Engaging Clinicians in their Learning Experience
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This presentation discusses innovative approaches that can be used as a foundation for designing an effective program that motivates caregivers to become engaged in their own learning. Outcome #1: The learner will be able to describe the essential elements of adult learning theory Outcome #2: The learner will be able to describe innovative approaches to education Outcome #3: The learner will be able to articulate real life training scenarios for various types of care-givers.
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Engaging Clinicians in their Learning Experience
- 1. Engaging Clinicians in their Learning Experience Patricia Mulberger, MSN, RN-BC Val Inmee, RCP
- 2. INTRODUCTIONS • Pat Mulberger MSN, RN-BC – Working in informatics since 1995 – Clinical Informatics Quality Supervisor KRH – West Region Director for ANIA (American Nursing Informatics Association) – Sits on Meditech’s NAC (Nurse Advisory Council) • Val Inmee RCP – Working in informatics since 1998 – Jacobus Consulting – 6.x Ready Certified 2
- 3. Kalispell Regional Healthcare • Nonprofit arm of Northwest Healthcare – Acute care hospital and a regional referral center • 162 beds • Level II Trauma Center – IT Host • 1 Short Stay Surgical Hospital • 3 Critical Access Facilities • 36+ Physician Office Clinics 3
- 4. Learning Objectives 1. The learner will be able to describe the key concepts of adult learning theory, constructivism, and flipped classroom 2. The learner will be able to describe one innovative approach to education 3. The learner will be able to articulate real life training scenarios for various types of care-givers 4
- 5. The Problem • Increased EHR Adoption – Poor training cited as barrier • Common Scenarios for training – Core Team creates training • Limited experience creating educational sessions – Start out with point and click – “How To” Step by Step walkthrough – Not enough time to “apply” and “consider” – Limited or No Use of Education Department 5
- 6. What’s Wrong with That? • Weaknesses – No use of theory – No support of change management – Time Constraints – Did not use resources available • Education Department – No True Competency Testing – Only Major Functions Addressed 6
- 7. Adult Learning • Key Concepts – Adults are internally motivated and self-directed – Adults bring life experiences and knowledge that should be used, shared and respected - collaborative – Adults are problem centered • Respond to learning based on immediate needs • Want to solve real life problems – Need to apply actively – their own workflows 7
- 8. Constructivism • Traditional Learning – Knowledge transmitted and external to user – Teachers can impart information but doesn’t mean students will learn • Constructivism Key Concepts – Learning occurs when learner uses information to think • Knowledge is constructed by learner’s actions, experience, and perceptions • Learning is active, authentic and resembles real life experiences 8
- 9. Constructivism • Supports adult learning theory – Adults bring life experiences and knowledge that should be used, shared, respected – Expands on wealth of knowledge brought into classroom • Technology – Use to support knowledge construction – Supports learning by doing – Access to knowledge and other learners 9
- 10. Flipped Classroom • Key Concepts – Use of Educational Technology – Learning through Activity – The Flip • From traditional model of lecture in class; homework outside of class • To learner obtaining basic concepts outside of class and cementing more complex concepts in a classroom setting with peers and subject matter experts 10
- 11. Flipped Classroom • Increased adoption driven by – Poor learning outcomes – Prevalence of online videos http://www.knewton.com/flipped-classroom 11
- 12. Flipped Classroom • Outside of Classroom – Saves time for “cementing” more complex concepts for in classroom w/ experts – “Homework” done in class with support – Supports adult learning concepts • Adults self motivated and self-directed 12
- 13. Trends in Other Sectors • Addressing Digital Literacy – Minnesota’s Northstar assessment free online measurement of skills http://digitalliteracyassessment.org/ • “Bridge” Models – Connect those who are close but need more help to succeed • Innovation – Bridge Course vs. Full Course? • Contextualization – In class coursework relevant to specialty not generic • Online Generic 13
