qi is our niche: a scaﬀolded approach to teaching data-informed healthcare quality...

QIisOurNiche:AScaffoldedApproachtoTeachingData-Informed

HealthcareQualityImprovement

Wednesday,September13,2017

JanTillman,DNP,MSN,RN,FNP-BCEastCarolinaUniversityCollegeofNursing

Ihavenoconflictsofinteresttodisclose.

OBJECTIVES

BytheendofthispresentaUontheparUcipantwillbeableto:•  iden&fyresourcestoextendDNPlearnersknowledge,skills,anda9tudestowarddata-drivenhealthcarequalityimprovement;

•  u&lizeresourcestodesignateachingplanaimedatfacilita&ngdata-informedqualityimprovement;

•  createDNPlearner-selectedassignmentsfromalistofalterna&veop&ons.

…iden&fyresourcestoextendDNPlearnersknowledge,skills,anda:tudestowarddata-drivenhealthcarequalityimprovement;1.  Data-to-Informa&on-to-Knowledge-to-WisdomviatheFounda&onof

KnowledgeModel(McGonigle&Mastrian,2015);

2.  Data-centricvs.Knowledge-centricPointsofView(McGonigle&Mastrian,2015);

3.  Nursesasknowledgeconsumers(McGonigle&Mastrian,2015);A.  Planningpa&entcareB.  Projec&ngresourcesneededC.  Retrospec&veandpredic&vemodelingD.  Conflictmanagement(Porter-O’Grady&Malloch)

…u&lizeresourcestodesignateachingplanaimedatfacilita&ngdata-informedqualityimprovement;1.  Databasesanddatasetsontheweb;

2.  Ins&tuteforHealthcareImprovement(IHI);

3.  Excel©,SPSS©,andotherso_wareapplica&ons;

4.  UniversalDesignforLearning;

5.  Student-drivenassignmentautonomy;

…createDNPlearner-selectedassignmentsfromalistofalterna&veop&ons.1.  Studentengagement&ownership;

2.  Replicabilitytotheworkplace;

3.  Planneddecision-making.

PrinciplesofUDL

MulUpleMeansofRepresentaUono  Sameinfoindifferentways;o  Requires&me,innova&on;o  Involvesmul&plesensesforfaculty&students

MulUpleMeansofAcUon/Expressiono  Assessesstudentcomprehension;o  Student-driven;o  Provideschoicesforstudents

MulUpleMeansofEngagemento  Basedins&mula&nglearning;o  Mo&vatesthelearner;o  Encouragescollabora&on&masteryofskills&knowledge

CAST.(2011).Universaldesignforlearningguidelines2.0.Retrievedfromhep://www.udlcenter.org/aboutudl/wha&sudl

MulUpleMeansofRepresentaUon

o  PercepUon–informa&onaccessibleforalllearners,regardlessofhowtheybestdevelopunderstanding(useofsenses,adjustablebylearner,learnercancustomizeyourmessage)

o  Language,Expression,Symbols–words,symbols,culturaldominance,socioeconomicexperiences

o  Comprehension–learners’transforma&onofinforma&onintoapplicableknowledge;ahamoments;metacogni&on


MulUpleMeansofAcUon/Expression

o  PhysicalAcUon–tac&le,kine&c,experien&al,movesandexplores;hightech,lowtech,ornotech;couldincludeassis&vetechnologies

o  ExpressiveSkills&Fluency–howlearnerssharetheinforma&onandtransforma&onofmaterial

o  ExecuUveFuncUon–increasingthecapacityforlearningandapplica&onsofknowledge


MulUpleMeansofEngagement

o  RecruiUngInterest–invi&ngcollabora&onandexplora&oninvariedandinteres&ngwayswithinthephysicalandcogni&veenvironments

o  SustainingEffortandPersistence–guidingandsuppor&nglearnersforprogressive,con&nualincreaseinknowledgeandapplica&onofthatknowledge

o  Self-RegulaUon–Includingsupportandtoolstoenhanceandincreaselearners’development

ofintrinsicregula&on


StudentAutonomyinAssignmentSelecUonPopularContext

Asthecoursefacilitator,I’m:Wan&ngtofindmeaningfulpedagogiesWan&ngtoengagestudentsWan&ngtoexplorehowadultsreceivethemessagesthat

I’msendingWan&ngtoavoidge9ngboredwithmyownmessages(Fink,2013)

StudentAutonomyinAssignmentSelecUonTheore&calContext

Self-DeterminaUonTheory:

Deci&Ryan,1985Autonomy–freedom,self-ruleCompetence–capacity,experUse,suitabilityRelatedness-relevance,congruence,perUnence

StudentAutonomyinAssignmentSelecUonTheore&calContext

TransacUonalDistanceTheory:

Moore,1993SituaUonsbetweenfacultyandstudentthatarevastenoughtorequiresomepedagologicaltweaks

WhatarethecostsandbenefitsofincreasingstudentautonomyinassignmentselecUon?

