Welcome and ethics
*****
TA: So, we're just going to discuss and hopefully validate the categories I've developed from the data that I got from you, during this research. We'll start by doing introductions. So I’ll do a very brief summary of how I got to the findings, and then we'll have a discussion of each of the categories and subcategories, and then we may proceed to discuss the central thread, or I might just begin to introduce my thoughts about that, or ask about your thoughts about that for certain. 
Individual introductions

TA: Okay, thank you. That helps us to understand everybody's context when you're replying to the discussions about these categories. Okay, so just a brief summary of the research process. Some of you might have been involved just with the first stage, the purposeful data collection and analysis and some of you with both stages. So, in the first stage, I talked fourteen people about their personal experiences of using online learning. I'm now using the language free online learning because only one person in the whole study actually, was really familiar with the term oers, or open education resources and actually the focus was on using free online learning, not open education resources as they're defined in the literature. And I developed eleven focused codes out of that, and those codes helped to determine the questions that I was asking for the second stage, which was the theoretical data collection. And at that point you'll have been invited, by seeing if you could answer those questions. I sent those questions round and ultimately, ten people talked about their own ideas about how nurses can be prepared for using free online learning. Those were five people who've been involved in the first stage and then five totally new people as well. Ultimately, I had eighteen theoretical codes that are, where I explored the data in depth and came up with the codes about all the patterns I was seeing in the data. These were sorted into the categories and the subcategories that we're going to look at today. So, the purpose of this meeting is to see whether you can make sense of what that data says, whether you can recognise the parts of it that you contributed to, not specifically, but whether you can recognise your own experience and thoughts in that data as well, and that's part of the validation. So, this is just a brief diagram. The eighteen theoretical codes sat beneath these arrows, but ultimately I have developed two main categories. One is professional learning as a social endeavour, and that has two elements within it, that's learning with others and making learning meaningful, and then the other is being swallowed up in practice and that encapsulates feeling supported and having time and space for learning as well. Those slides I circulated at the end of last week, also had quite a lot of the original quotes, so hopefully you'll be able to see from the quotes that I used, how I got to those labels, if you like.
So we're thinking about the first one. The first category professional learning as social endeavour and the first subcategory which was learning with others, which was a theme throughout the entirety of the two stages of the data collection. This was really focusing the importance of social nature of learning for professional practice, about learning from others, about getting other people's ideas about what works in practice, and how you apply knowledge. Having reflective discussions, and the fact that these reflective discussions themselves can prepare people to think critically when they're learning independently, because that's not necessarily a natural skill. Some people saw there was potential for team-based learning using free online learning resources, but that is only a theoretical viewpoint really, because it's not feasible when you're trying to get people together in practice, it just doesn't work. So, we need to think about ways of using those to learn from each other still. And the fact that free online learning can feel isolating, and also it can be impeded, if you need to stop, to ask questions or do fact checking and things. So, my first question then is can you relate to this category, as it's presented, and/or is it meaning for you meaningful for you? So, V1, I'll invite you first.

V1: I would say yes, definitely I feel that what you've found relates strongly to perhaps some of the things that I myself said, but even if I didn't say them, when I see them here, it makes a lot of sense to me from my practical experience and, you know, I can relate it to specific examples. Like you know when you're doing safeguarding training and I've done that online, that is so dry and it's so abstract. You need to have opportunity to discuss that, critically, with other people, to learn from each other, and to think about it in real life context, not just what is being taught to you, because what’s taught to you is not the same as what happens in real life, when you have to deal with situations.

TA: Okay. Thank you and thank you for the example as well. V2, what are your thoughts or feelings about this category?

V2: Yeah, absolutely. Safeguarding is one of those ones. To be honest. I hate doing child safeguarding because it's so traumatic, and it's almost I need someone to have a hug with. I was doing it yesterday for a while and then kept getting interrupted. I was trying to sort of, you know, lock myself away in the room, and the phone rang and a message came up that I needed to pop out to reception. That in itself does make it difficult to participate in your learning when you're constantly being distracted, but something like safeguarding, it is so emotive, that being able to do it and talk to someone, or just like have someone to lean on, in a group is a nicer way to learn. And being able to discuss things and reflect on, sort of see if anyone's been through that experience, or that thing, on various different types of learning is a lot more, meaningful and fruitful, than just reading a load of stuff on a page and clicking next, and falling asleep at the wheel, kind of thing.

TA: Okay. Thanks, V2. V3.

V3: My recent experience of free online learning, sorry, I don't want to be controversial but it's quite possible, shall we say, to just go through the online learning and not bother relating to anybody, because you're under a bit of a ‘well, has she done it? Tick, kind of thing. Do you see what I'm trying to say there?

