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Skip to 0 minutes and 6 seconds I’m Mel Ferguson. I work for the Nottingham Hearing Biomedical Research Unit that’s funded by the National Institute for Health Research. And I lead a research team who looks at research on people with mild to moderate hearing loss. I’m also a consultant clinical scientist in audiology. So I’ve got a background in clinical audiology, and I’ve had a number of years experience working in that field. The RLO-based project that we did was aimed at trying to improve knowledge and education for first time hearing aid uses.

Skip to 0 minutes and 42 seconds There’s quite a bit of evidence to show that when people have clinical appointments, that they forget a lot of the information that’s given to them by their health care practitioner, whether it’s a doctor or an audiologist. And there’s other evidence to show that about half of the information that’s given to first time hearing aids users by their audiologists in their hearing aid fitting appointment is forgotten a few weeks later. And one of the problems around this is that if people don’t know how to use their hearing aids– because they’re quite complex to use– that this can lead to non-use of hearing aids. Or people may not use their hearing aids as much as they probably should.

Skip to 1 minute and 22 seconds So we developed the RLOs and made an educational programme. And then we trialled it in a large, randomised control trial. We had 203 hearing aids users take part in the study. And we showed a number of benefits from the RLOs with our clinical trial. And basically what we showed that people who use the RLOs had better knowledge about hearing, hearing loss, communication, and hearing aids. They had better practical handling skills for their hearing aids. And also interestingly, in some people there was better hearing aid use. One of the really interesting points that came out was that the participants, or the hearing aid users, reported that they would much prefer having RLOs compared to written information.

Skip to 2 minutes and 9 seconds So that kind of shows that we were bringing on board something which is quite new and novel, because nothing like this has being used in audiology at the moment. And then finally, we had reports from a number of people saying that they found that the RLOs gave them confidence. They had more confidence going into what would typically be challenging listening situations, for example, talking with lots of people. They felt reassured by going back to the RLOs and finding out what it was that they should be doing. So we had a number of sort of hard measures in terms of how people benefit from the RLOs, as well as some really supportive self-reports, comments from our participants.

Skip to 2 minutes and 57 seconds As part of the research, we wanted to find out how often people use the RLO, so we gave them a video diary. And we found that nearly everybody– the vast majority of people– watched all of the RLO. So there was really high compliance in watching the RLOs. And our sample of participants reported that they found them highly useful. So on a scale from one, not very useful, to 10, highly useful, the average score was nine out of 10. And the majority of people– around about 80% of people– said that they would recommend them to other people. What I really liked about the RLOs is that they were based on learning theory.

Skip to 3 minutes and 39 seconds And pedagogical principles were embedded throughout the whole of the RLOs. So at the beginning, we had the learning objectives so our hearing aid users could see what the purpose of the RLOs were. There was lots of images, lots of different media. So we had a mix of animations, photographs, videos. We had a series of testimonials from first time hearing aid users. So they were able to go and put forward their own issues to go and get the message across to other first time hearing aid uses. All of this, I think, brought together a sort of a very rich, diverse set of materials.

Skip to 4 minutes and 21 seconds And I think this is what contributed to the fact that the majority of our people– it was over 90%– reported that they agreed with the statement that they found them very interesting and enjoyable. So one of the really positive aspects of the RLOs is that the hearing aid users are able to interact with them. Typically when information is given to a patient by a clinician, it’s a one way exchange of information. The clinician, in this case, the audiologist, gives the information to the patient, or the hearing aid user. And it’s very much one way. And there’s evidence to show that actually this isn’t the best way for people to learn and to benefit from whatever the intervention is.

Skip to 5 minutes and 6 seconds So what we have with the RLOs is that the hearing aids uses are able to engage with the materials. They do this by being able to choose what they want to look at. And they can go back as many times as they like. And what’s really novel, I think, is what we call the quiz at the end, where they’re able to go through, find out what they’ve learned with a multiple choice quiz. So they really are engaging with the materials, and sort of taking an interactive role, rather than passively sitting there and just being given the information. We worked with the team at the Health and Media Learning Group at the University.

