Digitally enabling and upskilling the whole nursing and midwifery workforce.

This case study is considering the following topic from a HEI perspective and the work that is being undertaken to provide pre-registration students across the healthcare workforce, with knowledge and understanding of eHealth in its broadest terms.

Background:

Nursing is a dynamic profession, and its workforce are increasingly being asked to assimilate and manage information from a variety of sources in order to ensure high quality patient care.

The use of information and communications in both clinical and remote healthcare settings presents challenges, but also offers new opportunities to all involved in healthcare. It also acts as a catalyst for change within the curriculum to enable future healthcare practitioners to develop the skills required in this changing landscape.

In response to these needs, “Systems of eCare” was designed and implemented in 2009 by Professor Paula Procter and has continued to be used across pre-registration courses in nursing, midwifery and the allied health professions at our institution.

Systems of eCare is a wholly online course, which has been designed to advance the knowledge of pre-registration students within the Faculty of Health, Wellbeing & Life Sciences in information and communication technology. The course runs in parallel to the curriculum and is mapped against it; helping to providing meaningful contextual relevance to the student. The key objectives underpinning Systems of eCare are to enable the students:

• to understand, implement, improve and shape the use of new technologies and informatics, including remote care;

• to find the most reliable sources of information to support evidence- based practice;

• to guide patients through publicly available information sources;

• to incorporate ICT into patient consultations;

• to manage the nurse patient relationship, where the nurse is not physically in the same place as the patient;

• to perform quick and accurate data entry at the point of care;

• to understand the legal and ethical issues associated with managing and sharing patient information;

• to extract data to support decisions and monitor the outcomes of practice;

• to understand the role of technology in the delivery and organisation of care

• to train other users such as patients and carers how to use relevant ICTs (P.Procter 2011)

The course comprises a series of 6 self-directed modules, with students completing one module per semester across their three-year programme. Each module requires approximately 10 hours of supported on-line study and is completed through modular on-line summative assessment. Student progress and the results of assessments are supported and discussed with the student during regular personal tutor sessions. This allows for an individualised approach to its completion and for discussion to be focused from the learners’ perspective and experience.

What is working Well?

Although Systems of eCare is not part of the core curriculum (being instead offered to students on a voluntary basis,) uptake of the module has steadily increased since its inception in 2009. Currently over 90% of students registered on a healthcare course within the faculty have chosen to engage with the programme. Encouragingly, adoption of the course by nursing students has been even higher, with all the current years 2021 intake opting to access the first two modules of the course. Of these students, 90% have successfully completed both modules, and the remaining students are continuing to work towards their completion.

In addition to strong engagement figures, feedback from students through module evaluations have also been positive, with learners reporting that the skills and understanding gained on the course has both helped support their wider field of study alongside bolstering their practice when attending placement. On a local level, Systems of eCare is known and well received by our practice partners. During our regular meetings, these partners have commented that students who have completed the course are able to demonstrate and evidence capability and are using their certification as a sign of competence in this area.

To ensure that the modules remain contemporaneous, a group of local and nationwide CNIO’s and Digital Midwives have been working alongside the current course manager to review the content and focus of them. Their individual expertise within this collaboration ensures that the skills being taught and developed continue to align with the needs and expectations from practice, ensuring relevance within the working environment. Plans are also underway to develop the modules to incorporate other areas such as genomics, AI and technology including robotics to ensure currency of modules and materials.

Following from the Systems of eCare successes, the course is currently being used as a basis to develop and build an online course to practicing healthcare practioners within the locality, enabling them to improve their knowledge and understanding of this area.

What needs to change?

Within the NMC Standards for pre- registration programmes Part 3: Standards for Education, there are 2 statements that refer to digital and technological literacy. The first states on point of entry to the programme that the approved institution can confirm that the student

1.1.7 have capability for digital and technological literacy to meet programme outcomes.

And during the programme

1.7 support students throughout the programme in continuously developing their abilities in numeracy, literacy, digital and technological literacy to meet programme outcomes,

https://www.nmc.org.uk/globalassets/sitedocuments/standards-of-proficiency/standards-for-pre-registration-nursing-programmes/programme-standards-nursing.pdf

Whilst these statements are set out in the NMC standards for the Future Nurse, there are no agreed Benchmark statements helping to define and frame expectations within this area, essentially leaving this to the discretion of each HEI. Although Systems of eCare has helped address some of the local needs, the absence of a common framework across HEI’s has created a situation where it has been difficult to pursue and promote collaborations across institutions, resulting in missed opportunities to share good practice.

What should we think about for the future?

Recognising the challenges above, a standardised approach to health informatics and digital literacy would help to ensure equivalence and parity across HEI’s, thus setting a minimum standard of future nurses when entering the workforce. The lack of clarity regarding expectations of the breadth and depth of the skills to be developed has meant that the Systems of eCare course has been designed to meet local needs and the needs as perceived by the core team. Without meaningful collaboration at a wider level, it is difficult to know how fully encompassing this may be and perhaps relevancies and areas for development are being missed.

Collaboration between practice and education has proved essential in the development and delivery of the course and a common framework would help create an environment where ideas, knowledge, expertise and practice could be shared, helping to deliver and develop portable skills at a wider national level, promoting and accelerating change within this digital landscape.

References:

NMC, 2020: Standards for proficiency, Standards for Pre-Registration Nursing Programmes.

Accessed(4/10/22) at: https://www.nmc.org.uk/globalassets/sitedocuments/standards-of-proficiency/standards-for-pre-registration-nursing-programmes/programme-standards-nursing.pdf

P.Procter, 2011, Advancing Information and Communication Technology Knowledge for Undergraduate Nursing Students, Journal: 11th International Congress on Nursing Informatics