TA: Yes. I'd invite you to be controversial because that helps me to challenge the validity, so please do offer any thoughts.

V3: So really my thoughts are, absolutely it is, beneficial beyond belief to share your learning with other people, and you get far more from it, and safeguarding is an excellent example of that, but equally it's not necessarily a given that when you go through these free online learning resources, that you will engage with others. That's the point I'm making I suppose.

TA: Yes. Is that? Can I just ask a question there? Is that by choice, would you say a bit more about whether that's by choice, or whether it's just the way it's set up or?

V3: Well, if I think about the, when we did the vaccinations for the COVID vaccinations, there was a whole bunch of online learning we had to do, and really and truly that was just get on with it and do it, because we need you finished so that you can start, sort of thing. And then there was a whole bunch to do once you were there as well. I didn't find that I particularly. I learned a lot of information. I got a load of information and I don't deny that wasn't helpful. It was helpful, but the impetus to learn with others wasn't really there. I have done other online learning for myself. I've done safeguarding recently for a voluntary role that I've got, and that did involve being in groups with other people. It had a kind of element of that which was done, also done online and I found that invaluable. So was it a choice, wasn't it? I suppose yes, in part it's a choice, if you decide not to engage in it, isn't it? But on the other hand, there's sometimes circumstances that make the choice impractical anyway.

TA: Thank you. It's good to have that insight. So, if any of you think there's something which you don't have to be here, just to agree with my findings. I'd like you to challenge them as well, please. So, thank you. Okay, V4.

V2: Obviously, sorry, I should say, COVID was obviously different circumstances, so wouldn't it have been nice to do all your COVID training in a group with other people! But obviously not possible.

V3: Yes, I know. But you could have done it on, there was a zoom option, wasn't there?

V2: Oh, I see.

V3: Yes, that's what I was meaning. Not really. No. I wasn't really thinking of face to face, in particular.

V2: But that would have been nice. 

V3: Hmm.

TA: Okay. V4?

V4: I would say I've got two experiences of online. One was vaccinations, so very much I was doing it on my own. It was hard work. It felt isolated and actually, I don't. I didn't learn an awful lot. Okay, the term surface learning sort of comes to mind. But there wasn't. I just had to plod through it, and I question, although it gave me lots of facts, then it was very difficult to relate it to practice, until I was in the practice setting. It was very dry and hard work. Then in my role as a [specialty] research nurse, the, not the dynamics, but the workspace allowed myself and a work colleague, you know, to share the same office. And so when there was online learning to do, and we did it together, yes, it. There was a different, definitely a different. I'd like to say flavour, but that's not quite the right word. Because, yes, we could chat about various points we were unsure of, or have a laugh, about something that we, that you know, the way that they phrased it. So, it was much more meaningful and made sense and yes, it was, you know, much, much deeper, so learning with others, is highly important. Yes.

TA: Thank you. So that's all very good useful points and I can see there there's an element of thinking about the depth of the learning in relation to learning with others, perhaps as being a part of that. But you can all at least relate to learning with others being important in the context of nursing or health care practice?

V4: Yes.

V3: Absolutely.

TA: Okay. Thank you. I'll move on to the next one then unless anybody's got anything to add on that one? Okay, so the second one took a while to come to the heading I suppose for this one, but it was all about making learning meaningful. And people did talk about this again a lot. And I suppose you've just alluded to it in the previous subcategory actually, but, people talked about the learning being taken and engaged with differently when it was self-led and intentional because you were getting something out of it. What was really interesting was that quite a few people said the employers don't seem to be that bothered in additional learning that you've done, or things which might be useful. And so, they didn't even often tell them, so they didn't share learning? In some situations where people were managers, they did actively encourage their staff to say what independent extra things that they've done, and then they’d sort of try and give them some sort of, not renumeration, but access to doing different clinical skills, for instance, to match that learning that they'd undertaken. But on the whole, learning felt more meaningful when it was either signposted or recommended by managers or people who were respected in practice, or in education and where it was in the context of your specific role in practice and people were prepared to actually invest in free online learning, because we know there are some hidden costs, like the certificates. But also, people were more ready to just spend a little bit of money on a programme if they wanted to, if they were doing it for their own purposes. So, I just wondered if, how you felt about that category as a heading, whether you can again relate to it or whether it's meaningful to you, or whether you've got an example. So we'll start with V2 this time.