- 14. Trends in Other Sectors • Acceleration – Integrating basic skills with coursework • Timing close so that the coursework builds on the basic skills • Intelligent Tutoring – Holding conversations with teachers and fellow students – Innovation: Ask participants what is wrong with current system • Instead of spoon feeding that the EHR is great because…. Make room for conversations about the pitfalls of paper • Supports Change Management 14
- 15. Trends in Other Sectors • Mobile – Games and apps • “Wraparound Services” – Additional support • Embedded & Blended Professional Development – Training very directly related to their workflow • Supports Adult Learning Theory 15
- 16. Top Trends in Ed Tech 2015 16 • Online corporate learning – Allows learner access 24/7 on any device • Skills measurement – Smarterer -10 questions measure skill set • Interactive w/ learner • Competency-based training – Stackable, scalable programs • Flipped-learning tech – Cloud based, mobile, and app solutions
- 17. Where to Begin? “What’s right is what’s left after everything else you’ve done is wrong.” Robin Williams 17
- 18. Tips Teaching-Learning Process • Make it Real – Let learners know how it will be useful to them – Innovation • Incorporate soft skills into program – Multidisciplinary courtesy » Discharge process 18
- 19. Tips Teaching-Learning Process • Engage learner as an adult – Collaborate on setting goals for class • What do you want to get out of this? – Participatory environment – Discussion on what needs to be improved • Buy in for change – Self-directed times • Scavenger Hunt 19
- 20. Tips Teaching-Learning Process • Draw on learner’s experience – Icebreaker opening – Don’t preach – Active • Group discussions – esp. w/ high value workflows • Relevant workflows – Get feedback and work the flow actively 20
- 21. Tips Teaching-Learning Process • Vary techniques to appeal to different learning styles • Use of blended learning – Technology – Classroom – Self-paced – Group 21
- 22. Tips Teaching-Learning Process • Create a positive learning environment – Cooperation not competition – Acknowledge effort as well as achievement – Honor risk – Comfortable environment – Food / Breaks – Fun • Videos, pictures, stories https://www.youtube.com/watch?v=t-aiKlIc6uk 22
- 23. Tips Teaching-Learning Process • Be sensitive to cultural differences – No acronyms, slang or jargon • Give frequent and immediate feedback – Use body language – Encourage applause – Throw candy • For doing it right AND making a mistake – Wow! That gives me an opportunity to show you something. I’m glad you did that. 23
- 24. Developing Content - Basics • Lesson Plan Template – Organizes Your Thinking • Audience • Purpose • Objectives • Aids and Materials • Course Contents 24
- 25. Why Bother with Objectives? Connects content with assessment Guides the selection of activities – meet objectives Learners know what is expected of them Basis for evaluation – teacher, learner, content 25
- 26. From Objective to Content • Set / Focus / Motivation: – General Interest – Activate Prior Knowledge – Share Purpose and Objectives 26
- 27. Content • Input/Model – The Body – Logical/Sequential – Teach in “steps” or present in a timeline or workflow format – Know their workflows! – Problem/Solution – Present the problem, give the solution Repeat. – Old vs. New – Present the old way/knowledge with the new way/knowledge – Top 10 (etc) List – Good when trying to convince your audience why the new is better than the old – Know your audience! • Line of service specific – Pediatrician vs Surgeon vs Anesthesiology • Unit specific – ICU nurse vs Pre-Op Nurse vs RT 27
- 28. Role-Based Scenarios • Admitting/Attending – Day of Admission – Day 2 & Forward • Transfer – ICU to Med/Surg, PACU to ICU, etc. – Discharge – DC to home, DC to IRF, DC to LTC • Surgeons – ED to OR to Inpatient – Elective Surgery to Inpatient – Same Day to OP 28
- 29. Role-Based Scenarios • OB – OB Check to Home – OB Check to Inpatient Vag Delivery – OB Check to Inpatient unplanned C-Section – Planned C-Section 29
- 30. Role-Based Scenarios • Acute Care Nurse – Admission Workflow • SOC – Standard of Care Orders • Ventilator Interventions/Documentation (ICU) • Daily Interventions/Documentation • Shift Interventions/Documentation – Daily/Shift Workflows • Chart checks • Acknowledge orders • Monitor Interface • Verbal, Telephone orders 30
- 31. Role-Based Scenarios • Acute Care Nurse, cont. – Transfers • Transfer between same LOC units • Transfer to higher/lower LOC – Discharge Workflow • Provider Discharge Orders/Documents • Nursing Discharge Documents • Rx’s 31
