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Delivering a (Massive) Learning Architecture for Change in the NHS

In a seminar given at 2014’s Learning Technologies event, Andrew Joly, Director of Strategic Design at LEO Learning, talked about the company’s work on a new suite of leadership programmes for the NHS Leadership Academy using the learning architectures model.

The project I am going to tell you about is one of the most ambitious LINE has worked on in its 25-year history. It is groundbreaking in terms of its scale and also in the learning model we have used. Because we have talked a lot about learning architectures in the past during talks and on our website, in mostly theoretical ways (and had a very good response to those ideas), we are now able to give an exemplar of what I believe to be best practice in learning architecture design in action. And an exemplar at massive scale.

The scale, in this case, is dictated partly by the sheer size of the organisation – the NHS is the world’s fifth largest employer, with 1.7 million workers– but also by the scale of the organisation’s ambitions for this, the NHS’s largest ever development programme.
For the first time, the NHS is taking a single, national approach to leadership development, looking to support the next generation of leaders of this very different organisation. The vision is to make leadership learning available to everyone who works in health and NHS funded care: ‘Leadership, at all levels, is the lifeblood that keeps our healthcare system delivering’.

This involved not one but five programmes, focused on different tiers of the organization, four of which were named for different historical leaders in health:

The Edward Jenner Programme – for newly qualified clinicians and/or those new to the NHS

The Mary Seacole Programme – for those with a UK degree or equivalent professional qualifications, or relevant experience

The Elizabeth Garrett Anderson Programme – for those with a good UK honours degree and/or 3+ years’ experience leading people who themselves have direct reports

The Nye Bevan Programme – for those who currently report to a statutory accountable officer level or equivalent

Top Leaders – for those in executive level roles, including Executive Directors and CEOs within NHS Trusts, CCG’s, and national organisations

We have worked on the Elizabeth Garret Anderson Programme, which is to be taken by around 2,500 people a year, and on the Nye Bevan Programme, with annual numbers in the hundreds.
LINE has worked within a consortium led by KPMG, involving, Birmingham and Manchester Universities, expert face-to-face trainers and international expert partners. Our job has been to provide consultancy, design and delivery of learning content, virtual campus and learning assets – and to support the programme for at least the first three years of its life.

The learning this replaces had been blended in a ratio of roughly one third online to two thirds face-to-face. Our key task was to reverse these proportions and make two thirds of the programme delivered online.

On the project we have worked and learned in many different ways how to use the right content in the right medium – videos for emotional impact, for instance – doing the learning architect’s job of matching learning modes (e.g. read, test, ask, watch) to channels (e.g. coaching, video, e-learning, PDF).

Plotting the learner journey

With a learning architecture there is a curriculum – and in this case, with two universities involved, the curriculum is very specific – but there is no course as such. The learner journey is what does the job of guiding people through the content. There is a lot of flexibility and learner self-direction in this, but also an appropriate amount of support and structure – if it’s too open you lose all control. The design of the blend was critical if it were to work.

Designing a sophisticated learning blend like this mixes art and science and is not an easy task – providing the right content in the right medium, sensitive to the context of use, allowing the right degree of flexibility for the learner and the organisation, and holding in balance the inevitable tension that arises with such an approach between control and openness.

So many different criteria come together – SME input, the capabilities of different media, User Experience, the culture of the organization, etc. The traditional handrails of instructional design still have utility in this new situation, but certainly do not provide all the answers. You have to stay close to the business requirements, and to the learner requirements as well.

And while balancing all these criteria and requirements, you have to produce something that has a bit of magic about it, a bit of ‘wow’ – an experience that will engage and inspire people. You need to take the theoretical concepts being opened up in the learning and give them emotional punch. In our design work on this programme we felt it really import that every new piece of content the learners engaged with would feel like opening another Christmas present under the tree.

To do this we used some very impactful video scenarios, shot to a high production value, and also, where relevant, light relief. In using humour, of course, context is really important: everything should work to drive relevance to the NHS and to the programme.
We used e-learning of many different sorts including ‘traditional’ e-learning (modules of self-paced instruction), but also interactive scenarios, nuggets, half-hour sessions, quizzes, video walls – lots of interviews with experts – ‘vox pops’, drama, personal stories, audio, etc. etc.

Not all of the content was from us: the programme also has some learner-produced content. On one of the forums, someone produced a poem that they had written from their experience as a nurse, in response to points made in content we had produced.
There are also forms, accessible downloadable content, handbooks, links; live training events have web material supporting them as well as printed workbooks, and so on. Virtual classrooms and face-to-face tutorials alike are all supported by website. We also have two or three mobile apps coming soon.

What have we learnt?

So what have been our learnings from such a massive programme, under such a new and innovative learning model?

• A programme like this is a whole team effort, a partnership activity
• Set up and planning are crucial, but you might have to scale up really quickly: in this case, with just four months to get it off the ground, we had to do the planning and the scaling up at the same time!
• Responsiveness and pragmatism are everything
• Don’t underestimate the learners: a lot of what such programmes are about is trying to make things clear and understandable, but don’t oversimplify
• You also have to trust the learners’ ability to self-direct, and use external resources once these have been signposted: remember there is a lot out there they can use – if a mature resource exists, don’t reinvent it
• One of the benefits of scale is that individual members of the design team can be freed up to show their particular strengths – learning designers often have to be jacks of all trades, but in a large programme there is room for more specialisation.

Our NHS Leadership Academy’s programmes have since been nominated for six international awards. Read the report here.

We can help you discover the right blended learning strategy to transform your organization.

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