Yesterday I was contributing to a staff development session for ST (specialty training) doctors and my stint was about e-learning. I talked about content that’s available on the web that can be reused and remixed under a creative commons licence and touching on the tools that support personalising learning and networked learning. Then I had to say they probbaly wouldn’t be able to access a lot of these sites for on the job teaching because the NHS denies access. At the end of the session frustrations with the NHS IT infrastructure were raised, issues with old web browsers (IE6) old operating systems (pre XP) and the inability to access useful online resources. These are all common complaints across different NHS Trusts and it’s why many doctors are keen to have a University PC/Mac on their desk.
The problem of accessing e-learning resources is covered in a short commentary in the latest edition of Medical Education by Prince, Cass and Klaber from King’s College Hospital, London (Medical Education 44 (5) p 436-7). Prince et al highlight the wealth of excellent resources that are being developed and made available but that there is a danger that enthusiastic learners will be unable to access them. They pick up on a paper published in the same edition looking at accessibility issues in African medical schools due to infrastructure and resourcing issues but go on to draw attention to the significant access problems faced by postgraduate trainees in the NHS.
Prince and his colleagues surveyed doctors across 37 English NHS Trusts in April 2009 to assess the accessibility of online resources to postgraduate trainees. Unfortunately I can’t see the table with the results referred to in the online version but the paper indicates that many experience blanket ‘internet denial’ leaving them unable to access important clinical resources and download PowerPoint presentation or pdfs of journal articles. Only 32% could access the The UK Department of Health ‘E-learning for Healthcare’ programme modules. YouTube is identified as huge source of medical video content which is blocked and likewise there is no access to iTunesU. The authors go on to say,
Whereas in Africa limited infrastructure is producing an information bottleneck, access in the UK is restricted by ‘denial of service’ restrictions placed upon a competent and fast modern system. Emerging Web 2.0 applications, such as wikis and blogs, provide creative and interactive learning environments within which all learners can contribute and interact, provided they are given ‘write-access’. Shouldn’t we be managing the risks more effectively in order to allow learners the freedom to use IT resources to better effect?
This question is how do we go about managing the risks more effectively to allow NHS staff to access online learning resources and tools which many of us take for granted. There are understandable concerns about the security of patient information and quite rightly so, I don’t think any of us would disagree that the NHS needs to diligent about this. It’s also essential that clinical systems take priority in terms of bandwidth, which is the reason sites with streaming video like YouTube and Vimeo are blocked in the NHS. All of this said individuals working in the health professions are called to be lifelong learners and need access to educational resources which are being increasingly delivered and freely available online.
Is there any dialogue going on at a national level that is seeking to address these issues? IT projects and the NHS don’t have a good track record, but are there are steps that can be taken to separate access to educational resources and tools from the clinical and management IT systems. I agree with Prince and his colleagues who end their short commentary by saying,
There is an urgent need for commissioners, providers and users of e-learning materials to be jointly involved in planning how, when and where resources will be used. Without such a partnership, there is a significant risk that ‘disconnection’ will severely compromise what could be one of our most valuable learning tools.
How do we make this happen?