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THURS: The Digital Nurse: experimenting with open sourced multimedia (Sarah Adrienne Hughes)

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Sarah Adrienne Hughes
13 January 2017

This presentation will describe how the author developed her own resources, reused open sourced learning artefacts, and her process of experimentation and research of online and networking tools for learning. The project was undertaken through participation in a postgraduate module entitled ‘The Networked Practitioner’ (The Open University, 2016a). Using a ‘Journey of Innovation’ (Zita, 2016), the author explored the use of both known and new ways of working with online multimedia and ICT tools and used a reflective diary to record developing ideas. The aim of the project started with the question: “How can I engage students in eLearning and provide information, skills and support for the development of future Health eTasks?  And is intended to inform the development of curriculum regarding ‘Nursing Informatics’ (McGonigle and Mastrian, 2012; Barthold et al, 2015; O’Connor, 2016).

Online engagement with curriculum and commitment to eLearning are considered key aspects of successful blended learning (Valentin et al, 2013; Neville et al, 2015): especially as the Nursing and Midwifery Council (NMC) stipulated specific hours of study in PRNP (NMC, 2010) and the importance of making curriculum ‘future proof’. This project is intended to underpin new Pre-registration Nursing curriculum to form a three-tier theme of Nursing Informatics to prepare new nurses for 21st century nursing.

Traditional Literature searching identified current issues in relation to Digital Literacy Skills, technical support and motivation for engaging with ICT tools, but failed to offer many solutions. Through the use of other resources, the author suggests that: ‘non-academic’ sources of evidence can be used to triangulate ideas in a divergent way (Stoker, 2011) to enable nurses to work alongside their technical colleagues; and that current ‘hierarchies of evidence’ be reviewed in order to meet the ever changing nature of the evidence (Draper, 2016) for technology and healthcare informatics.

Extra content

This session has been moved to THURS, due to work circumstances...

Sarah Adrienne Hughes
19:18 on 16 January 2017

Reference List

Hughes, S.A. (2017) ‘The Digital Nurse: experimenting with open sourced multimedia to promote motivation and digital literacy in Nurse Education’ TMA02 The Open University (2016), H818 - The Networked Practitioner The Open University, Milton Keynes.

McGonigle, D. and Mastrian, K.G. (2012) (2nd Edition) Nursing Informatics and the Foundation of Knowledge, USA, Jones and Bartlett Learning.

 NHS England (2016) NHS Five Year Forward View: Recap briefing for the health Select Committee on technical modelling [online] Available at  (Accessed 13.11.16)

NMC (2010) Standards for pre-registration Nurse education  available at   file:///C:/Users/shughe02/Downloads/Standards for pre-registration nursing education 16082010.pdf (Accessed 1.1.17)

O’Connor, S. (2016) Siobhan O’ Connor on Nursing Informatics Available at (Accessed 2.1.17. Also available via Twitter see #DigitalNurse.)

Ramen, J. (2015) Mobile Technology in nursing education: where do we go from here? A review of the literature. Nurse Education Today Vol 35. Pp 663 – 672.

Schmitt, T., Sims-Giggens, S., and Booth, R. (2012) Social Media Use in Nursing Education Online Journal of Issues in Nursing Education Vol 17, Issue 3, e1-14 [online] Available at  (Accessed 13.11.16)

Valentin, A., Mateos, P.M., Gonzalalez-Tablas, M.M., Perez, E., and Garcia, I. (2013) ‘Motivation and learning strategies in the use of ICTs among university students’ Computers and Education Vol 61, pp52-58.

Webb, L., Clough, J., O’Reilly, D., Wilmott, D., and Witham, G. (2017) The utility and impact of information communication technology (ICT) for pre-registration nurse education: A narrative synthesis systematic review. Nurse Education Today, Vol 48, pp 160-171

Zita, T. (2016) What is Innovation? [Online] Available at (Accessed 13.11.16)

Sarah Adrienne Hughes
13:19 on 5 February 2017

The Presentation has been forwarded to the moderator for uploading onto the conference.

An accessible version (with alt text) is available on slideshare :

Feedback on functionality of the links and alt text within slideshare would be appreciated for future use.



Sarah Adrienne Hughes
13:22 on 5 February 2017 (Edited 07:58 on 9 February 2017)

Embedded Content


Andy Brooks
4:39pm 27 January 2017

Hi Sarah, what would you class as a Health eTask? Would you say then, that nursing training has remained pretty much static over the last 10 years or so?

