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Blending Instructor-Led Training and eLearning to Save Lives

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Presentation by Leanne Batchelder

Instructional designers and developers know that a blended learning approach is ideal, but where to begin? Learn about the design and development of a patient training curriculum that saves lives by building skill and confidence in a complicated medical therapy--through the use of online simulations, e-learning, videos, quick reference guides, and a variety of nurse tools.

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    good presentation
    good going with blended learning and elearning.
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  • Our Objectives today:Explain how learner demographics (in this case older learners) impact training designIdentify ways to gather critical, stakeholder feedback.Identify ways to incorporate multiple training solutions into ONE cohesive toolkitAsk learners “Why Blended?” “What does Blended mean?” “When have you used it?”
  • Set up activity: As we get started looking at what blended learning really is, and is not, let’s take a moment to do a quick inventory of your current practices and perceptions.I’m going to display a series of statements. Use your handout to mark your response as I review the statements. You’ll then be able to score your results.Your three response options to each item are:YesNoNot Sure
  • How many of you would rate your current courses as Highly effective?So-so?Low?Transition: You’ve got a starting point. Let’s see if we can identify how using a blended learning approach can help you improve the effectiveness of your training curriculums.Blended learning for today’s purposes means:blending a mix of delivery methods and engagement methods.ensuring that we are creating meaningful, memorable, and motivating learning experiences along the way in digestible chunks. not assuming ONE solution can do all things or meet all learning objectives.
  • Provide details on the customer, treatment, and current state of training:Home hemodialysis therapy: a mix of using the device, “sticking” yourself with needles, learning about the illness, and basic wellness/nutritional issues.Patients as learners: Average age 58. Not in good health. Besides needing dialysis, often have other health issues. Must be “prescribed” the therapy.Caregivers as learners: Mostly spouses and children; sometimes siblings. Patient must have caregiver participation and support to qualify for therapy. Ideally, patients and caregivers should be equally skilled and knowledgeable upon completing the training.Therapy is complex and intimidating. Patients must overcome being scared. Nurses are not trained educators. Current training tool is the 1000+ page detailed User Guide for the device and any materials dialysis centers put together “on the fly”—some nurses create their own so even with in one center, training is not consistent. Training is primarily “Show and Tell.”Doctors hesitate to prescribe therapy due to backlog of patients needing training, length of training, and current drop rate.
  • Analysis tools and techniques: therapy/training observations, focus groups, online patient surveys, 2-day process map and design workshop with nurses and clinical educators, review of existing training materials, review of customer call logs and dialysis call logs. We used:Focus group questionnairesSurvey monkey for online surveys to groupings of patients/caregiversProcess mapping techniqueContent/training material mapping techniqueTransition: We heard from ALL stakeholders, from the learner to the trainer to the business owners. Once most of the analysis was gathered, we brought the exemplar trainers and business owners together to find out “What’s going on with the CURRENT learning experience and what should the FUTURE state be?” We called this the Process Map workshop. A powerful and insightful analysis and design tool.
  • Explain Process Map workshop.Each post it was a learning objective and each color was a topic. So we had color coded topics and many learning objectives for each one. We asked participants to plot the post its on a 4 week calendar to show us what the current state looks like.This is the result of one critical activity of the workshop: Mapping out the current training programAs you can see, it is jammed packed with topics across 3-4 weeks. Day 2 of week 2 is the “Dr. Phil” moment of breakdown and drop out for many patients. Transition to detailed timeline (behind workshop photo) to show the topic names and stress the technical nature of the topics, as well as the amount of them on any given day.
  • SHOW ANALYSIS REPORTTell participants to go to handout and review analysis results. Then, have Steve go to analysis report and share more insights from survey. Specifically:Average age 58 with other health issuesAll have internet access and technology/devicesAll thought training was the right lengthAll agreed remembering the process steps was the hardest thing, along with troubleshooting.Everyone wanted more visuals and demos.Flipchart participant ideas for designing the curriculum.
  • Improve training process for nurses – nurses will still be crucial to success. Process will still be approximately 3-4 weeks in length.Use video (including interactive video) and other technologies. Reduce and organize materials. Use photos, graphics and checklists – avoid so much text.
  • Emphasize the following: The curriculum is divided into five topical areas. We have assigned numbers, colors, and icons to the topics and will use them in the branding of all materials, so the organization and structure of the curriculum is clear and easy-to-use for learners, trainers, and clinical educators. All topical areas, sections, courses, and solutions are conversationally titled and action oriented. Simple and easy to understandAll verbiage is real—emotional and yet positive!
  • Process MapBefore we could identify the tools needed to support learning, we first identified the “ideal” training process map. With subject matter experts, we looked for efficiencies in the training process for a single learner. The goals were to:Accurately identify how long it takes (on average) to train a learner.Move topics within the training period to increase retention and decrease feelings of being overwhelmed for both trainers and learners. Provide a mix of training tools and techniques to increase SHOW and DO in order to improve learner engagement and knowledge/skill retention.
