Health Informatics in Health & Social Care
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Student No. 08003837
INTRODUCTION:
The use of PowerPoint as a visual display first emerged in education (Linkroll
c. 2007) and business marketing around the late 1980’s, the programme
originally named ‘The Presenter’. It was created by Gaskins and Austin, both
software developers, as an application for Forethought Inc. (Computer
Literacy c. 2008). In 1987 ‘The Presenter’ became PowerPoint 1.0, was
released by Apple MacKintosh only functioning in Black and White, with text
and graphic pages available on overhead transparencies (Linkroll c. 2007).
The following year a full colour version emerged and was made available to
the market. Also in 1987, Forethought Inc. and PowerPoint were purchased
by the Microsoft Corporation for $14 million (Linkroll c. 2007), since 1990
PowerPoint has been a standard part of the Microsoft Office suite of
applications (Microsoft Office Online c. 2007)
From an operational viewpoint the application of PowerPoint is wide and
diverse, its forms can be described as contributors to the concepts of
Information Communication Technology (ICT) or Health/Medical Informatics
as argued by van Bemmel & Musen (1997), who claimed Medical Informatics
to be ‘the science that studies the use and processing of date, information and
knowledge applied to medicine, health and public health’. It is the area around
knowledge sharing that this assignment will concentrate, focusing on the use
of PowerPoint to share, enhance and improve the knowledge base of a
defined group of health care professionals working within maternity services in
NHS Highland.
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National drivers dictate the importance of skills maintenance in the safe
delivery of maternity services particularly in rural and remote areas ‘to provide
effective and safe care for low-risk women to manage obstetric emergencies
within remote and non-specialist units’ The Remote and Rural Midwifery
Service (2007).
This assignment will outline the rationale behind the choice of PowerPoint in
contributing to the important skills maintenance agenda and will also provide
critical reflective analysis of use and integration into practice. Importantly, new
knowledge around improving the construction of a specific PowerPoint
presentation will provide direction in new perspectives aimed at enhancing
delivery of learning materials contained within the presentation. Lastly, and
with regard to the former a system of evaluation will be recommended to
ensure quality is further enhanced, ultimately contributing to the safety of
women and babies in NHS Highland as supported by recommendations from
the Scottish National Patient Safety Programme (SPSP) by using ‘evidencebased tools and techniques to improve the reliability and safety of everyday
health care systems and processes’ SPSP (2008)
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RATIONALE & METHODOLOGY
The sharing of knowledge is a fundamental component in the epistemology of
skills maintenance in order to embed the ‘theoretical perspective’ (Crotty
2003: 3) therefore providing the necessary skills required by professionals to
maintain safe and effective practice. This concept is further supported by
governing bodies tasked with the regulation of practice ‘you must keep you
knowledge and skills up to date throughout your working life’ Nursing and
Midwifery Council (2008). Therefore, in this regard methods of teaching must
be used to ensure this concept does meet the requirements of its audience.
As argued by Jones (2003) ‘appropriate use of PowerPoint can enhance the
teaching and learning for both staff and students’ in contrast to ‘old
technology’ (chalk and talk) which according to Jones ‘makes little use of the
new and flexible opportunities offered by the use of PowerPoint’. The wide
ranging elements of this form of knowledge delivery is of immense benefit
from an educational viewpoint even at its earliest point of introduction.
Versatility is paramount particularly when developing teaching materials again
illustrated by Jones (2003) with regard to ensuring materials are up to date
‘editing of each PowerPoint file is very easy’. In the latter regard PowerPoint
has the required capacity to ensure that updating is straight forward and time
efficient in comparison to more dated methods of visual display such as
slides using a manual projector.
The construction of PowerPoint is reliant on computer hardware and software.
With regard to latter, and as mentioned in the introduction,
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PowerPoint is part of the Microsoft Office suite and must be installed to fully
utilise the resource. However users do not necessarily require this software
to access and use PowerPoint as a ‘read only’ resource, presentations can be
viewed using ‘PPS’ file type supported by Microsoft as a free PowerPoint
viewer (Microsoft Office Online c. 2007) . Depending on the users access to
hardware this can either be portable or a fixed desk top item or, both. Another
example of the versatility of PowerPoint is that data can be transferred to
portable devices such as compact discs (CD’s) or Universal Serial Bus (USB)
flash drives which can then be transferred to any computer terminal virtually
worldwide – a benefit for those tasked with knowledge sharing. The author
has had direct experience of such concepts when delivering training
programmes around Managing Obstetric Emergencies in Malawi. However,
although materials can be viewed on a computer terminal it does not suit the
requirements for a larger audience therefore hardware such as a Data
Projector and screen are required to maximise the benefit of the PowerPoint
Presentation again illustrated by Jones (2003) ‘there may be a shortage of the
key technological elements’ facilitators should be mindful of this.
