Human resource development using work based projects in open learning programmes in UK health care
The NHS in the 1990s
The Work based project
Stimulated Human Resource Development
Future Human Resource Development and implementing new health policy
Effects on individual learning
The authors have experience of working in two universities on an open learning postgraduate management certificate for first line managers from a wide range of professional backgrounds. The programme is based upon distance / open learning materials from the Open University (Open University 1993) and it is sponsored by the National Health Service (NHS) in the United Kingdom (UK). There is a recognised need within the NHS for managers who can cope with increasingly complex patterns of service delivery and rapid pace of change (Caines and Hammond 1996).
The two universities were independently accredited by the Institute Health Services Management (IHSM) as centres for the delivery of this programme. Originally it featured an examination as the summative assessment. Based on discussion with students and human resource development specialists this was replaced by a work based project designed to consolidate the students learning and utilising an andragogical approach (Rogers et al 1983, Knowles 1983).
This paper discusses an evaluation of the impact of project work in open learning on the individual as a manager and the health care organisation during the period 1995 to 1998. The evaluation informs the further refinement of these open learning programmes at the two universities and the national delivery of the program accredited by the IHSM.
The Managing Health Services (MHS) programme is an open learning programme funded by U.K.s National Health Service (NHS) through a project called Management Education Scheme by Open Learning (MESOL). The open learning materials have been designed and published by the Open University (OU) with writing teams drawn from the NHS. The programme is supported by the IHSM and since the programme commenced in 1990, 12,000 Health Service managers have gained a Post Graduate Certificate in Managing Health Services. The programme is delivered by the OU and by 40 other open learning centres.
The working context for health service managers was becoming increasingly complex and turbulent as a result of the introduction of the Internal Market within the NHS (Department of Health, 1989). The publication of a government policy document (Department of Health, 1997) further necessitates managers who can cope with and thrive upon increasingly complex working environments and conflicting demands. Training and development is seen as essential to ensure that managers can effectively meet these demands in the future (Caines, K. and Hammond, V. 1996).
The programme initially used an end of course examination and course assignments as assessment methods. Pilots studies conducted during 1994 to 1996 assessed the value of work based projects as an alternative to the examination. Following these pilots the IHSM allowed other centres to adopt this form assessment. Since then our two universities have now had over thirty students who have completed the work based project.
The project is submitted as a 5,000 to 7,000 word management report and is based on the occupational standards for UK managers (Management Charter Initiative, 1997). This should include reflections which illustrates the application of theory to practice and encourages experiential learning (Schon,1983, Winter, 1989). There is an established and thriving literature from practitioners working in management education supporting the use of project based learning to enhance individual, team and organisational development ( Dodds and Smith, 1997).
Thirteen (43%) of completed students were randomly selected and interviewed from both Universities. In addition three training and development managers were interviewed representing three major client organisations.
Semi-structured interviews were conducted either by audio taped telephone or face to face interviews.
Students were from a variety of clinical and non-clinical occupations and consequently chose a wide a range of project titles.
A wide range of knowledge and skills, which had enhanced their management role, were reported by students, these included;
- project management,
- time management,
- conflict management,
- change management,
- organisational networking,
- departmental and organisational team building,
- writing management documents,
- looking at things objectively,
- rational planning including problem solving approaches,
- managing finance,
- interpersonal skills.
From interviews with students the project appeared to stimulate a better understanding of most students departments and organisations but interestingly there was a mixed response on whether if it helped to clarify students roles as managers or their understanding of the wider health care system.
There was consensus across those students who did give a view and training and development managers that a project could address major issues arising from the UKs governments major recent health policy document, The New NHS Modern & Dependable (Department of Health, 1997). Either individual or groups of first line managers could approach projects in this respect.
One training and development manager noted that her organisation wished to build a database of potential projects reflecting strategic issues ready for development as work based projects or degree dissertations. A second training and development manager noted that this "was a golden learning opportunity" as students could be asked to explore via a project their understanding of this document and also their organisations response to the New NHS Modern .Dependable.
Areas of positive impact were reported as increased confidence to learn, the ability to apply theory to practice and therefore reinforce learning, to deliberately use reflective practice as a learning method, to undertake more research and raise self awareness of personal strengths and weaknesses. There was an issue for some students when asked to report on their learning from the project and then their learning from the remainder of the programme, some students understandably could not disentangle and comment upon the two possible stimuli for learning.
There was consensus from students that the project helped address a major piece of real life work in a structured way. Wide recommendation and support came from the students for the project as it allowed for theory to be tested in practice. However several students commented that carrying out the project whilst working through the open learning materials that they did not feel that they had a sufficient understanding of all areas of theory needed to apply to the project. There was a fear held this would compromise the academic quality of the finished project. There was consensus that the individual and the organisation could gain from project work. Most students found that the project helped to consolidate learning.
Training and development managers felt unable to comment on the impact of the project on students individual learning. However they all recommended the project as an effective approach to learning despite the reservations of one who preferred shorter assignments and examinations. Two recommended the approach without reservation believing that the project promoted the application of theory to practice. One further commented that the project tested and developed skills and attitudes of the student. However students gained knowledge from studying the course materials. Another noted noting that shorter assignments allowed the student to develop academically whilst the project allowed them to develop practically. He continued by noting that the major advantage of the work based project was the stimulus for the student to "engage" with their organisation and consequently lose some control over a real project, compared to shorter academic assignments.
Conclusions from our work are that:
- projects do positively contribute to the learning and management development of first line managers in the NHS.
- a wide range of specific skills have been directly enhanced through completing the work based project.
- the project is extremely time consuming when it runs concurrently with other shorter assessments and reading on the programme,.
- project based learning offers a suitable vehicle for addressing the implementation of health policy at the micro level of first line managers working individually or in groups.
- undertaking projects develops the skills of reflection (Schon, 1983) and thus facilitating personal and professional growth.
Recommendations following from this work are that:
- this approach to management development should be further developed and evaluated across the NHS and applied to the implementation of health policy at the local level.
- more research is needed to study the relationship between individual managers undertaking projects and wider organisational change and transformation (Pedler, 1997)
Caines, K. and Hammond, V. (1996) Creative career paths in the NHS: The Agenda for Action. London, NHS Executive
Department of Health (1989) Working for Patients, London, HMSO
Department of Health (1997) The New NHS Modern . Dependable, London, HMSO
Dodds, B. and Smith, B. (1997) Developing Managers through Project Based Learning, Aldershot, Gower.
Knowles, M. Andragogy: An Emerging Technology For Adult Learning, In: Tight, M. eds. (1983) Education for Adults, Volume 1, Adult Learning and Education, Beckenham, Croom Helm.
Management Charter Initiative(1997) Management Standards Level 4, London, MCI
Open University (1993) Managing Health Services, Milton Keynes.
Pedler, M. (1997) The Learning Company : A Strategy For Sustainable Development, 2nd ed. Maidenhead, McGraw-Hill.
Rogers, C.R. et al. (1983) Freedom to learn for the 80s, London, Merrill
Schon, D.A. (1983) The Reflective Practitioner: How Professionals Think in Action, New York, Basic Books
Winter, R. (1989) Learning from Experience :Principles and Practice in Action- Research, London, Falmer.