Translating research into practice: Evaluation of an e-learning resource for health care professionals to provide nutrition advice and support for cancer survivors

J Murphy, L Worswick, A Pulman, G Ford, J Jeffery
Nurse education today 35 (1), 271-276
Nurses and other allied health professionals are in a key position to provide appropriate and consistent advice on nutritional issues to support cancer survivors. However gaps in their nutrition knowledge and education warrant the need for enhanced learning as part of their Continued Professional Development (CPD). In the UK there are currently no formally recognised nutrition education programmes. Therefore e-learning offers a solution to provide flexible learning to target this need.

This study aimed to develop and evaluate the efficacy of a freely available, internet-based learning resource, for nurses and allied health professionals who provide nutrition, diet and lifestyle advice for cancer survivors. It sought to explore the attitudes and conceptions of the resource and current knowledge base of those involved in the care pathway for cancer survivors.

The design and development of the e-learning resource were informed by the best available research and policy evidence and in a format to facilitate on-line learning. A robust evaluation strategy incorporated focus groups and telephone interviews to gain in depth insights into the experiences of using the resource.

Themes included ‘Plugging a Gap’ which shows an improved knowledge base for nutrition. Information was ‘All in One Place’ showing that the resource was valued as being within a ‘trusted’ organisation. ‘Everyone Benefits’ illustrates how learners felt that the resource provided them with an evidence base, whilst the ‘Current and Live’ theme captured how professionals felt about the information being up-to-date.

The project has shown the benefits of interprofessional working to develop an e-learning resource for Health Care Professionals to support cancer survivors in following healthier lifestyles. Positive attitudes and potential improvements in the knowledge base and changes for professional practice were demonstrated. Further research is required to gauge sustained impact in the work environment by embedding the resource as part of CPD.


Munchausen by Internet: Current Research and Future Directions

Pulman, A. and Taylor, J., 2012.
Journal of medical Internet research, 14 (4).


The Internet has revolutionized the health world, enabling self-diagnosis and online support to take place irrespective of time or location. Alongside the positive aspects for an individual’s health from making use of the Internet, debate has intensified on how the increasing use of Web technology might have a negative impact on patients, caregivers, and practitioners. One such negative health-related behavior is Munchausen by Internet.

Munchausen by Internet occurs when medically well individuals fake recognized illnesses in virtual environments, such as online support groups. This paper focuses on the aspect of Munchausen by Internet in which individuals actively seek to disrupt groups for their own satisfaction, which has not yet been associated with the wider phenomena of Internet trolls (users who post with the intention of annoying someone or disrupting an online environment).
A wide-ranging review was conducted to investigate the causes and impacts of online identity deception and Munchausen by Internet drawing on academic research and case studies reported online and in the media.
The limited research relating to motivation, opportunity, detection, effects, and consequences of Munchausen by Internet is highlighted and it is formally linked to aspects of trolling. Case studies are used to illustrate the phenomenon. What is particularly worrying is the ease with which the deception can be carried out online, the difficulty in detection, and the damaging impact and potential danger to isolated victims.
We suggest ways to deal with Munchausen by Internet and provide advice for health group facilitators. We also propose that Munchausen by Internet and Munchausen by Internet trolling should be formally acknowledged in a revised version of the Diagnostic and Statistical Manual DSM-5. This will assist in effectively identifying and minimizing the growth of this behavior as more people seek reassurance and support about their health in the online environment. We also suggest directions for future research.

How young adults with type 1 diabetes interact with technology and how their views and experiences can inform the development of a patient-centric mobile health app

AJ Pulman, 2016
Bournemouth University


Views of young adults with type 1 diabetes are vital in developing quality support services and improving their lives, yet research on their lifestyle and use of technology to support their condition is sparse.

(1) Develop an insight into use of Internet and web/mobile technology and its impact on the lives of young adults, by understanding their experiences from qualitative interviewing, exploring how they made use of technology concerning their lives and condition.
(2) Utilise sociotechnical design principles and develop a mobile app, seeking participant opinions on design and usefulness during the development cycle.

Data collected through semi-structured, qualitative interviews (n=9) of young adults aged 18-21 with type 1 diabetes. Data analysis undertaken during initial interviews (n=4) to locate ideas for development. Later interviews assisted in the iterative design process (n=5). Pre-launch feedback also obtained from clinical staff (n=5). Evaluation data collected from different young adults from a wider range of demographic backgrounds post launch (n=11) on app usability, usage and usefulness.

Six themes were identified providing an understanding of participant experiences with their condition and their use of technology. From suggestions prototyped, a clinically approved mobile alcohol guide app was developed. Post launch data analysis identified six different themes relating to app usability, usage and usefulness.

The study contributes to new knowledge regarding:
(1) The lives of young adults with type 1 diabetes, by providing examples of how their lives could be improved based on use of the Internet and web/mobile technology.
(2) The technical development process, by documenting best practice procedures and principles involved in creating a patient-centric educational health app (downloaded globally 2,639 times as of July 2015).
(3) Policy, by highlighting areas where care and support were lacking in the target group and where there were gaps in knowledge and understanding.

Link to thesis

Empathy and Dignity through technology

A Pulman, K Galvin, M Hutchings, L Todres, A Quinney, C Ellis-Hill, … (2012)
Electronic Journal of e-Learning 10 (3), 349-359

A person’s sense of dignity is a complex phenomenon and is intertwined with their sense of feeling human and being respected as a human being. In 2010, the School of Health and Social Care developed a collaborative lifeworld led transprofessional curriculum for health and social work disciplines harnessing technology to connect learners to a wider view of evidence based practice. The purpose was to increase use of technology-enhanced learning, introduce lifeworld-led philosophy to the curriculum, release staff potential, and expose students to research undertaken within the School. Delivered to undergraduate students the Exploring Evidence to Guide Practice Unit was facilitated by a number of resources including lectures, group work and a variety of web-based learning materials.
Central to the unit were seventeen web-based case studies which included the human experience of the impact of specific illnesses (such as stroke and living with dementia) and more general experiences (such as social isolation and homelessness). Each case study provided stories and poems, qualitative and quantitative research and policy and practice issues related to specific topics.

At the heart of the philosophy underpinning the unit was an opportunity for students to integrate understandings about different kinds of knowledge for practice, conventional evidence, understandings about the person’s or service user’s experience and the student’s own insights that came from imagining ‘what it was like’ for the person experiencing a condition or situation and encountering human. The project built on the successful development of Wessex Bay, a virtual community of case scenarios, used as problem-based triggers to engage students in learning activities relating to residents.

This paper discusses the development of the web-based case studies and how they integrated visual and audio materials with the aim of enhancing the lifeworld experience of students and helping to show the importance of humanising healthcare.

Link to article