The spectrum of Information Communication Technology (ICT) is available to
the PowerPoint user as it has the capacity to ‘enable rapid and efficient
communication of information through the use of computers’ (Levett-Jones et
al. 2009) when constructing a presentation which can then be shared with an
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audience. Moreover, as argued by Fearn (2006) a ‘modelling approach’ can
also be applied to the construct of a PowerPoint presentation whereupon the
presentation will take on a construct and be broken down into simple parts
beginning with definitions, moving on to more detailed descriptions
complimented with images describing aspects of the emergency faced.
Culminating in solutions again complimented with appropriate imagining. This
technique should encompass four strands as detailed by Booch, et al. (1999)
– to visualise, to specify, to provide and to document. In the context of using
this PowerPoint presentation importantly learners have an opportunity to have
‘hands-on’ practice around what is discussed in the presentation. Therefore
three elements alluded to by Booch et al. are achieved with last element
achieved by the evaluation process which will be discussed later.
With regard to the main subject of this assignment around a particular aspect
of skills maintenance in maternity care ‘Managing Malpresentations and Mal
Positions’ digital imaging can be used to reinforce messages and give a visual
view of the mechanism being described. This concept fits well with the
modelling approach referred to earlier. Furthermore, this paradigm meets the
requirements for a pedagogical pattern of learning which aims to ‘capture
expert knowledge of the practice of teaching and leaning’ (Pedagogical
Patterns c. 2010) Again this approach is supported by Jones (2003) in the
context of non-linear use of PowerPoint where he claims ‘is mainly a
pedagogical issue that PowerPoint can be adapted to provide’.
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Another aspect often used to compliment the PowerPoint presentation is
around the learner going on to practice what he/she has seen on the
presentation using manikins designed for the purpose of ensuring a ‘hands
on’ experience. This method is used by the author following delivery of the
‘Malpresentation & Malposition’ PowerPoint presentation. It is a well known
phenomena that learning is enhanced by opportunities to physically articulate
what is being discussed in the ‘classroom’ as described by Fitts & Posner
(1967) and is currently used in a diverse range of teaching environments from
the formal classroom to Mobile Skills Units now used in ensuring skills
maintenance in rural and remote parts of Scotland (Clinical Skills Managed
Education Network, 2008). However, although technology does contribute
significantly to learning it is merely a ‘tool’ used to enhance and share
knowledge some educators believe that it ‘has minimal impact on the quality
of learning’ (Funderstanding c. 2008)
Finally and importantly with regard to rationale and methodologies used in
PowerPoint materials can also be relayed by teleconferencing facilities
therefore enabling an audience from a variety of settings to join in an
interactive learning session Kiger et al. (2003).
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CRITICAL REFLECTION:
Dewey (1859-1952) argued reflective thinking is important as ‘it enables us to
know what we are about when we act’ (van Manen c. 2010). Dewey also
emphasised hands-on learning and opposed authoritarian methods in
teaching (A Time Capsule of Training and Learning c. 1999). His ideas
prompted a drastic change in education in the United States (US) in the early
part of the 20th Century. This ideology forms part of the aims of the
PowerPoint presentation as used in conjunction with ‘hands-on’ workstations
already mentioned. Moreover, as argued by Herbart (1776-1841) who
stressed the study of psychological processes of learning as a means of
devising educational programmes based on aptitudes, abilities and interest of
students. Again this is significant to the aim of using this presentation. As
alluded to earlier Herbart is acknowledged as the ‘father of scientific
pedagogy’ (A Time Capsule of Training and Learning c. 1999). Moreover, as
suggested by Schon (1983) on the subject of reflection ‘we can think about
doing something but that we can think about something while doing it’. The
concepts of continual critical reflection play a vital role in maintaining quality in
teaching and learning materials.
