Evaluating SWICE-R (South West Information for Clinical Effectiveness - Rural). Final report for South West Workforce Development Confederations (Knowledge Resources Development Unit)

Yeoman, A., Durbin, J. & Urquhart, C. (2004). Evaluating SWICE-R (South West Information for Clinical Effectiveness - Rural). Final report for South West Workforce Development Confederations, (Knowledge Resources Development Unit). Aberystwyth: Department of Information Studies, University of Wales Aberystwyth. Sponsorship: South West WDCs (NHS)

Executive summary (edited) The thrust of recent government policies for health and social care stress the importance of workplace learning, better training for social care staff, and clinical governance. To help NHS and social services organisations meet government targets, support services need to be put into place. This evaluation of SWICE-R (and SWICE) aimed to assess whether the electronic information resources provided met the needs of the staff and whether the services were starting to have an impact on patient care and professional practice. To use these specialised information services, training is required by most staff, and the evaluation also assessed whether the training and support services were effective. The objectives of the evaluation were to: ? determine the acceptability of access to the e-library ? assess the usefulness of the content of the e-library to various professional groups ? assess the alignment of the training programme to national and local policy objectives ? identify the existing barriers to training and how these might be overcome ? assess the acceptability and effectiveness of the training programme ? identify whether use of the resources was having an impact on formal and informal CPD ? identify the impact on clinical practice Key messages and recommendations Access This seems to be improving but usage patterns suggest that usage levels are not yet near the maximum that might be expected, particularly in community and social care environments. Demand is for ?anytime, anywhere?. Web site design Compared to other health e-libraries, both SWICE and SWICE-R designs are clear, and simple to navigate. They lack (as do many of the comparable health e-libraries) good help and feedback facilities. Some use of commercial site design features might help infrequent users. Compared to the National electronic Library for Health site, and some other commercial sites, many of the health e-libraries, including SWICE and SWICE-R are very static. There is little to attract the user to revisit to see ?what?s new?. Promotion Library services play a key role in promoting SWICE and SWICE-R, both through publicity and more indirectly through the training programme. Libraries, together with trainers, need to target senior managers in their area, as personal contact may be necessary to promote services to PCTs, community health services and social care. Content of the e-library Several resources appear complementary to the core resources of MEDLINE, CINAHL and BNI on SWICE. Few resources are considered 'never useful'. The low usage for some resources is more likely to be attributed to lack of promotion, and those SWICE-R users who had tried the more novel resources such as Internurse could perceive many applications. Information skills training programme The information skills training programme has succeeded in giving more confidence to many of the potential users, and the Somerset programme (the main focus of the evaluation work) is widely praised by the social care staff interviewed. Although there has been a policy emphasis on e-learning, and the ECDL, for example, may be supported by learning packages, an e-learning approach does not seem appropriate for promoting, supporting and training for the SWICE and SWICE-R resources, as the users need (and appreciate) personal support to help them realise how the resources might help their education and practice. General comparisons of performance against government targets for clinical governance suggest that the training programme should concentrate more on community and social care, as the need is greatest there. Trainers cannot easily conduct outreach training and offer informal top-up support, reliably and consistently, at a later date. The libraries need to be viewed as the learning hub, and provide administrative support for the trainers, for a training diary that can have some block bookings pre-arranged. A training strategy for users outside the acute NHS Trusts needs to take account of the greater difficulties of outreach work there. Trainees need to be persuaded that the libraries can continue to offer the personal support initiated by the trainers. Workforce development and patient care There is evidence that SWICE/SWICE-R resources are supporting changes in practice. Sometimes the change is more at individual level (often through continuing professional development activities) but there is also evidence that clinical teams are using the resources to support organisational changes in practice. Some information is passed on to patients, but there is some uncertainty about the procedures and policies on this. There is a policy imperative in the social care sector for minimum NVQ standards for care staff, but progress is hampered by recruitment problems. Care home managers have to juggle many competing priorities, and this may make interest in SWICE-R training more difficult to achieve initially. Attendance at training programmes needs to be seen to count for something. The resources are used by staff acting as mentors for undergraduate students, but the mismatch in resources provided, through the different NHS and HE Athens password authorisations, continues to cause some local difficulties. Among regular users, satisfaction is high. Methods used The methods used were those described in the proposal: ? Document analysis ? Interviews with o Training programme participants o Users o Stakeholders involved at a strategic level o Information skills trainers (focus group) ? Postal/online questionnaires for participants in training programmes/users In addition, the researcher was invited to observe a training session carried out by one of the Information Skills trainers. A total of 40 face-to-face/telephone interviews were conducted (of which 31 were with training programme participants; 2 with social care expert informants, 1 with a member of the SWICE-R board, 1 brief interview was with an education informant, and 5 trainers were interviewed together as a focus group). Ninety-three postal questionnaires were despatched with a response rate of 43% (40 replies). The online questionnaires received 382 responses although the vast majority (375) were from the SWICE Web site.