Nurse Education: encompassing open educational practice

Open laptop

This essay is by Sarah Wiggins who is a nurse educator and recently completed the module EDM122. She has licensed her essay under CC-BY and writes…

In recent years technology has developed and grown with advanced methods of education visible. There is global recognition that open education has been used in strategising education and teaching opportunities. This has paved the way to create pioneering changes that have proved to be effective within healthcare and education (UNESCO, 2019).

The scope of Open education encompasses the use of open access, open technology, open licensing and Open Education Resources. UNESCO (2019) defined Open Educational Resources (OER) as “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”.

An objective of Open Educational practice is demonstrated by making learning accessible and available to all by minimising the limitations of access to material. This provides an opportunity for teachers and students to develop by collaborating, building and sharing knowledge. The development and move towards OER has been driven by the need for inclusivity whereby distance education methods facilitate lifelong learning and the growing needs of the market.

As a registered nurse educator, lifelong learning is essential to maintaining high standards of care delivery (DOH, 1999). My perception of lifelong learning, the delivery of teaching and educational motivation has changed significantly in recent years. This is mostly related to the Covid-19 Pandemic where globally, changes had to be made. Education had to continue and within my role I had to find new and innovative ways to improve. Access to nursing education was of upmost importance and in light of this I understood that working collaboratively with learners and taking an open pedagogical approach would be appropriate in the evolution of change. (Petrovic et al, 2023). My use of open education practices has increased in recent years, hence the desire to reflect on this topic and not digital literacy. For the purpose of this assignment, I will focus on open education resources, open pedagogy and open technologies as these are appropriate to my style of teaching.

Open Education Resources

In nurse education open educational resources (OER) are widely used particularly within my role. This has become a revolution in the way teaching can be delivered in the 21st century.

The accessibility of OER makes it particularly useful as it is available to all staff by and can be accessed worldwide. The digital library contains educational materials which I have used within my role to support my teaching and provide education. The resources that I have used include journals, videos, pictures and open books. The educational materials I have accessed are released under Creative Commons (CC) licenses which allows the user permission under copyright law.

I deliver education to nurses and healthcare support workers under the umbrella term the Fundamentals of care. The methodology and educational resources I use in teaching vary slightly as I teach in house simulation and also use blended learning for other subjects. Generally, my teaching is delivered by a powerpoint presentation. The educational material I have used has come from open books and the latest evidence based practice. In particular subjects I have used pictures and videos to enrich my teaching practice and the learning experience of my nursing colleagues. For example, I have recently created an e-learning module about Mouth Care and I have included a short video which highlights the significance of providing oral care to patients and demonstrates the impact poor oral care can have on an organisation. The video was released under CC-BY and the creator of the video acknowledged allowing the credits for the author to be attributed. Using this method supports Wiley et al (2018) proposal of CC that the video can be retained and reused.

The e-learning module is available to all staff and can be accessed via a digital platform (Moodle) used in Barts Health NHS Trust (OECD, 2011). The benefits of using educational digital videos are recognised in a study by Rodríguez-Almagro et al (2021) who advocate that students can link the theory to practice, enabling the students to develop a better understanding of the subject. Another advantage I found is that I could adjust the content of the module to tailor to the needs of the target group (Weller, 2021).

Active teaching methodologies have changed and a method that is used widely in education have been introduced by the use of technology such as mobile phones. As my career in education progressed, combined with the impact of the Covid-19 pandemic, changes were made to adapt to the current climate. The use of enhanced technology was paramount to ensure healthcare professionals maintained their educational and professional development (Rodriguez et al, 2020). I have supported the use of mobile phones as students are able to log into a classroom using a Cat QR code where the attendance is recorded centrally. Staff were able to continue accessing resources that were designed specifically for purpose. The advantages of this are such that healthcare workers could download an App onto their mobile phone and use for educational purposes, patient care and access to various healthcare related systems. However, I had to ensure that open resources that were provided were safe to use and had a recognised CC license. The disadvantages of using OER for educational resources are the quality and safety assurance of the provider. Some apps may not give details of the producer and therefore prove to be unreliable (Ventola, 2014). An App that I encourage staff to use is IRESUS as I know it is produced by the Resuscitation Council and is a reliable source of open education with a CC license.

