NHS England - E-learning Modules on ME/CFS

[Kitty]

I was definitely under the impression that his consultant post was in rehab with a cardiac emphasis.

I thought he was a diabetologist.

Both right. Associate professor of cardiometabolic health at University of Exeter Medical School.

 

[Elara Grey]

With regards to the format:

I find the whole setup of elearning modules with arrows to follow and pictures and multiple choice questions rather childish as a way of presenting information to experienced professionals. Why not a well reasoned article with a clear summary of key points?

Doing this type of thing with different things to click on to progress through and multiple choice questions to answer is typical of the NHS. Almost all e-learning has similar styles, and it's to 'make sure' people actually complete the whole thing.

Certificates for the e-learning are only issued if each and every thing that has to be clicked on or answered, has been. It's designed this way so that people (in theory) can't just open it, press play on a video and walk away without watching it, or open an article without reading it.

There's so much mandatory e-learning every year that the majority hate it. It's also very repetitive, having to repeat the same modules at certain timeframes e.g. annually or every two or three years.
It has been known for people to do as described above, without paying an ounce of attention to the content. Often leaving the e-learning video playing while muted and they're doing something else entirely. Just to get the certificate checked off.

There's only so much interest they can muster up in forcing people to click and tick boxes on e.g. which fire extinguishers do what every year and how not to burn the place down by plugging in daisy chains of extension cords. Or by overloading the sockets. Or to avoid blocking fire escapes. Or to mop up spills so people don't slip.

This kind of formatting is designed to force the learner to at least be present and actually looking at the screen, to some extent. It tracks the learner's 'progress', often matching it against timing. So that if you just click on everything within a few minutes without reading it, the certificate isn't issued.

It's not infallible either. As others say, this still makes for people hardly paying much attention and easily forgetting everything later.

So, I'm not defending the formatting just explaining why it is the way it is.

And yes, I agree with this sentiment:

then it is time the NHS employed some people with a bit more nous.

But, in reality, it's far more an extensive issue than hiring the right people. It would need an entire overhaul of the entire system. To start with, sorting out endless mandatory e-learning about countless modules of little importance/substance. But mostly ensuring the system has the funding, staffing levels, resources and culture to not burn out their entire staff in bureaucracy and endless paperwork and checkbox exercises instead of patient care.

All this is also partly why there has been so little uptake on the e-learning. People have to spend around an entire working week's worth of hours on mandatory e-learning. On topics incredibly mundane that it's actually painful sitting through it. Not many want to go out looking for extra to do - especially when they've still got their jobs to do and usually have to find additional hours to do said mandatory e-learning.

And at the same time, I don't mean to dishearten everyone with the above explanation.

By NHS standards, this is actually one of the most well put-together and interesting e-learning modules available. It is a far higher standard and more 'catchy' (attention-wise) than their usual stuff. Even though, yes, it is still delivered as though it's to:

the main intended audience are people with an educational age of 8

And, regardless of the NHS generally otherwise producing e-learning so painfully boring to sit through, this is still a massive achievement from a system so disinterested in ME/CFS, even with the current flaws in it.

Overall, I thought the content was generally good, though I do share the critique already raised. Much of the content is a vast improvement on what the majority of NHS workers think, even though it could be better.

If I could choose one thing to remove as utmost importance, it would definitely be the link to BACME.

Hopefully (or maybe wishful thinking), further feedback will lead to the flaws being fixed. We've got to start somewhere.

 

[Jonathan Edwards]

And, regardless of the NHS generally otherwise producing e-learning so painfully boring to sit through, this is still a massive achievement from a system so disinterested in ME/CFS, even with the current flaws in it.

But is it?
My impression is that data so far suggest that five people and maybe a dog have done it.
I find it hard to believe that this sort of module is used for teaching on al diseases? If I had to work through this sort of thing for every disease that was going to come along I would resign from being a GP or physician and go and run a cake shop or something sane.

This sort of exercise is utterly repelling. But a department seminar or a review in BMJ or Pulse that I could read when I had a quiet moment could be really interesting and change my view.

