Nick Napper

Nick Napper

With over 30 years’ experience of creating innovative training, Nick passionately promotes evidence-based education in healthcare. His research specialism is visual support for learning.

Location UK


  • Some years back I was carrying out a formal observation of a Cert Ed student teaching a group of nurses.
    It was one of the most ineffective teaching sessions I had ever seen; totally one-way, and the look of boredom on the faces of the learners who did nothing apart from sitting and listening was frankly embarrassing.
    Afterwards I asked the student how she...

  • @EMMABORDERS You've hit the nail firmly on the head.

  • @EMMABORDERS Something else that's worth a try; you could create a single visual image which comprises two halves. One half shows something old (maybe a glass and steel syringe or a 1950s ward) alongside the text '4 years' (in an old looking font too). The other half of the image shows a contemporary syringe or vaccination-related image and brief text that...

  • This is a significant issue when training experienced professionals, indeed when teaching anyone with a well-established mental model. We face a similar challenge on this course as we encourage learners to replace any educational myths they may hold with evidence-based practice.
    A trainer has to find a way to get learners to go into their own mental model and...

  • We mention this phenomenon later in the course, it's sufficiently common to have its own name: 'the Curse of Knowledge'.

  • @AdeolaOke You pose a very valid question. One might also ask whether the findings would be the same in a teaching institution with a different educational culture. Or perhaps even a teacher with an enlightened approach.
    Learners have consistently been found to be largely unaware of what helps them learn best; sometimes even after the results have been...

  • @DianneHorvath Because it's a five week course that started June 7 this year, consequently the bulk of participants had completed and left the course by early August. As a result it can feel a little lonely in terms of sharing comments with others later on.
    Although I can't speak for my colleagues, I visit the course at least once a day - our role is chiefly...

  • [Is this area of education being considered too?]
    There are differences in approach according to which country one considers.
    One author we would recommend is Barbara Oakley in North America. Her MOOC (Massive Open Online Course) Learning How to Learn has been hugely successful. Her recent book 'Uncommon...

  • [ONLINE is BETTER] The difficulty with any generalisation such as this is that there are so many variables, such as quality, content, design, and so on.
    A considered review of the research is available from Will Thalheimer here:

  • [No surprise, I didn't receive any further jobs training for them.] But you maintained your integrity.
    Though not cheap, Laerdal Medical's RQI programme with its associated self-practice carts are beginning to be accepted as an alternative to face to face training; see for example...

  • @RuthO'Donnell Is there some way you can discretely feed back the evidence on this?

  • @RehmatullahKhan [Although the concept of VR and AR looks interesting, but is the cost and expertise required of this more than the intended benefit it seeks to produce?]
    A pertinent question - and one which will becoime clearer as more research is undertaken in these areas.
    We can say with some certainty that some areas, such as flight simulators, do offer...

  • @YadiraNúñez Please leave comments in the course language so that others may read them.

  • @KV You raise a valid point. Empathy clearly underpins communication and healthcare in general, however in the wider sense of applying theory of mind to the needs of learners, it is perhaps not always evident in training.
    We will cover this in the course book next year, but unfortunately we did not have sufficient space to include it in this relatively short...

  • The course commenced June 7, and this message was for anyone who arrived at this step before the end of the first week (the other end-of-week steps contain a similar message).

  • When we designed this course, we made a conscious choice not to use educational terms and jargon. In this step we used 'mental models' in place of the term 'schema'.
    If you’d like to explore this area, there's a helpful and more in-depth explanation of schemas here:
    If you’re interested further, a book...

  • I agree. For this course to function optimally, it should contain more peer-reviewed activities, and each learner would have a local, experienced mentor to guide them through and help them incorporate the elements into their practice. There would also be an area/regional group microteach session which includes peer and expert feedback.
    In some ways we are...

  • @SantoshPradhan There was some confusion about dates previously but I think it was sorted - can you click on the pink Support button on the bottom right of this page and ask please - as educators we don't have access to this area of the course.