V2: A lot of the things I'm trying to keep up to date with are the mandatory training that you know, that means I've just got to tick a box to say I've done that training and, yeah, that is. Where we do like group training, which we normally do for basic life support, that's almost become almost a joke. We've had, so it's a group, with a teacher and some overheads and that kind of thing, but it's been the same one for so many times that I now know all his punch lines to his jokes, so I get in there before him. So, I don’t know, I’ve had to do, what’s it, COSHH? You know, substances harmful to health and a cleaning one, and it was asking me what mop head goes with what mop and bucket, in what room? And I don't care, to be honest. It's not anything to do with me. So those ones are, I felt, really tedious. But ones like safeguarding, things like vaccination updates and diabetes related ones, whether they're just slides, or if it is a Teams thing, those ones I tend to know that they are so much more related to my practice I have to do them, and I need to do them, and I kind of want to do them. But yeah, it's still, it's a lot harder to do it, just even locking yourself in a room on your own, with a headset on, or whatever. Or just with the slide set, clicking through is, yes, it's hard going. And the ones where I'm told to do them, that you know, that that I'm not so interested in, they are really, really hard to do, and I don't. V4, what did you say? Surface learning? I like that. I haven't heard that expression before. That is it. It goes in one ear and out the other because I just needed to do the certificate at the end. That's awful. 

V3: Yes.

V2: Does that answer the question?

TA: Yes. Thank you. Thanks, V2. V3?

V3: Yes, I had the exactly same experience as V2 with, you know, the mandatory learning you had to do, you know, and I do remember the mop heads and the buckets, and all that stuff. And obviously there's a bit where you can see that this is absolutely important that we do know this, but at the end of the day we could fairly easily find out what we need to, when we need it anyway, over that kind of thing. But that would be, that was meaningful in as much as yes, you can see in the big picture, it's important that we all know this, that everybody has access to the same information kind of thing, on important, on essentials, let's say. But meaningful in a kind of personal sense as a personal learner, that's a different thing really. The only example I can really provide related to practice, I've done lots of other online learning not related to practice, but in related to practice, with the COVID vaccinations initially, how it ran was that adult nurses just vaccinated adults, basically and you didn't vaccinate children. And then as time went on, you then started to vaccinate children. Now I hadn't had any work with children for an awful long time and so I did some online learning around, things that I thought would help in that. For example, the Level 3 safeguarding and that sort of thing I did, and a few other things to help me more get up to speed on the caring for children really. Because it's different from having children, isn't it, when you're like, caring for them. And so then it was very meaningful. I selected it. I was supported to select it and take it, and had the time and things like that, really, so that that was very different. So, it certainly makes a difference if you've got, if you've got that kind of, I suppose the word would be personal investment in learning. It makes it much more meaningful, so I can see the point of your category, Tanya.

TA: Okay. Thanks, V3. V4?

V4: When I think about online learning that I have to do, because it's mandatory, part of my job, I feel quite, at times I feel quite cross and frustrated, because I am either doing it in my own time, or I'm doing it in the context of my job, which is already busy, and it's an add-on. So, yes. So, whereas, and I have looked at resources, you know, as in outside, not outside my job, but I've pursued, not because it's mandatory, but because I've got an interest, I certainly approach it differently. I'm much more curious. I enjoy and, I feel as if it's, whatever points I gain, it's like adding new knowledge to me, as a person? So, I suppose maybe it's the circumstances, or when I'm being asked to do this online learning, and then that, frames, in some ways, what I take and how I engage with it.

TA: Okay. Thank you. That makes sense. And V1?

V1: Yes, I really relate to what you just said there, V4, and there's a few things that are sort of coming to mind as I hear what everyone's saying and think about, you know, what you've come up with, and a big thing for me is, it is around motivation. And that relates to this category and the previous one as well. I feel like they're very much interconnected, because when you've got, if you go think back to the previous category, you know, when you've got that social interaction with other learners, other nurses, that's helping to make learning meaningful, as well, and sometimes even when you're doing something that technically is meaningful, it does relate to your role, it's hard to find it meaningful when you're being forced to do it in quite a unnatural sort of situation of just sitting in front of a computer scrolling through, pages and pages of questions, you know. I remember, I think when you interviewed me last time, I remember I had recently done some online learning in relation to equality and diversity, and I actually thought it was a very good online educational tool, but I did not have time to spend thinking about it. Or. I just had to get it done and it just became so much less meaningful. And so then the motivation isn't there so much, and when you then know that you've got online training coming up, you don't look forward to it at all, whereas in the past maybe you would have done a bit, because it would have been. It's like if you go to a conference and you're given that protected time to go and do that, to be with other people, to reflect, to be inspired and motivated back in clinical practice. Well, now when I think about online learning, you know, it doesn't feel like that. Obviously, as someone doing a PhD, I'm doing a lot of online learning, but it's very different to when it's for clinical reasons, especially if it's sort of mandatory training. So I agree with what you've come up with and the only thing that sort of really sort of struck me as maybe something, a word that isn't there, is around motivation.

