Getting the most out of End of Life Care for All (e-ELCA) e-learning

Categories: Education.

e-learning has gained popularity; while there are concerns over internet accessibility, digital literacy and participant motivation, its advantages include the ability to reach a great numbers of learners at the same time, as well ans being a flexible and accessible learning method for individuals (1,2,3,4).

A recent research study by the US Department of Education concluded that, on average, learners using e-learning performed better than those receiving face-to-face instruction. (5)

e-learning has been used in a wide range of ways from palliative care education in sub Saharan Africa (6) to blended learning in English care homes (7).

A recent study of GPs’ end of life educational needs reported that e-learning was the preferred method, with blended approaches recommended (8). Moreover, a recent survey indicates similar trends in multi professional European palliative care leadership programmes (9).

Health Education England also recommends the use of e-ELCA in a blended (face to face, discussion and e-learning) format for end of life education (10).

e-ELCA is one example of the e-learning available to support the development of workforce skills in end of life care.

It is a free of charge, written by experts and rigorously peer reviewed, with over 150 interactive sessions (all of which will be updated by the end of March 2016). It can be used as a single learner or by groups.

e-ELCA is supported by the Association for Palliative Medicine and NHS Health Education England and has been recommended by the NICE guideline ‘Care of dying adults in the last days of life (11).

While there remains some ambivalence about e-learning as an education method for busy clinicians and educators there are many ways to get the best out of it.

For example, e-ELCA provide Making the most of e-ELCA and Five ways to motivate and engage learners .

Blended learning

In my experience, e-learning particularly contributes to knowledge and practice through blended learning and the flipped classroom approaches. For example, when designing education programmes and workshops I plan which modules are useful for the learner to look at before attending or which interactive sessions can be used within the day itself.

It has also been useful to signpost learners onto further modules after a workshop and then use as the basis for reflective practice and discussions.

Garrison and Kanuka (12) argue that blended learning has the proven potential to enhance both the effectiveness and efficiency of meaningful learning experiences.

Moreover, others report upon the benefits of ‘blended’ e-learning programmes which incorporate a mix of classroom and distance-based learning (4). Building upon this, e-learning has a place in the ‘flipped classroom’ approach where classrooms become the place to work through problems and engage in collaborative learning (13) because some learning has already taken place (eg through e-learning).

It is also often forgotten that e-learning can take place both formally and informally on different online platforms, with different level of interactivity.  For example, informal e-learning can occur when engaging with content on YouTube or Twitter (14).

So how to use e-ELCA in the real world of palliative care and education?

Bridget Moss who is the director of education and research at St Helena’s Hospice in Colchester, Essex, reflects on how she uses e-learning:

“I mainly tend to signpost people to e-ELCA, especially when they are new to palliative and end of life care. There are specific ones I use when teaching communication skills, especially the module on empathy.“

Antonia Dean, lecturer practitioner at the Hospice of St Francis, Berkhamsted, Hertfordshire explains how she uses e-ELCA in both a flipped classroom and blended learning approach:

“There is an absolute wealth of information there presented in bite size chunks. It works best with a blended approach although some people enjoy going through it alone. I have asked people on our education programmes to access sessions before discussing a certain topic. I also use it as a library and I check e-ELCA content when I’m planning teaching.”

Professor Christina Faull, clinical lead for e-ELCA and consultant in palliative medicine at LOROS, comments: “I’ve used the e-ELCA session on discussing do not attempt CPR decisions within a study day we run four or five times a year at LOROS. It provides a wealth of factual information and case scenarios that the nurses and doctors who attend can reflect on and allows me as a facilitator to really challenge the group and their practice.

“My aim is to shift their confidence and competence in having discussions and using the session as a basis for group work adds an important dynamic. I’m there as a facilitator and expert advisor.  It’s not me delivering facts. That’s done for us. We can work together to look at complexity and be sure we all understand the framework and the challenges. It also makes teaching, especially a repeated session, very energizing for me.”

So how to get the best out of e-ELCA?

  • Think about how you want to use e-learning. Is it to refresh knowledge, learn more, stimulate debate or provide consistent learning material content?
  • See e-learning as a blended learning approach – it creates shared material to discuss and explore as individuals or groups. Engage with the variety of materials from real life case studies, articles, quizzes, videos and presentations.
  • Test out the scenarios and think to yourself how would you would react in certain scenarios.
  • Consider a flipped classroom approach where you and others complete e-learning sessions in advance and then discuss together.
  • Think about how you can use the materials in your education planning sessions to check content and use as interactive sessions.
  • Use the ‘Making the most of e-ELCA’ and ‘Five ways to motivate and engage learners’ leaflets to help you get the most out of the platform.

You can find out more about e-ELCA on the website, and if you are attending the 11th Palliative Care Congress, you can find out more about e-ELCA at the Friday morning masterclass, chaired by the APM.


  1. Ahmed H. Hybrid e-learning acceptance model: Learner perceptions. Decision Sciences Journal of Innovative Education. 2010;8:313-346.
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  3. Wee B. Can e-learning be used to teach end-of-life care? BMJ Supportive & Palliative Care. 2012;2(4):292–293.
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  5. Means B et al. Evaluation of Evidence-Based Practices in Online Learning. US Department of Education; 2010. Available at:
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  7. Farrington CJ. 2014. Blended e-learning and end of life care in nursing homes: a small-scale mixed-methods case study. BMC Palliative Care. 2014;13(1):31. Available at:
  8. Magee C, Koffman J. Out-of-hours palliative care: what are the educational needs and preferences of general practitioners? BMJ Supportive and Palliative Care. 2014. doi:10.1136/bmjspcare-2014-000764
  9. Koffman J et al. Meeting the Needs of Emerging Leaders in Palliative Care: Results from a European Wide Online Survey. 2013.
  10. The Democratic Society. Training and education in end of life care: recommendations for Health Education England 2015.
  11. NICE. Care of the Dying Adult. NICE; 2015. Available at:
  12. Garrison DR, Kanuka H. Blended learning: Uncovering its transformative potential in higher education. Internet and Higher Education. 2004;7(2):95–105.
  13. Tucker B. The flipped classroom. Education Next. 2012;12(1):82-83.
  14. Kassens-Noor E. Twitter as a teaching practice to enhance active and informal learning in higher education: The case of sustainable tweets. Active Learning in Higher Education. 2012;13(1):pp.9–21.

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