COVID-19: essential training is still possible

How to use distance learning to keep skills developing and morale boosted

Moving study days online ensures skills can still be developed. Image: iStock

When departments are busy or short staffed, its not uncommon for training to be cancelled, which can result in fewer staff having expert skills and lower staff morale.

In my role as a practice educator at the Bournemouth Royal emergency department (ED) I am well placed to identify gaps in training and provide in-department learning opportunities.

Scarcity of triage-trained nurses

Amid the COVID-19 pandemic, high levels of staff sickness absence due to illness and self-isolation were anticipated, so I understood that as a result there would not be enough triage-trained nurses available.

This shortage would present a risk to patient safety: there would not be an expert available to determine the clinical priority of patients arriving into the department and ensuring that the sickest patients receive timely care.

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Triage is a key emergency nursing skill, previously taught at my trust, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, via a full study day and multiple supported shifts in triage, before a final assessment by a member of the senior nursing team.

However in the current climate this level of face-to-face training is not possible, due to social distancing measures, service demand and staffing pressures.

To overcome these challenges, and ultimately provide a continuous service in the ED, a triage distance learning programme has been created. The programme comprises a theoretical self-directed learning document, assessment activity workbook and competency assessment.

The programme aims to:

  • Provide a continuous professional development opportunity for staff to develop new skills during a time of unprecedented service demand.
  • Provide a training opportunity that can be completed while respecting social distancing measures.
  • Enable a large number of staff to complete training without affecting service delivery or staffing levels on the shop-floor.
  • Safeguard patient care.

On completion of the distance learning programme, staff are assessed by the practice educator and, if deemed competent, could then triage in the department if required.

To ensure patient safety, only nurses who have a minimum of six months’ emergency nursing experience are eligible to undertake the programme. It has also been used as refresher training for experienced emergency nurses who have been redeployed to the ED during the pandemic.

Staff feedback has been positive; overall, staff are pleased to have the opportunity to undertake training at a time when most has been cancelled. Those staff who have previously performed triage but who have not recently worked in emergency care report feeling reassured at being able to ‘top-up’ their skills.

Top tips for developing a distance learning package where you work

  • Identify an area in which training is required: this may sound obvious but it is key. Once identified, explain this need to the people who will be undertaking the training – no one wants to do training unless there is a clear patient benefit
  • Form learning outcomes: when planning for any teaching, identifying the intended learning outcome ensures you remain focused on delivering the most useful content
  • How will learning outcomes be measured? To evidence that education has been effective, learners will need to demonstrate that they have met the learning outcomes; this could be through a variety of activities (reflective accounts, multiple-choice questions or practical examples)
  • Make it accessible: learners need to be able to access the education package easily, this could be online or in written document. Consider learners who have additional needs – using dark text on a pastel background and the use of pictures may appeal to learners who have dyslexia
  • Make it achievable: if the perception of the learner is that the time taken to achieve competence in a skill will outweigh the benefit of completing the learning, they will lack motivation and may fail to engage


Following an offer to collaborate via Twitter, this programme has now been shared with ED educators across the UK.

About the author

Jennifer Wilkins explains how to adjust training during COVID-19
Jen Wilkins is the practice educator in the emergency department at Royal Bournemouth Hospital. She is undertaking a PGCert in higher education and is a Resus Council UK instructor