  • I believe the so called 'rule of seven' for PowerPoint slides is a myth founded on Miller's 1956 paper 'The Magical number seven plus or minus two; Some limits on our capacity for processing information'. It actually relates to short term memory and processing ability (
    There's some discussion of its relevance to...

  • I agree, we do need to emphasise this. The challenge for us is encouraging busy practitioners to actually do it when they may believe it is not necessary.

  • @SantoshPradhan I'm unsure whether you are criticising the concept of evidence-based practice, or those professionals who don't keep up to date?
    One issue we face in education is a lack of 'research translators', i.e people who read research articles and distill the knowledge to busy practitioners.
    For example, the finding in the 1930s that including...

  • @AbigailMepham [Therefore sometimes I think you have to start at the end and work backwards in chunks]
    This is the sort of topic-specific requirement we refer to in Week 5 (Step 5.3) where we mention 'Subject Teaching Knowledge' *. Spending time with a mentor who is skilled at teaching a given subject can save a trainer much time from having to work such...

  • If we can be of any assistance, let us know.

  • Re the practice educator course, is there some way you can discretely feed this back? The person in question likely has no idea they they are doing this...

  • @dukustiv Certainly, see below.
    Coffield, F., Moseley, D., Hall, E., & Ecclestone, K. (2004). Learning styles and pedagogy in post-16 learning: A systematic and critical review. I think you can download a PDF here:
    Also worth reading is: Pashler, H., McDaniel, M., Rohrer, D., & Bjork, R. (2008). Learning styles:...

  • @JoanneNobleRGNMBE I'm not sure what you're asking me?

  • @NABAHYAKALIMIRA The course is free for anyone to undertake. The upgrade for NHS and affiliated staff is paid for by the NHS.
    Other organisations can fund upgrades for their staff, but unfortunately that is outside our influence.

  • @NABAHYAKALIMIRA Social distancing presents challenges to training and learning. Some of these can be overcome with blended learning approaches and active online synchronous learning, for example using breakout rooms with Teams or Zoom.
    But ultimately, whatever approach we use, it comes down to the question, 'Will we achieve the learning outcomes?'

  • @HamzaAmir [shortcuts if beneficial don't hurt, keeping patient safety as utmost priority]
    In the context of this course, we would define a shortcut as an approach which contains an element of risk to patient safety, such as through omission of a check of some kind.

  • [All of our courses are massed (including TTT)]
    You are not alone - although many colleges and other providers space TTT courses such as Level 3 Education and Training, there are a surprising number in the UK who cram them into as short a time as possible - effectively ignoring best practice

  • It is bewildering when this happens. One possibility is that such assessments have been created by someone without an educational background, and not quality checked.
    It's one of the reasons healthcare would benefit from evidence-based education.

  • Agreed. It is ironic that topics designated 'mandatory' are often offered in a way that is educationally ineffective.
    I don't think anyone actually intends this to happen, but the need to report on them tends to encourage 'delivery methods' that facilitate easy reporting.

  • @NaveedaKhan Apologies for this. FutureLearn currently don't allow anything other than free text to be uploaded (even though we asked).
    I'm hoping to find a way around this for future courses.

  • @DonnaAngell [I recently went on a course where the teacher spent the first 30mins telling what she wasn't going to teach us and why.]
    There is a classic case of this from Initial Teacher Education. Some trainee teachers had received so much content from course tutors about what they (the tutors) felt was wrong with behaviourism and BF Skinner's 20th century ...

  • @MariaFrancis Many trainers have successfully adapted courses to run synchronously on Teams or Zoom and found the breakout rooms, whiteboards etc. encourage a lot of interactivity.
    However, if you're being asked to make it asynchronous, that's more of a challenge.
    What are your topics?

  • @HassanYaqoob If you meet the criteria here , try contacting FutureLearn Support via the pink button at the bottom right of the page.

  • @JessicaMills We identified an issue - if you try again, it should work - if not, contact me via the link at the end of week 5 and I'll advise.

