 Hello everybody. My name's John Brindle. I'll be, yeah, I should be. I hope they're all on. My name's John Brindle. I'll be a chair for this session. There's a lot of people who were in the last session who are here as well, which is quite cool. Well done for making it this far. I think it's been quite an intense conference for everybody, but I'm absolutely delighted to introduce Kate, Lisa and Gabriel, who are going to talk about creating the Banes family tree. So this sounds like a fascinating talk. So without further ado, I'll pass on to you. Hello. Welcome everyone and those online. Our presentation is about creating the Banes family tree, which is an e-learning resource created by healthcare academics and learning technologists from the University of Leeds. Are you introducing this? Oh, yes. So I'm Kate Phillips. I'm a nurse lecturer at the University of Leeds. Yeah, I'm Lisa Bobsgran. I'm program lead for the mental health nursing course at Leeds University. And I'm Gabriel Jones. So I'm one of two learning technologists in the Faculty of Medicine and Health at the University of Leeds. And our aim today is to demonstrate how learning technology can be used to enhance traditional healthcare education. So we've tried to be more creative and kind of engage students more effectively within our healthcare courses. And we're hopefully going to showcase the benefits of the Banes family tree e-learning resource. But also we've developed a collaborative framework and we hope to kind of explore that and share the benefits of that as well. So the way we're going to do that is we're going to start off looking at some healthcare and digital education context. Then we're going to do an overview of the resource, then an overview of how we've collaborated, how we're working together. Then Lisa's going to take us through some of the applications, the resource, how it's being used in different ways across the School of Healthcare. Then we're going to have a hands-on demonstration. So just to pre-empt, it'd be useful if you have devices ready, laptops would be good. We might be pairing you up and we'll be using VBOX as well. We have a session ID to come just to let you know that's on its way. And then we're going to wrap up by looking at some student feedback and discussing some of the positive student outcomes that we've recognised so far. But yeah, to start off with our hand back to Kate to talk about some of the healthcare context. No, it's okay, we'll come later. Okay, so we thought it'd be important to discuss the sort of underpinning theoretical concepts that underpin the development of our resource. So the nursing and midwifery council education standards govern student learning within nursing programs and it sets the learning culture that we must provide as nurse educators. So myself and Lisa as nurse educators, I've got to ensure that we support students to apply theory to practice, develop the skills and competence to deliver safe and effective patient-centered care. So in order to do this, we've got to strive to be innovative and develop resources that are going to support students to apply theory to practice and meet these key proficiencies. Next slide please. So the biggest challenge that we've got as nurse educators is what is known as the practice theory gap. And in literature, this is defined as the discrepancies found between what students learn in the formal classroom, setting and what they experience in clinical settings. And the reason for this is that nursing can be very task and procedure centered. So our students when they go out into clinical practice might not be involved in the total care of the patient. And also when they're on clinical placements, when they're nursing people on the wards, they often just see the patient in the hospital bed and they don't consider the patient's personal holistic needs or the social and environmental context in which they live. So we wanted to try to bridge this theory practice gap and we wanted to develop a resource which would focus less on task and procedure but would help students to be more patient-centered and consider patients in their social and environmental context because this is really important when we're thinking about identifying the social determinants of health of those patients and the health resources that are available to them. So this gave us the idea to develop a virtual family known as the Bains family tree. And a virtual community in pedagogy terms is defined as an online teaching application featuring a fictional community that has multiple intersecting and unfolding character stories. So in healthcare education the focus of these stories is on health related issues and students nurses and learn about the concepts through the context of the character stories within the virtual family. So I'm going to hand over to Gabriel who's going to look into the resource a little bit more closely. Yeah and it kind of works the way we're going through the presentation because this is how it worked that Lisa and Kate had the idea and they came to our team with this idea and already had in mind producing a new learning resource but it was our expertise that we were then able to combine to sort of address this issue. So family tree learning resources have been used before in healthcare education it's not a totally new idea but they've traditionally been paper based and that's limited their interactive potential as well as the ease with which they can be adapted and developed in the long term and also their complexity. So research into the application of e-learning resources has shown that manipulation and interaction are key to the student experience and by interaction practitioners construct their own understanding and use of the resource and by embedding digital assets or information objects into an interactional framework practitioners give them educational purpose and value producing learning activities or designs and this is precisely what we've undertaken in the generation