. They should be the one, providing these ones, so, I don't think so.

TA: Thank you. 


