Teaching Lean Online

University of the Highlands and Islands P G Cert in Healthcare Quality Improvement

I teach and coach within the NHS, and I was excited when the University of the Highlands and Islands – UHI – gave me the chance to teach on line.

The Course

UHI wanted to establish an online Postgraduate Certificate in Quality Improvement, linked to an existing MA. There is a lot of focus on healthcare quality in Scotland, through the Scottish Patient Safety Programme (SPSP) and the iHub. There are some excellent on line resources, but it’s not always easy to find University accredited courses.

The University linked three modules – a Lean module, a QI Science module and a Patient Safety module, and obtained accreditation to offer them as a Post Graduate Certificate. The course is taken on line, over three semesters.

I was pleased to be asked to co-design the Lean module, and to lead the module teaching. The challenge is how to make a course on Lean – a practical subject – work on line.

Developing the Module

Working with a colleague, Brian James, and with support from NHS Highland, we decided there were important principles we wanted to embed in the content and method of delivery:

  • Link theory to application
  • Give people as much opportunity as possible to reflect on application to their own practice
  • Encourage participants to try out methods in their workplace
  • Maximise the opportunity for participants to learn from one another
  • Let participants hear as many different voices as possible – no one person can know everything about the application of Lean


Semesters last roughly ten weeks, so we structured the on-line Lean teaching materials in to five main blocks, to help students to pace themselves. We set a combination of voluntary and assessed assignments during the course, which are posted to a shared Discussion Board. This helped to encourage students to use the Board. As the assignments were public, there was discussion of the postings, which supported the interaction we wanted and let people reflect on experiences in other settings than their own.

Over the course of the semester, I ran eight optional evening webinars. Some of these dealt with housekeeping – course structure, approaches to questions, responses to items that came up on the Discussion Board and the like – but most of the webinars were planned to let participants hear from other people. The people who kindly gave up their time to lead sessions included national leaders, such as Iain Smith, service managers, and Lean practitioners. There was no payment to the speakers, and it was humbling to discover the number of people who were willing to give up part of their Monday evening to share their experience with others.


20 people enrolled for the module – the maximum number the University wanted on the course in its first year. Some people had to defer because of competing demands, but of the 18 people who took part in the assessment process, all passed. Feedback from the external examiner on the quality of the assignments was very positive, and students seemed to enjoy the course.

I was flummoxed, but delighted, when students nominated the course for a University award as ‘engaging‘ This was a reflection of the time and effort the external speakers, and the students, put in to the course.

The University plan to run the course for a second time in 2020/21, and may decide to offer the course to international students in due course. My focus is on expanding the tutor base, and two colleagues have agreed to shadow me this year, so that we can scale up if there is demand, and to give us a succession strategy.

My main learning from the work is that the same things that work in person, work on line. People don’t want you to go over things they can read for themselves. They want to think about application and about how they can use ideas to benefit their patients. People want the chance to learn from one another, and from people who have tried out ideas in practice.

I was anxious about moving my usual coaching practice on line: I need not have been. If you have the chance to teach on line, my advice is not to hesitate – people are people, and they are hungry to learn methods that can help to improve their service, no matter the medium of delivery.

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