This presentation has been used to teach health care professionals involved
in maternity care provision in NHS Highland for five years and modifications
have been made. Broadly it has been well received in a variety of clinical
settings. Evidence of this is gathered in course evaluation questionnaires.
This presentation forms part of a suite of topics covered in the
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training day designed to support practitioners in managing Obstetric
Emergencies all of which have both a presentation component complimented
by ‘hands-on’ workshops. Therefore, the experience gained by the author is
wide ranging. Moreover, from a personal reflection viewpoint frustrations do
emerge when attempting to explore and utilise ICT in the context of improving
teaching materials particularly with regard to producing ‘user friendly’ and
motivational tools. There has been little true effort to examine the
effectiveness of information delivered therefore it could be argued that critical
reflection is lacking in this regard. This is an essential part of professional
practice. Although some efforts have been made to ensure ‘customer
satisfaction’ using traditional course evaluation forms this does not provide
adequate evidence that what is being taught does impact on the knowledge
and skills of attending practitioners. Therefore, a recommendation would be to
ensure that this is rectified and critical reflection becomes a regular feature
from a professional practice viewpoint.
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NEW PERSPECTIVES:
Since its inception the use of PowerPoint as a learning resource has made a
significant impact on teaching techniques particularly given the versatility
afforded by this approach as mentioned earlier. However, there are now
available techniques that enhance the delivery of a PowerPoint presentation.
Moreover, they encourage audience participation thus providing opportunities
to further embed knowledge as argued by Collins (2004) who claims that ‘a
presentation should be designed to include as much audience participation as
possible’. One technique that integrates effectively with the existing
presentation is the application of Hotspots within Microsoft PowerPoint (JISC
c. 2010), an invisible graphic and is widely used in Web development and
Multimedia applications. In the context of this presentation adjustments could
be made to encourage the learner to respond to a question on a slide asked
by the presenter, the answer would be hidden in the slide and activated by
clicking on an object hidden in the slide. Hotspots can be created quite simple
by following a series of instructions created by Microsoft Office. This is an
approach the author intends to take to provide more robust learning
opportunities for her audience.
There are other application that can be used within a PowerPoint presentation
which can draw the audience further into the subject matter. The use of
hyperlinks to open short video footage can take the learner into a possible
real life scenario regarding the subject matter as suggested by Jones (2003).
Again the author intends to explore the possibilities of using such a
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technique even in its simplest form for example making a short video of an
aspect of the subject using manikins to illustrate the point. This would be
followed up with an opportunity for the learner to practice the technique using
the same manikin which would then be familiar. This technique further
emphasises the importance of ‘hands-on’ opportunities following an
interactive PowerPoint Presentation.
The techniques to enhance the quality of imaging form part of new
perspectives intended to be operationalised by the author. Ensuring that
slides within the presentation are of the highest available standard is vital as
illustrated by Yam (2005) who describes using PowerPoint 2003 to create
high resolution images. Yam argues that this can be achieved by the use of
Microsoft PowerPoint 2003 ‘without the need for other image-processing
software such as Photoshop (Adobe System). He claims that the quality is a
‘little-know feature of PowerPoint 2003’ and goes on to describe in detail how
this can be achieved in his 2005 article.
Another technique that can be utilised is AuthorPoint to animate the
presentation with a view to sharing it in podcasts and video formats. This of
benefit to practitioners working in rural and remote areas who may have
difficulty in reaching venues where face to face training is provided. This
approach can also be used in teleconferencing as mentioned earlier and
could form part of a scattered group who could work together without the
necessity to travel.
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Ensuring that existing knowledge and new perspectives integrate to maximise
the benefits of ICT in the context of learning therefore ensuring skills
maintenance is essential with particular regard to patient safety.
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APPLICATION IN THE WORKPLACE:
As alluded throughout this assignment ensuring approaches to further
enhancing the presentation, ensuring this meets with
requirements of
practical application in the workplace is vital. Given both the variety of
workplace settings and practitioners involved in learning opportunities
versatility as always is paramount. This refers to simple considerations around
venues particularly with regard to size, suitability to show the presentation and
following workshops. The experience of the author in this regard varies from
very sophisticated learning centres such the Centre for Health Sciences a
resource available within NHS Highland to more basic environments such a
local village hall. As argued by Hutchison (2003) the environment for learning
is of immense importance.