Moreover, equality and diversity are central to the pedagogy of an inclusive educational system. An inclusive approach embraced by Higher Education England (2010, P4) supported a larger diversity of students to access education. Within the NHS in the United Kingdom, and in Barts Health, diversity and inclusion are of paramount importance. The workforce consists of staff from varied cultural and ethnic backgrounds and this needs to be taking into account when planning and designing a curriculum. Barts Health welcome international healthcare professionals from countries such as the Philippines and India.  The use of OERs such as YouTube videos are particularly beneficial when teaching the Fundamentals of care. Bed baths are a fundamental aspect of care and who delivers this care this differs somewhat internationally.  In the UK, bed baths are provided by the healthcare professionals. In international countries personal care is provided by the family. Collaborative working, sharing and embedding OER into the design of teaching will not only provide the international nurses with a cultural competence, it is accessible and available to all (Breslin et al 2017; Cronin, 2017)

Open technologies

Wiley (2018) supports the notion that open pedagogy is connected to open educational resources which can be used to support learning and the open sharing of teaching practices to improve education and training at all levels. This highlights further how this practice demonstrates inclusivity as it is available to those at an institutional level, universities, professionals and individuals as a whole. The term “open” signifies this as the OERs are released under an open license which grant permission for everyone to contribute. This is reinforced by Wiley’s recommended 5Rs activities that are: “retain, reuse, revise, remix, redistribute”.

In everyday practice and working collaboratively with my team, we are always looking at ways to improve the delivery of teaching by using open technology. This derives from the reworkings that were made during the Covid 19 pandemic where classroom learning reduced and was replaced with blended learning. Skulmowski and Rey (2020) argue that the pandemic sped up the use of digital platforms and recognised that this will initiate change for the future. Those changes are visible today whereby nurses and other health professionals use mobile phones and laptops to gain access to educational material. The resources desired determined which hosting platform would be used. Twitter was commonly used and one of which my line manager favours. Twitter allows the user to showcase ideas for others to see or as a way to gain ideas. It encourages open communication and sharing of ideas with other staff within healthcare that I might not necessarily see every day. If I search further using a hashtag I can search different platforms and gain further information. I have used Twitter to share information on topics about mouth care and falls prevention. I have learnt to ensure that I use creative commons licensing when redistributing on a blog or other platform.

Open pedagogy

Clinton-Lisell (2021) define open pedagogy as practices that make changes to learning and teaching accessible by using content creation through an open license. However, there are many definitions and conceptions of open pedagogy that have encouraged my research on this. It is argued that open pedagogical practices have been proven to have a positive impact on a student’s learning. This is evidenced by students showing increased engagement, motivation and self-directed learning (Wiley et al, 2017; Dermody, 2019; Tillinghast, 2020). With this evidence in mind, in practice I need to determine what is open about open pedagogy and how do I conceptualise this? The word ‘open’ could mean such as open access, open teaching, science, the right to access and use according to Pomerantz and Peek (2016). My interpretation of this is aligned with Cronin (2017) conceptualisation that students can access education and resources free. Due to the movement of OER students are now able to contribute to open textbooks and can help to create a curriculum by sharing what they feel is necessary to meet their learning objectives.

An idea I would particularly like to try would be open pedagogy notebook based on the Fundamentals of care. The goal of the notebook would be based on the learning objectives of underpinning knowledge of the Fundamentals of care. My nursing colleagues could create a piece of work that would be used by healthcare professionals and the general public. The notebook could be divided into a few small chapters, each focusing on a different aspect of care.  Each nursing colleague could contribute to a chapter each based on their knowledge. A peer review shared amongst each other, possibly by each chapter, would enable the writer to gain a different perspective and give feedback. After a final review the book could be published. Advantages of this style of education are that learners are involved in making an educational change. Involving the learners will help to increase their critical thinking skills and encourage a collaborative style of learning. It will enhance their communication skills, boost their confidence, develop a deeper understanding of the fundamentals of care and empower them as learners. As an educator, I would need to ensure that have been taught about copyright, ensuring that they use Creative commons licenses that they are comfortable with.

To conclude, the changes bestowed upon us as a result of the Covid-19 pandemic have been unfound. The present and the future have been dictated by the movement of open educational practice. This has proven to have had a clear impact in nurse education and will continue to support the lifelong learning goals that a nursing career requires from you. Working through this module, has given me great insight into the cultural inclusion that open education practices permits, allowing access to all and new ways to actively involve learners in their own education. On reflection, I have found this module to be beneficial to me as an educator. It has given me scope to think of innovative and new ways to embed education encompassing open pedagogical practices, educational resources and technology. I would like to develop my skills using Creative Commons licensing and explore this further with learners. This is an objective I would consider for continued professional development in my nursing career.


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