Heather Bloodworth
5:42pm 27 January 2017

Hi Sarah, what can we do as nurse educators to takle the digital literacy problem in order that we can improve student engagement and motivation with eLearning?

Julie Skeats
5:51pm 27 January 2017

I now work for The Priory group which has four divisions, healthcare, education and children’s services, adult care and older people’s care , it has an eLearning program that all staff have to complete. It has learning materials, consisting of videos, audio text, then assessments for each unit. It means all staff are trained to the same level in all aspects. It is a pain doing it, but I can see the benefits.

Sarah Adrienne Hughes
3:08pm 28 January 2017

Dear Andy,

Thanks for starting off my presentation'sdiscussion!

I do not have a definition of an eTask. It is something that I 'invented' to start a discussion with students.... Where as they have nursing tasks, management tasks and learning tasks, I wanted to get them to consider what would be different if we included 'eTasks'! In my opinoin, they are not separate, but a part of everything else....

Nursing has not remained the same, in that it has to evolve with patient needs..... Good question! I guess what needs to change is how we prepare nurses to interact with the digital arena, and be able to use it in the transformation of 21st century nursing.....



Sarah Adrienne Hughes
3:21pm 28 January 2017 (Edited 9:53am 29 January 2017)

Dear Heather,

I admit that many nurse educators are already considering this field in many respects: we use a variety of tools to present our ideas throughout the curriculum.

Earlier research states that lack of digital skills often hinder the development of this sort of thing in practice, but when you look deeper, it is more to do with Digital design of systems, appropriateness of systems and lack of motivation to use them, because of the former! There also appears to be a lack of technical support in many areas (in practice and in university). In my experience this year, it's mostly not the majority of students that have difficulties in general, but a handful of people who need support with enhancing their skills, or glitches in the system, that I can't solve!!!

I look forward to any suggestions or questions. My project has come to a more workshop style for exploring the subject, then presenting the topic!!!

So to answer your question, we all need to upskill, experiment bravely with the tools that are common place, such as MOOQs ( a topic close to your heart!) and twitter!

If we then use them in a creative way to enhance what we do......

I am trying out ways to capture attention or invent new ways of getting students to participate....



Sarah Adrienne Hughes
9:51am 29 January 2017

Dear Julie,

That sounds like an efficient way to ensure people have the skills... However....

"It is a pain doing it, but I can see the benefits." (Skeats, 2017)

What I would like to do, is to find a way of delivering the content in a way that students enjoy the journey, and then are more interested with finding solutions in the future!

If their experience is a negative one, doe this mean that they will be less inclined to get involved with future projects? I would welcome some ideas here!!


Andy Brooks
12:55pm 29 January 2017

Thanks Sarah, so is it your view that the way nurse training is delivered needs to change, do you think technology innovation is drastically outpacing training? Do you think the core nurse training should be given a complete overhaul or is this something that can be tackled via workshops etc?

So am I right in thinking that these health eTasks are tasks that do not neccesarily exist at present but tasks that most certainly will exist in the near future as more technologies are implemented in day to day nursing. By the way sometimes it is necessary to invent a term if there is nothing available to adeqautely describe the thing you are trying to describe eh:) Real fasinating area you are looking at!

Jude Toasland
2:44pm 29 January 2017

I was really interested in your use of a reflective diary Sarah.  How are you managing this and how do you plan to integrate it into this project? It sounds like a fascinating tool and not one I had considered but may do in the future.

Sarah Adrienne Hughes
4:36pm 29 January 2017

Good questions, Andy!

The NMC IS currently reviewing pre-registration nurse training to include other aspects of more expanded nursing practice! There could be less practical experience required and more subject matter. My new job as timetabling and resources PL will enable me to explore how HEIs can support and facillitate learning for this potentially 'new nurse'!

So yes, I would say that eTasks are yet to be defined in many cases!

It could cover aspects such as drug administration using technology to record that patient's have taken what they should have, with links to the side effects and drugs that can't be taken together... That's already happening in London!

But when you research the current trends in Healthcare technology development, we could be using iWatches to monitor health and even pulse in our patients: we might use skype to complete an assessment before admission and to give face to screen advice in the interim! This has great scope for both rural and housebound patients and service users. There are also many apps available....

I am just trying to see how we can get nurses involved and motivated: whereas they wish to be nurses, technology is often outside their area of interest. Thus it needs to be patient focussed and relevant!




