This essay was written by Mitzie Facey-Williams who is a clinical nurse educator and took the module EDM122 in October 2022 – February 2023. This is her final assignment for the module that she has shared with a CC-BY licence on it She writes:
The impact of open Pedagogy on the professional development of nurses and evidence-based nursing practice:
To meet the challenges of the evolving health care system, there has been calls for nursing education to be transformed (Benner et al 2010), however according to Ironshore (2015) this need to take the form of different pedagogy. Open pedagogy provides an opportunity for nurses to be able to freely participate in learning by accessing resources that are freely available on online platforms (Brown et al 2009). Studies involving nurses from there different hospitals have found that e-compendiums were pivotal to their learning (Usrtad et al 2021). It has been concluded that e-compendiums were valued for reinforcing and retaining knowledge. Research also shows that there have been 100%increase in learners accessing learning materials over via the internet (Law and Jelf 2016).
In this essay I will be reflecting on how open pedagogy has impacted on my practice as a clinical nurse specialist and nurse educator.
What is Open Pedagogy?
My research into the aspect of open pedagogy have made me realise that there is various definition of open pedagogy, however in this essay I will be focusing on Wiley’s perspective. Wiley viewed open pedagogy as the use of open education resources (Hilton and Wiley 2018). Although open pedagogy and open education resources have different definitions in literature, According to III Hilton and Wiley (2018) it has been argued that open pedagogy is only possible through open education resources (OERs). According to UNESCOS (2010), “Open Educational Resources (OER) are learning, teaching and research materials in any format and medium that reside in the public domain or are under copyright that have been released under an open license, that permit no-cost access, re-use, re-purpose, adaptation and redistribution by others.” This includes lessons plans, textbook, games, software and any other materials that supports teaching and learning (Wiley and Hilton 2018).
Prior to open practice, the majority of literature would have been published on platforms that require a fee to access the resources (Open research Society 2018) This means that learners from financially deprived backgrounds may be deprived from equal opportunities to access education resources, hence OERs now provides opportunity or freedom to individuals or organisations to be able to access learning and transform teaching, since the digital resources provide worldwide access to free quality education materials (Sanchez Vera et al 2022). According to Paskevicius and Irvin (2019) a recent study has revealed that open pedagogy has been beneficial across teaching learning and assessment. They found that within the aspect of teaching and learning there has been a shift in roles and responsibilities which also includes more collaborative working and peer reviews. In relation to learning outcomes, there has also been more critical approach to knowledge and literacy. It also encourages a more diverse multidisciplinary source of resources which is quite beneficial to the teaching contents. It supports personalised learning and provides ways for learners to promote and share their work.
How does OERs impact on practice?
It is the requirement of the Nursing and Midwifery council (2018) (NMC) that nurses keep their skills and knowledge up to date. This must be evidenced in the form of continual professional development. The code also stipulates that to practice safely, nurses must practice in line with the updated evidence. I will reflect on how CPD and evidence-based practice (EBP) is achieved by looking at how OERs impact on sections of the NMC code.
NMC Standard 6: always practice in line with best available evidence –
6.2 Maintain the knowledge and Skills you need to practice safely:
According to Urstad et al (2021) a vast amount of knowledge in healthcare is gained through experience in working collaboratively within multidisciplinary teams. While this may be true in some areas of practice, the ethical guidelines for practice can only be based upon learning which has been attained from peer reviewed evidence-based research. This means that such resources will need to be available to nurses to access, however, the quest for knowledge can be hindered depending on the availability of resources (Benner et al 2010). Base on the evidence that OERs provide opportunities for the public to retain, reuse, revise, remix and redistribute learning materials, it would be fair to argue that open pedagogy is pivotal to nursing professional development since it provides opportunity to access published literature.
I will now provide a reflection on how the 5Rs of OERs impact on practice within my team.
5Rs of open practice:
Retain: I have examined the way in which my team and other nurses retain evidence-based knowledge. Many of the learning activities that my team participates in is via online conferences via social media platform such as YouTube, as well accessing updated literature from online platforms. As agreed by Petrovic et al (2023) attending conferences requires resources such as time and money; however, the use of social media to host conference facilitates accessibility, as it allows information to be retain after the event as argued by Beckinham (2018). Barts health employee have access to literature from NHS open Athens, however; regardless of the availability of literature on OERs, some of the literatures are not available in full content and therefore requires a purchase or subscription to the platform in which they are published, which therefore restrict access to due to cost. As argued by Petrovic et al (2023) there need to be more critical open pedagogy opportunities for nurses. According to Bali et al (2020) the ability to access learning material via OERs helps to close the gap between social injustice.
Revise and remix:
As stated by Brown et al (2009), a large amount of learning in practice is gained from practice experience; however in order to use share knowledge, the learning need to be supported by published evidence based literature (NMC 2018), hence it could be argued that open learning allows nurses to collate their learning with theories that have already been published , hence providing an opportunity to remix literature by applying individual’s own knowledge which has been gained from experience.
