SAT: Learning Beyond Language (Rachel Adams)

The use of visually augmented health education for low-literacy patients and carers in the community

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Rachel Adams
31 December 2018

In 2017, more than 3.5 million Emergency Department attendances in England were considered unnecessary and could have been managed in the community (digital.nhs.uk). This puts tremendous pressure on the National Health Service, as well as being disruptive and upsetting for patients and their families.

One of the ways the NHS is seeking to tackle this situation is by increasing the availability and resilience of community-led healthcare. Keeping an unwell patient in their home environment, where it is appropriate to do so, has obvious benefits for the health service. However, it also reduces distress for the patients and their families as hospitals can be unfamiliar and confusing places. This in turn can have physiological and psychological benefits that improve patient care.

For the decision to manage an unwell patient in their home to be made, a healthcare professional must ensure that the patient or their carer knows how to evaluate the progression of the illness and how to respond in the case of deterioration. While face-to-face/telephone-based contact is essential in beginning this healthcare education journey, the amount of time a healthcare provider can personally give is limited. This needs to be supplemented by resources that can be left with or are accessible to the patient/carer to ensure comprehension and retention of information. Typically, this is done by the provision of written materials that explain the condition and any actions that need to be taken.

While this may be sufficient in the majority of cases, UK Census data shows that in some urban areas up to 12% of households do not count English as their main language (ons.gov.uk), and 16.4% of adults in England have ‘very poor literacy skills’ (literacytrust.org). This leaves a significant proportion of people disadvantaged and will inevitably contribute to unnecessary hospital attendances and admissions. A move towards visually augmented resources would reduce the reliance on language-based resources and increase the accessibility of health education. In turn, this will help reduce pressure on the NHS and ensure the best outcome for sick and vulnerable patients.

 This presentation will first address the generic questions:

  • What is visually augmented learning?
  • Why is it important?
  • Does it work?

It will then move on to consider what visually augmented resources for use in the community might look like and consider how open practice between clinical staff and developers, drawing on work done by the wider educational community, is essential for their successful creation and implementation. It will also briefly consider the transferability of this approach and its relevance and impact on other aspects of accessibility.

References

National Literacy Trust (2017) ‘Adult literacy’ [Online]. Available at https://literacytrust.org.uk/parents-and-families/adult-literacy/ (last accessed 8 February 2019).

NHS Digital (2018) ‘Unnecessary A and E attendances’ [Online]. Available at https://digital.nhs.uk/data-and-information/data-tools-and-services/data-services/innovative-uses-of-data/demand-on-healthcare/unnecessary-a-and-e-attendances (last accessed 13 January 2019).

Office of National Statistics [ONS] (2013) ‘Language in England and Wales: 2011’ [Online]. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/language/articles/languageinenglandandwales/2013-03-04 (last accessed 17 January 2019).

Extra content

Embedded Content

Get ON the bus

Get ON the bus

added by Rachel Adams

Learning Beyond Language - Full Presentation

Learning Beyond Language - Full Presentation

added by Rachel Adams

Example of visually-augmented OER

Example of visually-augmented OER

added by Rachel Adams

Contribute

Sonia Pardos
9:58pm 11 February 2019


Hello Rachel, I am glad to see you here at last! 

I loved you poster when you first shared it with all of us. I think your project is very interesting. I advocate for visual aids whenever possible. I read your abstract and I think that your initiative could help many patients that, as you mentioned, English is not their first language or those who struggle reading text whatever their circumstances. 

I can't wait to see your presentation. Best wishes,

Sonia

Sonia Pardos
9:58pm 11 February 2019


Hello Rachel, I am glad to see you here at last! 

I loved you poster when you first shared it with all of us. I think your project is very interesting. I advocate for visual aids whenever possible. I read your abstract and I think that your initiative could help many patients that, as you mentioned, English is not their first language or those who struggle reading text whatever their circumstances. 

I can't wait to see your presentation. Best wishes,

Sonia

Potenza Atiogbe
10:39pm 11 February 2019


Hello Rachel,

A really interesting and well needed project.  I can see real benefits of  visually augmented learning  for patients in the community setting and can reduce any serious untowards incidences etc due to non-comprehension of materials.

Looking at the video, I like the layout a lot.  Clean and simple,  well done.  Perhaps slowing down the video of the temperatures so you can see the figures and when to ring the numbers it moved a little bit too quickly.  I had to watch it a few times to get the detail.  

I wondered what networks you dipped into to develop the project and the website?  Which ones were particularly useful?  You mentioned drawing on work from the wider educational setting so just wondered if it was those networks.

The launch of the Topol Review: Preparing the healthcare workforce to deliver the digital future The Topol Review An independent report on behalf of the Secretary of State for Health and Social Care February 2019 took place today and I really think use of virtual augmented learning in the way you explain it in your project could be included:  https://topol.hee.nhs.uk/wp-content/uploads/HEE-Topol-Review-2019.pdf

It does look at augmented learning, simulation etc it made me think of elements of your project and how innovative it is.  All the best with your presentation preparations and hope it goes well :-).

Bernadette Laffey
10:56am 18 February 2019


Though it was a shame you couldn't be at the conference for your presentation, I thought it was excellent. I loved the bus viusal as an analogy for excluding preople with low literacy. I also think visually augmented learning benefits a much wider pool of people (as universal design principles do). I am thinking of people like my elderly mother who is literate but who could benefit from more visual clues if feeling anxious or confused. 

Dr Simon Ball
4:19pm 18 February 2019


Hi Rachel

Well done on a great presentation! Shame fate prevented you from presenting live but it was clear from the comments that your recording went down very well. Here is a summary of the comments and questions you received following your presentation (including those you may have addressed verbally). Please respond in whatever way you choose - I suspect you may wish to deal with the first few in one response!

Best wishes

Simon

  • This is a whole area I didn't know anything about, and it's immediately interesting and useful for me. Big thanks to Rachel Adams for introducing it to me!
  • Do you think that 23yrs after the diabetes study that this type of learning is now more accepted? We live in a very visual world now with icons being used everywhere
  • Excellent video. I think it is just as applicable to learners with high literacy skills.
  • Are end-users involved in co-creation?
  • Are there links to Makaton?#
  • Excellent explanation Rachel. We struggle with the diabetic students' care plans. We are all relatively litterate and they are difficult. It would be excellent to have a visual representation.
  • When did you first become interested in visually augmented learning?
  • What are Rachel's plans for continuing research or practice in this area,
  • What is the scope for visual approaches being more iterative? -- one of the difficulties I always have in creating presentations (for instance) is the time it takes to find the 'right' image.
  • Thanks Rachel, use for neurodivrse learners too?

Dr Simon Ball
8:14am 28 February 2019


Many Congratulations Rachel! Your presentation has been voted by delegates to be one of the most effective of the H818 Online Conference 2019 and you are officially one of our H818 Presentation Star Open Badge Winners! Please see how to Apply for your Badge here: http://cloudworks.ac.uk/badge/view/33

Well done!

Simon

H818 Conference Organiser

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