E-learning: the revolution

easy is it for an OHN to improve their knowledge or even gain a specialist
higher qualification via the internet? We look at the pros and cons of remote
learning, by Greta Thornbory

In her Ruth Alston Memorial Lecture more than 12 months ago, Judy Cook1
hailed e-working as the ‘occupational health revolution’, and encouraged OH
practitioners to embrace computer technology.

She went on to say that the days of the disempowered, isolated Occupational
Health Nurse (OHN) will disappear. This is very true, for nowadays,
practitioners can keep up to date, chat with colleagues and search for
information on the internet.

The worldwide web does exactly what it says; just like a real web, it catches
all the information we could need and keeps it readily available.

However, finding the relevant information may be difficult, and using the
internet is not without its problems. This article aims to explore the
different levels of information available via the computer as e-learning for OH
practitioners, and discusses some of the pros and cons.

What is e-learning?

In his talk on e-learning at the Networked Learning Conference 2002, Robin Mason
of the Open University2 said there is considerable ambiguity and contradiction
about what e-learning actually is. But he did highlight the following
definition from the Chartered Institute of Personnel and Development, which
describes e-learning as: "Learning that is delivered, enabled or mediated
by electronic technology, for the explicit purpose of training in
organisations. It does not include standalone technology-based training, such
as the use of CD-Rom." (CIPD 2002)3

During the conference, discussions were held on the new UK eUniversity
(www.ukeu.com), a new Government initiative aimed at enabling students
worldwide to study entirely by remote e-learning. Can we now look forward to a
time when OHNs can gain their specialist higher qualifications entirely by
e-learning? And if so, what might be the advantages and disadvantages?


– Accessibility is one of the main advantages of e-learning courses. OHNs
will be able to access courses from anywhere in the country, whereas at the
moment they are only offered in a few universities, and often require expensive
travel and lengthy periods away from work. This adds to the costs – which many
companies are not willing to pay – resulting in a shortage of well-qualified

– Reduced costs – see above

– Easy access to other resources, materials and subject experts

– Ability to study in own time and not within university, travel and work
time constraints

– Flexible programmes that are more suited to individual needs


– Isolation has never been a factor at the face-to-face courses I have
attended as a student and tutor. Networking, and the exchange of ideas, values
and beliefs that mould and develop the practitioner – and at times the teacher
– are able to take place. Without a ‘classroom’, this may be difficult to

– Access to poor and possibly dangerous information may occur without help
or support to determine its quality

– Support systems will need to be complex and the supporters well versed in
the use of personal support via a range of media

– Course design will need to change to take account of different learning
styles and speeds. Specific types of assessment will need to be developed to
prevent essays consisting of a series of downloaded material being used without
thought or understanding.

There is much to be taken into account before the first qualified OHNs
emerge from completely online courses. But fear not tutors – you will still be
needed to design, produce, implement and monitor the courses.

Support via e-mail, specific discussion groups and interaction on a
one-to-one basis will become all important. Developing exciting OH courses
‘outside the box’ will provide a wonderful challenge for the forward-thinkers
to tackle.

Typography of e-learning

In his conference paper, Mason presented the typography of e-learning in
table form. It outlines the three main sectors: web-based training, supported
online learning and informal e-learning, all of which are relevant to OH

Web-based training and supported online learning are both ‘formal’ and may
be equivalent to training sessions, short courses and higher education,
depending on who is offering them and what accreditation they have.

Relevance to OH practice

The educational needs of the OHN can be placed roughly into three main

– Ways of working: for example management skills, committee skills,
budgetary skills and so on

– Personal efficacy: Teaching and presentation skills, communication skills,
continuing professional development, healthy living and lifestyle

– Clinical skills: for example risk assessment, first aid, vaccinations and
so on

Take first aid as an example. Keeping up-to-date with first aid knowledge and
skills may be difficult without attending refresher courses – yet web-based
training is available to do just that.

By visiting the St Johns Ambulance website, www.sja.co.uk you will be
directed to the ‘BBC Health First Aid Action’ online first aid course –
www.bbc.co.uk/health/first_aid_action This is a good refresher for the OHN and
would certainly help first aiders in training with their revision, or even help
them keep up-to-date between certification.

All the theory is presented online using interactive scenarios, the first of
which is a collapse of scaffolding, and very much relevant to OH practice.

Once this online course is completed, there is an opportunity to enrol for a
practical session at a local St Johns centre. The online course is free, but
there is a charge for the practical session.

However, it fulfils clause 6 of the NMC Code of Professional Conduct4
provided you record it in your portfolio, which may also be online – see
www.rcn.org.uk and the RCN members’ online ‘learning zone’ for an online

It also demonstrates Mason’s e-learning typography for web-based training,
in that it is:

– Content-focused

– Delivery-driven

– Working as an individual without any interaction from a tutor (other than
on-screen feedback when you make a mistake)

– No collaboration with other learners – unless you discuss it with a
colleague, perhaps during a clinical supervision session, or with a first aid
student after the experience

Another example of web-based training relevant to OHNs and available free
online is the NHS National Nursing Leadership Project –
www.nursingleadership.co.uk. The programme is delivered via the internet, and
helps with continuing professional development. It covers skill development in
areas such as:

