Why does the patient voice matter in healthcare training?
Improving patient outcomes is a, if not the, top priority for all healthcare practitioners. In recent years, the patient has moved from the margins to the center in terms of their role in some aspects of healthcare decision-making. The UK’s ‘No decision about me, without me’ white paper has repositioned patients as key participants in their healthcare decisions and encapsulates the essence of similar moves across North America, LATAM, APAC and EMEA to incorporate the patient voice into their diagnostic and treatment pathways. But the pandemic has changed our working cultures, and our medical affairs teams need training and support to continue to adapt and meet the new needs of their healthcare partners. For instance, an online consultation between a doctor and patient may have seemed unusual and distant merely months ago; however, with people forced to adopt remote working as much as possible, online consultations have worked very effectively and continue to do so alongside normal clinical settings. Consequently, it is imperative that current gaps continue to be bridged between training needs, professional practices, and patient outcomes, with greater attention paid to keeping the patient in mind during knowledge and skills development training, whether internal or external.
Digital innovation in training can be a game changer in such scenarios, with the added bonus that investing in a well-designed digital learning environment can also help save money and time in the longer term and contribute to a culture of continuous lifelong learning, which is an essential tool for HCPs within such a fast-paced and dynamic environment. In this article, we will investigate how embedding digital tools at the development stage of your training process can help keep patients central in the mind of your learners and look at some great in-practice-strategies to carry forward into a post-COVID world.
How can you include digital innovation in the development phase of your training program creation?
Within training circles, ‘ADDIE’ is a commonly used instructional systems design framework. It is an acronym, standing for the five phases of activity that take place when developing a training program: Analysis, Design, Development, Implementation and Evaluation. The focus during the development phase should be on bringing the learning activities, assessments and content you have chosen to meet your learners’ needs to life — this can include everything from graphics, audio-visual media and colours, to any tool that helps create an end product for learners. Although by this point, the scientific content of the training should have already been decided, the development stage plays a huge role in how the content is delivered to the learner, how they interact with it and how engaging the learning activities are. Ultimately, decisions made here will truly reflect on the quality of the user experience, the accessibility of the materials, what and how well the user will remember, and even influence how well they will be able to utilise their learning in practice. Traditionally, voice, pen and paper or digital devices serving a similar role have been the staple media through which training has been developed; however, this has changed rapidly over the past few years, and now there are a host of digital platforms and tools that can be used, many of which bring more personalized, more engaging and more patient-focused learning.
Why is digital innovation such a powerful resource during the development phase?
Among the core attributes of the healthcare industry include its fast pace, tight regulation and competitiveness, as well as its continuous desire for innovation. It is hardly surprising that successful learning and development (L&D) activities should want to follow suit to become more relevant, personalised, motivational, secure and easily translatable to practical action. Of course, ‘digital innovation’ in L&D does not mean one strategy or one way of thinking; it encompasses a plethora of opportunities that can be integrated during the development phase to improve the learner experience of training.
Examples here include everything from blogs and podcasts to interactive real-life simulator trainings that assess the user based on real-world situations in the workplace. In the quest for more integrated professional development, micro-learning has appeared as a frontrunner, providing bite-sized content centered around specific learning objectives. For patient engagement, multichannel-optimised videos or gamification of learning materials often provide positive reinforcement to help educate and drive behavior change in a more enjoyable way.
Security has emerged as a key consideration too — both in terms of access and assessment quality to reduce instances of e-cheating, itself a booming industry in our increasingly digitalised professional landscape. Data validation and robust assessments are enhanced by the application of appropriate technology. This can improve a learner’s experience by providing immediate feedback and links to additional learning resources and lines of support, as well as reducing instances of plagiarism and cheating though data checks and user validation processes.
Whatever your impetus towards, or away from, digital innovation, it’s imperative that the tools, platforms and products you choose are the right ones to deliver the right training, at the right time, to the right person, whether this be an MSL, HCP or patient. There’s no point, for instance, taking the leap and going completely digital if this carries the risk of developing an L&D strategy that is innovative in theory but falls short in practice because your learners need to undertake some learning activities in person to meet their learning outcomes and professional benchmarks. Similarly, it’s not wise to create a perfect learning platform that only works on desktop devices if up to 50% of your learners prefer to engage through mobile ones. Consultations with your colleagues, learners, training providers and digital teams will ensure that you’re making the best possible choices for developing learning content that meets your audience’s needs.
How else can technology help to keep the patient in mind when developing training?
While learner-centric training models continue to gain popularity, there is still an industry tendency to first focus on what is deemed to be essential scientific content knowledge, for example, drug X is now approved for condition Y and all the corresponding relevant information, such as the pathophysiology of the disease and the mechanism of action of the drug. Although it is important that HCPs are up to date with the newest data, this content-centered way of learning can often miss a crucial step — how to use and apply this knowledge in the clinic as part of the patient journey. Instead, a combination of learner-centered and patient-focused approaches should be encouraged, which contextualise scientific knowledge in relation to the patient and their experience.