Learners

Learner-drivenEnergizingMo&va&ng“Incharge”ofproducts&

resultsMoreresponsibility&

accountability

FacultyEnergizingAc&veEngagingMo&va&ngCoachLotsofwork&organiza&on

What’sthelikelihoodthatthiswillmakeanydifferenceinthelong-run?

Masteryofknowledge,skills,&a9tudes=emo&onalaeachment

(Benita&Roth,2014)Innova&vepedagogiesaresynergis&cforstudents&faculty

(Usta&&Hussan,2013)Studentautonomy=students'engagementwithpercep&onsofcapabilitytoapplyknowledge&skills,andmutualcollabora&onwithfaculty

(Sibold,2016)

WheredoIStart?

WheredoIStart?

WheredoIStart?

WheredoIStart?

PURPOSE:IncreaseandenhanceDNPlearners’knowledgeofdata-miningandapplica&onofmineddatainplanninghealthcarestrategiesandinterven&onsforpopula&onhealthimpact. FORMAT:#1-One1-hourdidac&cclasssessionviainforma&ondeliveredonBlackBoard; #2–Independentself-drivenexplora&onviareadingsandvideos #3–One3-hourexplora&onlabduringDNPIntensives(face-to-face) LEARNERS:Post-master’sAPRNs&BSN-to-DNPpost-licensurestudentsenrolledinNURS8271

Session#1:1-houronlinedidacUcviaBlackBoardcourse LearningObjecUves (withdomainand

level)

ContentOutline MethodofInstrucUon

Timeallohed

(inminutes)

ResourcesandReadings

EvaluaUon AssessmentMeasures

ObjecUve1 Learnerswillexplain&comparethedefini&onsofdata-relatedtermsusedforthisunit.(Cogni&veDomain;Understanding–Level2)

I.  DefiningTermsA.  DataB.  Data-MiningC.  DataAnalysisD.  DataDisplay

1-Icebreaker:Cap&onShare&QualtricsVote2-Prework:Survey-mul&plechoiceselec&onofterms;3-Voice-overPowerPoint recording/lecture-IntroofUnit,Terms,&Founda&onofKnowledgeModel -Defini&onofterms -Data -Data-Mining -DataAnalysis -DataDisplay

15 1-QualtricspollembeddedinBB; 2-Faculty-preparedPP; 3-Textbook

1-Cap&onthecartoon(AppendixA)&shareviaDBinBB&Qualtricsvoteforfunniestcap&on; Defini&onofterms 2-Self-assessmentofaccuratedefini&on (Success=100%comple&onofalldeliverablesbyduedates)

WriteahumorouscapUondefiningthiscartoon&submitthecapUontotheappropriateBlackBoardassignmenttab:“CapUontheCartoon”.

Data-to-Informa&on-to-Knowledge-to-WisdomviatheFounda&onofKnowledgeModel

(McGonigle&Mastrian,2015p92)

WHATisdata&WHYdoesitmaher?(PowerPoint)



level)


Timeallohed

(inminutes)



ObjecUve2 Learnerswillcreateaunique5-variableques&onrelatedtotheirtopicofinterest.(PsychomotorDomain:Ar&cula&on–Level4)

DefiningQI&QI’srela&onshipwithdata

1-IHIVideos heps://www.youtube.com/watch?v=5vOxunpnIsQAND heps://www.youtube.com/watch?v=nVF8IbjnSVE; 1-Internet(self-directedinquiry); 3-Textbook(Ch.3)

12 1-IHIVideo; 2-Independentresearch;and 3-Textbook

Writeaques&oncontainingaunique5-variableques&onrelatedtothetopicorissueofinterest (Success=80%ofstudentswillsubmitaques&onwith5uniquevariables;15%with4uniquevariables;5%withfewerthan4variables)



level)


Timeallohed

(inminutes)



ObjecUve3 Learnerswillformulateameaningfulessayusingtheirthe5-variableclinicalques&on. (Cogni&veDomain:Evalua&ng–Level5)

Introduc&ontoAHRQArchives(datasets)

1-Voice-overPowerPoint recording/lecture -Whatisadatawarehouse/ dataset; -IntrototheArchives -Demonstra&onof“howtouse” theArchivesfordata extrac&on

33 1-Faculty-preparedPP; 2-LinktoAHRQArchivesviaweb

1-One-pager;“Usingthe5-variableques&onrelatedtoyourclinicalinterest,determinewhetheryourques&oncanbeansweredusingtheAHRQArchivedataset.”WriteoneparagraphonHOWthisrelatestoyourtopic.WriteonesummaryparagraphaboutWHATyouhopetoshoworsupportwiththedatafoundasyouansweryour5-variableques&on. (Success=80%willscoreminimumof85ontheone-pager)


