When the COVID-19 pandemic hit, one of the first questions within the chiropractic industry for the General Chiropractic Council was how chiropractors were going to be able to fulfil their continued professional development (CPD) hours. Beyond the chiropractic community, there was also a big question mark over the ability to fulfil the number of hours learning with others that is required of all health professionals. Luckily, professional bodies and educators were quick to respond, launching a slew of online training solutions to meet people’s requirements, and continue sharing knowledge, resources and information – albeit it in a very different way. 

Not only did the boom in online training solutions bring with it a flexible and more accessible way for people to continue their training and development remotely, it also helped to cultivate a greater sense of community among health professionals. Added to this, it proved that training can be delivered effectively and to a good standard outside of a physical lecture theatre, thus becoming a more accepted means of education throughout the health industry. But, as restrictions continue to lift and in-person training becomes a viable option again, will online training solutions continue to play as big a role in our training and development? 

Breaking down online learning barriers for healthcare

More than anything, online training offers flexibility:

• Flexibility for you to learn and pursue a successful career in healthcare even if you live in a more remote area
• Flexibility to learn at your own pace and in different formats
• Flexibility to diversify your knowledge and explore certain areas in more depth due to having more information at your fingertips 

All these things are hugely appealing and remove a lot of the barriers that stop people from taking up healthcare degrees because they are historically so intensive.

Indeed, wider use of eLearning could help to address the need to train more health workers across the globe due to its flexibility and accessibility. According to a recent WHO report, the world is short of 7.2mn healthcare professionals, and the figure is growing. eLearning could enable millions more students to train as chiropractors, doctors and nurses worldwide.

Dr Josip Car from the School of Public Health at Imperial College London said: “eLearning programmes could potentially help address the shortage of healthcare workers by enabling greater access to education; especially in the developing world where the need for more health professionals is greatest.” He noted that there are still barriers that need to be overcome, such as access to computers, internet connections and learning resources, but that this could be helped by facilitating investments in ICT, and universities should encourage the development of eLearning curricula and use online resources to reach out to students internationally. 

The benefits of online learning do not stop there, however. In the chiropractic profession, CPD events are an ongoing challenge because they need to balance the cost of putting on the event with the cost of the programme, and there is understandably a limit to how much people are willing to pay. Seeing virtual CPD events run so successfully during the pandemic has helped to establish online forums as a credible and cost-effective solution to deliver this type of training. 

It's also no secret that healthcare changes every five minutes and there’s a need to keep pace with all the developments. The accessibility and immediacy of online learning helps people stay up to date. It provides a space to not only learn about new developments, but also discuss them with your peers in real time. 

Putting digital healthcare learning into practice

Of course, the most obvious challenge now and in the future is that in order for people to train and graduate as competent practitioners, they need to put their learning into practice. Online learning is purely theoretical, and you do not get the time or opportunities to put your learning into practice, which is so vital – particularly as a healthcare professional. So, the question remains: If you are learning skills that need to be applied in practice, does online learning meet that requirement? 

This is something we need to keep in mind, whether we are undertaking or planning undertaking learning. For example, a question that I always ask myself for the virtual healthcare training we deliver at Oakley Coaching is ‘How am I going to structure this so the students can go away and put this into practice and then come back with any questions they have?’.

Through Oakley Coaching, online training is delivered via virtual webinars where one speaker is delivering the seminar, and the other is providing live-feed support to provide additional links to resources and answer any questions that may come up. This the perfect opportunity to speak directly to peers and receive live feedback, creating an interactive experience and helping to maintain engagement and attentiveness (a common issue for any online training event). A community feel for learners is paramount to online learning where they can engage and network with each other. This is continued through our private Facebook group which enables members to review learning, share information and knowledge, and access resources at their own pace in a secure forum. 

I consider this “aftercare group” a vital part of the training, as it not only provides further peer-to-peer support and feedback once attendees have had an opportunity to test their new skills in clinical practice but opens up the conversation about other topics of interest. I believe this not only builds attendees confidence in learning their new skills but increases the likelihood of them continuing to develop their knowledge base, knowing they have experienced ongoing support available to them. This is particularly important with the coaching skills we teach, as these often involve changing internal dialogue and refining ingrained communication skills. By putting additional support in place, we can encourage sustainable change through eLearning, rather than simply being a box-ticking exercise to meet CPD requirements.

The BCA utilised a similar process for their autumn conference and their hugely popular ‘CPD Sessions’, often hosting training delivered by members to members. I have mentioned before the importance of community and addressing the isolation that was felt by many independent practitioners even before the pandemic. Utilising a blended learning and content approach of virtual seminars, resources, podcasts, Q&A sessions, infographics and more, the BCA worked at pace to cover as many learning preferences as possible. By creating this information resource for members, which continues to be invaluable asset to the profession, they have developed a unique and sustainable training platform that will be utilised for many years to come. The pandemic may have accelerated our use of virtual learning but this type of CPD is here to stay and technology will only improve. 

There will also always be people who naturally prefer in-person training or synchronous online training with a lecturer delivering content then and there. Certainly, having a two-way interaction with a lecturer and the ability to ask questions can make it easier for some people to absorb and retain information more effectively than they would through online learning. 

Finding the right balance in healthcare studies

One thing that seems to have been overlooked with the shift to online during the last 12 months is that people need to learn how to learn virtually. Some people will naturally be pleased with the prospect of online learning continuing to play a larger role in their training and development beyond the immediate effects of the pandemic. However, learning to balance working from home with children around with the determination and restraint to sit down and do online learning, for example, makes it more challenging for a lot of people to absorb and retain information. Attrition rates from online learning can be high, simply because it involves such a paradigm shift in the way many of us are used to learning.

This is something that I believe will be addressed as we become more familiar doing online learning and the courses themselves become even better quality and structured in such a way to maintain attentiveness. In the interim, however, it’s important that we’re optimising online learning and pedagogy for engagement. I’m also sure patients will want reassurance about the effectiveness of their health practitioner’s training: they’ll want to know that the training their health professional had was of sufficient calibre, quality and sufficiency, and know they’ve retained that knowledge. 

Although, research by Imperial College London reveals that students acquire knowledge and skills through online and offline eLearning as well as or better than they do through traditional teaching. However, it also suggested that combining eLearning with traditional teaching seems most suitable for healthcare training courses that rely fully on eLearning because of the need to acquire practical skills, or for more senior medical students, for whom direct patient contact is critical. 

Fundamentally though, there has been a shift change in our attitudes and behaviours towards learning which I expect to continue beyond the immediate effects of the pandemic. Instead of switching off completely to return to lecture theatres when we can, I’d like to see a more blended approach across all health sectors moving forward, which combines the ease, flexibility and variety of online theory with critical opportunities to put this theory into practice. 

Byline written by Philippa Oakley, chiropractor, member of the British Chiropractic Association and Clinical Director at Acorn Health and Oakley Coaching.