Pain on the WEB The Challenges and Practicalities

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Pain on the WEBThe Challenges and Practicalities

• Eileen Mann
• Pain Management Clinical Scholarship Team
• Institute of Health Community Studies,
  Bournemouth University, Bournemouth UK

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Our aims

• To develop E-learning units of study at Masters
  level to support the Continuing Professional
  Development of Health Care Professionals who are
  involved with the complex needs of patients in
  pain.
• Ensuring that health care professionals have
  contemporary knowledge concerning appropriate
  assessment and management of pain. Challenges and
  barriers to change are also an essential
  requisite.

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Developing topics

• Clinical experience
• Current literature
• Political climate
• Brainstorming with colleagues
• Feedback from potential/past students
• Feedback from Trusts,Voluntary Sector, Patient
  and Charitable Organisations etc.

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Course Design

• Rationale, aims and objectives of the course
  clearly stated
• Easy to navigate see course map
• Small manageable segments
• Single pages
• Using external web links,podcasts,pdf files
• Accessibility broadband? PC?

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Selecting materials

• Contemporary guidelines and research e.g.
  Bandolier, Cochrane, Prodigy, Clinical Evidence
  Concise by the BMJ, National Clearinghouse USA,
  Pharm. industry etc.
• Using the resources that will email advice when
  new material on a particular subject is published
  or available.
• Zetoc, Medscape, Peerview, Pubmed etc.
• Search engines such as Google Scholar can be
  invaluable.

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Motivating students

• Pre-course information
• Introductory phase for e-learning Logging on
  passwords, Athens, managing email, discussion
  forum, downloading Adobe etc., anti-virus and
  security software, help desk and student support
• Tutor access and online support visible,
  facilitation by phone or email. Develop a
  dialogue - get to know them
• Telephone or email particular individuals who
  appear to struggle or are lurkers
• Get into the discussion forum regularly
• Keep discussions on track
• Keep everything up to date - email/post to the
  forum the latest paper, guideline or podcast for
  discussion

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Motivating students

• Design the assignments so that they can move from
  the academic to something tangible for use in
  clinical practice e.g.
• Develop an evidence based change in practice to
  include literature review, swot analysis,
  business plan, audit and evaluation strategies
  etc.
• Contribution to discussion forum assessed!
• Quizzes for self-assessment

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Development Process Problems

• Lack of feedback from potential students - what
  works and what doesnt
• Assumptions of students level of knowledge
• Staff and students support issues and guidance
• Validation - levels of expectation are greater
  than for a traditional unit of learning
• Changing the organisational culture. On line
  registration, assignment posting etc.
• Marketing issues

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Moderating on-line discussion

• Difficult to get students to debate (Mason 1999)
• Reluctance due to social comparison (Light
  Light 1999)
• Intimidated by having thoughts publicly exposed
• Anxieties about having to appear intelligent
• Reluctance to criticise other students comments
  for fear of being impolite (Edwards Hammond
  1999)
• Williams C (2002) Learning On-line a review of
  recent literature in a rapidly expanding field.
  Journal of Further Higher Education 26
  3263-272

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Three units now developed Virtual tours..

• Managing low back pain (2004)
• http//ihcs4u.bournemouth.ac.uk/ebl/mapain/mapain.
  asp
• Click here
• Developing Clinics Services for People in Pain
  in Primary Care (September 07)
• http//ihcs4u.bournemouth.ac.uk/ebl/mapain2/mapain
  .asp
• Click here
• The Multidimensional Nature of Pain Unit
• http//ihcs4u.bournemouth.ac.uk/ebl/mapain1/mapain
  .asp
• Click here

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Evaluation of 1st unit

• Logs were kept of issues arising from the start
  of the unit through to its completion.
• Time spent on the unit was logged detailing staff
  involvement.
• Both the Discussion Forum and Virtual Coffee Shop
  were monitored for student feedback.
• Once the unit had been completed a reflection on
  what worked and what didnt.

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Evaluation of 1st unit

• Key Question - Has the unit made a positive
  difference to the student learning experience ?
• Access, pedagogy and participation are the main
  concerns for the evaluation (Williams, 2002).
• On-line questionnaire using a range of open and
  closed questions.
• Request for semi-structured telephone or local
  interviews with participants to further inform
  the evaluation. (AP)

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Evaluation of 1st unit

• Comfort with technology - initial frustration
  then students learn effectively/proud and
  motivated.
• Communication - not enough interaction with other
  students/missing student and tutor rapport.
• Environmental experience - lack of study days,
  nature of work, lack of accessible computers.
• Learning adjustment - more control but need to
  handle self-discipline and time-management.
• Impact of web learning on practice
• instant application of some of the info into my
  clinical setting.
• reading for the module helped me with the
  competencies
• assessment. I was able to discuss things in
  greater depth, my
• boss was impressed.

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Negative comments

• self-discipline to study with home distractions.
• little or written feedback from other students
  isn't as informative as discussions in groups.
• worries when link didn't work for about a week.
• unsure about negotiating study leave from work.

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Summary of evaluation so far

• The E-Learning unit Managing Low Back Pain has
  made a positive difference to the student
  learning experience.
• offers students a chance to study at their own
  speed.
• retrieving information more easily and allowing a
  focus on items of particular interest.
• convenient with no travel constraints.
• viewed positively - provides superb
  opportunities and is challenging and
  interesting.

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e-learning - can we hack it?

• Underestimating time scales and costs!
• Negotiating traditional paper administration
• Support to start and use the unit
• Moderating on-line discussion
• Considerable enthusiasm and subject knowledge but
  lack of experience in designing actual e-learning
• Facilitating e-expert contributions

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Review and conclusion

• Adopting new approaches to education is
  challenging especially where best practice is
  in its infancy
• New infrastructures are required within brick
  to support click
• Biggest challenge is developing a genuine virtual
  learning community

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Acknowledgements

• Dr Eloise Carr, Reader in Pain Management
  Research Education
• Andy Pulman, Web Team Leader

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Reading

• McConnell D (2005) Examining the dynamics of
  networked e-learning groups and communities.
  Studies in Higher Education 30 (1)25-42
• Salmon G (2000) E-moderating the key to teaching
  and learning online. Kogan Page, London
• http//www.merlot.org/Home.po MERLOT is a free
  and open resource designed primarily for faculty
  and students of higher education. Links to online
  learning materials are collected here along with
  annotations such as peer reviews and assignments.
  
• Definition of terms http//www.webopedia.com