Hoy en día, las plataformas de e-learning y recursos multimedia son herramientas habituales en la educación médica. Estas herramientas se pueden utilizar en los cursos de grado o postgrado, incluyendo las áreas de capacitación clínica. Son la base para la realización de cursos en línea, pero los recursos de e-learning y multimedia también pueden desempeñar un papel importante en los hospitales y otras instituciones de salud para apoyar sus procesos de capacitación y aprendizaje. El actual trabajo de investigación tiene como objetivo desarrollar y evaluar un método de enseñanza que permita a los profesionales diseñar, implementar, entregar y evaluar los cursos de formación en entornos hospitalarios.Nowadays, e-learning platforms and multimedia resources are typical tools in medical education. These tools can be used either in undergraduate courses or postgraduate including clinical training areas. They are the basis for delivering online courses but e-learning and multimedia-based resources can also play an important role in hospitals and other healthcare institutions to support training processes inside their walls. The current research work aims at developing and assessing an instructional approach that allow practitioners to design, implement, deliver and evaluate courses in hospital training settings.
This research started in the year 2008 when an e-learning platform (Moodle-based) was implemented at the hospital La Ribera (Alzira Spain) that has about 1500 employees and provides clinical attention to a population of 250000 inhabitants. At the beginning, Moodle platform was used in very specific contexts mainly oriented towards training courses in ICT skills and Risk Management issues. Nevertheless, hospital managers soon realize about the platform possibilities in other training settings, related to very different user profiles (healthcare professionals or hospital staff) and clinical disciplines from Medical issues, Nursery attention, Radiology images or Electronic Medical Records (EMR). Such circumstance determined the progressive generation of new courses and adaptation of existing instructional resources. The result was an exponential growth in the number of courses and users attending them. Today, more than 400 courses are offered to 4000 attendants by year within the hospital and many of them are supported by the Moodle platforms as online or hybrid courses.
However, as the number of courses and registered users increased, several troubles were detected such as the instructor overhead, a poor fitness between user training requirements and course contents or a lack of homogeneity and coherence among courses. These troubles led training managers to develop an instructional approach in order to organize the hospital courses providing a common framework for them but also recognizing their particularities. An e-learning procedure was established for detecting hospital training needs, controlling the course proposals, determining their basic structure (template) and checking the course outcomes. Another component in this approach was the analysis of professional competences within the different hospital areas to obtain the required goals to be covered in prospective courses. A blended-learning strategy was also addressed that combined the flexibility of scheduling online sessions with learning in real hospital scenarios. This instructional approach and its application in Hospital la Ribera is currently being researched in a doctoral thesis developed by one of the training managers and supervised at UPV (Universitat Politècnica de Valencia).
The proposed e-learning procedure starts from the Analysis of user needs and training competences required by the healthcare institution and ends with the Evaluation of the different outcomes obtained through those e-learning processes performed during the course. Central phases in this approach deal with the Design of instructional resources or learning activities, the Implementation of the multimedia materials or tasks used within the course or their Delivery by means of virtual environments (e.g. a Surgery simulator or a serious game on Risk Management) or any kind of e-learning platform (not only Moodle but also Youtube or Google Drive whose resources are easily integrated in this platform). It is important to remark the “value chain” among the different phases since, for example, those goals defined in the Design step are based on the competences or needs gathered in a previous step, or the selection of an e-learning platform or services depending upon the type of materials to be developed or the tasks to be performed. The blended-learning strategy applied in the current approach is based on the Design of online resources such as screencasts elaborated by hospital instructors or video clips recorded and annotated by course users and the Delivery of forum or videochat services combined with sessions implemented in the hospital premises where specific medical applications (EMR) or clinical equipments such as Radiology instrumentation or Surgery monitors were checked.
This instructional approach has been tested in a set of courses during the period 2010-12 and several interesting outcomes has been collected that reveal the suitability of e-learning platforms and online methods fostering the active training of hospital employees and the acquisition of relevant clinical skills. For example, the adequacy of video records and screen casts to provide rich multimedia materials or the potential of forum activities to encourage the users’ work and their engagement in the learning process. One key aspect in this blended learning strategy is the balance between those resources and services that can be used in online sessions and the residential activities and tasks, which can be only performed inside the hospital.
The obtained outcomes have revealed the importance of several issues such as allowing users to participate in the elaboration of instructional resources or keeping active the forum contributions and the responsibility of instructors in this task. Further works include questions such as the proposal of evaluation methods and mechanisms that enable a better fitness between the required competences and the activities submitted to course users, or the assessment of works developed by users during the course to check that right competencies were achieved. An additional aspect to be investigated is the use of mobile devices and the potential that provide in the context of hospital training. For example, the chance to record videoclips by the own students through phone or tablet cameras in clinical scenarios and upload them to the e-learning platform within a forum thread. Another interesting topic is the possibility to incorporate new serious games to complement the available online resources adding an interactive component. Eventually, all these issues will foster the role of e-learning as a crucial item in the training program of the hospital La Ribera by adapting it to future competencies and requirements.