TA: Thank you. Perhaps that's encapsulated one of the main things that came out, which was really interesting, was about nurses not necessarily driven to do independent learning. I see your hand V4. And also accessing learning in the moment, so it's not meaningful, unless you need it for clinical practice, or you need it for your revalidation. But otherwise it not generally meaningful because it's not, it's something extra. Sorry, V4?

V4: Just expanding on V1’s point about motivation, I think it links into your intrinsic and extrinsic motivation, so, yes, much more, you just present itself. I think for a lot of people your intrinsic, you know with that, new facts you enjoy, you're more likely to gain more from it, whereas that extrinsic is being driven by other forces.

TA: Thank you. Thank you for that. That's something for me to look at in a bit more depth. Thank you. Okay, if there's no more comments, I'll move on to the next slide. Okay, so this, the term for this category is something that one of the participants said to me about nurses being swallowed up in practice. The honest situation is that nurses are just swallowed up in practice. They don't actually have the time, or the, necessarily the inclination or the space to try and do this free online learning, so being supported was a big element of this, that the nurses need to feel supported in order to be able to achieve it. And that starts right with technical support right from the beginning, just to not make assumptions that, people may not even know how to turn on a computer at the start, and they may not know how to use devices and apps, and all sorts of things. And technology is increasing massively in the NHS all the time, so it's a bit about that support to use all those tools and things. It's also, as well as practical, it's also about cognitive support, so it's about nurses being supported to actually understand how to search for free online learning that is relevant and meaningful, and accurate for their use. And it is overwhelming. You could do a search. You could find hundreds and hundreds of resources and you don't know where to start, so that's immediately something that might turn you off. So, you need support to signpost where that thing comes from. And also support from managers and peers in the practice context is really important. This links back to the other category, doesn't it, a bit of being meaningful and learning with others really, and having educator support in that setting as well, helps to tailor the learning experience, so you can look at your role in context and think, okay, what do I need to learn to improve my role or to develop or to go for a promotion or something like that. Again, the discussion with others about the critical analysis skills gives feedback support, which you don't get in online learning. You tend to get a tick box quiz. You might not agree with the answers. There's no real commentary to explain why those answers are why they are, so you need that support to just check your understanding and to fact check as well. And educators themselves, would like more information about Creative Commons licencing for using open education resources, and they'd like to know about contemporary apps. So, there was a feeling that educators should be looking much more at things like TikTok and things where, you know, learners now learn by looking at a quick video. That's the way that they learn something in a really quick snapshot. So, these are the things which kind of encompass feeling supported. So, I'd invite your comments then, on this sub-category and whether you can again relate to it or whether it's meaningful. So V3, you're first this time.

V3: Yes. Thank you. I'm sorry. Can I just ask you what Creative Commons licencing is?

TA: It is a specific form of licencing, which means that as an author you might put something on the Internet, but you would choose to do it with a Creative Commons licence, which means that other people could reuse it, they could adapt it, they could change it, they could use it in a different context. They would still have to attribute you as the original author, but they could change it, and then it could go somewhere else it be changed again. So that's the essence of open education resources, is that an educator might take something, or a nurse, and then make it different for their own practice setting, but under copyright law they can do that. They're enabled to do that. 

V3: Right.

TA: But people weren't really using open education resources at all, because they don't understand the Creative Commons licencing, and because there's enough other resources out there on trusted portals, like NHS professionals and e-learning for health, LinkedIn and other places.

V3: Okay. Well in relation to the category, I can absolutely see being swallowed up in practice would really shine forth in people's discussion about the use of open learning, because whatever field of nursing you're in, it's just, there's just too much to do in the time available really. So, because there's too much to do in the time available, that's where this whole bit about motivation comes in, because you're. It seems to me that you're only really going to, I would imagine, you would only really focus on the open learning resources that are really pertinent to your practice. And when I say focus, I mean actually concentrate and maybe engage with at a deeper level those resources that are really going to be relevant to your practice, as opposed to the other types of learning that we're obliged to do just to remain an employee and in the job, if you see what I mean. An example in education would be, you know the IT type, open resource educations that you have to do. You just have to do them by a certain date, otherwise you get sent a million letters about why you haven't done it. Do you see what I mean? So, I think this is a vital category, but very much linked up with motivation, because it's not just about being swallowed up in practice because if you, as I think V4 was saying, you found some education that was really pertinent to what it is that you do, and what you want to do, then you're really going to be motivated to do it anyway. And even though you're swallowed up in practice, you'll probably do it, do you get what I mean? You'll find the space is what I'm trying to say. You will find the space where there's certain things where you may resent finding that space, and then not doing it in your own time.

