CETI

Driver for change: the role of

education and leadership

Professor Steven C. Boyages

November 2010

Challenges to the health system

Rising Demand Growing & ageing population Chronic illness rising High levels smoking, obesity,

stress High consumer expectations

Constrained Capacity

Patient Safety

Workforce shortages and

attitudes

Manage demand within finite

resources

Cost vs investment

NSW spends about 28% of

budget on health care

1.3 million dollars per hour

2

Investing In Health IT perceived as a

solution to some of the challenges

Benefits

Improved automation

Improved productivity

Reduced duplication

Improved safety

Improved patient and staff

experience

Improved reach of

information and service

Risks

Financial investment not realised

Poor connectivity

Lack of common standards

Increased risk to patients

Increased staff frustration and lower morale

Staff expectations not realised

Poor execution and implementation due to inadequate training

3

Execution is the key

Evolution as opposed to revolution

Engagement with key staff in design

Integration with key legacy systems

Understand complexity and complex systems

Manage expectations and scope

Understand nature of the workforce

Appropriate start up and sustainable training

Medical Mistakes trigger major inquiry

into health system-2008

Clinical

Education

and Training

Institute

Clinical

Excellence

Commission

Agency for

Clinical

Innovation

Bureau of

Health

Information

The Four Pillars of Reform of the Public

Hospital System

Clinical Education and Training Institute

VISIONTo lead, facilitate and build sustainable capacity to improve health and achieve

better health through education, training and development of a clinical workforce that will meet the healthcare needs of the people of New South Wales.

MISSIONInvestment, Innovation and Influence

GOALS

To achieve inter-professional standards of competency for new graduates

To build better systems and models of clinical supervision

To develop and role a learning management system to facilitate e –learning and blended learning opportunities

The Five Cs to Success

Competency

Culture

CommunicationCollaboration

Capacity

8

Success is 80% related to people

9

Understand the nature of the work

• Workforce• Mobile

• Collaborative

• Team based

• Bee-hive mode

• Disconnected

• Malunga.C, 2000: The Beehive Model for Team Building, Footsteps Magazine no 43

Copyright Not for Reproduction 2008

Technology Paradox of Work vs Personal

12

Disconnect in School

13Slide Courtesy of Cisco, Australia

Drivers for change

14Slide Courtesy of Cisco, Australia

Technology Enabling

• New Ways of Organising Learning

• New pedagogy

• New relationships

• More sophisticated learning mix

• Richer assessments and evaluations

• Data at all levels

15

Technology (finally) ripe for education

16Slide Courtesy of Cisco, Australia

Content versus collaboration

17Slide Courtesy of Cisco, Australia

eLearning is evolving

eLearning is an evolving format which has been

enabled through technology. Just as the landscape of

‘technology supported activities’ continues to evolve, so

does eLearning

19

Developing a common platform

eLearning by definition is any learning that can be delivered

(and undertaken) electronically.

There are 2 elements to eLearning:

o the technology, or learning experience, ie the electronic

media of formats

o the learning design, or the learning experience, ie the events,

activities and relationships that the learner is involved in

While the technology and the learning design are

intrinsically bound together, it is useful to be mindful of these

elements in isolation when considering eLearning.

20

Element of blended learning

The right place to situate eLearning is within the equally

contemporary idea of ‘blended learning’

Blended learning is a concept that acquired currency when

learning designers began to consider how to integrate

self-directed technology-supported learning activity into

learning programs

The key is that technology supports non-instructor facilitated

learning, ie learning done outside a classroom or traditional

learning environment and which is undertaken in a ‘self

directed’ manner. Such learning can be done according to the

speed of an individual’s own capacity to absorb information,

and also their inclinations as to other choices open to them

where there is no instructor.

21

Element of blended learning

The term ‘blended learning’ now simply serves to consciously

remind the learning designer of the spectrum of possible

approaches and techniques from which he or she can draw

from – and of the need to duly consider both the technological

and the instructional elements of what they are looking to

achieve in designing a learning program.