Skip to 5 minutes and 48 seconds And we used a method that they had used on a number of RLOs. And I think this really brought something really novel to the process that we went through. So first off, we held a series of workshops and focus groups. We invited over 35 hearing aid uses to come and take part. And what we were able to do with the workshop is to try and capture the personal perspectives, and thoughts, and attitudes around hearing loss and hearing aids and capture them all on large storyboards in picture format. The storyboards– we had over 25 in total– which were developed by our hearing aid users, really formed the content of the RLOs.

Skip to 6 minutes and 41 seconds So we’ve got at the very heart of our content the perspectives and the thoughts of hearing aid uses. And I think this is what makes them very relevant and very appropriate. And I think it’s contributed to the success of this project. The second part of the development, which was developing the specifications for the RLOs, we had eight in total. We involved what we called our patient panel. So we had four hearing aid users as part of our project team. And at every single stage of the development of the specifications, and also the RLOs when they were developed, they provided us with feedback. They told us what they liked about the specifications and they are RLOs.

Skip to 7 minutes and 28 seconds And there were occasions when they thought we weren’t so clear in our message. So we were able to go and tweak that to get something which was really understandable, really relevant, and really appropriate for what we wanted to try and do. This has been a really successful project. We’ve taken the views and perspectives of hearing aid users, captured them in RLOs, trialled them in a large, randomised control trial. And now we’re at the stage where we’re putting the RLOs into clinical practise. We’re making them available to people who want them. For me, as a translational researcher, getting my research into clinical practise is exactly what we should be doing.

Skip to 8 minutes and 12 seconds So our next big development is we’re working with Helm to make the RLOs available online. We will be putting them on YouTube. So all the RLOs will be there. And we’re making them freely available. So anybody who wants to use them can. We imagine that they’ll be used in clinical practise, but also I anticipate that members of the public will also use them and also get benefit from them. This RLO project is probably one of the best research projects I’ve ever worked on. It’s covered so many different aspects. It involved the user, so we had a strong element of public and patient involvement. We involved clinicians, bringing their views to the project.

Skip to 9 minutes and 9 seconds We developed the RLOs, so we have a nice output. We’ve trialled them to get the evidence base to show that they are beneficial. And I think that’s really important when we’re trying to go and get some intervention into clinical practise. And we’re at a stage now where the RLOs have been developed, we’ve got them available on DVD. They’re out there with the wider world. One big development which we’re about to launch is we’re going to make the RLOs freely available, open access through YouTube. We’re calling this “See To Hear” [? online.

Skip to 9 minutes and 49 seconds ?] And the really exciting thing about this is we were able to make all that work we’ve done and make it available to as many people who want to access it.

A clinician's perspective of reusable learning objects

Watch this video clip in which Dr Melanie Ferguson Consultant Clinical Scientist at the National Biomedical Research Unit in Hearing talks about the development and use of reusable learning objects in a project called C2Hear.

(00:00-01:56) Mel begins by telling us about the problems with people not using their hearing aids and how RLOs were developed to address this issue. She gives an overview of the results of the study and how often people used the RLOs

(01:56-2:56) Mel describes the attributes of RLOs that patients found beneficial. “RLOs are better than written information”

(02:56-05:40) Mel talks about the features of RLOs that worked well.

(05:40-06:56) Mel discusses the HELM method used to design the RLOs and the value of the storyboard workshops involving patients.

(06:56-07:40) Mel talks about writing the specification to ensure quality.

(07:40-10:07) Mel summarises why the project was successful.

Have a look at the C2HEAR RLO Mel is describing.

Discussion point

Do you think the C2Hear RLOs would help any of your friends or family?

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This video is from the free online course:

Designing E-Learning for Health

The University of Nottingham