– Techniques for mastering paperwork

– Ways to make meetings more effective

– Conflict-management strategies

– Confrontation strategies that help resolve conflicts productively

– Negotiation skills

– The value of effective communication when getting people involved and
adjusted to change

– Effective strategies for leading change

– Ways to develop relationships

– Ways to nurture staff

– Ways to make empowerment work

– Good stress management techniques

– How stress operates at work

– Characteristics of stress from overwork

– Ways to increase stress tolerance

– Appropriate strategies for dealing productively with difficult managers
and co-workers

Five courses are currently available:

– The mark of a leader

– Building your support system

– Time as a resource

– The interpersonal side of conflict

– Coping with stress

The following additional courses will be available shortly

– Developing interpersonal skills in your team

– The emotionally intelligent leader

– Leading through change

– Managing a project with your team

– Difficult people in the workplace

– Budget management

Although this is an NHS initiative, it is open to all nurses, regardless of
where they are based.

The site offers a range of support systems including newsletters, technical
support, FAQs, phoneline support, opportunities to make comments and
suggestions, plus online discussion groups and chatrooms. Web-based training is
evidently already working and available for a number of projects suitable for
OHNs to access.

Supported online learning is still in its infancy, although it is developing
rapidly, with the first UKeUniversity courses becoming available at the end of
2002. These are not yet in the healthcare fields, although work is under way to
get some in this area.

Exploring the internet led me to just one university offering e-learning
higher education for nurses. Through www.e-learningzone.co.uk, I accessed
information about a BA nursing degree which first level nurses can do, as long
as they have APL (accreditation of prior learning), from the Virtual Campus of
the Robert Gordon University.

This course is not completely virtual, as it requires three days ‘classroom’
attendance at the beginning.

Although e-learning encourages diversity, it is hoped that it will create
programmes that are much more tailored to market needs and move away from the
more traditionally validated programmes (Forman et al 20025). This will be of
definite benefit to the OHN as specific needs and skills would be recognised –
as Mason’s typography shows, supported online learning should be
learner-focused and activity-driven.

Informal e-learning

Is accessing information from the internet, such as the guidelines for UK
Guidance on Best Practice in Vaccine Administration6 (The Vaccine
Administration Task Force 2002) for example, informal e-learning? Because if it
is, it is at odds with Mason’s typography. It is not group-focused,
practitioners do not act as both learners or tutors and there are no multiway
interactions among the participants.

However, for those who have signed up to the OH section of Jiscmail, the
National Academic Mailing List service which ‘facilitates discussions,
collaboration and communication within the UK academic community and beyond’
(www.jiscmail.ac.uk), this list does fulfil some of the informal e-learning
aspects highlighted by Mason.

Informal e-learning is usually practice-driven, when the practitioner
identifies a need for further information or updating in a particular area of
practice, and falls under the concept of life-long learning and continuing
professional development.

The internet offers a wealth of useful sites and information for the OHN.
Membership of a professional organisation such as the RCN offers free access to
databases – the annual fee for individual access to the British Nursing Index
is more than the annual fee of the RCN. Membership also gives you access to the
full texts of 10 professional journals and to a number of other journal

Journal articles and research papers can be downloaded free of charge.

Care must be taken to ensure that websites visited are from reputable
organisations, and the same rigour must be applied to critiquing website
information as would be used for evaluating research.

Many government documents, HSE research reports and guidance can now be
downloaded as pdfs (portable document format) from the internet. All government
sites and many others offer the free Acrobat Reader programme necessary for
downloading and reading pdf files.

Some of the best websites for OH nurses are given in the Resources Guide on
page 33. Using the NMC PREP guidelines to reflect on what you have learned from
accessing and reading this information and how it influences your working
practice, will turn it into a true informal e-learning experience.


Mason2 ends his conference paper by saying that those involved with
e-learning are already looking around for a new name in light of their
experiences, such as M for ‘mobile learning’.

It appears that what has emerged so far from research is that the true value
of e-learning is the opportunity to integrate working, learning and community
in the workplace – which is exactly what is needed for occupational health

As Cook1 says, ‘using the vast resources of the internet, OH can be brought to
many more people’ by better educated and informed practitioners. E-learning,
m-learning, or whatever it will be called, is the way forward for education in
the 21st century.



1: Cook J (2002) Joining the Revolution Occupational Health Jan 02 Vol 54 No

2: Mason R (2002) Review of E-learning for Education and Training Networked
Learning Conference 2002 www.shef.ac.uk

3: Chartered Institute of Personnel and Development (2002) Training and
Development 2002 Survey Report CIPD London

4: Nursing and Midwifery Council (2002) Code of Professional Conduct NMC

5: Forman D, Lovemore N Rich T (2002) E-learning and educational diversity
Nurse Education Today Jan 02 Vol 22 No 1 p76-82

6: The Vaccine Administration Task Force (2002) UK Guidance on Best Practice
in Vaccine Administration Shire Health London

Mason’s typography for the applications of e-learning

Web-based training                 Supported online learning                   Informal e-learning

Content-focused                       Learner-focused                                   Group-focused

Delivery-driven                         Activity-driven                                      Practice-driven

Individual learning                     Small-group
learning                             Organisational

Minimal interaction                    Significant
interaction                            Participants
act as
with tutor                                  with
tutor                                              learners
and tutors

No collaboration                       Considerable
interaction                        Multi-way
with other learners                    with
other learners                                among

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