TA: Yes. Thank you. Yes, that's really useful context, so thank you for that, V4?

V4: Quick question. Is this about doing online learning in, when you're in practice?

TA: Most people don't have the opportunity to do online learning in practice. The reality is that people don't have the chance to do it, but it is being. It's about being supported I suppose, the next subcategory I'm going to discuss the time and space, is more about doing it in practice. This is more about being guided and supported to find the right things, to know which direction to take, because you don't know what you don't know when you start and you are a registered nurse, you don't necessarily know what you need to know to progress in that role, or about that speciality. So, this is more about physical support for the technology, and the cognitive support about signposting really.

V4: Okay, this might not answer your question. If it's about, in practice and signposting what you need to know, I wouldn't use online learning. I would go and talk to people. Now, if having said that, I’m going to probably contradict myself though here, because I suppose. Yes, that would be my first preference to go and talk to people, now, I would look at online resources, if I needed to go deeper into the subject. So, if I wanted to go for promotion, or I needed to know a bit more about it, then I would then say that the online gives me a different presentation on the topic, than talking to somebody. What does it give me? I think it gives me more facts. It's more factual. It gives me legislations, it gives me safety points, to then have information to take forward for, let's say, promotion. I'm not sure I'm answering the question here. 

TA: No, you are.

V4: I suppose the only other thing to say is that if I'm delving into online resources, the ones that sort of, are meaningful are those in which there's been an incident in practice, that I, that sort of remains in my head. And then when I, when it's explored, you know, points come up on the online learning, then I am able to untangle whatever it was that was in practice, that made it memorable. I'm not sure I've answered your question.

TA: No, that's a really interesting perspective and I value your, I value that perspective. I suppose when you were talking, I was thinking about the support might be, if you need a very quick resource in practice, you might like to be signposted to a relevant one for your practice, in the terms of what I'd explored, in the category, and what the data had said so far. So, if you wanted an in the moment resource, having some support for that, which ones are the good ones to go to could be useful, but you wouldn't then necessarily do online learning about it, except you've made that really good point about untangling and maybe more critical reflection, as a way of, learning.

V4: I would, yes. Nobody has ever said to me have a look at this online learning. It's only been those mandatory, or that I wanted to gain more understanding.

TA:  Okay. Yes. Okay, that's very useful. Thank you. Okay, and V1?

V1: Okay, I feel like I've got quite a lot to say on this one. Just hearing everything everyone's saying, you know, makes you think about it all. So, my first thing is that it's easy to feel frustrated or negative about e-learning. When I think about it now, sitting here, because so much of it has been about, you've got to do this and you've got to do that and then, you know, hours and hours in time, that's not really given to you, to trail through all this stuff, even though a lot of the content is very, very good. But actually, something that looking at this has just reminded me is that access to e-learning in itself can help us to feel supported, and you know, I've just been reminded of that, while we're having this conversation. And a good example. You know if you think back to when we first went into nursing, and we didn't have access to this stuff, yes, there would be people to ask, but that didn't mean that you always got really good evidence based, structured learning, which you can get now for things, quickly, when you need to, and that can make you feel very supported. So, an example for me was when I was doing like V4 was saying, something comes up in clinical practice, and you're like, I need to address this. You know pretty much the same day I was able to address an issue because I worked with somebody who was expressing suicidal thoughts and, you know, it was a whole clinical incident, and I had to help this person in in clinical practice and I realised that I felt like I didn't have quite the right skills and knowledge. And I wanted to upskill myself, so I found some suicide prevention training online and was able to do it, you know, within 24 hours of the thing. I mean, I probably did it in my own time [brief laughter], but I did it and then I was able to tell my colleagues about it, whether or not any of them did it [hint of humour] I don't know. But then, you know, I was a manager, so I was able to disseminate that to other people. So, I felt supported because I had access to that. I felt then more confident, if a similar situation came up in the future. And then I suppose just other examples are where I've signposted, or people have signposted to me, learning such as the safe use of insulin, which actually is just a really good, simple, structured e-learning programme, that's really perfect for somebody who's working in diabetes, or anybody who's working with patients, because they all have diabetes. So, you know when we’re having these conversations, I, my first feeling is ohh e-learning, oh dreary, oh online, ohh it's tedious, but when I say no, stop a minute, you know it has opened up a lot of opportunities for us. It's just, obviously, to some extent that's been a bit, exploited perhaps, by systems, so then it's not so easy to see the good side of it.