Sarah Adrienne Hughes
4:42pm 29 January 2017

Dear Jude,

I have been recording my reactions to things as I go along, to remind myself of what I have done in my search! It's rather informal, but something we often ask our student nurses to do as 'reflection on action' to consider if anything different would have been more useful at the time.

So an example is that I started my project looking at making a video, but I found it difficult to put the results online. I could have used a camera, but reflected that if I was to project into the future, hand held technology is more likely to be used anyway... This got me to looking at facebook and twitter, where my tablet was able to link to....

I have just found out about 'Vlogging' today, so that will also go in my diary!!!!



Stephen Gardiner
11:36am 1 February 2017

Hi Sarah

You mention in your response to Heather "In my experience this year, it's mostly not the majority of students that have difficulties in general, but a handful of people who need support with enhancing their skills, or glitches in the system, that I can't solve!!!"

What are these glitches and what do they relate too, is it accessibility issues for those that may have special learning difficulties are is aimed at those that may not have the required digital skills.  As we are now moving into an era of where more and more people now coming through the education system are more digital aware do you think this may change, where as before those entering into nursing where possible mothers returning to work and may not have the basic skills or am i barking up the wrong tree.

It will be interesting to see.

Uffe Frandsen
4:58pm 1 February 2017

Hi Sarah. I think your talk will be very engaging. Sound interesting how you have used this module to experiment with tools for use with your curriculum. I am especially interested in your recommendations in regard to student engagement. Do you have any particular points in respect to this?

Heather Bloodworth
5:19pm 1 February 2017

Hi Sarah, we've been getting our advanced nurse practitiones to blog about their history taking experiances. They were very reticent at first but once they got some positive  peer and tutor feedback we couldn't hold them back! Some of the reflections were fantastic and were incoroprated into the assignment as well as used as part of ther NMC revalidation.   

Sarah Adrienne Hughes
5:59pm 2 February 2017

Dear Stephen,

These are good points, not to be forgotten, as assumptions are often made about who has what IT skills. I admit that it must have appeared to be an 'off the cuff' comment, but I have not had any feedback where students are unable to access the forums, WIKIs, and ePortfolio set up. Part of my ongoing scholarship is to develop blended learning and online tools and part of that will be researching the views/skills/concerns of students.... However, I am leaving that for my PhD!

"What are these glitches and what do they relate too, is it accessibility issues for those that may have special learning difficulties are is aimed at those that may not have the required digital skills." (Gardiner, 2017)

The glitches that I have experienced were related to the functionality of particular parts of the programme that I was using. For example, a 'browse' button, to find users, did not work and has been referred back to the 'supplier'.

Accessability is key, and I have tried to design tools that are as straight forward as possible. We then have 'student ambassidors' and 'learning technology student' who are available to support peers. I have also arranged training sessions over the last two summers for my colleagues and one to one support for their development.

The tools that I have been using are part of the VLE, and the learning development team also have workshops on e.g. the development of an ePortfolio and using databases.

Thank you for widening my thoughts...



Sarah Adrienne Hughes
6:10pm 2 February 2017 (Edited 6:16pm 2 February 2017)

Dear Uffe,

'Student Engagement' was the starting point for my project and I am still exploring the possibilities. The evidence base appeared to relate to ICT skills deficit and lack of technology support, but later studies in the clinical sector highlighted that motivation and seeing the relevance of digital processes were more an issue in practice. With the Consumer Act (2015), the HEI sector is being held to account more for student experience, thus I am trying things out to see what interest people have in them and how they stimulate discussion and student led learning. Anecdotally, for me, images and multimedia activities and tools appear to engage my students more online, with more 'student activity' in the classroom. (Less 'Chalk and Talk'). However, I must be mindful that students also want to hear about our experience as practitioners.

So my project is the starting point for both curriculum relating to Nursing Informatics for the future 21st century nurse, as well as enhancing my own and team's toolkit for learning.

I am also collaborating with a colleague to actively engage students in using Twitter professionally, starting with the new intake of First years next week. She has produced  guidance for both students and the lecturers supporting them.

Not sure that I have answered your question, Uffe? How does that relate to your experience?

Kind Regards,




Sarah Adrienne Hughes
6:13pm 2 February 2017

Good to hear of your experience, Heather.

Have you written it up?! I haven't reached 'BLOGs' yet, but will hopefully be able to get students to write something similar in their ePortfolios....



David Jenkins
11:15am 4 February 2017

Hi Sarah, I'm looking forward to hearing exactly what non-academic evidence you use and about how "triangulating ideas in a divergent way" works in practice.