Session#2:3-hourExploraUonLabduringDNPIntensives(face-to-face) LearningObjecUves (withdomainand

level)


Timeallohed

(inminutes)



ObjecUve1 LearnerswillbuildanExcel©tabletoreportSolitaireresults. (PsychomotorDomain:Manipula&on–Level2)

1-TerminolgyExplora&on; 2-Discussionofhowclinicalques&onscanbeanswered,clarified,orbroadenedusingdataexplora&on; 3-Discussion:group

1-Icebreaker:Solitaire:Individual-SmallGroup-TotalGroup; 2-Mini-Lecture: a.  Rela&onshipofIcebreakertodata

crea&on,u&liza&on,anddisplaytorepresentclinicalinforma&on;

b.  DefiningQI;c.  ClinicalQues&onsansweredwith

data;d.  ReviewofAHRQArchives;e.  Facultydemonstra&onofpulling

datafortwo5-variableques&ons

30 1-OnlineSolitairegame; 2-Excel©; 3-AHRQArchiveswebsite

1-Par&cipa&oninIcebreaker; 2-Individual,SmallGroup,andTotalGrouprecordingofSolitairestatsinExcel©; 3-Par&cipa&oninQ&A (100%willcompletetheSolitaireicebreaker;100%willpar&cipateinQ&A)



level)


Timeallohed

(inminutes)



ObjecUve2 Learners’willdevelopdatatablesandvisualrepresenta&onsofdatafromtheArchivesduringthelab.(PsychomotorDomain:Ar&cula&on–Level4)

1-Facultywillcoachlearnersondata-mining,Excel©u&liza&on,&datadisplayinprepara&onfornextsteps(AlternateAssignmentchosenbylearnertobecompletedindependentlyinsubsequentweeks)

1-GroupQ&A 2-Individualcoachingonlearners’self-iden&fiedareasofneed

150(includesone15minutebreak)

1-Piratenetworkinternetaccess; 2-AHRQArchivesWebsite; 3-Excel©onlearners’computers

1-Ac&vepar&cipa&onindataextrac&on,Excel©u&liza&on,&datadisplaywhileoncampus; 2-SubmissionofExcel©workbook&5graphicalrepresenta&onsofdataviaBBsubmissiontab(due48hoursa_erExplora&onLab) (80%oflearnerswillscore85ontheExcel©deliverable)



level)


Timeallohed

(inminutes)



ObjecUve3 Learnerswillaskforclarifica&onforunknowninforma&on.(Affec&veDomain:Receiving–Level1)

1-Learnerswillpostques&onsontheeduca&onalunitvia“UnitQues&ons”inClassDiscussionBoardinBB;facultywillrespondwithanswers

1-DiscussionBoardinterac&onbetweenlearnersandfaculty

Varied 1-CourseDB“UnitQues&ons”

1-Ongoinginterac&on

PURPOSE:IncreaseandenhanceDNPlearners’knowledgeofdata-miningandapplica&onofmineddatainplanninghealthcarestrategiesandinterven&onsforpopula&onhealthimpact. FORMAT:#1-Independentprac&ceanddemonstra&onofinforma&onlearnedinParts1&2ofUnitFour LEARNERS:Post-master’sAPRNs&BSN-to-DNPpost-licensurestudentsenrolledinNURS8271

IndependentDemonstraUon LearningObjecUves (withdomainand

level)


Timeallohed

(inminutes)

ResourcesandReadings EvaluaUon AssessmentMeasures

ObjecUve1 Learners’willbuildaprocessflowmap.(PsychomotorDomain:Manipula&on–Level2)

1-FacultywillcoachlearnersonbenefitsofProcessFlowMapping 2-Studentswillprac&ceProcessFlowMapping

1-On-linelectureviaVoice-overPowerPoint; 2-Student-drivenIndependentResearch; 3-Forma&veandsumma&vefeedbackondeliverable.

Varied 1-Voice-overPowerPoint:ProcessFlowMaps 2-IndependentResearch:ProcessFlowMaps

1-ProcessFlowMapwillbecompletedaccoun&ngforstepsfromdevelopmentof5-variableques&onthroughusingExcel©tocreatedatatablesandgraphicalelements. (80%oflearnerswillscore85ontheflowmapdeliverable)



level)


Timeallohed

(inminutes)


ObjecUve2 Learners’willdevelopastrategyforpopula&onhealth-relatedtopicofinterest.(Cogni&veDomain:Crea&ng–Level6)

WriteapaperSynthesizinginforma&ongleanedfromexplora&onofyour5-variableques&ontoinclude: Abstract Ques&onorProblem Method Results Implica&onstoHealthcare

1-Wrieeninstruc&ons; 2-Rubric

Varied 1-PreviousdeliverablesfromUnitFour

1-Formalpaperusingtheprovidedrubric (80%oflearnerswillscore85ontheformalpaper)



level)


Timeallohed

(inminutes)


ObjecUve3 Learnerswilldevelopapresenta&onforthepopula&onhealth-relatedknowledgelearnedinUnitFour.(PsychomotorDomain:Ar&cula&on–Level4)

1-Learnerswilldevelopapresenta&onfordissemina&onofknowledgegleanedfromUnitFourac&vi&es.

