English - the European Oncology Nursing Society

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E-learning in cancer educationExploring the potentialGraham G. Dark. Centre for Cancer Education, Newcastle University, Westgate Road, Newcastle upon Tyne, NE4 6BEEveryone learns all the time, using agood and bad content and thereforevariety of means, but the initial hypethe skills of navigating and locatingof promise from e-learning was metthe right information at the right timeby resistance and a perception ofwill be key. Trusted providers of highinferiority. What everyone missedquality knowledge and learning willwas that ‘e-‘is only the methodprevail in this global market.of delivery and that the impact ofthe education was dependent onLearning technology has introducedthe quality of the learning withinjust-in-time and just-enoughthe content and not how is wasapproaches which deliver relevantdelivered to the user. These earlytraining, on-demand, to thepredictors of e-learning saw theindividual learner in their workplacereplacement of all classroomenvironment. The usefulness ofteaching and that e-learning wastraining is therefore improving,all about the technology. The initialas is the return on investment forofferings excited everybody withcorporate purchasers of training. Thethe level of instructional design andmodern workplace for healthcareinteractivity and this increased theprofessionals has changed andavailability of learning opportunities.e-learning allows the wholeMany organisations quickly jumpedworkforce to participate in learningon the bandwagon and purchasedthat accommodates their workor developed their first generationpatterns and allows them to study atof e-learning technologies, buta time and place that is determinedunfortunately the evaluation of these initial approaches did not by the learner and not by the teaching.support the over-hyped expectations and a downturn in popularityfollowed. The initial hype of e-learning focused on the technology and The problems of traditional teaching can be found in e-learninghas now been replaced by a refocus on the educational pedagogy, too. The largest challenge is to maintain curriculum congruence,producing learning materials that are engaging learners in activities where the intended learning outcomes are matched by the learningthat reward their efforts.activities and addressed by the assessment by choice of method anddepth of questioning. This clearly requires that the method of learningWeb-based learning is here to stay and a number of important and assessment are appropriate for the module outcomes, butlessons have been learned over the last 10 years. The content must more importantly, that they are appropriate for electronic delivery. Abe useful to the learners and technological glitz cannot replace practical skill can be observed from a video, but not easily assessedcontent. The development time and cost of quality resources was using a web cam. Adults learn best when the content is relevant andfrequently underestimated, usually by an order of magnitude. So purpose to everyday issues, when the learner is actively involved ande-learning allows the interaction of users, tutors and content using the objectives are clear and unambiguous, with students demandingtechnology, so e-learning really is about the technology. Everyone more feedback that is timely and constructive. These requirementsgets seduced by the technology and yet successful e-learning is are made both e-learning and traditional teaching and thereforealways about the learning and not the technology. The investment innovative approaches are required to ensure that such requirementsin e-learning should therefore be: 5% in student factors, including are delivered. The difficulty with the online student is that they canstudent training, 10% in the technology, 15% in staff factors, including have a shorter concentration time and often expect a response muchmentoring and staff training, and 70% in content creation. Projects quicker that their face-to-face counterparts. This can increase thethat have technology as the main expenditure often do not deliver burden to the online tutors to respond quickly to student enquiries.on-time nor on budget.Nevertheless, by improving the materials in response to studentqueries, the support requirements can be diminished. It is more aKey points:process of understanding the students and learning from them, which• Don’t believe the hype – look for evidence of what worksin turn allows the delivery team to use their time and resources more• ‘e-‘ is only the method of deliveryeffectively.• focus on excellence in the education, not the technology• invest in your staffThe modern approach to working in teams can, and should, beextended to learning in teams, and multidisciplinary education canbe a powerful tool for deep learning. E-learning provides a meansIn 20 years, education will be different as we move from a justin-caseapproach, like learning algebra at school, to a just-in-time the geographical and temporal boundaries that can impede groupof communication within a learning environment that removessolution, delivering learning immediately after users identify their learning activities. Utilising this approach requires a commitmentneed. There is a constant demand for access to reliable knowledge to high quality materials, simplicity of technology and teaching staffand learning, and users are willing to pay if the service is useful to with appropriate skills. Although e-learning utilises technology as anthem. The technology is well advanced but the problem remains effecter of the teaching, it is important to remember that in e-learningaccess to quality content. In the future, the doubling time for‘e-‘ is only the method of delivery, and that it still requires qualityknowledge will be so short that users will be overwhelmed with both learning content.18 - newsletter fall 2008
