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E-Learning and the Direct Care Workforce

By Robert Espinoza | October 30, 2018

E-learning has increasingly captivated long-term care leaders who want to tap the power of technology to effectively train a growing number of direct care workers, while improving learning outcomes and achieving cost efficiencies. But what exactly is its potential for this workforce?

PHI Director of Workforce Training Solutions Jerry Philip weighs in.

Q: Can you give us a sense of history–how did e-learning emerge?

Philip: The term “e-learning” is believed to have been first used in the late 1990’s as part of a computer-based training systems seminar in Los Angeles, California. E-learning emerged out of the technology waves of “personal” computing in the 1980’s and 1990’s, broadband availability in the 2000’s, smartphones in the late 2000’s, and the widespread adoption of social media over the last decade.

We saw schools offering online courses in the 1990’s, businesses beginning to use e-learning to train workers in the 2000’s, and e-learning formats inspired by social media this decade. In short, computers became smaller, cheaper, and more widely available; the internet became a reliable pipeline for content and transactions; and we’ve adapted ourselves to consume content, socialize, work, and learn online. Organizations have been trying to make the most of these changes through e-learning.

Q: Can you paint a picture of how an e-learning course works in the direct care context? What are some of the most popular elements?

Philip: From our point of view, effective e-learning for direct care workers is scenario-based, which means that we’re interested in combining case study principles with those scenarios. We want to introduce the learner [the worker] to a client using a narrative with pictures and audio to help them see the individual and to understand their needs.

We then want to simulate scenarios that give learners a chance to “practice” key caregiving skills. The scenarios and the accompanying story are designed to “unfold” in unexpected ways. We want learners to reflect on their “practice” experiences.

Lastly, we want to give our learners a chance to finish the story of their client. We’re using the basic elements of e-learning—video, audio, textual elements, and branching—for storytelling, and other interactive elements to make the experience as engaging as possible.

Q: What are the two most essential elements of an effective e-learning program for direct care workers?

Philip: With the reality of limited training time, effective e-learning programs must teach specific skills that lead to quality care. Effective programs must also provide opportunities for meaningful practice and feedback. The more that programs mirror “real-life,” the likelier that workers will learn these new skills and use them in their caregiving.

Q: What does it mean for an e-learning approach to mirror real life?

Philip: Our goal as designers is to put ourselves in the shoes of direct care workers and to consider real life conditions they will face in caregiving each day. If we are building a scenario to teach a specific caregiving skill, we want to use pictures, video, and audio to make the person they are caring for in the scenario as “real” as possible and the skill as obvious and reproducible as possible for the learner. This helps build empathy in the learner and ideally gives them the confidence to generalize that skill to real life when they start working.

Q: We often talk about the importance of “blended” training approaches that combine in-person and virtual elements. Why is this important when it comes to training the direct care workforce?

Philip: Right now, the quality of hands-on, in-person classroom practice exceeds that of simulations in e-learning for direct care workers. Blended approaches allow us to combine the digital enrichment of the e-learning environment with hands-on practice in the classroom.

In addition, many prospective direct care workers do not come with high levels of technological literacy or significant post-secondary training experience. A blended environment accounts for this fact and offers greater opportunities for one-on-one support for learners.

Q: It seems that long-term care providers are increasingly using an e-learning model to train their workers, ensuring they have the skills and knowledge to succeed in their roles. What’s the appeal of e-learning?

Philip: It can be seen as a cost-saving strategy. It offers a way to train workers without the expense of trainers, curriculum writing, and, for some, training space. The flexibility to train workers when they need it and wherever they have Wi-Fi is powerful when you are dealing with scheduling and staffing challenges.

Q: What are the benefits of e-learning for direct care workers?

Philip: The primary benefit of e-learning for direct care workers is that workers can access training when it works best for them. This is particularly meaningful for those workers who face considerable transit challenges, or child and family care responsibilities.

E-learning also offers the potential benefit of training in multiple languages for workers with limited English proficiency. And it can serve as a real-time job aid or refresher, particularly for workers in home- or community-based settings who have limited access to live support.

Q: What is the appeal for businesses to adopt e-learning technologies?

Businesses—even in sectors that are typically late adopters of technology—have recognized the cost and time savings of e-learning. Workers with greater technological literacy are well equipped to benefit from e-learning, and their success with this format has helped justify organizational investments.

Q: Are there any drawbacks to e-learning in this sector?

Philip: Direct care work can be stressful and isolating. Trainings build community and offer a chance to validate and celebrate the rich experiences and knowledge of workers, as well as a chance to build trust and provide early support for workers who are struggling. E-learning can sometimes exacerbate challenges for workplaces that don’t have a culture of retention.

Q: Are there ways that e-learning can account for these drawbacks?

Philip: The critical factor here is whether workers have previously experienced a sense of community through a purely digital platform. Given the limited training time and the general lack of adoption of community-building tools in long-term care, e-learning approaches might struggle to have the same impact as traditional methods.

That said, many e-learning providers have spoken positively about the potential of elements like gamification with leaderboards, group and peer messaging, and integration with social media, among others.

Q: I’ve learned from you that “e-learning” is not the same concept as “online training.” What’s the difference?

Philip: The difference is not about technology, but how you see the learner and the point of “training.” When we create programs that give information and knowledge that we expect the learner to memorize, we promote passivity. With e-learning, we strive for engagement, relevancy, and, most importantly, the application of knowledge, skills, and attitudes to the “real world” of caregiving.

Q: Are there any technology innovations in recent years that have the potential to improve training among the direct care workforce?

Philip: Augmented and virtual reality technologies offer the chance to narrow the gap between training and real-world caregiving by making the experience truer-to-life while building empathy. This really matters when we are trying to help learners combine and apply all their new knowledge and skills to real-life scenarios, particularly for clients with complex needs.

AR- or VR-assisted simulations give workers a chance to feel the emotion of the case and to “see” the impact of their actions on care. This helps the workers retain more of what they’ve learned and makes it easier and more likely for them to put their new skills into practice.

Q: Is there a specific example in regard to augmented and virtual reality?

Philip: “Augmented reality” providers are doing very interesting work in helping caregivers to “experience” the impact of dementia firsthand, which helps them brainstorm how to improve the care they provide. There is high demand for training direct care workers to support individuals with dementia, given the growing numbers of people with dementia.

Robert Espinoza
About The Author

Robert Espinoza

Vice President of Policy
Robert Espinoza oversees PHI's national policy, research, and communications division. He has been a national policy expert, communications strategist, and writer for 20 years.
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