TA: Okay, that's a really interesting perspective, but I hadn't thought about the feeling supported because the learning’s there, at a really rapid pace, that you can get that support really quickly, even if there's not somebody else there in the setting with you, so that's really powerful. Thank you. V2, have you got any thoughts? Does this make sense to you, this category?

V2: Yes, I was thinking the bit I would probably have had more to say would be on this, the space and time allowed bit, but actually yes, you said about exploited, that's a really good word as well. Because I think, you know, when you have to do the mandatory training and there's not enough time and all that, I feel frustrated that I'm not, even if I've got allocated time, something will always interrupt it. I was, we all had allocated time the other day, we did a wellness walk, we came back and had chats and cakes, all being paid for it, which is mad, and then we had our e-learning time, so I thought right, I'll go down and I'll crack onto these e-learning modules that I've got to do. I start going through them, then a couple of newly qualified colleagues, one of them came through and asked me a question. Something came up in conversation about a vaccine and it turned into quite a long winded session, and we, and I. But, the thing is, I was able to quickly access the information online and also we get like vaccine updates, so I could then forward the e-mail to them. I thought actually, to be honest, I did quite a lot of online education, learning, training and revision, because it was right there in front of me and I could. So, I yes, what was from like, oh, God, here we go, I’ve got to do my e-learning. Yeah, it's exploited because I then, instead of getting a book off the shelf, the green book, I could go online, green book, find the information I needed in seconds, to learn and educate, and all at same time. So, yes, it's so second nature to Google everything. But, and then I mean, I hate computers, and here I am right now on a shiny new laptop, but because it's just made life so convenient at times. So, yeah, it's good when it's good and it's bad when it's bad I suppose. So, yes, I feel supported in that I've got a computer at work and all the Teams Net learning is right there, for me, and I know I can call someone who's more tech savvy than me, if I need them. So yes, supported in that way, yes, the cognitive. It's more the time and the space, to do the actual modules that I struggle with. But yes, I like the word exploited. We've exploited it because we use it so often, yes. Does that answer the question?

TA: It does. Thank you, very much, yes. Has anybody got any other comments on that slide? If not, we'll move to the next one.

V4: I'm sorry. Can I just add something? On that technical support. It's really important, and I don't think all online, learning, considers this, because being dyslexic, I find that some of the ways that the information is presented, or the questions that are asked, are really taxing for me to understand and then answer, in the correct way. They almost, I almost feel as if they're trying to catch me out, at times, with the questions, so.

V1: Can I quickly add to that, V4, I think that's such a good point. I don't have dyslexia, but I've got several family members who have, and I can fully appreciate that this, this new way of learning, because obviously it's not that new now, but actually, that can be very challenging for people when things are not designed with that in mind, the way the page is, the questions, the way the questions are, and I think that that must be very challenging for quite a lot of people. 

V2: I'm not dyslexic, but I get tripped up by the wording of the question sometimes, and then I get annoyed that I got the question wrong, even though I did know the answer, just the question confused me. And you can't actually shout at the computer.

TA: Well, you can shout at it, but you won't get a response. You won’t get any feedback from it will you, when you argue that you are right. But that does lead nicely on to the next thing, because actually in the next category I put the space, I put the factors about additional learning requirements, because this did actually come up for quite a few people. And here I've given more emphasis to it, on this slide, in terms of reasonable adjustments. So, the fact that if you were doing some learning in a face to face situation, you would have some adjustments made. You might have some extra time, but if your employer’s given you time for e-learning, there's no extra time. It's just, you'll just get on and do it, because that's how long it takes or whatever. So, I did begin to explore those kind of things, in here, but I think the dyslexia could place quite nicely in the other one as well, so thank you for that. Having time and space for learning is exactly what it says it is. Obviously, time and space was something that was evident throughout both sets of interviews, from the COVID times, where people did most of their learning in their own time and their own space, in public, shared spaces, where there was some arrangements depending on the lockdown situation, but there was a clear emphasis on needing to do most of the work on your own in your own time, on your own resources and in your own space, and where you were doing the work, the prioritisation of clinical work, or educational delivery, overtook the space that you had, and the time in the space. And people, throughout the whole research as well, described how they didn't have time to independently research free online learning, and it is overwhelming, so you, immediately you're given some time, you'd look and think, well, I don't have time to explore more than two links here out of three, or four hundred or whatever. So, I'd invite your comments on this category of time and space, please. So V4, you're first, I think this time.

