Design of blended learning for civilian and military trauma care

Abstract

Violence in society is increasing, but action plans to mitigate this problem are insufficient in several countries. New educational strategies, such as blended learning which integrate face-to-face and online education are needed. Knowledge about how to design such strategies and learning environments can contribute to strengthening and coordinating medical resources, sharing competences and more collaboration in the development of civilian and military trauma care. The model in Nordic countries, of necessity share specialized healthcare professionals between the civilian and military medical systems. The overall aim of this thesis was to increase knowledge about the design of blended learning and builds on four studies:

Study I explored the similarities and differences in education and training at military medical services in the Nordic countries and to what degree blended learning was used. Results showed opposing views; some were negative to e-learning, whereas others were much more positive and saw potentials for innovating education. Contextual knowledge of healthcare was identified as the crucial key to success, but in order to blend education and training into blended learning, modern pedagogical competencies were needed.

Study II identified educational challenges in civilian and military trauma care, expressed by health care professionals and was studied through observations, interviews and survey during education. The most difficult aspect of learning in management of complex trauma patients was perceived as the lack of real practice in extreme environments. Blended learning was seen as the potential of supporting learning processes.

Study III, through interviews and video recordings investigated what internationally trauma experts described as challenging in teaching. Eight educational challenges were identified which represented particularly difficult aspects to teach and master in the area, and which were viewed as crucial for decision making. The results contributed as basis for identifying and introducing design principles for the design of virtual patients.

Study IV introduced these design principles, then developed and tested two virtual patients. The virtual patients addressed the specific educational challenges in complex trauma care, provided possibilities for unlimited training, and supported decision making. They were integrated with the existing face-to-face education into one example of a blended learning model.

Conclusions and implications: Key persons in the Nordic military medical systems, senior healthcare professionals and educators identify different and sometimes contradictory educational challenges and solutions, but share the view that there is an urgent need for developing education and training in the area. A particular mindset when managing complex trauma patients was identified as crucial by trauma experts. Two virtual patients were designed to address some of the challenges. Course participants appreciated the virtual patient cases and viewed them as realistic but expressed a need for more feedback. A pilot test confirmed that the decision-making in the cases posed challenging for the target group in the way the educators had predicted. Design principles and an educational model for blended learning for civilian and military trauma care are suggested.