Therefore, eLearning and eLearning design is a facet of

learning and learning design generally.

22

Types of eLearning

Web-based or online tutorial

Podcast / Vodcast

Virtual or Simulated Reality

Webinar / Virtual Classroom Session

Blog

Threaded online discussion

Wiki

Yammer; Twitter (micro-blogs)

Mobile learning (mLearning)

Others e.g. Web sites, Video or Phone Conferencing

23

Discrete eLearning objects

Learning design element

Design standards, methodology and processes

Policies regarding content authorisation and intellectual property

rules

Designers with capability in the design methodology and

processes and understanding of policy

24

eLearning Modes / Formats

Technology element

Platforms and software applications supporting the learning

mode/format

User access to the infrastructure, platforms and software

applications

Users with skills to use skills the platforms and software

applications

Development capability in the toolsets required for the

modes/formats

25

Summary of Current eLearning Practice

Active in a range of operational areas across a range of learning contexts

Not active in many operational areas and learning contexts where it potentially could have strong value

Operating without a formal state-wide process framework of policy, standards, methodology and process

Developing unevenly without a consistent approach

Fairly low on the scale of sophistication

Not supported by uniform technical infrastructure, platforms and tools

Significantly less effective thank it could be

The source of both real and potential unnecessary cost (through restricted accessibility, duplication, inefficiency)

The source of real and potential risk (through lack of policy and process assurance)

26

What the Current State Report Recommends

NSW Health will undertake a State-Wide IT Literacy Change

Initiative to improve the level of IT literacy (in line with ICT’s

strategy to increase the PC to person ratio). This will enable

the organisation to take best advantage of the benefits of

eLearning.

NSW Health will develop eLearning development skills to

enable eLearning to move beyond ‘page turners’ and basic

simulations to address, in part, the heavily constrained

environments and roles.

NSW Health should provide infrastructure and technology

to support and host eLearning developed by NSW Health.

27

What the Current State Report Recommends

An eLearning Centre of Excellence will be established in an

area best suited to providing the most significant and widest

range of benefits as a result of the application and usage of

eLearning.

The area recommended is the Clinical Education & Training

Institute (CETI), which has a brief for provision of clinical

educational and training services and is currently engaged in

establishing a framework for its eLearning practice.

28

Current State Report Recommends

This centre might be centralised (and informed by a distributed

Community of practice), or may indeed be a Community of Practice.

The eLearning Centre of Excellence should own a eLearning

framework. This framework should be designed to provide:

Technical standards

Visual design standards

Instructional design methodology

Multimedia development standards and methodology

Selection of supported tools and platforms

Intellectual Property (IP) and copyright advice and standards

Accessibility standards

Processes for publication, maintenance and management of eLearning

29

Developing NSW Health eLearning Excellence

Develop the ‘eLiteracy’ of NSW Health’s wider IT user community –

through a broad strategic change management and capability

development program

Develop the capability of NSW Health’s eLearning practitioner

community – through a targeted capability development program

Deliver the technical infrastructure and environment required to

support eLearning

Support eLearning practice with knowledge, assets and capability –

through the establishment of an Centre for eLearning Advice (CeLA),

which provides internal expertise in eLearning, and internally

leverages best practice, the CeLA will develop and support an

eLearning Framework

30

Implementation

31

Summary

We are on the verge of a great era of transformation in health care through health IT

Intelligent Investment

The future will be spearheaded by a better understanding of workflow

Intelligent Work

Better access to real time information about patient care and health system performance underpinned by sustained investment in technology

Business Intelligence Systems

This transformation will lead to a sustainable, flexible and safer health system where the patient is at the center of care as an active participant

Intelligent Health Care

Technology Enabling

• New Ways of Organising Learning

• New pedagogy

• New relationships

• More sophisticated learning mix

• Richer assessments and evaluations

• Data at all levels

33

Changing Learning

34Slide Courtesy of Cisco, Australia

Future

35Slide Courtesy of Cisco, Australia