V4: Yes. I think I would. Yes, I would agree with prioritise, so, even though you, I, am able to set time aside to do my e-learning, yes, working in the NHS means to say that actually, I'm not able to do that e-learning which I’d, you know, sort of set aside for two hours, you know, for example in the morning. And I think when you're in the practice setting, when you're undertaking online learning, that, those links that you could explore, again, you don't necessarily do it. You might look at one, but no more because you're ever conscious that there's, you're needed elsewhere. So, if you're going to do online learning, then you need to be, for me, I need to be somewhere away from the practice setting, so I can choose a particular, you know, other areas, at [NHS Trust name], and that's much better, because I'm just. It's a quieter space for me, which is what I need anyway to really, take information in and to work with it. So, it is better if I place myself somewhere differently, when I'm working in practice, to undertake this online learning, otherwise I get pulled away.

TA: Okay. Thank you, V3. I think. Ohh V1, sorry mixed up with my alphabet, V1.

V1: Yes, I agree. I mean, you know, it's absolutely about having the protected time, but sometimes in clinical practice, you're theoretically given the protected time, but then as others have said, the reality is you're doing it in an environment where you're going to be interrupted. You don't have the protected environment, whereas when you're doing in person learning, you are physically removed from that situation, you know, or someone's come in and is delivering the session, so you know, it is really important to have that. And I also echo what you said, V4 about you're not going to be clicking on the extra links, because you would just feel like that was not a good use of your time, because it’s not. I'm talking about the mandatory training now, but you know you're doing your mandatory training and all these different things that you're allowed to look at, you know, policies or white papers, whatever. Well, you're not going to click on those, because that would just. You would feel guilty about doing that, because you should be going back to practice, you know, not doing this thing that you don't actually have to do. But then of course, you know, if it's something where you want to do it, then you find ways to do it. But those tend to be the things that are not the mandatory things, they tend to be the things that are more about your own professional development and something that's very specific to your clinical role, where you know you need to look at it now, and you can quickly access it.

TA: Yes. Just before proceeding to V3, V2, I'm really muddled up aren’t I, on my last run, sorry. Some, it was interesting how some participants talked about even face to face learning not being protected, in the sense that people going to face to face learning in practice, or in an environment close to, in their education centre, were told to take their uniforms, so that they were called from the education, if they needed to be. So, even though they were given time and space to go to face to face education, in the setting, there was an expectation also they could get called and would be back in practice within a blink of an eye. So, that kind of relates to the time and the space for learning broadly as well.

TA: Okay, V2, have you got thoughts or comments?

V2: Yes. I didn't know people got to go to things and then have to put a uniform on, during that time. That's terrible. That's, but that's a similar thing. Even if we've been to a meeting elsewhere in the building, you're still, they know you're there. They can find you and they can get you, sort of thing. So, I mean, we've all done it, when we know the doctor's upstairs having their lunch, but a query comes in and we’ve got to go up and tell them, or ask them, because we know they're physically there. If they're physically not there, you can't. So, that makes a difference. So, I'm in my room and I'm, you know, locked into a computer, someone comes in and I'm, that, they don't take any notice of the fact I'm in the middle of some training. They wouldn't dream of just going ‘ohh, so sorry’. Even if I've got, you know, headphones in, it's a Teams thing, they'll just interrupt, because they need that urine dipped, or the patients fallen over outside, or whatever it is. So yes, protecting it is really difficult. Because, yes, we're in that coal face kind of job, where, you know, we could be needed at a moments notice. The only way to be removed from it is to be physically, actually not in the building. And I know I would find that, well, I don't think I could do the same kind of training at home, because I don't think I can access the. I don't know if I can access, and actually I don't want to know if I can, because if I can, that means I'll never be off so I'm not even going to ask the question. But I don't get to the stuff I do at work, at home unless it's. I know I used to do my [Trust learning system name] actually, so I'm probably, yes. I used to do the [Trust learning system name] and I have done that at home, and I used to hate having to do safeguarding at home, under my own roof, thinking about horrible things happen to children where my children are sleeping. But the new stuff that we've got, yes, I've never accessed that from home. I'm not going to attempt to, I don't think. Because I just, you just never away from it, do you? I think, yes, that is the thing. If I could go, if I could be literally incognito somewhere, where I am not to be disturbed, I probably could get a lot more done, because as soon as you’re interrupted the thread's gone and then I think of stuff, and there's always a cupboard to sort out, and stuff to order, and it's easy to be distracted.