  • @dukustiv If a health care professional didn't know the GCS or ALS protocol and needed to read it from a chart first, then it would be JIT. However, I believe most countries require medics and nurses to have knowledge and skills such as these as part of their procedural memory skills, so they will not need to pause and read in an emergency?

  • @اسامةصادققاسمسعيدغالبمزاحم Please write in the course language so that other participants can read your comments.

  • @AmirMora Does online learning accelerate the rate of learning?

  • @YadiraNúñez Please comment using the course language then others will be able to read your posts.

  • @DierkUnterbrink Thank you! Now amended

  • @roxanaotavalo Please can you use the course language to comment so that others can read your contributions?

  • @YadiraNúñez Please can you comment using the course language so that others can read your contributions?

  • We made a conscious choice not to use educational terms and jargon on this course, and we've used 'mental models' in place of the term 'schema' in this step.
    There's a helpful and more in-depth explanation of schemas here:

  • Hi Rahmat, apologies re this - unfortunately it's a feature of the FutureLearn platform. I'm going to try again to persuade them to change it.
    Thanks for adding to the feedback on this.

  • @RebeccaFord Please contact FutureLearn Support via the pink tab at bottom right of the page. If you explain the situation and confirm your NHS status, hopefully they will be able to refund your fee.
    It was mentioned on the pre-sign up course information page, but looking at it again, I can see...

  • It's a really valid point that you raise here. It is not uncommon for trainers to bear the brunt of decisions made by others behind the scenes, and your experience is a prime example.
    Although trainers always wish to be loyal to the organisation and not criticise decisions made at a higher level, we can to some extent recognise such frustrations when...

  • @JessicaMills The free upgrade allows NHS staff and those defined as affiliated to the NHS to gain a certificate and retain access to the course material.
    However, I believe it was switched off on 18 July as that was the last day anyone could enrol on the current course run.
    When did you enrol?

  • @JessicaMills You ask an extermely pertinent question. For heutagogy to grow into a functioning element within healthcare learning, both those who support learners and the learners themselves require a working understanding of how humans learn.
    Barb Oakley's 'Learning How to Learn' course (available free on Coursera...

  • @PatrickS Yes! Thank you for spotting my mistake! (Now corrected)

  • And lecturers are not given much preparation time.
    Although as mentioned elsewhere, the first research which showed that learning is retained longer following discussion-centred activities than after lectures was published in the early 1930s.
    Research which suggests a technique which requires additional effort is not always welcomed!

  • [it appears that everyone is or has been at some point]
    Not this lead educator!
    Hans Christian Anderson's 'Emperor's New Clothes' had a lasting impact on me in this context, and I've sought educationally functional alternatives to reading from text right back from when many colleagues 'revealed' text on OHPs.
    That said, to link with your comment about a...

  • [I receive no time/resources etc for preparing educational events, nor do my colleagues]
    This is a common factor, or at least a woefully inadequate amount of time. It seems to apply across the whole teaching spectrum to some degree, and is why many school teachers hate Sundays as they have to prepare for the forthcoming week.
    The irony is that for those who...

  • [ agenda of learning to deliver...]
    It is very noticeable how often we see the terms 'deliver' and 'delivery' used in the context of trainer-centred teaching.

  • It's certainly true that for some sessions, some learners like the experience more than others.
    However, for expert trainers who create learner-centred experiences, it is much more likely that everyone will have a positive experience.

  • @IanHarwood Tempting as the notion may be, it is not in HEE's remit to inspect training in the way that the Office for Standards in Education, Children's Services and Skills (Ofsted) does for UK schools.
    By completing this course, you have joined a community of informed trainers. We hope you and others will assist in spreading the concept of evidence-based...

  • Hi Jamil
    Have you checked your eligibility via this page

  • @GillianMiller I think you've made a very valid point, many expressed preferences/styles may be a linked to having positive experiences through that medium.

  • @LynneGilbert You make a really valid point. For some learners, it is as though they feel possession of the slides equals possession of the knowledge.
    A colleague used to refuse to give detailed slides to her students, instead encouraging them to process the material and create their own notes. But she said that some would be quite vociferous about...