In order to build a patient-focused approach, you may need to ask yourself the following questions:
- What skills do my team need to have the best possible interaction with the patient?
- Where are the current gaps in knowledge, and what knock-on effects could this have on the patient?
- How can I ensure that learning objectives are linked to practical skills in the clinic?
- How will achievement of learning outcomes be measured in order to best demonstrate the effect on patient outcomes?
It may help to work backwards by visualising the ideal situation, in which HCPs are completely up to date with essential knowledge and are able to apply this in the clinic to support strong patient outcomes. Ask yourself what this looks like and then investigate which digital tools might best be used to highlight the patient voice in training materials.
For example, including a virtual patient or avatar can be a great way to highlight aspects that are important to the patient; the best treatment option for the disease may have quality-of-life consequences for the patient that should be considered in any decision-making. Avatars can be a useful tool to remind HCPs to be empathetic and make choices based on the individual and not on data alone. In a similar way, patient stories and voices can be highlighted through patient speakers or though patient organizations. Digital mediums, such as streamed video interviews or podcasts, can offer an informal way for HCPs and MSLs to learn more about the patient experience and their priorities. Crucially, this can offer a perspective perhaps not seen in the clinic and certainly not from big data. Although measures must be taken to ensure any interactions with patients are supported and facilitated within the confines of local regulations, this can be an extremely powerful tool to provide lived experience and context for your learners.
Another method of bridging the gap between knowledge enhancement and clinical practice could be to implement virtual simulated roleplays. For example, after an HCP has learnt about the use of drug X in disease Y, they can be taken into a virtual clinic simulator and met by a virtual patient, who may be an assessor, a fellow HCP or a cleverly designed algorithm. Here, the HCPs can practise interacting with and responding to patients who were created with the knowledge of real-life patients in the clinic. This medium can offer real-world learning and gives an opportunity for quick, efficient feedback against predetermined competency frameworks that should be designed with a patient-centered focus.
Additionally, websites such as Skills Platform and FutureLearn can offer bite-size eLearning modules useful for all those associated with the healthcare industry to be completed on demand across a variety of topics. In this way, HCPs can opt to undertake eLearnings that are suitable for them in their own mission to optimize outcomes for their patients.
eLearning in a post-COVID world
The COVID-19 pandemic brought about one of the fastest and most significant increases in technology adoption and digital literacy ever seen. Almost overnight, many employees were required to work from home, bringing in a series of logistical difficulties and opportunities — L&D was no exception. Organizations needed to digitalize training that had been primarily delivered face-to-face. While this was a shock to the system to start with, the digitalization of L&D has already shown that it can provide a richer, more flexible user experience, with improvements in deep-learning opportunities and lower rates of non-compliance. It also fosters connectivity, both on a global and peer-to-peer level and contributes to a culture of continuous lifetime learning. Training no longer needs to be physically organised to be on a certain day; instead, users can self-allocate appropriate trainings to do at a time convenient for them. There is also an increased ability to log and track learning activities, as well as a reduction in the time taken to deliver content. Additionally, digital communication platforms allow MSLs or HCPs to interact with geographically diverse stakeholders, without the time and cost implications of face-to-face interaction.
For example, the dynamic nature of the NHS workforce during the pandemic has seen many HCPs pulled away from their normal roles to work on the pandemic frontline. Initially, there were worries about the possibility of large numbers of staff being off ill or self-isolating and a parallel need to backfill the hands-on skills quickly lost by these personnel. Thus, many individuals required ‘refresher’ courses, and volunteers needed training on how to perform practical skills, such as administering test swabs or vaccinations. The vast majority of these trainings and courses were delivered in part, if not wholly, through a digital format. Of course, in some cases it is only appropriate that trainers and trainees be together in a physical space — for practical assessments or training — but the shift to digital delivery facilitated quick and effective training for HCPs and volunteers during the pandemic.
However, there is reason to be cautious with the increasing digitalization of L&D activities as we move forward into a post-pandemic future. The ‘novelty’ value of digital learning may yet wear thin. Some learners may continue to underestimate the importance of, or overlook, learning opportunities as it is easier to ignore an email notification than it is to not turn up to a face-to-face seminar, for example. Efforts to provide high-quality digitally innovative training may also prove ineffective for those who refuse to embrace the change. Equally, a standalone 2-minute micro-learning video may not be appropriate for serious topics such as patient safety — although digital tools can certainly be used to test retention of important information, such as adverse event rates. Ultimately, a hybrid learning strategy seems the best approach to enable organizations to gain the most benefits from learning options, and this can be brought to life during the development phase of your training program creation.