Hybrid Training: e-learning model in Promotion of Mental Health

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Background
This is the era of technology; the world is getting smaller thanks to the internet. It is impossible to think of life without the internet. Internet has become an indispensable part of all industries and in the last decade has been widely incorporated in the healthcare sector. It shouldn’t come as a surprise to anyone that internet is increasingly being used and accepted as a medium for mental health service delivery across the world. Since, internet has the potential for providing universal interventions and promoting the psychological wellbeing.
The Virtual Knowledge Network at NIMHANS- ECHO (HUB and SPOKEs) is been running in collaboration with Project ECHO, University of New Mexico, USA. In this model there are weekly live multi-point video conference sessions for Doctors in the periphery ie. The General practioners (GP) working in PHC’s. The GP’s get an opportunity to present clinical cases & get suggestions / guidance from the network Expert didactic modules covering various addictive disorders are carried out for these GP’s. The GP’s are awarded with a certificate of completion /CME points on completion of module evaluation.
VKN hybrid training is one of a kind training programme in India, which is helping medical, mental health and allied professionals to come under one roof through the power of internet and technology advancements. This way the people from various diversities come under one channel and share and learn new theories, concepts and their experiences of the cases they see during the practice. The challenges of working with a virtual session range from adapting existing teaching/skilling behaviors to competing for participant’s/learners attention in an environment that one has limited control over. The benefits of the hybrid training synergize to offer a unique skilling experience to the learning champions.
Observations
The scholars of one-year Fellowship in Mental Health Education were posted in the Virtual Knowledge Network at NIMHANS, to learn and understand how use of virtual learning can become an innovative mode to enhance training and learning in the field of mental health education, among masses staying at different parts of the country.
In spite of belonging to diverse backgrounds, the VKN posting was a new experience for all the Fellowship scholars. The one month rigorous posting at the Virtual Knowledge Centre gave them an insight of the potential of e-learning in terms of promoting Mental Heath Education. The scholars also witnessed, how much work goes into making the virtual lessons available to the participants, behind the scenes of the live sessions which were conducted twice a week along with the technical difficulties the team had to face and the brilliance with which the overcame it.
During the VKN sessions it was also observed that, online health education has the potential to be the best of both worlds – to counter some of the barriers that prevent some people from seeking formal professional help by providing anonymity and easy access, while providing more in-depth and evidence-based information and guidance which might not be received from other informal sources such as friends or family members a finding which was also reported in other studies.¹
Implications
In the past decade, there has been increasing interest in the use of the internet as platform for the delivery of public health interventions. Thus far, positive outcomes have been reported in RCTs of internet interventions across a wide range of clinical outcomes including and not limited to mental health problems1 ² In this regard, The Department of Mental Health Education, NIMHANS simulating the Virtual Knowledge Network (VKN) model has planned to roll out a virtually interactive training session “First Aid for Mental Health” with the objective of giving people, a set of basic skills to assess those at risk for developing mental health problems and to provide initial assistance. At the end of the session, the participants would benefit by being able to spot the early signs that could lead to a mental health problem, feel confident helping someone experiencing a mental health problem, provide help on a first aid basis, help stop a mental health problem from getting worse, help someone recover faster and guide someone towards getting the right support.
This course is being developed targeting professionals, non professionals, students and care-givers in the community. This course has been successfully running in real time by the Department of Mental Health Education, for the past 2 years and more than 400 people have been trained in this programme. Due to an increased demand from the people across the country and abroad the department has taken the initiative to start with this e-learning program.E-learning is a computer based educational tool or system that enables you to learn anywhere and at any time.
Today e-learning is mostly delivered though the internet, although in the past it was delivered using a blend of computer-based methods like CD-ROM. Technology has advanced so much that the geographical gap is bridged with the use of tools that make you feel as if you are inside the classroom.³E-learning offers the ability to share material in all kinds of formats such as videos, slideshows, word documents, PDFs or a Videoconference. Hybrid training model includes all these methods to impart knowledge and education.
Strengths & Limitations
The success of the e-learning model depends on two reasons. We’ll first talk about the Pragmatic Reasons which makes the model stand out, reduced travel costs for trainers and trainees, being able to deploy training quickly and the facility of reaching out to a wider population in a small time. The second are the Instructional Reasons which make the model more effective than other tools. The option of having a real-time interaction between learners and instructor, the option of content visualization and the most important is collaboration among participants and moderate social presence. All these reasons are imperative for the success of the e-learning model in mental health setting.⁴
To make it simple, imagine a real life scenario in a classroom. In an effort to enhance the credibility of course material, oftentimes a professor will summon a field specialist to give a lecture relevant to the topic at hand. In the traditional model of education, the professor would have to extend an invitation to said expert, and incur the costs of his flight, stay and training. With e-learning the professor has the ability to host a guest lecture without having to spend much money. It can be done virtually, with cameras for both the lecturer and the students, and with the use of microphones to facilitate the same level of interaction that would be possible if the lecturer were physically present in the room. The added benefit comes in when we are able to replay the lecture and gain even more out of it. Students that missed out can view the recording, or students that attended can watch it again to further their understanding.
This model has its own share of challenges and shortcomings. To name a few, there are a lot of technical issues one can experience with this platform, someone who is not technology savvy is in for a lot of trouble. The lack of interaction and engagement with participants is also a drawback of this model, although some might argue it is a blessing in disguise for people with social anxiety, but for most of the people basic human interaction is important and not everybody is comfortable sitting alone and learning. Moreover, practical skills are somewhat harder to pick up from online resources. There are some health concerns also, e-learning requires the use of a computer and other such devices; this means that eyestrain, bad posture and other physical problems that may affect the learner. Another difficulty with this platform is the lack of awareness in the community about such programs. The most important hurdle is preparing instructors to deliver training virtually, because the best of the minds in our country have a lot of catching up to do with technology and as already mentioned most of the people are of the school of thought that traditional blackboard teaching is the most effective.
Conclusion
Some of the most important developments in education have happened since the launch of the internet. This is the twenty first century and in this age of technology and globalization people use the internet for everything from learning how to cook on YouTube to getting knowledge on various diseases they might be suffering from on Medscape. There is a need for a reliable repository of information for the masses, which gives them appropriate, scientific and trustworthy information. Although the potential for broad population reach with Internet interventions is substantial, the current (albeit limited) evidence suggests that there are low levels of actual reach across a range of settings specially health care.
That is where e-learning modules come into picture. E-learning is here to stay, as computer ownership grows across the globe e-learning has become increasingly viable and accessible. Internet connection speeds are increasing, and with that, opportunities for more multimedia training methods arise. With the ismmense improvement of mobile networks in the past few years and the increase in telecommuting, taking all the great features of e-learning on the road is a reality with smartphones and other portable devices. Since they are very simple to use, easily accessible and not very difficult to update and maintain. It is the future of education in general and Mental Health Education in particular.
References

1. Griffiths F, Lindenmeyer A, Powell J, Lowe P, Thorogood M. 2006. Why are health care interventions delivered over the Internet? A systematic review of the published literature. J. Med. Internet Res. 8:e10

2. Bennett, G. G., & Glasgow, R. E. (2009). The delivery of public health interventions via the Internet: actualizing their potential. Annual review of public health, 30, 273-292

3. The New Virtual Classroom: Evidence-based Guidelines for Synchronous e-Learning, Ruth C. Clark, Ann Kwinn; ISBN: 978-0-7879-8652-0; March 2007, Pfeiffer

4. (2014). E-learning Concepts ,Trends, Applications (Vol. V 1.1) Retrieved September 22, 2017 from www.efrontlearning.net