of our virtual community via the Bains family tree e-learning resource. So here you can see a couple of slides from the resource which will have the opportunity to try out shortly. So the top slide you can see there shows the central hub of the tree with 40 family members each of whom can be selected and then that takes you to a tab based screen that you can see in the lower slide containing their personal social health medical and events or scenario based information. The resource is designed to allow students to freely explore the lives relationships and interactions of the different family members over the course of a three-year narrative with the ability to switch between years using the slider provided. So you can see at the bottom there you can switch back and forward and family members sadly die or get divorced or situations change and yeah something which we won't be getting you to do today just to keep things simple but each year is password protected so the idea is the first year students will have access just to the first year but they can sort of see the shape of the three-year resource, second year students will have access to the first two years and third year students will have access to all three years and that's all in the same place the same resource with each year password protected which as Lisa will talk about later also is helping to instill ideas about confidentiality about not passing on information to other students kind of simulating real-life engagement with these sorts of cases. So this interface has enabled a lot of different applications which we're going to go through but first I'd like to illustrate a little bit more the combination of expertise and technology that we've used to support the pedagogy of the resource. So here is our team you can see Lisa and Kate on the right so they'll be considered as the lead authors who first had the idea for the resource in last summer. So they're chiefly responsible for the generation of the content and working with peers across the School of Healthcare to ensure that the learning outcomes and teaching needs of different programs are met so because there's so many family members it means that lots of different issues can be addressed in one resource. So I'm the chief designer there that's a photo shot of one who used to be a kind of concert pianist so excuse the black and white using articulate storyline to construct the resource in response to Lisa and Kate's content. Dan Ward in the middle there is our senior learning technologist in the Faculty of Medicine and Health and he's the project coordinator responsible for overseeing the effective running of the project and that goes from things like just storage protocols to strategic oversight and he's been really important with his expertise as well instructing me how to make best use of the software. Crucially we also have student stakeholders Claire Cooper and Faith Kennedy on board as long-term project consultants making personal contributions but also collective contributions on behalf of their of the student body who are interacting with it at full team meetings and finally at the top left there you can see David Woodcock who is a service user as well as a carer himself and he provides input again in connection with other focus groups about the authenticity and realism of the stories being told. So we view this as a combination of interdisciplinary expertise so that ranges from subject matter experts to learning design specialists but also students and service users in other words experts in the experience of digital learning and the lived experience of the content and the concepts that we're communicating. This combined expertise is then mediated through authoring communication and data management software in different ways to positively affect the functionality, interactivity, adaptability, authenticity, inclusivity, flexibility, accessibility and sustainability of the resource so all of these benefits which we're still sort of theorizing the way in which those different things work but all of those are being sort of served by that combination of expertise and technology. So I'll now hand over to Lisa who's going to tell you a little bit more about how these benefits have been put into practice in the School of Healthcare. Yeah so I'm going to think with you a bit about the application so as Kate and Gabriel discussed in nursing the use of case studies is not new and they're commonly used within our teaching often though what happens is students are given a case study in a lecture they spend 20 minutes focusing on that case study and then they never meet it again and actually lecturers are constantly creating case scenarios and case studies that students just work with on a one-off basis. What we wanted to do was have this as kind of running throughout the program across all modules so the students kind of invest emotionally in these characters there's a kind of soap opera style approach to our story writing you know there's cliffhangers there's what's going to happen next and the students revisit those family members and the depth and complexity increases through the program. So the way we've used it so far we've used in teaching so the students meet family members now within tutorials within their modules so if we're doing a tutorial on diabetes they might meet and I'm going to test myself now Andre who has diabetes and they'll think about that particular diagnosis and some of the family members have been in prison for example so when the mental health nurses look at the needs of prisoners and mental health and the increase in mental health issues in terms of the prison population they'll look at that particular character and think about that character to kind of add a context to that to that piece of learning. We're also trying to use it to think about the more abstract concepts for our first year students they're not out in practice till the second semester so for the first semester they're learning