CETI
Driver for change: the role of
 education and leadership

   Professor Steven C. Boyages
         November 2010
Challenges to the health system

 Rising Demand                        Constrained Capacity
     Growing & ageing population         Patient Safety
     Chronic illness rising              Workforce shortages and
     High levels smoking, obesity,
      stress                               attitudes
     High consumer expectations          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                          Risks
     Improved automation              Financial investment not
     Improved productivity             realised
                                       Poor connectivity
     Reduced duplication
                                       Lack of common standards
     Improved safety
                                       Increased risk to patients
     Improved patient and staff       Increased staff frustration
      experience                        and lower morale
     Improved reach of                Staff expectations not
      information and service           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
The Four Pillars of Reform of the Public
Hospital System

                            Clinical
                          Education
                         and Training
                           Institute




            Bureau of                     Clinical
              Health                     Excellence
           Information                  Commission




                          Agency for
                            Clinical
                          Innovation
Clinical Education and Training Institute

VISION
To 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.

MISSION
Investment, 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




          Capacity                                       Culture




                Collaboration                Communication




                                                                   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
Technology Paradox of Work vs Personal




                                         12
Disconnect in School




                       Slide Courtesy of Cisco, Australia   13
Drivers for change




                     Slide Courtesy of Cisco, Australia 14
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




                            Slide Courtesy of Cisco, Australia 16
Content versus collaboration




                          Slide Courtesy of Cisco, Australia 17
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




                    Slide Courtesy of Cisco, Australia 34
Future




         Slide Courtesy of Cisco, Australia   35

CETI Driver for change

  • 1.
    CETI Driver for change:the role of education and leadership Professor Steven C. Boyages November 2010
  • 2.
    Challenges to thehealth system Rising Demand Constrained Capacity  Growing & ageing population  Patient Safety  Chronic illness rising  Workforce shortages and  High levels smoking, obesity, stress attitudes  High consumer expectations  Manage demand within finite resources  Cost vs investment  NSW spends about 28% of budget on health care  1.3 million dollars per hour 2
  • 3.
    Investing In HealthIT perceived as a solution to some of the challenges Benefits Risks  Improved automation  Financial investment not  Improved productivity realised  Poor connectivity  Reduced duplication  Lack of common standards  Improved safety  Increased risk to patients  Improved patient and staff  Increased staff frustration experience and lower morale  Improved reach of  Staff expectations not information and service realised  Poor execution and implementation due to inadequate training 3
  • 4.
    Execution is thekey 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
  • 5.
    Medical Mistakes triggermajor inquiry into health system-2008
  • 6.
    The Four Pillarsof Reform of the Public Hospital System Clinical Education and Training Institute Bureau of Clinical Health Excellence Information Commission Agency for Clinical Innovation
  • 7.
    Clinical Education andTraining Institute VISION To 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. MISSION Investment, 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
  • 8.
    The Five Csto Success Competency Capacity Culture Collaboration Communication 8
  • 9.
    Success is 80%related to people 9
  • 10.
    Understand the natureof the work • Workforce • Mobile • Collaborative • Team based • Bee-hive mode • Disconnected • Malunga.C, 2000: The Beehive Model for Team Building, Footsteps Magazine no 43
  • 12.
    Technology Paradox ofWork vs Personal 12
  • 13.
    Disconnect in School Slide Courtesy of Cisco, Australia 13
  • 14.
    Drivers for change Slide Courtesy of Cisco, Australia 14
  • 15.
    Technology Enabling • NewWays of Organising Learning • New pedagogy • New relationships • More sophisticated learning mix • Richer assessments and evaluations • Data at all levels 15
  • 16.
    Technology (finally) ripefor education Slide Courtesy of Cisco, Australia 16
  • 17.
    Content versus collaboration Slide Courtesy of Cisco, Australia 17
  • 19.
    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
  • 20.
    Developing a commonplatform  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
  • 21.
    Element of blendedlearning  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
  • 22.
    Element of blendedlearning  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
  • 23.
    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
  • 24.
    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
  • 25.
    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
  • 26.
    Summary of CurrenteLearning 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
  • 27.
    What the CurrentState 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
  • 28.
    What the CurrentState 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
  • 29.
    Current State ReportRecommends  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
  • 30.
    Developing NSW HealtheLearning 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
  • 31.
  • 32.
    Summary We are onthe 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
  • 33.
    Technology Enabling • NewWays of Organising Learning • New pedagogy • New relationships • More sophisticated learning mix • Richer assessments and evaluations • Data at all levels 33
  • 34.
    Changing Learning Slide Courtesy of Cisco, Australia 34
  • 35.
    Future Slide Courtesy of Cisco, Australia 35