Continuing Professional DevelopmentAssessing clinical skills through objective assessment and portfoliosEileen Furlong, Lecturer UCD School of Nursing, Midwifery & Health Systems, Belfield Dubin 4The assessment of clinical skills performance poses a challenge fornurse educators. Two methods of assessing clinical competence arethe Objective Structured Clinical Examination (OSCE) and the use ofPortfolios. This paper aims to highlights key literature on the abovemethods of assessment and discuss some practical examples of howcompetence can assist in the integration of theory with practice.The OSCE emerged as an assessment strategy for medical educationin Scotland during the 1970’s. It is an assessment approach tostudents’ clinical skills that is objective rather than subjective(1). This assessment is used widely in medical education and hasnow emerged in many other disciplines, including nursing. Theclinical competence is divided into various components such ashistory taking, or the interpretation of clinical data (such as nursingdiagnoses) with each component being assessed at a differentstation (2). Students rotate through a number of stations, spending apre-specified equal amount of time at each station (1).There are two principle types of stations: (a) procedure or observerand (b) question or marker stations. Generally the procedure /observer station involves task performance, usually presented in ashort written scenario (1,2). This is followed by a request for therequired action using a pre-determined check-list of criteria, with theperformance being checked by an observer (1,2). The advantageof this checklist should be increased reliability and objectivity (1).The observer stations are particularly suited to clinical skills of aninterpersonal and / or psychomotor nature and also to interveneperformance (2,3). However, many variations exist and some stationsmay be longer and involve multiple choice questions or longer writtenformats (3). The use of a modified OSCE used by oncology nurseshas been evaluated (4). This evaluation was a non-experimental postonlyevaluation of oncology nursing students’ perception of an OSCE.Students were asked to complete the evaluation form indicating theextent to which they agree / disagree, with statements relating totheir degree of preparation for the OSCE exam, their views on theefficacy and relevance of the exam in testing clinical skills and thelevel of anxiety or stress experienced as a result of the OSCE. Thefindings indicated that 90 % of the students (n=185) viewed the OSCEas stressful despite their high level of preparation and affirmativeviews on the relevance of the skills tested. Using the OSCE inconjunction with a number of assessment methods may attempt tomaximise the transfer of knowledge to clinical practice (4).Objective Structured Clinical Examination(OSCE)• Emerged as an assessment strategy for medicaleducation in Scotland during teh 1970’s(Harden & Gleeson 1979)• Adopting by nursing• Approach that is objective rather than subjective• Clinical skills are tested rather than pure theoreticalknowlegde• Clinical skills laboratories and simulation of practicebecame important in nursing faculties/universities inpast decade• A product consistent with adultlearning• Organised collection of writtenevidence• Record of continuingcompetence• Personal and professionaldevelopment• Reflect upon achievements• Assessment of skills andknowledge• Critical analysis of contentsA portfolio used by nurses and midwives is generally understood tobe an organised collection of documents chronicling an individual’scareer. These accumulated documents may be drawn upon whenapplying for jobs or courses in order to demonstrate learning.Portfolio contents can help individual nurses and midwives to identifytheir own strengths and areas requiring development, plan how theycan enhance their knowledge and skills in order to improve clinicalpractice, maximise their opportunities to undertake appropriatecontinuing professional development and develop strategies forachieving their individual career goals (5)The development of a portfolio supports independent and lifelonglearning. It is suggested that portfolio strategy puts students at thecentre of the learning process (6) and encourages nurse to criticallyanalyse care.A major requirement of the nursing profession is to safeguardthe public in providing a valid and reliable means of admitting topractice only those who meet the minimum requirements and whoare deemed competent (7). As nurses in practice, management andeducation we must strive to ensure that competence is achieved.References:1. Harden R.M, Gleeson F.A: Assessment of medical competenceusing an objective structured clinical examination (OSCE) ASMEMedical Education Booklet 8, 3-10, 1979.2. Ross M, Carroll G, Knight J, Chamberlain M, Fothergill-BourbonnaisF, Linton J: Using the OSCE to measure clinical skills performancein nursing, Journal of Advanced Nursing 13 (1): 45-56, 19883. Newble D: Techniques for measuring clinical competence:objective structured clinical examination, Medical Education 38,199-203, 2004.4. Furlong E, Fox P, Lavin M, Collins R: Oncology nursing students’views of a modified OSCE, European Journal of Oncology Nursing 9,351-359, 2005.5. National Council for the Professional Development of Nursing andMidwifery Guidelines for Portfolio Development for Nurses andMidwives, 2006. www.ncnm.ie/publications6. Corcoran J, Nicholson C: Learning portfolios – evidence of learning:an examination of students’ perspectives. British Association ofCritical Care Nurses, Nursing in Critical Care. 9 (5) 230-237 2004.7. Bradshaw A, Merriman C: Nursing competence 10 years on: fit forpractice and purpose yet ? Journal of Clinical Nursing 1263-1269,2008.newsletter fall 2008 -19
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