TA: Yes. Okay, thank you. I'm aware of the time, V4, so you might have to pop off in a minute, and if you do, obviously just wave goodbye and I’ll say thank you. But I'll move on to V3.

V3: Thank you. Yes, I absolutely agree with everything everybody said. It's that, having the time, when there are bigger priorities, that you just can't park. Those clinical priorities are going to come first, and that's that. So, it's a real conundrum, isn't it? So, a couple of things I thought about. You know, when people are talking about there's often loads of links in there and you can't explore the links, and that's absolutely right. I suppose the only good thing about the links is that we're all different, aren't we? And we've all got different, particular interests and needs, so it might be that, having all the links just enables us to explore, even one that just suits us, even if it leaves two hundred and ninety nine unexplored. Do you see what I mean? It, at least it's there. It's quite a great thing to have it there, kind of thing. What else was I going say? Something V2 said then, made me think. 

V2: Sorry, there was a lot.

V3: I can't remember what it was, but yes, it's. No, I've got it. I remembered it. There's this thing, it’s about the mandatory training. It's come up all the time, throughout this whole focus group, and you can't help but think, is there too much of the mandatory training? Is it too frequent? I mean, I wonder if anybody, is looking at that, because it presumably will squeeze out maybe, that other type of education that people want to engage in, that is much more individual to them and their role. Do you get what I mean? That's just a thought.

TA: Yes. Thank you. Again, some really rich and interesting comments there for me to consider in that category. But overall, do you feel that makes sense, the whole category of time and space for learning? [All nod yes].

TA: Okay. So, the final slide then before the thank you slide, is to just show you that overall kind of diagram again, with where the threads fit together, or where the themes fit, or the categories fit together. So, the professional learning as a social endeavour, which is almost like an enabler, isn't it? The being able to learn with others and to make learning meaningful is very positive, and is really beneficial for learning, and then the thing about being swallowed up in practice is really much more the challenges, is about the need for feeling supported, and about the need to actually have some time and space for learning. I don't know if anybody's got any comments or thoughts about that, or any ideas where they think the central thread. It's not your job necessarily, to identify the central thread for me, I have ideas about this already, that are fairly formed already, but if anybody has any thoughts, obviously you're welcome to share them.

V2: So, the first one is sort of the outcome, is greater than the sum of the parts. If you learn together with other people, it's not just that information, it's how you process it and reflect on it, with other people, with other people's ideas and views. And the second one is how to break it in one swift move, if you, so if one piece of the puzzle is gone, you've lost the whole lot sort of thing.

TA: Thank you. Yes, very eloquently said. Thank you.

V1: Yes, I would just sort of add, when I look at it as a whole like this, the thing that sort of keeps coming up to my mind is that, the e-learning has got many benefits obviously, but it's not. It can't be a stand alone instead of. It's got, do you see what I mean? I'm not expressing it quite right. I don't know how to say it, but I think you know what I mean. There's something that's not been sort of actually spelled out, which is, we can see the benefits of e-learning. We know it's necessary. We want to have it, but it cannot be totally instead of. Yes.

TA: Yes.

V1: Flawed. It’s valuable, but flawed, yes.

TA: I mean where I'm thinking about it, is thinking about it in the context of social learning theory, or situated learning, and the free online learning as a tool, but thinking about how practice areas, or organisations, work as a community of practice, so that we're looking at more things almost like a service improvement project, where we draw on the e-learning in a meaningful, and a relevant way. Because then you're more likely to have time and space and support from your managers [raised tone as if questioning], because it's something that's going to benefit the service, and there's something about that being lost with this move to independent e-learning, that the service doesn't really have so much input on what the learners are learning, if they are learning anything beyond the mandatory learning. Because it's all about learning in the moment, and getting the clinical information, when you need it, and getting the tick box mandatory stuff done, which does leave people overwhelmed and swallowed up, so they just don't have the energy and the time to look for more, that pure learning, learning for learnings sake, learning about your clinical area because you really want to learn about it, for instance, is where I'm thinking of, is next, really. As the overall kind of thing.

V3: Yes.

TA: So, if there's anything there that you've got a comment about then feel free to comment, but otherwise I'd really like to thank all of you for your contribution throughout this whole project, the whole of the data collection for this project. It's been really interesting, and it's given me some data which I wasn't expecting, which is always really positive, and powerful too. So, I'm really excited now to draw it all together into a theory. And then then you'll be able to see how you've contributed to that later. So, I appreciate you're all busy and time is very precious. I really, really appreciate you helping me. 
Thank you. I'll turn the recording off now.