about a lot of concepts that we use in healthcare confidentiality accountability so we're trying to think about how we can support those students applying that knowledge to practice through the family tree so we have a discussion about confidentiality you cannot talk about this family outside of this room you cannot discuss it on the bus you cannot leave notes lying around if you've made notes about this family and again we're replicating some of the professional expectations that there'll be of those students in their practice area so we use it to teach those more abstract concepts but also kind of the theoretical base around particular conditions and issues and social situations and we use it in simulation so we used to teach clinical skills in quite a dull way to be honest we talk about taking a blood pressure we go through the theory of it students would come in practice taking blood pressures on each other then the next time they were let loose doing that was on the ward what we've done now is created clinical simulations using members from the family tree so they'll come and meet everine veins who will be in our we've got a ward simulated ward on our um in our area um so they'll come into that ward area they'll meet everine they'll need they'll get a hand over and they'll have to interact and communicate with everine to take her blood pressure so again it's about more than just learning the blood pressure everines confused and disorientated so they need to think about their communication they know about Harold her husband and that her grandsons having some issues so there's all that context one of our students talked to everine about gardening because they'd read that she liked gardening and it was those kind of things that we couldn't do with the paper-based case study and if we weren't following that family through um in all the modules we're also using it in assessment so in their summative assessments again in that first module um students choose a member because they've met the family they've done the simulation we've talked about different family members throughout the module they then choose one of those family members to write about for their first case study around person-centered care and identifying needs and we found that significantly improved the quality of the essays the students are far more engaged and the marks have improved significantly since we started using this approach so it's been a positive all-round which leads us on quite nicely possibly to the next slide which is about student feedback oh no it's not we're going to let you use it first so we want to give you a chance to explore the tree and we thought the best way to do that was to yeah just go and explore it so the top qi code um will take you to the family tree if you're using a laptop this short um link will take you can type in and will take you to the family tree um our main aim for the next five minutes is just to get you to explore the tree we have created a v-box quiz if you'd like to do that alongside you might need to work in pairs if that's so you've got one device for the tree one device for v-box but what you can do is try and use the year one version to answer questions about the family members and just find out a bit more about them and explore that so we'll give you five minutes to explore the family tree have a go at the Bains family tree scavenger hunt um through v-box and if you've got any questions while you're doing that or there's any issues let us know and we'll come and help yeah the v-box is a survey that we've set up so that could give you some inspiration but mainly it's just for you to have a go and get used to it so um yeah enjoy for five minutes and we'll uh walk around answer any questions you might have do uh do work together and talk to each other it's not going to be totally isolated it does work best on the laptop by the way we have made it so it is accessible on phones but we encourage students to use it on their laptops or kind of tablet it's a new prototype so usually you would just click that and it would take you back so yeah if you put it's harder to see on there um but yeah this in fact we didn't do any we'd ask students for your view how it all works but yeah when you're in a family you can click on the family tree icon in the bottom right to go back to the you're so frustrated in this I'm going to tell you two things oh Edeline and one of the children's development steps is like it becomes a bit of a teacher on adventure that sounds oh but depending on the student response and the clinical simulation depends on all that so for some students he doesn't make it but other students he kind of do follow the protocols and things that he does so it's in yeah and every they kind of follow her possession and so there's a few members actually so if you click on this to just navigate back we didn't know who how to use it currently sorry and John has just come out of prison so he's the person he's recently been in prison and develops kind of mental health issues whilst in prison and so then we spend a bit of time thinking about how to support John the students get so invested though they like these characters have become like that about yes well we keep saying because Gabriel is a concept he and I just we keep saying we need a theme to and yeah and because it's a family like we get them to like when in mental health when the challenges we have to find these students focus on the mental health and that's important but they don't think about maybe the children or the partners and so actually we do a whole session focusing on the children of the families where the mental health issues so actually what about Scott's daughter and and some of the challenges we've kind of built in some of the common things that young hair has experienced for Dan and Kirsten we can kind of just add depth all the time it's it's kind of like we started with about eight characters I think it's grown to go up to we actually it was a sketch on