As the DIGIHEALTH project moves from design to implementation, the alpha and beta pilot phases has offered a critical opportunity to test not only the content of our training modules, but the assumptions that underpin them. Across Lithuania, Austria, Greece, Germany, and Italy, early piloting activities have brought internal and external testers: care assistants, VET educators, and healthcare organisations into direct engagement with the DIGIHEALTH E-Course materials.
What emerges from this phase is not simply feedback on training effectiveness. It is a clearer understanding of how digital upskilling actually happens in practice — within the constraints, routines, and realities of frontline care work.
The DIGIHEALTH E-Course were developed in response to a well-documented gap: the mismatch between the digital competencies required in modern care environments and the training accessible to care assistants and home helpers at EQF levels 1 and 2. The pilot phase was designed to test whether a modular, accessible, and context-sensitive learning approach could begin to close this gap.
Initial implementation confirms one of the project’s central assumptions: accessibility is not a secondary feature of training design — it is the determining factor of participation. Modules that could be completed in short segments, accessed via mobile devices, and delivered in clear, non-technical language saw significantly higher engagement across all partner countries.
Participants consistently highlighted the importance of flexibility. As one care assistant involved in piloting in Greece noted:
“I could do this after my shift, in small parts. If it was like a normal course, I would not start it.”
Findings from DIGIHEALTH field research and existing literature consistently indicate that time constraints and inflexible training formats limit participation in digital upskilling among frontline care workers.
Across all pilot sites, care assistants and home helpers expressed a strong sense of relevance and immediate applicability of the training content. Rather than abstract digital concepts, participants engaged most with modules that directly reflected their daily tasks — documentation, communication with colleagues, and navigating digital care systems.
A participant in Germany described this shift succinctly:
“Before, I was afraid to make mistakes in the system. Now I understand what I am doing, not just clicking.”
Research on the adoption of digital nursing technologies shows that confidence and effective use depend on adequate training, alignment with workflows, and users’ understanding of how technologies support care delivery (Walzer et al., 2025).
At the same time, feedback also reveals the diversity of starting points among participants. VET Teachers in Lithuania noted that differences in language proficiency, prior exposure to digital tools, and educational background required continuous adaptation of facilitation approaches. In practice, this meant slowing down delivery, incorporating more guided discussion, and allowing space for peer learning.
The pilot phase has also reinforced the central role of VET educators in translating digital content into meaningful learning experiences. While the E-Course provides the foundation, the Academy’s facilitated activities will be essential in building confidence, especially among participants with limited prior digital exposure.
Teachers reported a need for creating a supportive, non-judgmental learning environment is as important as the content itself. In several pilot sessions, participants initially expressed hesitation or anxiety about engaging with digital tools. So the training environments will support this in creating space for questions, repetition, and collaborative problem-solving, to decrease hesitation.
A VET trainer in Lithuania reflected:
“The biggest change is not skills — it is mindset. When they realise they can learn this, everything opens.”
Findings from Eurofound (2025) also highlight that training participation among care workers is shaped by working conditions, time availability, and access to employer-supported learning opportunities.
While the overall response to the DIGIHEALTH modules has been positive, the pilot phase has also highlighted several persistent challenges.
Time remains the most significant constraint. Even with flexible formats, care assistants often struggle to allocate uninterrupted time for learning within demanding work schedules. In some cases, participation depended heavily on employer support — including allowing training during working hours or recognising it as part of professional development.
A second challenge relates to infrastructure. In several pilot settings, limited access to devices or stable internet connections affected the consistency of participation. This highlights a broader structural issue: digitalisation efforts are not always accompanied by the practical resources needed for frontline staff to engage with them effective.
Finally, the diversity of the workforce continues to require careful consideration in training design. Language accessibility, cultural context, and varying levels of formal education all shape how training is received and applied. Research on gender and care work highlights that training models which do not account for these factors risk reinforcing existing inequalities in access to professional development.
Despite these challenges, the pilot phase has already demonstrated tangible outcomes. Participants report increased confidence in using digital systems, reduced reliance on informal workarounds, and improved communication with colleagues through digital platforms.
In several pilot sites, VET teachers observed that care assistants began to support one another informally — sharing knowledge, troubleshooting issues together, and encouraging continued learning beyond the structured sessions. This peer-to-peer dynamic represents an important, often underestimated dimension of sustainable upskilling.
Emerging evidence suggests that even small gains in digital competence can improve aspects of care quality. Research in digital health and nursing literature indicates that structured digital training is associated with improvements in documentation practices, workflow efficiency, and user confidence. While the DIGIHEALTH pilot phase is not designed as an impact study, early observations point in a similar direction
The insights gained from piloting are now feeding directly into the refinement of DIGIHEALTH outputs. Adjustments are being made to module length, language simplicity, and the balance between self-paced and facilitated learning. Additional guidance is being developed for trainers to support adaptation to diverse learner needs.
Crucially, the pilot phase reinforces the importance of co-creation. Effective digital upskilling cannot be designed in isolation from the people it is intended to support. It must be shaped through continuous dialogue with care workers, educators, and organisations — not only as end-users, but as active contributors to the learning process.
The project is coordinated by VsI Integruotu Sveikatos Paslaugu Centras (ISPC) in Lithuania, the country’s first provider of palliative care services. The research work package is led by Ostfalia University of Applied Sciences in Germany. FRODIZO in Greece, with experience training over 700 caregivers, leads the E-Course development. Consorzio Cooperative Sociali GLOBAL MED CARE in Italy, a consortium of 26 social cooperatives, leads the Academy development. Mainstreaming and quality assurance are coordinated from Vienna, Austria. Together, this consortium spans multiple national healthcare and VET contexts and brings together expertise from higher education, vocational training, and frontline care provision.
The pilot phase marks an important transition for DIGIHEALTH — from identifying the problem to actively testing solutions. Over the coming months, further pilot activities will expand, and insights from implementation will continue to shape the final versions of the E-Course and set up the content for the Academy.
Digital transformation in healthcare will not succeed through technology alone. It depends on the people who use it — and on whether they are given the tools, time, and support to do so effectively. The experience of piloting DIGIHEALTH modules confirms that when training is accessible, relevant, and grounded in real work contexts, meaningful change is not only possible — it is already beginning.
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DIGIHEALTH — Emerging Digital Competences of Healthcare Staff — is an Erasmus+ Cooperation Partnership in Vocational Education and Training (KA220-VET), funded by the European Commission. The project runs from December 2024 to November 2026. This publication reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein.
