How e-learning can help treat a sick child

This e-learning resource can give clinical staff the tools to improve their paediatric skills, says Dr Nicholas Blackwell.

It can be hard determining if a child with a fever has a serious illness (Photograph: SPL)
It can be hard determining if a child with a fever has a serious illness (Photograph: SPL)

The internet is a massive resource with fantastic potential, but it can be a double-edged sword, sometimes encouraging patients to self diagnose - often erroneously. However, one of the most exciting uses of the internet is the potential that it offers for on-the-job training for all those involved in the health service, from healthcare assistants through to GPs and senior consultants.

Keeping up to speed
Online learning is becoming an increasingly popular tool in clinical education. One huge advantage that e-learning has is the speed with which new techniques, initiatives and research can be incorporated into any online learning material. By comparison, the time it can take text books and papers to be published means the materials may be out of date as soon as they hit the shelves.

However, e-learning is not just a cheap form of education: its development requires a substantial investment of both time and money. Producing high quality e-learning material is far more complex than simply placing pages of text or presentations online; learners expect to be engaged.

An effective e-learning tool
Creating a clinical online resource is a complex task, and there are several key factors that need to be addressed if the resource is to be effective.

A good online resource should include some, or all, of the following:

  • Clear key learning objectives that underpin the resource.
  • Measurable outcomes of success for the user.
  • Real examples of good practice so the experience is practical and realistic.
  • Expanded key learning points.
  • Video footage of real life situations.
  • Interactive assessments so users can measure their progress and create an individual programme.
  • Extensive use of a range of clinical media.
  • Adaptive clinical scenarios and simulated collaborative environments.
  • Access and links to useful external resources.

In 2009, the DoH, recognising that e-learning can be a powerful training tool, commissioned a not-for-profit website resource. Spotting the Sick Child is designed to help clinicians who have regular contact with sick children, but may not have in-depth paediatric experience, expertise or training. This resource is available for an annual subscription of £5.

Working with sick children can be difficult for a range of reasons, and the amount of experience needed to make an accurate diagnosis is hard to come by. When faced with a child complaining of illness, the first dilemma is deciding whether it is a serious illness requiring immediate action, such as hospital admission.

This is not always easy to determine. For example, does a child presenting with a high fever have a viral, self-limiting illness or a more serious bacterial illness? In addition, symptoms like fits or drowsiness usually have different causes and meaning in children than adults, while deterioration usually happens more quickly.

This means that making a mistake could have more serious consequences.

Real patient scenarios
Fortunately, improving the skills and knowledge needed to diagnose a sick child more confidently is not difficult: experience and some reasonably basic teaching in paediatrics is all a trained clinician really needs.

So, when the DoH commissioned Spotting the Sick Child, it was decided that an online resource would be the most efficient and cost-effective way of reaching as many health professionals possible.

Not only would classroom-based training be expensive and resource intensive, but the aim was to make the resource as close to real life situations as possible through the use of video clips as opposed to words or photographs.

As a result, Spotting the Sick Child contains more than five hours of video clips of real patients and was filmed in one of the UK's busiest emergency departments.

It also includes films of genuine paediatric problems, such as inconsolability, the quiet, listless child who is seriously ill, a non-blanching rash in a child with meningitis, children developing respiratory failure, severe croup and fitting children. This enables users to be as close as possible to experiencing the real situations, ensuring they are better equipped to identify and deal with a seriously ill child.

The resource also includes sections on assessing seven common symptoms in children, again illustrated with real examples.

Users can make the material relevant to their own specific training needs through the 'My Learning' section, which enables users to create their own programme and track their progress and also has a section where the user can test themselves using real scenarios with real patients.

So, the next time an ill child comes through the door, as they will regularly, be as prepared as possible. Start by using the tools and training packages available to get the knowledge and experience that will benefit these vulnerable patients.

With so many exciting resources being developed, and so many advances in training technology, you may find the experience both educational and enjoyable.

Learning points

1. Spotting the Sick Child can help doctors expand their knowledge of some common paediatric complaints as well as some more serious conditions.

2. The resource includes hours of real-life video consultations to aid learning.

3. The 'My Learning' section enables users to create their own learning programme and track their progress.

  • Dr Blackwell is director of the health education research and development unit at the University of Leicester Medical School

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