Technology Enabled Dementia Education in Rural Scotland: Version 4
Research type
Research Study
Full title
Technology Enabled Dementia Education and Support (TEDES) for Health Care Practitioners in Rural Scotland
IRAS ID
267096
Contact name
Kevin Muirhead
Contact email
Sponsor organisation
University of the Highlands and Islands
Duration of Study in the UK
1 years, 8 months, 29 days
Research summary
Research Summary
Increasing dementia prevalence is intensifying the need for effective dementia education for health care practitioners with existing evidence suggesting gaps in dementia specific knowledge and skills amongst practitioners. Dementia education is a critical determinant of care quality for people living with dementia and their families and contributes to improved staff well-being and retention. The need for dementia education may be greater in rural areas due to access barriers to traditional education, migration patterns that favour older people, and increased dementia prevalence. Technology enabled learning is increasingly used in health care education and may be a feasible approach for dementia education for rural practitioners. The aim of this study is to explore the dementia education needs of rural health care practitioners and the relevance of technology for dementia education towards developing a technology enabled dementia education framework for rural practitioners based on the study findings. A convergent parallel mixed method design will include an online survey of rural practitioners from acute hospitals, primary care services, and care homes to establish dementia education needs and technology acceptance. Qualitative interviews with stakeholders in dementia care and education from rural areas will explore the experiences and perceptions of these key participants to better understand rural practitioners’ dementia education needs and relevance of technology for dementia education. The study will incorporate public involvement by including stakeholders (a dementia nurse consultant, representative from Alzheimer Scotland, practitioners, and people living with dementia) in a study advisory group to strengthen the interdisciplinary and co-production agenda which are critical to developing education. The research aims to offer an original contribution to knowledge that can inform dementia education policy and practice in rural areas at a time of unprecedented technological and demographic transition.
Summary of Results
Study Information Technology-enabled Dementia Education and Support for Health and Social Care Practitioners in Rural Scotland [TEDES] was a research study undertaken as part of a PhD programme at the University of the Highlands and Islands [UHI]. The wider PhD was funded by the European Social Fund and Scottish Funding Council as part of Developing Scotland’s Workforce in the Scotland 2014-2020 European Structural and Investment Fund. Rationale Geographically isolated health and social care practitioners [HSCPs] in rural areas may experience access barriers to traditional in-person dementia education. Technology may provide a flexible and convenient mode of dementia educational delivery that can transcend geographical boundaries and equip HSCPs in rural Scotland with the confidence and competence to provide quality care for people living with dementia [PLWD] and their families. Aim The aim of the research was to explore if technology has a role in supporting the dementia education and training needs of HSCPs in rural Scotland by: a) exploring the dementia education and training needs of rural HSCPs b) exploring rural HSCPs’ acceptance of technology for dementia education c) exploring the relevance of technology-enabled dementia education for rural HSCPs from the perspectives of multiple stakeholders in dementia care and education in rural Scotland. Methodology Dementia education needs and acceptance of technology for dementia education among HSCPs were explored using an online survey questionnaire. Virtual interviews were conducted to explore the relevance of technology-enabled dementia education [TEDE] from multiple perspectives. Data gathered from the online survey and interviews were collected concurrently and then compared and contrasted to produce an elaborate and holistic portrayal of the research phenomenon. Study Location The study took place across ten health boards in Scotland which were chosen as they contained acute, primary, and social care services in rural areas. Acute care services were community hospitals, primary care services were GP practices, and social care services were care homes. Participants Participants were forty-seven acute, primary, or social care practitioners who completed the online questionnaire. Fifteen stakeholder interviews were conducted with a variety of practitioners, service managers, educators, and PLWD. Patient and Public Involvement The study involved patient and public involvement [PPI] in the form of dementia care professionals participating in a project advisory group [PAG]. PAG provided expert guidance on established dementia care and educational practices in rural Scotland, best practices including dementia inclusive and accessible participant information sheets and consent forms when including PLWD in research, and assisted with the development of research connections with professionals and PLWD. Ethics Ethical approval was gained from the North of Scotland Research Ethics Committee [1] in February 2020. RD&I management approval was gained from all participating health boards before study activity began in October 2020 following a research pause due to COVID-19. Findings from Survey Questionnaire HSCPs in rural Scotland provided dementia care frequently and self-reported good levels of dementia care competence. Most primary and social care practitioners self-reported that their dementia training needs were being met; however, most acute care practitioners did not feel that their dementia training needs were being met. Analysis of dementia training needs confirmed that acute care practitioners had greater dementia training needs compared to primary and social care practitioners. Most HSCPs were accepting of technology for dementia education, were digitally competent, and had access to desktop computers at work. Convenience was the most widely reported advantage of TEDE. The main disadvantages were limited opportunities to interact and discuss with others. Findings from Stakeholder Interviews Analysis of data from stakeholder interviews resulted in five themes which described: (1) the culture and systems of rural dementia care; (2) change drivers and the value of TEDE; (3) readiness for TEDE; (4) collaborative conditions to enhance TEDE; and (5) the pedagogical methods required to ‘get TEDE right’ for rural HSCPs. Combined findings The findings revealed HSCPs in rural Scotland to be professionally isolated with access limitations to in-person dementia education and support. Dementia education was considered necessary to support autonomy and competence in dementia care, improve care standards, and avoid patient transfers to urban services. TEDE was advocated in the rural context with potential to support travel, time, and distance barriers to traditional in-person education which can incur cost for practitioners and resource limited services. Acute, primary, and social care practitioners had dementia education needs of varying types and priorities. TEDE was considered to be a feasible approach that could address dementia knowledge gaps among acute care practitioners who were providing care for an increasing number of inpatients with cognitive impairment and lengthy hospital stays. TEDE for primary care practitioners could reduce reliance on resource limited psychiatric services and reduce inappropriate inpatient admissions involving PLWD to acute care. TEDE for social care practitioners could contribute to equality in access to dementia education which is currently fragmented across the social care sectors despite practitioners meeting increasingly complex care needs of service users. The study findings revealed optimal teaching and learning methods in TEDE for rural HSCPs. Interactive learning and collaboration in real time were considered to be essential components; however, HSCPs also required access to concise and flexible learning resources that were supportive of workforce challenges including time demands in practice. Conclusions TEDE is a convenient, flexible, and accessible mode of dementia education. TEDE for HSCPs in rural Scotland requires delivery using a blend of self-directed [asynchronous] learning resources and facilitated synchronous sessions in real time. A blend of asynchronous and synchronous [bichronous] delivery is recommended and may improve organisational capacity for dementia education, provide equality in access to dementia education, and improve care quality for PLWD. Successful implementation of bichronous TEDE for rural HSCPs will require an organisational commitment to ensure that practitioners have access to protected learning time, digital equipment, and support for digital skills. Future Research Based on the study findings, a funding application is being developed to conduct further research that will aim to evaluate the effectiveness of a bichronous TEDE programme compared to traditional asynchronous delivery methods. Dissemination The research findings will be made available in an academic thesis made publicly available by UHI. The research findings are pending write up for publication in peer reviewed journals with focus on educational methods in health and social care. The findings will also be disseminated at national and international academic conferences. Findings from the research will be shared among study participants and academic networks of the Chief Investigator. A brief report of the study findings will be made available to NHS Education for Scotland, the PhD studentship funder, and local RD&I departments as required.
REC name
North of Scotland Research Ethics Committee 1
REC reference
20/NS/0021
Date of REC Opinion
3 Feb 2020
REC opinion
Favourable Opinion