So, this is what SPOR Module training looks like in the midst of a pandemic ... It seems similar to many other online training courses I’ve taken over the years, although it’s significantly more interactive. There are several technical platforms used, but surprisingly, it’s not clunky. As an outsider looking in, I might not be aware that this wasn’t the standard delivery of this training module. But as a member of the Saskatchewan Centre for Patient-Oriented Research (SCPOR) staff team, I know there’s more to the story…
Taking a cue from their own handbook, right from the start SCPOR involved Patient Partners in the inperson delivery of the Strategy for Patient-Oriented Research (SPOR) Module training. SPOR Module training was developed by a national working group of Patient Partners, researchers, clinicians, decision makers, SPOR staff and representatives from the Canadian Institutes of Health Research (CIHR) as a way to provide patients, researchers and others with an understanding of, and the skills to engage meaningfully in patient-oriented research (POR). As Candace Skrapek, a retired nurse and nurse educator, as well as a Patient Partner who has been involved with SCPOR since its inception, explains, “Patient Partners bring real life experiences and stories to the content that’s explored in SPOR training. It not only makes the material memorable, but it helps to create a better understanding of the value patients bring to the research team.”
The training, which until this year has always been delivered in person, has been considered for online delivery in the past. Proponents for remote delivery see the benefits of participants able to attend from anywhere in the province or complete the bulk of the content on their own, allowing them to work at their own pace, when time permits. Therefore, when COVID-19 hit and SCPOR closed its physical offices and put a hold on all in-person training and events, the concept of moving SPOR Module training online was not new. While the uncertainty about the pandemic left many to “wait and see” how best to move forward, SCPOR took a proactive approach in addressing the training issue, primarily because the SPOR Module training was highly sought-after, and a new group of SCPOR Trainees needed to complete it as a part of their grant requirements. As retired nurse and nurse educator as well as Patient Partner and SPOR facilitator Diana Ermel states, “There was a need, there was a deadline – what are you going to do? We could no longer wait for that ideal time to launch an online version of SPOR training – the time was now. Sometimes adversity is the mother of invention!” And so, together with SCPOR staff, Diana, Candace and fellow patient partner Marie Agioritis began to fast-track the process to move SPOR training online.
To launch the project, SCPOR staff, led by patient engagement specialists Caroline Beck and Sarah Fang, initiated research into available and functional platforms to host the training. This presented a fairly steep learning curve, because of the unfamiliar technology. But that was only one part of the equation – moving online would require restructuring the course delivery and there would be challenges in how to engage attendees and ensure relationships and conversations amongst participants could thrive in a virtual environment. In addition to the course specific challenges, COVID-19 had created restrictions that included social distancing and virtual meetings taking the place of in-person interactions, adding another layer of complexity to the process. Recreating the entire delivery of the SPOR Module training would require a significant amount of collaboration and reliance on expertise not normally called upon. Patient Partners became a key component in undertaking such an ambitious project, especially given the limited time and resources available. In only 5 weeks, the team was able to put together and deliver SCPOR’s first online SPOR Module training.
Part of the success was a result of each Patient Partner bringing diverse and relevant skills to the table, along with passion and enthusiasm. As a newcomer to SPOR Module facilitation, Maria states, “Initially, it was a little intimidating working alongside these exceptional patient partners, who were not only experienced in the delivery of the SPOR Module training, but who had life experience as nurse educators, and were so well suited for this project.” But she soon realized that she could contribute in equally valuable and unique ways, for example, by looking at the course through a fresh perspective and focusing on how attendees would experience it.
The delivery of online training could have gone two ways; SCPOR staff could have simply moved the class online and presented the content in a virtual meeting, similar to how the in-person content was delivered, but with limited attendee participation. They chose, however, to go with the second option that included the use of multiple platforms and a combination of pre-learning and remote collaboration with shared delivery by SCPOR staff and Patient Partners.
While the in-person training included a full day of learning, typically taking place from 8:30 am-4:00 pm, says Sarah, “We knew we couldn’t stand in front of a computer and lecture at attendees for 8 hours. No one would benefit from that experience. When you’re face-to-face, you can break out into groups or chat with others during coffee or lunch - you don’t have that opportunity online. The conversation doesn’t flow as naturally.” In order to overcome these limitations, a new multi-faceted approach was incorporated to the online SPOR Module training. Much of the material that would normally be presented via lectures is now provided through the online tool Moodle, and features pre-recorded video segments, along with a variety of quizzes, questions and case studies that students complete prior to attending the remote sessions. This allows the bulk of learning to take place at the students’ convenience and enables the participants to focus on discussion, collaboration and shared experiences during the three 1- to 1.5-hour remote sessions, delivered on platforms such as WebEx to host the virtual meeting and Mural, which allows for participant interactivity and a “classroom feel”.
Equally important was the inclusion of Patient Partners in the implementation and delivery of the course. Says Marie, “Having Patient Partners included in the delivery, even in this new format, brings a sympathetic social view to the material and brings compassion back to medicine. Many of the attendees in class are not patients, and so it’s a good reminder that we aren’t a production line. We’re human. Recognizing that helps with outcomes.”
Adds Diana, “For those patients in the room, many of whom haven’t worked in an academic or research setting, it can be intimidating, and make you feel like you’re not there. Patients are the subject of discussion and should be part of the conversation. Having Patient Partners involved in every level of the SPOR training ensures that isn’t lost.”
Having now launched the second round of online SPOR Module training, the team has been able to improve upon the initial launch, which was presented solely to a cohort of SCPOR Trainees in May of 2020. Attendees of that session were encouraged to provide critical and constructive feedback to make positive changes. Based on their responses, adjustments were made to how and where the content was presented, and communication of pre-learning expectations was enhanced.
One of the most significant contributions the Patient Partners provided following the initial training was the development and implementation of a conceptual POR diagram. Says Diana, “Initially, everything felt a bit disjointed in presenting the material, virtually. The model introduced a great visual element to help bring it all together and act as a sort of roadmap to the training.”
Like so many of the changes that have resulted from this pandemic, however, the transition online doesn’t come without its challenges, the first being technology. “Our participants must have access to not only the technological equipment and some basic knowledge of how it’s used, but reliable internet is now a major consideration,” says Candace, who experienced technological issues even as we discussed this project. “There are issues that come up unexpectedly, and I think that will continue to happen. We’ve had to create a new set of housekeeping standards to ensure all participants can gain value from the training without interruption, and I’m sure we’ll face some technical bumps from time to time. But each time we present the SPOR training online, we learn which areas can be improved upon and how we can enhance the overall experience for attendees.”
Perhaps, the most significant challenge SCPOR faces with the online version of the SPOR Module training lies within their ability to facilitate relationships without in-person interaction. “Patient-oriented research is about relationships. We’re proud of the success we’ve experienced in this online version, but we also realize that nothing quite compares to the relationship building capacity an in-person experience can provide,” says Sarah. “We’ll continue to survey participants and evaluate the training while we seek new opportunities and make improvements along the way. For now, we’re happy to be able to provide this option, and we hope to see online delivery continue into the future. But we also look forward to the time when we’re able to offer both in-person and online training.”