  • SHOW DESIGN DOCEach topic relies on a blend of tools and techniques for optimum learning success:Self-StudyKeeping it clean: An e-learning course that focuses on dirty, clean, and sterile concepts as well as sterile techniques and precautions.Video: 2 minute how-to on proper hand washing techniques.Video: 3 minute how-to on safely handling cycler and needle connections.10 Min Nurse-Led, Quick Reference Guides and Flipbooks:How Do I….Take Precautions? Universal precautions tip sheet.How Do I…Sterilize? Nurse leads hands-on demonstration using GlitterBug lotionHow Do I…Prevent Infection? Photos or illustrations of infected areas to illustrate signs of infection.  
  • What do we mean by tools and techniques?Self-Study: Tools meant to be taken online. All ten online modules share these characteristics:Accessed on the patient portal via a PC or laptopPatient may complete online modules during treatment, or outside of treatment time.Even if the tool is a video only, it will still be accessed online rather than via a DVD player.Nurse-Led: Tools include 22 quick reference guides and are used by the nurse in conjunction with a master Nurse Guide and visual Flipbook to teach all concepts and skills.
  • EXIT PPT AND GO TO EXPLORER TO SHOW 3 SAMPLES: KEEP IT CLEANNOT AS SCARYCOMPLETE TREATMENTExamples showcase use of:Large fontClean UISimple navigationLots of visuals, less textPractice opportunitiesVideoReal people, real emotionsSimulationSee how the quick reference guide, nurse guide, and flipbook samples show coordination across all tools and props.
  • One topic trained using: Nurse guide—kicking off topic with small intro/lecturette. TELL E-learning course TELL Video SHOW Nurse flipbook to review key concepts from video/e-course and to SHOW concepts in action Nurse uses prop—glitter bug lotion—to SHOW Learners practice hand washing techniques DO Learners use quick reference guide as they DO
  • We realized we couldn’t just give nurses the new training program and toolkit and assume they knew how to put all the pieces and parts together. We had to train them and give them their own set of tools. In addition, we had to convince them that moving beyond lecture was a GOOD thing and would be beneficial to them as well as their patients.GOAL: Creating a repeatable training process that is easily learned and implemented across a variety of locations with a variety of learners and trainers.
  • We created a Train-the-Trainer program to help clinical educators encourage, teach, and support the new blended learning curriculum, that included a one-on-one workshop with nurses (about 1-2 hours in length) on the importance of adult learning principles. Concepts featured include:Primacy, recency, and difference 7 +/- 2 and other ways to avoid cognitive overload Importance of emotion and fun in learning Difference between a facilitator, coach, and presenter and techniques to use for each roleThe program includes techniques that nurses should implement when teaching patients as well as practice activities the clinical educator can use during this mini-workshop and throughout the five days of practice/observation. The guide will include “each teach” and “see, do, practice” approaches to help nurses get comfortable incorporating adult learning concepts and using the patient training tools. Case studies of “typical patient challenges” will help nurses think through how they might alter their training technique for a specific patient. Other activities will require nurses to rephrase highly technical, medical “speak” into more conversational, laymen’s term explanations.
  • TRAINER TESTIMONIAL 1:Nithya,I want to thank everyone who worked on the new NxStep training material.  I Love it.  We trained 3 patients using the previous training supplies and I was dreading training any more.  There was no direction to follow with that training material.  This new information is wonderful.  I feel very confident I will cover everything the pt needs to know with home hemodialysis using NxSteps.Thank you, thank you, thank you,TESTIMONIAL 2:I was following up on a case at the above acct and speaking to Ruthie Sims and she told me how much she enjoys using NxSteps! She said she went to Nithya’s training workshop in Ohio and really thought she was going to continue to train “her way”. (I think with Nithya persuasion)Ruthie agreed to give it a go and is very satisfied!!She said it makes a lot of sense, she thinks patients grasp the material quicker. Ruthie is “tickled to death” with the tool. She has trained 2 patients so far using NxSteps. These patients went home and she had to call them; she usually expects several calls from patients the first week and these 2 patients were comfortable with the procedures.  It was great to hear her enthusiasm and I wanted to share with you both. Congratulations!!!!
  • Week one: one-on-one with clinical educator. Trainer completes full curriculum experience but “accelerated” along with all online modules and quick reference guides as a learner. Goes in topical order same as traditional learner. Areas of red are specific to prepping to teach. Notice day 5, week 1 is prepare for first learner.Week two: Morning spent teaching new learner using all tools in toolkit, with assistance and observation by clinical educator. Afternoon spent receiving feedback from clinical educator and prepping for next topical day with learner. Day 5 week 2 is trainer assessment and recap/next steps.RESULTS as of May 2012:We have trained 613 centers, which represents 75% of our total since last July. Our last class is scheduled for June1st.We now have 1154 pts currently trained with NxSTEPS, which is about 42% of new patients starting since March 2011 when the pilot started.The controllable drops have gradually improved to a difference of 3%. NXSTEPS trained drops are 10%, non- NxSTEPS trained are 13%. They means some decent improvement in revenue, as well. Business goals are getting met! (Since this report, drop rates have improved by 6%)We have very positive feedback almost consistently, esp from the newer nurses in Home Hemo. They are very grateful to have such good resources and tools to help them train. Some of the "older" nurses that have trained much longer can be resistant to changing what they do, but we expected that. And even some of then have been very happy with what we have for them to use now.