a piece of paper in the pub was where it started yeah yeah and just and like we we have really good fun writing it down so and Gabriel has got favorite characters like please don't do anything to change them sometimes some go and some can't oh but we've only been using it for last year there's been a couple of changes so this is our newest version which we haven't launched with the students yet and we've changed there's been a few that didn't quite work and we've had to change and we've had real issues because we tried to make it diverse with the photographs that we can use and the live with actually something that we needed a obese child that was a particularly ethnicity and it wasn't available in the start so we've got some funding now though to get some so we're gonna commission some photography because and we're working with an animator in the medical school who's going to animate some of our characters so we're going to have little films and then we've done some voice and my daughter's just done a voice-over for one of the characters talking about her experience of living with a parent and she's also going to be our voice-over when we do our video around it but we want like an intro video that we can show at open days where we start talking about the essay and like this is my family and we're going to learn about us through that way so we just started doing that. Yeah the separations, divorce, adoption, yeah and we included like Ben's adopted but we needed a character to be the third day mental health student so it's quite isolated as had a baby removed. So we've got his mum is on there so the students think about yeah and the same with Susan's sister is quite an isolate because we had this a bit of an issue actually about how do we feed people who are isolated because not everyone lives in a family and yeah and we had to be there and yeah that's fine so okay we better keep going. Yeah we'll just do a quick wrap up and then maybe have some silent questions. So just going to wrap you up there we've got some V-box responses but as we as we suspected there are the answers for the people who got to the questions. Yes if you did get some questions these are the answers. As we as we hoped it's more of an opportunity for you to get to try it out so yeah. We'll move on for Lisa to wrap up sorry for the people online to talk about some of the student feedback and the outcomes that we've witnessed. So hopefully you enjoyed using the tree and you got the sense of what the feedback we get from some of our students that is they get really invested in this family and really keen to know what's going to happen next and what this looks like. This is one of the piece of feedback from one of our second year students who talked about using the Bains family tree in module assessments has given her a more personalized connection with case studies among the whole group and she felt the novel narrative element helped invest in the characters inspired her to look further. A lot of students for example we asked them to do a presentation around a character and their environment and they researched we've given them all addresses in and around leads they researched that area and the needs and that area and the resources available so students if they wanted to could take it deeper and further which was great and that was and as Claire puts that would not have been possible with a simple character brief so it's provided that more personalized and holistic approach and the level of detail provided that yeah more in-depth discussions than the previously experienced with traditional case studies and made the overall assessment feel less this theoretical and more grounded in reality which kind of met what we hoped in terms of our initial objectives with this resource and some of the other you know student outcomes we've had through our initial evaluation reflected what we'd seen hypothesized in the literature about using virtual communities and that was that there's this and you know students are better able to conceptualize theoretical concepts through the authentic patient stories and the development of emotional intelligence so students develop an emotional connection and they're thinking more about their communication then when they are doing the simulation for example about how do I interact with everyone how do I build that therapeutic relationship and it's improved active engagement and teaching and learning activities now with our students who've been using this a while as soon as we say Ben's family treat the bugger off on the laptops they're all ready to go and it's it's kind of quite exciting whenever we're going to a lecture and that that happens it still surprises me but it's great and the emotional connectedness to the families and characters is really helpful in our learning activities it does feel like students are more engaged then in the activities that we do in particularly around the group work which all there's no can be problematic sometimes in terms of student engagement it's definitely helps them understand in terms of confidentiality we found that kind of a real really useful benefit and we've also had feedback that because we really try to make the family tree a diverse demographic that students do feel a sense of inclusivity and one student says she can see herself in that and she's not always seeing herself in case studies that have been used previously so that was some really good feedback as well and in terms of the future we're hoping to do a more formal evaluation this academic year so we've got some funding to do some more formal evaluation and we're hoping to have some interprofessional working around the family tree so the social work students are going to use it this year so we've added in some extra layers about social issues and things that the social work students can engage in and we're hoping that i'll promote some interprofessional learning and that's some audio content to support the the varying styles of learning