- 32. Role-Based Scenarios • Clinic Nurse – Clinic Visit • Review Lab / Imaging / Other results – Gather and add to electronic chart • VS, Patient Prep • Follow-up appts – Return to clinic – Visit, Lab, VS, etc – Appt with outside Lab/Imaging/Other – call or enter orders? – Entering orders for procedures • Follow-up reminders – Distant reminders – mammogram, colonoscopy, etc. 32
- 33. After the Class / Ongoing • Parking Lot • Multiple methods of communication are needed – Weekly newsletters / Tips & Tricks – Intranet / SharePoint site (Easy Access) – Email – Meetings • Communication needs to be a two way street – Answers/Resolutions from Parking Lot – Feedback/Suggestions(Constructive!) from staff 33
- 34. Intranet / SharePoint • Repository of – Instruction Manuals – Tips & Tricks – Searchable by keyword • Announcements – Upgrades – New functionality/routines – Today’s Hot Topic • Blog / Submit Questions feature 34
- 35. Meditech – External Link Build external link in MIS to Intranet, SharePoint Grant access in MIS User/Person Dictionary Provider can access link from anywhere in Meditech by clicking on the world icon in the lower right of their screen 35
- 36. Meditech – Order Sets Clicking this world will open an email with the ‘To:’ filled out with a pre-defined address. A person on the CPOE team, Order Set Governance or other facility committee will be responsible for monitoring the emails and bringing forward to the appropriate party. 36
- 37. Feedback from ANIA Listserve 37
- 38. Contact Information Patricia Korolog Mulberger westregion@ania.org pmulberger@krmc.org Val Inmee vinmee@jacobusconsulting.com
- 39. References • CAEL linking learning and work. Retrieved from http://www.cael.org/pdfs/buildingblocksforbuildingskills • Knewton. (2013). Flipped classroom. Retrieved from http://www.knewton.com/flipped-classroom • Laughlin, D. (2012). The midlife learner. Journal for Nurses in Staff Development, 28 (5), 238-242. • O’Neil, C., Fisher, C., & Newbold, S. (2004). Developing an online course: Best practices for nurse educators. New York, NY: Springer Publishing Company • Russo, A. (2014). So you think you can education adults? Retrieved from https://www.edsurge.com/n/2014-07-11-so-you-think-you- can-educate-adults 39
Editor's Notes
- In the beginning, we put together a class with a manual and a sign in sheet. The manual listed all the things we wanted to teach sometimes with screenshots. For novice trainers, it was easy to get sidetracked and then difficult to get back on track.
- If the students have clear objectives Help the instructor guide the learning activities Student is better able to easily assess/evaluate whether the instructor was able to meet these objectives
- Workflow mapping should be done prior to developing the content. This should be done in a multidisciplinary approach and every process that is taught needs to be carefully mapped out. Sometimes this requires management approval for certain scenarios. Not just managers, but working staff should be involved!
- Provide workflow for each scenario keeping in mind that all providers do not practice the same!
- Keep this current!!
- We use you tube videos especially for provider training. They can access from their phone or iPad and we get feedback they actually watch them. We can incorporate in an LMS module or send a link via email or include in JIT popups in their apps Debi Camp RN, MSN Vanderbilt Medical Center A few years ago I was consulting w/a company where we were working on a go-live implementation. Education was very disjointed; however, the OR education team was creating a “book” using iBooks Author, an application that is free from Apple. What they showed us what remarkable in terms of it’s concept, design and capability. It was actually a “how to” type book [some type of surgery] that included interactive components. And you don’t need a Mac to access the material. I checked out the App Store today and the original app is still free but now there are about a dozen additional apps, most costing $$, but look helpful in boosting the original application. It’s might be worth looking at… Elaine Selan I work with 2 EHR’s and for Meaningful Use Stage 2; we developed MU Playbooks for each stage and each EHR. We used a similar program to Captivate and it is a SAP product, Work Performance Builder. The end product was an interactive step by step instruction for how to meet the measures within each EHR with additional information on registration, reporting, and attestation. We were able to build in links to other documents like troubleshooting guides, role based education guide, etc.. We could have included testing and additional feedback, but opted not to at the time. Judi Payne, RN BSN McKesson Specialty Health