  • Tools to support analysis and design tips include:Learner and trainer surveys and focus groups, observationsTechnical specifications questionnaire for IT department/contactTraining process mapping Design workshop
  • Tools to support development tips include:Image library organized by topicCharacter profiles spreadsheetScreen template catalog
  • Transcript of "Blending Instructor-Led Training and eLearning to Save Lives"

    1. 1. Blended Learning to Save Lives Session #611 2/20/2013
    2. 2. Agenda1.Introduction2. Spotlight on a project3. Designing a blended solution4. Solutions in action5. Tips and tools6. Q&A
    3. 3. Knowing where you are RIGHT NOW.
    4. 4. When we develop a learning solution or anentire curriculum, we consciously managelearners’ “cognitive load.” Yes No Not Sure
    5. 5. Our learning solutions are “outcome-driven”rather than “content-driven.” Yes No Not Sure
    6. 6. We know what our learners find compelling –and what bores them. Yes No Not Sure
    7. 7. Our courses contain only essential contentthat we expect learners to remember anduse in their jobs or in their daily lives. Yes No Not Sure
    8. 8. We SHOW and let learners DO more than weTELL. Yes No Not Sure
    9. 9. We use a 1:3 approach: no more than 1/3 lectureor “teach,” combined with 2/3 interactive learningactivities. Yes No Not Sure www.bottomlineperformance.com
    10. 10. We link new information and skills that we wantpeople to learn to what people already know or arefamiliar with. Yes No Not Sure www.bottomlineperformance.com
    11. 11. How effective are your learning solutions?___High (6-7 “yes” responses). We manage cognitive load; our solutions engage learners via visuals and stories. We LIMIT content to “must know,” we use lots of technique to help people remember and retain).___ So-So (4 to 5 “yes” responses) We do some good stuff that matches criteria listed in assessment items – we can improve!)___ Low (Less than 4 “yes” responses). We’re focused 100% on content. We haven’t really considered what learners find engaging – or what outcomes we’re hoping they achieve post-training.)
    12. 12. Agenda1. Introduction2.Spotlight on a project3. Designing a blended solution4. Solutions in action5. Tips and tools6. Q&A
    13. 13. The project goal Reduce patient drop outs Patients can safely and confidently perform ongoing treatments at IncreaseImprove home. patientsmarket trainedshare per month
    14. 14. What we did & how we did itGathered opinions, thoughts, ideas from Nurses, Dialysis Centers, Patients and Care Partners Conclusions
    15. 15. What’s wrong with this picture? Monitoring the machine and vital signs during Disease treatment Making batches of state dialysateBefore Week 1 Week 2 Week 3 After Infection Control Self-cannulation or vascular access Steps for machine set-up Troubleshooting alarms Medical Emergencies Manual Rinse back Disconnects Labs (clinical specific)
    16. 16. What would you do?• Using the analysis results provided, what would you include in your curriculum design for these learners? View Analysis Report
    17. 17. Conclusions
    18. 18. Agenda1. Introduction2. Spotlight on a project3.Designing a blended solution4. Solutions in action5. Tips and tools6. Q&A
    19. 19. New patient training program• Conversational• Color-coded• Ordered and organized
    20. 20. Let the blending begin…• Training topics plotted on “ideal” 3-4 week patient training schedule
    21. 21. Achieving objectives by blending
    22. 22. The toolkits
    23. 23. Agenda1. Introduction2. Spotlight on a project3. Designing a blended solution4.Solutions in action5. Tips and Tools6. Q&A
    24. 24. Solutions in action
    25. 25. Blended reinforcement
    26. 26. The Train-the-Trainer goal Apply Adult Learning Principles Nurse Trainers can accurately and confidently Use train patients Teachmultiple using NxSTEPS. therapytools at accurately once
    27. 27. A roadmap for success: T3 program How will I use this?
    28. 28. The Train-the-Trainer toolkit
    29. 29. The 10-day Train-the-Trainer plan
    30. 30. Analysis and design tips• Gather technology requirements, preferences, and usage experience during analysis phase.• During design, connect learning objectives to delivery methods—don’t assume ONE delivery format will achieve ALL objectives (or even one objective).• Put your design through the TELL, SHOW, DO test. Only 1/3 of your courseware should be TELL.
    31. 31. Development tips• During development, create a seamless and consistent training experience by:• Pilot one component of your curriculum before developing the entire program. Make tweaks to that one component AND adjust the remaining components accordingly• Don’t assume facilitators/training administrators will know how to implement a blended approach: give them a roadmap for success.
    32. 32. Agenda1. Introduction2. Spotlight on a project3. Designing a blended solution4. Solutions in action5. Tips and tools6. Q&A
    33. 33. Questions?
    34. 34. Thank you!• Email: leanne@bottomlineperformance.com• Website: www.bottomlineperformance.com• Twitter: @lmbatch, @BLPIndy• LinkedIN: Leanne Batchelder• Phone: 317-818-1378
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