CETI Driver for change: the role of education and leadership Professor Steven C. Boyages November 2010
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