I was able to re-examine my team’s dynamics in relation to the remix, reuse and redistribution of knowledge, and found that in spite all of the team members possessing expertise knowledge and experience in the area of tissue viability, none of the members have taken opportunities to publish any work. This may be due to the lack of knowledge around the use of creative commons and publishing via OERs; however, according to (Sela et al 2019) this attitude appears to be common among nurses working at a lower band. The literature suggests that regardless of the wide area of experience and knowledge that nurses gained through collaborative working and access to OERs, evidence suggest that there is still room for more innovation among nurses (Brown et al 2019).
Brown et al (2009) concluded that a lack of innovation was common negative factor among nurses who participated in the study. Many nurses did not gravitate to the idea of carrying out new research or detailed assignment due to their time-consuming nature and potential cost.
On the other hand, it is evidence that regardless of the availability of resources there remains a gap between nursing practice and the application of theory. An example of this would be from my own analysis of information that I gather from root cause analysis (RCA) of pressure ulcers reports. The RCA frequently identifies gap in knowledge as a root cause for acquired pressure ulcers. Seleh et al (2019) also highlighted similar findings. Their study found that there is a gap between knowledge and practice in relation to pressure ulcer prevention and treatment. It could be argued that one possible reason for this is the lack of time to be relief from duty to carry out the research and analyse information.
Reuse and Redistribute: The Cape town open declaration (2007) stipulates that unlocking education resources provides more learning opportunities that are less costly. In recent years nursing education have evolve into digital platform which includes access to e-learning resources. This is also supported in Urstad et all 920 study who also found that e-compendium were valued for reinforcing and retaining knowledge.
I have reflected on how my team facilitate learning among nurses in our organisation. An example of this is the Tissue Viability e-learning module which is designed to continuously educate nurses on aspect of wound care and pressure ulcer prevention. We designed the course content and Moodle page using materials available from OERs; hence this allows the nurses to have access to learning resources that would otherwise be time consuming and cost effective to retain. This is also supported by Petrovic et al (2023) who argued that Open pedagogy may facilitate the evolvement of nursing education as it will allow nurse educators and students to analyse and disseminate information on a broader scale.
According to Paskevicius and Irvine (2019), studies have revealed that the implementation of e-learning has a positive impact on the outcome of nurse education, and as OERs becomes increasingly available nurses are expecting to carry out self-directed learning or e-learning activities.
In my experience in delivering the tissue viability module, nurses often request that I share the teaching slides, as this will allow them to revise the information in their own time. Several international studies including Wallis (2012) and Alqahtani (2022), have highlighted that a lack of availability and tight work life balance has been identified as a hindrance to updating knowledge; therefore to reduce the gap between theory and practice, in addition to bespoke training, Seleh et al (2019) also suggest implementing regular updated learning materials on best practice to the ward staff including newly qualified nurses.
Implication on future practice
NMC Standard 22.3: keep your knowledge and skills up to date, taking part in appropriate and regular learning and professional development activities that aim to maintain and develop your competence and improve your performance
As agreed by Mackey and Bassendowski (2017), it is crucial for registered nurses to continuously seek out new knowledge in order to close the gap between theory and practice. With healthcare practices being a rapidly evolving sector, it means that new evidence and information emerges regularly that could change the way care is provided (Petrovic 2023), and to be able to provide safe evidence-based care nurses need to have easy access to these information without incurring cost (Brown et al 2009) (III John and Wiley 2018).
Platform such NHS open Athens not only provide platform for undergraduate nursing student to be able to freely access resources that will help them to persist and successfully complete their course without adding additional financial burden (III John et al 2018), it also of benefit to registered nurses, as it provide free access to resources that nurses may access to be able to freely participate in education that will contribute to their professional development as well as promote the best evidence based practice (Mackey and Bassendowski 2017).
While it may be apparent that OERs can only be of benefits to nursing practice, it would not be a balance conclusion without looking at the pitfalls. One of the pitfalls of OERs is that it allows publication of literature that have not been peer reviewed (Cape Town Open Education Declaration 2007), hence it could be argued that using articles that has not been peered reviewed may potentially lead to nurses acquiring misinformation in instances where there are errors in the publications. Any such Misinterpretation of information and data could also compromise patient’s care (Benner et al 2019) therefore it is crucial the information that is retain from OERs are scrutinise for evidence-based content for accuracy prior to applying them to practice in order to preserve the safety patients as well as the public (NMC 2018)
In relation to nursing publications, according to Baldi (2020), nurses should also be encouraged to produce renewable assignments, as the evidence suggest that there need to be more critical open pedagogy to nursing education (Petrovic 2023). However, as the opportunity to publish using creative commons license becomes more to the forefront, it could inspire more nurses to participate in innovation if there is the opportunity to publish and share their work (Brown et al 2019). This will also help with building confidence in relation to sharing information. As agreed by Petrovic et al (2023), one of the driven factors that drives nurses to become educators is their vast knowledge and skills and their ability to impart such knowledge and skills to undergraduates as well as colleagues.
According to Ramazanzade et al (2022), sharing such knowledge helps to foster positive attitude and well as impart generational knowledge; therefore, it could be argued that the opportunity to publish evidence-based knowledge via OERs platform may benefit the individual who produce the resources as well as undergraduates and organisation.
It can therefore be concluded that the impact of open pedagogy on nursing practice includes facilitating professional attitudes towards acquiring and sharing knowledge for the development of healthcare from individual to organisational level. Open education resources platform is an opportunity for nurses to share details of their work.
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