I don't see these modules as changing anyone's view because the material is presented as pseudo-medicine. It is quite clearly put together by someone who has no real idea of what the terms mean or why they are useful. People with ME/CFS have got used to this sort of pseudo-medicine as if it was the norm. It never used to be and I doubt it is even now for other diseases.

And, as I have said before, I think there is a major danger that this sort of material will just wise up the health professionals to how much ME/CFS services are just window dressing by people who don't know what they are doing. And people with ME/CFS will be assumed all to have a pseudo-illness that has to be treated with politically correct lip service according to the module but otherwise ignored as much as possible.

The more I think about it the more it seems to me that the problems for looking after people with severe ME/CFS are near enough unique. Health care professionals need to be told "Forget all your usual wasy of thinking about disease. Be a human being for a minute and look at this quite differently". No jargon. No pretend explanations.

 

[Elara Grey]

If I had to work through this sort of thing for every disease that was going to come along I would resign from being a GP or physician and go and run a cake shop or something sane.

This sort of exercise is utterly repelling.

Precisely my point actually about reforming the entire system. I wouldn't hesitate in hazarding a guess that the majority of NHS doctors are thinking similar thoughts to your description about resigning. The same goes for nurses. And they wouldn't be the first to quit to do something else for similar reasons. (Though not just the state of the eLearning).

this sort of module is used for teaching on al diseases

Can't comment specifically on all diseases because generally-speaking, AFAIK, NHS e-learning isn't designed to teach physicians about diseases... otherwise what would the point of medical school be? /rhetorical
But yes, almost all NHS e-learning is repelling, or at least more repelling than this module is.

It might be worth considering that NHS e-learning is generally targeted to the whole of the NHS as its audience? With the exception of some specific modules being designated for specific roles or leadership roles in various forms. I get the impression that any NHS e-learning modules on specific diseases/or illness are nothing more than awareness modules. That's how I see the ME/CFS ones presented.

I don't see these modules as changing anyone's view because the material is presented as pseudo-medicine.

We are in agreement.
I suppose I just saw the module as an awareness module targeted to all members and roles of the NHS. And, to be quite frank, I never had any expectations that an NHS module would achieve changing anyone's view. So my opinions were formed off a very low bar to start with.

The more I think about it the more it seems to me that the problems for looking after people with severe ME/CFS are near enough unique. Health care professionals need to be told "Forget all your usual wasy of thinking about disease. Be a human being for a minute and look at this quite differently". No jargon. No pretend explanations.

And yes, exactly this!

I just don't see anyone writing an NHS e-learning module actually putting those kind of statements to their name. Or the NHS agreeing to put such sentiments to their 'branding'. At least, not at this moment in time.

Those statements coming from the NHS would be the same as admitting a) we don't know anything about ME/CFS, and b) they need to overhaul what they are doing. Akin to admitting they are doing something wrong. And the system as it stands does not seem to do that. It seems protects itself at all costs.

So the only way I see something being produced by the NHS that has the aim of changing anyone's view completely is when research has caught up and there is tangible evidence of disease and/or a biomarker.

Yes, the pseudo-medicine is not going to help any of us. Yes, it is far from being an enthralling, mind-changing learning module. My previous comments were about it being mostly positive FOR THE NHS. Starting from a very low bar. Against the standard of their other e-learning modules, this is better than what they usually produce. But that's not to say it's all that productive in terms of what we actually need!

I guess I just never had any expectations of it being exceptionally revolutionary to begin with. Especially in its first (or slightly amended) creation. And I see the module as an awareness module for all levels of the NHS e.g. domiciliary carers looking after people with severe ME/CFS.

I doubt any e-learning module, with or without NHS logo attached, would achieve education about a disease that would completely swing physicians' views. As you rightly say, that would take something aimed at physicians, from a respected source. I'd add more importantly from inclusion in medical education. No e-learning module is going to compensate for the general lack of its inclusion in the latter.

As above, I'm not trying to defend the e-learning in its current version or argue that it's good. I completely agree with the numerous valid points and criticisms against it. And I'm on the same page that this kind of structure of e-learning is utterly repelling. Therein lies my point as to why the NHS uptake on it has been next to nothing.