Some Background Learning – a simple way to add education to your ED

In medicine we are always looking for new and innovative ways to deliver education. In the post-COVID age the traditional model of everyone sitting in a room receiving a presentation can now only be a small part of our strategy.

I recently came across this open access article in “Perspectives on Medical Education”, and although the authors described their idea as a “failure” I think it deserves some thought (and perhaps action!)

Methods

In this study^​1​ they “placed an iPad-based live fact feed in the resident workroom of our emergency department, therefore allowing for passive learning while on shift“. The content was based on the 100 facts and questions for one of the year’s 13 curriculum blocks of study and knowledge then tested. The fact feed was only available to those doctors working in the ED and the authors hypothesised that this would lead to them having better test results than those EM trainees rotating through other specialities.

Results

The authors expressed disappointment that the intervention “failed”, in that there was no statistical difference between those who had access to the board and those who didn’t. In a web based survey after the study participants also said they preferred “active” methods of learning and education rather than passive transmission of information (although this isn’t consistently reported in the literature)^​2​

The investigators did note some positives, which I would argue may be more important than test results alone: “nurses and technicians would frequently stand in front of the board and quiz each other on facts, then ask the residents for clarification on the answer to the question. Consultants would come to the emergency department to see a patient, then stop in the resident work room to read a few facts and even use it to teach their fellows, residents, and medical students if the topic happened to pertain to their patient. One of our nursing supervisors adopted the fact board concept to use in the nursing department to display various learning points and public service announcements for the nurses after seeing their satisfaction with the board.”

Discussion

Bearing mind the (very) low cost of this intervention (except perhaps in time and enthusiasm) and the positive effects it could have, I sought a way that we might be able to implement something similar to this in our ED.

As we all recognise, all staff are spending more and more time in front of screens. The “desktops” are often chaotic and cluttered, with backgrounds randomly selected..

With that in mind I suggested to our clinical leadership, that we could standardise the placement of icons on the desktop (with the most used easily available in one row) and also attach these to the taskbar (I rationalised the “Start” menu too – I couldn’t help myself). All of this left a large redundant space in the middle of the screen to which we added a “slide show” of educational nuggets, patient safety messages and “top tips”, each changing every ten minutes (so over a ten hour shift they would never see the same slide twice). The slides also contain links to further reading. The method for doing this took approximately one minute per PC and is detailed at the end of this post in a “how to” section.

The result looked like this…

I truly believe that delivery of education in the ED has to be a mix of lots of different methods which complement each other. Shop floor teaching, small group sessions, e-learning and simulation all have their place. This very simple (and cheap) intervention certainly can do no harm and may even do some good. I’ll report back in the next few months about how it has been received in our department and if you fancy giving it a try in your ED everything you need (including a set of slides to get you started) is below.

How to Add Background Slides in Windows

1, Download and then open the Powerpoint File “St Emlyn’s Fact File” by simply clicking on the link

2, Review the content of the slides and add/amend as you wish. This type of education suits “pearls” or “nuggets” that are easily digestible in just a few moments.

3, Save the Powerpoint as a PNG or JPEG files using the drop down menu – when asked “which slides do you want to export?” select “All slides”. This will create a folder of the images.

4, Find the “Windows Settings” and click on “Background” in the section called “Personalisation”

5, Select “Slideshow” as the background

6, Browse to locate the folder containing the Images saved from the Powerpoint

7, Select how often you would like the picture to change – one slide every ten minutes will mean no repitition over a ten hour shift if you have over 60 slides.

8, Choose “Fit” as your fit. The slides are created as 16:9 and this will give you space above and below to display your desktop icons.