Moving on to the detail of ensuring learners benefit from an enhanced
approach to this aspect of the Managing Obstetric Emergencies it is essential
that nothing is lost from the existing method as materials contained within
both the presentation and following workshop is evidenced base. With regard
to the latter point this is fundamental to learning and must not be lost in
attempts to make the presentation more in line with advancements in
technology.
Furthermore, with regard to the learning environment the existing approach
has proved successful in all settings with evaluations demonstrating
encouraging evidence of this. It is important that any changes made to the
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approach does not interfere with this proven track record. This would mainly
be around the length of the presentation and possible time constraints around
the important aspect of ensuring practitioners get ample if not more
opportunity for ‘hands-on’
Finally, on this point and yet to be explored by the author the important issue
of ensuring that skills learnt can be safely applied in a real life situation. This
is a complex area and may prove difficult to measure as argued by van
Lonkhuijzen et al. (2010) ‘training programmes may improve quality of care,
but strong evidence is lacking’ However, essentially and as referred to on
several occasions the main aim of this type of approach to skills maintenance
is to ensure it is effective and practitioners will have the knowledge and
practical skills to manage an unforeseen emergency with diligence therefore
diverting the likelihood of a poor outcome.
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EVALUATION:
Evaluation forms a crucial component to any activity involving a learning
experience as pointed out by Kirkpatrick (1959). The purpose of which is to
ensure effectiveness and importantly provides opportunities for adjustment to
further enhance learning. Given the planned changes to this PowerPoint
presentation the author intends to ensure that the audience if fully aware of
the changes and request that specific attention is paid to the topic of
malpresentation and malposition. This could be done as a pilot scheme in
conjunction with work colleagues also involved in provision of training around
skills maintenance. Work such as this should not be done in isolation and
must be collaborative Royal College of Nursing (2007) and must also
continuing to be directional in terms of the fundamental aims of the skills
maintenance programme.
Given the success of the presentation to date introducing new knowledge and
perspectives must have an aim of improvement ultimately giving practitioners
further confidence in their own abilities to manage an unexpected event.
Practitioners are ‘responsible for maintaining and developing competence’
Nursing and Midwifery Council (2004) to ensure safe practice. Therefore it is
incumbent upon the author and colleagues to ensure that meaningful
evaluation is introduced and adhered to regardless of the content. Ultimately,
if the changes made to this particular element of the training programme
proves successful the same approach will be taken to enhance the remaining
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PowerPoint presentations which help support the topics delivered in the
Managing Obstetric Emergencies training day.
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CONCLUSION:
The journey undertaken by the author with regard to advancing knowledge in
ICT or informatics has been extensive leading to application of new
techniques in the workplace. Essentially, this new knowledge and skill will be
of benefit to learners and work colleagues. We now function in an age where
technology plays a vital role in many aspects of our professional and personal
lives and it is incumbent upon us to ensure we maximise opportunities to
ensure that not only our own knowledge is of the highest standards but also
and more importantly that this knowledge is translational with regard to our
professional responsibilities. In the context of the work undertaken by the
author and colleagues and in regard to this the component of this assignment
it is the full intention that new knowledge will be applied to one aspect of the
training programme as a starting point. To follow on from that and in
anticipation of encouraging evaluation the author will then collaborate with
colleagues and follow a similar approach to the remaining components of the
training day.
It is of course, essential to maintain standards that are in keeping with all
aspects of governance whilst further developing approaches to skills
maintenance particularly in regard to safe practice in maternity services
Expert Group on Acute Maternity Services (2003) and this must be in regard
to both national and local guidance. There can be hazards if a maverick
approach is adopted in relation to skills maintenance therefore strict codes of
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conduct must be adhered to Nursing and Midwifery Council (2008) in the
delivery of training programmes.
Finally, it is essential that contributions to learning such as this approach
using combined resources should meet the standards posed by NHS
Scotland Information Governance Standards (2005). Technology certainly has
its place in learning but it is merely a tool to enhance knowledge. Evidence to
measure effectiveness is vital which in turn substantiates the value to
practitioners with regard to confidence and ability to act appropriately should
unforeseen event arise that requires specific safe and effective management
in order avoid an adverse outcome. This is an overarching theme that every
healthcare professional involved in skills maintenance must remain vigilant to
these requirements.
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