International Journal of Healthcare Simulation

Background:

As COVID-19 hospital admissions rose in 2020, there was a requirement to prepare wards and staff to care for COVID-19 patients, especially given the rapidly emerging and frequently evolving guidance, and high levels of re-deployment (GMC, 2020). In one London Trust, this need for educational material geared towards ward staff resulted in a multi-disciplinary simulation education team being commissioned to produce an e-learning resource. We measured the effectiveness of the resource for ward staff as well as any improvement in learners’ COVID-19 knowledge.

Aim:

The aim of the study was to quantify the effectiveness of an e-learning package in improving learners’ COVID-19 knowledge.

Method:

In November 2020, an e-learning package was created, comprising a video series documenting the journey of a patient with COVID-19 covering admission to discharge (filmed from the patient perspective). This was integrated with content highlighting key aspects of COVID-19 care, ending with a mandatory assessment with an 80% pass mark. The e-learning was disseminated to hospital staff (doctors, nurses and allied healthcare professionals) with data collection via SurveyMonkey® from November 2020 for 3 months. Pre- and post-surveys were included to investigate the average improvement of learners and the impact of the resource on learner self-efficacy through self-rating on six learning outcomes. Free-text options in the post-survey allowed qualitative feedback, aiding continual resource development.

Results:

In total, 108 learners, about half of whom were doctors, completed both surveys, with a significant difference (p < 0.01) between the pre- and post-learning results and an overall improvement in learners’ knowledge after completion of the e-learning (Table 1). The greatest improvement was in ‘Discharge requirements’ (94%) and 100% of learners passed the assessment. The majority found the resource useful, and none reported finding the resource difficult to use. Most positive feedback referred to the format, resources, content and audio-visual aspects.

Table 1:

Average pre- and post-learning scores of learners’ self-reported knowledge and percentage improvement

Key learning outcome	Pre-learning mean (out of 10)	Post-learning mean (out of 10)	p-value	Percent improved
Recognize symptoms	7.2	9.0	<0.01	73
Understand TEPs*	6.7	8.8	<0.01	73
Treatment options	5.8	8.7	<0.01	89
Features of deterioration	6.3	8.7	<0.01	83
Escalation protocol	5.0	8.6	<0.01	93
Discharge requirements	4.6	8.2	<0.01	94

*Treatment escalation plans.

Implications for practice:

E-learning can rapidly disseminate learning, at a time when most feel the pandemic has had a mixed or negative impact on learning opportunities (Dean E, 2020; GMC, 2020). The e-learning is continually updated with new evidence, with plans to expand access across London. An iterative process was undertaken with updates in response to learner feedback due to the speed at which the resource needed to be developed, for example, turning resources into PDFs for home access. The e-learning remains live given rising COVID-19 cases. Further work is required to investigate the effectiveness of this resource across London and how beneficial it has been for clinical work.