as well oh she's hear that just some audio content oh yes sorry yeah and some audio content to support the varying styles of learning so these are the references to the things that kind of yeah that have informed our work and then final slide with our contact details if anyone wants to get in touch and but have we got a few minutes for questions we didn't do that then any questions yeah should we start i think yeah we should use the mic one of us yeah you go for the mics i will jog around yeah and i'll hand this between here i need the exercise i was just wondering with everything being as real as possible whether you had students that kind of you know took things a little bit too far and maybe you know went round to that address in Leeds and thought that that member of the family might actually be there or maybe if there were issues when you were developing the stories about you know admissions to hospital and they were thinking oh this person you know had an MI they went into this ward and the treatment wasn't very good and then the students were thinking well i'm going there on placement next does that work you know whether it just got a bit too real sometimes not yet we've tried to mitigate that by although they have an address they have a postcode it's not a real postcode so it's and it's they're not actually real addresses that we've given them so we we did try and mitigate that and we do use fictional hospital places so we don't use the local hospital names to avoid that um but yeah that has been an emotional connect and we do have to think it has given us opportunity to think about things like reflective practice self-care as well that actually we've just had a really difficult which we promote anyway but we've just had a really difficult session talking about Everine and she's moving into a care home how how do we support each other how do we you know leave that here and not take it home so it's let which we need to think about anyway in nursing so that's we've almost used that to add another dimension to the teaching around reflective practice and self-care so not yet but we'll keep you posted it's an interesting mission thank you very much that was fascinating um can i just ask how long it took you to develop this resource it's so in-depth um so we started last summer i started the job at Leeds last august and this was the perfect project to be given as soon as i started work as a learning technologist and yeah you're right that we should have put it in the slide well next time we present we've got literally just a piece of paper with a few orange pen circles and people's names written in which i believe was developed at the at the pub at the cricket club so it really goes back to basics but i think hopefully what i really wanted to include today is an overview of our of our team and the way we've worked together so it's it really has been about kind of a model of of collaboration between academics and learning designers and learning technologists in terms of how it's worked so that's enabled it to move smoothly and to work effectively so so you've actually been using this so so did you start off with a smaller family tree like or did you develop it all and then launch it like it sounds like you've been teaching with it last year so but you didn't start to look yeah well we were able to get off the ground pretty quickly so this is this is version six that we're using now and i'd say version two or three were the ones we first started using and Lisa and Kay have been fantastic in getting feedback right from the very very outset so yeah it's all just gone smoothly i think you know we get on very well so that helps we started with one module in one year so we started with the module one for the first year students and everyone loved it and everyone wanted to use it so then in the second semester it was used first and second year in more modules and then this year it'll be the first time we're using it in all three years so we've incorporated it i'm just about to launch a module where we're going to use in third year so this is the first time we'll have used it all the way through curriculum next in the net well within this academic year but Gabriel turned it around really quickly put it together within a month and we were ready to launch kind of four weeks after that initial paper design so and it's just kind of evolved since then okay we have time for one more question which is going to be down here so hello thank you very much it's a lovely presentation i can see lots of words going to i know how complicated they can be and i was wondering for like future development sort of where do you see it going is it sort of going a bit more complex in terms of like doing decision branching scenarios those types of things yeah so the complexity does grow within each year but we are hoping to get all our programs within the School of Healthcare to use it and within their teaching isn't it so that we can sort of it'll co-create sort of into professional learning we're hoping to add audio and links to other things that are going to support our teaching yeah i think there's been so much development as well that i think there's going to be a need at some point for a stage of business as usual just to let it settle a little bit because it's been so exciting and there's so many uses that for the time being i think we need to still the benefit of having so many characters is that so many of them are yet are still undeveloped there's lots of room for development that respect but in terms of the format and how it's being used i think it's probably going to stay more or less the same but maybe with the supplement of some multimedia stuff to go with it perhaps thank you and we do want it to like remain authentic really and realistic so it's not used for everything but issues where it'll be useful and effective that's absolutely fantastic oh not time right so um that was absolutely fantastic so let's show you some appreciation for Gabriel Payton