engaging clinicians in their learning experience
TRANSCRIPT
Engaging Clinicians in their Learning
Experience
Patricia Mulberger, MSN, RN-BCVal Inmee, RCP
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
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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
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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
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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
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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
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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
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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
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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
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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
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Flipped Classroom• Increased adoption driven by
– Poor learning outcomes
– Prevalence of online videos
http://www.knewton.com/flipped-classroom
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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
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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
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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
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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
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Top Trends in Ed Tech 2015
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• 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
Where to Begin?
“What’s right is what’s left after everything else you’ve done is wrong.”
Robin Williams
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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
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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
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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
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Tips Teaching-Learning Process
• Vary techniques to appeal to different learning styles
• Use of blended learning– Technology– Classroom– Self-paced– Group
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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-aiKlIc6uk22
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.
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Developing Content - Basics• Lesson Plan Template
– Organizes Your Thinking• Audience• Purpose • Objectives• Aids and Materials• Course Contents
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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
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From Objective to Content• Set / Focus / Motivation:
– General Interest
– Activate Prior Knowledge
– Share Purpose and Objectives
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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
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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
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Role-Based Scenarios• OB
– OB Check to Home– OB Check to Inpatient Vag Delivery– OB Check to Inpatient unplanned C-Section– Planned C-Section
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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
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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
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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.
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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
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Intranet / SharePoint• Repository of
– Instruction Manuals– Tips & Tricks– Searchable by keyword
• Announcements – Upgrades– New functionality/routines– Today’s Hot Topic
• Blog / Submit Questions feature
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Meditech – External LinkBuild 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
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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.
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Feedback from ANIA Listserve
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Contact InformationPatricia Korolog Mulberger
[email protected]@krmc.org
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
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