Sarah Adrienne Hughes
3:16pm 4 February 2017

Dear David,

I have been exploring new ways of thinking throughout the last yeat, thus 'thinking out loud' here. Having read a definition of Triangulation by Stoker (2011) in relation to formal research methodology, I started to view the online, open sources, that would not score highly in traditional 'Hierachies of Evidence', as a way of creating more ideas to explore. Stoker identified this as 'Divergent' triangulation as a way of creating new data to interrogate. As I am not aware of any hierachies that current enable analysis of the robustness of evidence, I am suggesting that we compare it with traditional research to see what resonates, and what are different views to see new areas of study.... So if you have an open source, that is yet to be cited or viewed many times, the researcher can go looking for the same ideas in the formal research. The non-academic evidence could be an online recorded discussion.....

Not sure if I am making sense here, or am completely correct in my thinking, but am trying to be creative!




Dr Simon Ball
4:30pm 9 February 2017

Hi Sarah
Please find below the main questions and comments from your live presentation. It's up to you how to answer them, whether you wish to group them, or whether you wish to point to an answer already given above, for example.
Best wishes

  • Partnership between academic and technical staff is essential!
  • Absolutely although I find we don't always speak the same language so early collaboration is crucial.
  • I think you touched on it Sarah but have you at times found the use of technology to be a hinderance in an educational setting?
  • Using Twitter is fascinating - how will you ensure that this is "appropriate" use by students?
  • I hope you are looking at SFHEA if you do not already have it! This work could be used as the basis for a strong case.
  • We have recently introduced a social media online course for our students, to address those very issues!
  • We've just had new NMC guidelines in relation to using online tools.
  • I agree,embedding nursing informatics in the nursing course is essential.

Pat Townshend
4:03pm 10 February 2017

Hi Sarah

I've just watched the presentation and you gave a great perfomance!  Your handdrawn graphics skills must be a great help when getting over ideas - and no worry about copyright either.                                                              

Sadly my students are very resistant to using Twitter. They like the privavcy of their closed WhatsApp group. I think encouraging them to be more outward-looking could be a long-term challenge for their tutor.

I was thinking about whether tech gets in the way in eduaction. I think it might if it has barged its way in, and sat down unceremoniously between learner and tutor, metaphorically speaking. However if it serves needs and does not take over the `space' I think its good.

I'm looking forward to reading your responses.

Sarah Adrienne Hughes
12:15pm 12 February 2017

Thanks @Simon, for the summary!

I have tweeted some of my responses to share our ideas and thoughts. Pat, I too struggle with student engagement, thus am experimenting with GIFs as well today @BucksUniNurses : new term starts tomorrow!


Tech does get in the way, so I am experimenting with pictures, diagrams and multimedia to gain attention. The trouble is that you need to keep producing content to keep their attention! My colleague is already finding this time consuming and hopefully we will be working as a team to keep up the content! Tech has sidled it way in in the social setting, I guess I am trying to piggy back that for learning!!!

@Simon "Using Twitter is fascinating - how will you ensure that this is "appropriate" use by students?"

We signpost students to Professional standards from Day one in Pre-registration Nursing: I did that last week in Registration/Welcome week! Students are asked to read the Code and are also introduced to other NMC guidelines. Thanks, Heather, for the information about the new NMC Guidance for Social Media (2016), I circulated it on Twitter and will update my Nursing Informatics Presentation/Multimedia/Blended Learning!

@Simon "We have recently introduced a social media online course for our students, to address those very issues!"

It would be good to work together with a multidisciplinary team on this!!

@Simon "I hope you are looking at SFHEA if you do not already have it! This work could be used as the basis for a strong case."

Thank you for this feedback, It is excellent to read!!

Dr Simon Ball
6:08pm 20 February 2017

Many Congratulations Sarah! Your presentation has been voted by delegates to be one of the most effective of the H818 Online Conference 2017 and you are officially one of our H818 Presentation Star Open Badge Winners! Please see how to Apply for your Badge here:

Well done!


H818 Conference Organiser

Danny Ball
11:43am 21 February 2017

Congratulations Sarah on winning the Presentation Star Open Badge! I loved all of your various project illustrations!

Leanne Johnstone
12:25pm 21 February 2017

Congratulations Sarah. Well deserved :-)

Sarah Adrienne Hughes
9:42am 22 February 2017

Wow, thank you all,

It is always a pleasure to receive positive feedback. This has not only given me more confidence in involving more multimedia in my teaching, but also as an artist! I have not really shared my cartoons with anyone previously!



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