1-LearnerswillchoosefromthethreeALTERNATIVEASSIGNMENTOPTIONStodevelopapresenta&onfordissemina&onofinforma&on(selectonlyoneofthethreeop&ons).Theop&onsare: -Voice-overPowerPointuploadedtoyoutubeANDanop-edsubmieedtoyourlocalnewspaper; -AdigitalstorycreatedanduploadedtoyoutubeANDanop-edsubmieedtoyourlocalnewspaper; -Avoice-overPowerPointordigitalstorysubmieedtoBlackBoardandpresentedLIVEtoaprelicensurenursingclassORacommunityagency,suchastheBoardofHealthorCityCouncil 2-Facultyfeedbackonthefinalproduct

unknown 1-PreviousdeliverablesfromUnitFour 2-Independentresearch

1-LinktoyoutubeproductANDscreenshotofop-edsubmissionreceiptatlocalnewspaper;OR 2-SubmissiontoBlackBoardANDaphototakenwiththegroupyoupresentedLIVEtopostedtoBlackBoard 3-Summa&vefeedbackonthePowerPointordigitalstoryusingtheprovidedrubric (80%ofalllearnerswillscorean85onthepresenta&onANDsubmitscreenshotORphoto)

References

AgencyforHealthcare,Research,&Quality.(2012).2012na&onalhealthcarequalityanddispari&esreport[datafiles].Retrievedfromheps://archive.ahrq.gov/research/findings/nhqrdr/nhqrdr12/datasources/index.html

Benita,M.,Roth,G,&Deci,E.L.(2014).Whenaremasterygoalsmoreadap&ve?Itdependsonexperiencesofautonomysupportandautonomy.

JournalofEduca&onalPsychology,(106)1,pp,258-267.DOI:10.1037/a0034007CAST.(2011).Universaldesignforlearningguidelines2.0.Retrievedfromhep://www.udlcenter.org/aboutudl/wha&sudlDeci,E.L.,&Ryan,R.M.(1980).Theempiricalexplora&onofintrinsicmo&va&onalprocesses.

InL.Berkowitz(Ed.),Advancesinexperimentalsocialpsychology(Vol13,pp.39-80).NewYork:AcademicPress.Fink,L.D.(2013).Crea&ngSignificantLearningExperiences,RevisedandUpdated:AnIntegratedApproachtoDesigningCollegeCourses.SanFrancisco,CA:Jossey-Bass.Ins&tuteforHealthcareImprovement.(2008).Definingquality:Aimingforabe]erhealthcaresystem(video).Retrievedfromheps://www.youtube.com/watch?v=5vOxunpnIsQIns&tuteforHealthcareImprovement.(2015).Qualityimprovementintro.Retrievedfromheps://www.youtube.com/watch?v=nVF8IbjnSVEMcGonigle,D.,&Mastrian,K.G.(2015).Nursinginforma&csandthefounda&onofknowledge(3rded.).Burlington,MA:Jones&BartleeLearning.Moore,M.(1997).Theoryoftransac&onaldistance.InKeegan,D.(ed.).Theore&calPrinciplesofDistanceEduca&on(pp.22-38).London,England:Routledge.Porter-O’Grady,T.,&Malloch,K.(2018).Quantumleadership:Crea&ngsustainablevalueinhealthcare(5thed.).Burlington,MA:JonesandBartleeLearning.Sibold,J.(2016).Learningalacarte:Atheory-basedtoolformaximizingstudentengagement.JournalofCollegeTeachingandLearning,(13)2.RetrievedfromCluteIns&tute.Usta&,R.&Hassan,S.S.S.(2013).Distancelearningstudentneed:Evalua&nginterac&onsfromMoore’stheoryoftransac&onaldistance.TurkishOnlineJournalofDistance

Educa&on,(14)2.Retrievedfromhep://eric.ed.gov/?id=EJ1013753

QIisOurNiche:AScaffoldedApproachtoTeachingData-Informed

HealthcareQualityImprovement

Wednesday,September13,2017

JanTillman,DNP,MSN,RN,FNP-BCEastCarolinaUniversityCollegeofNursing

[email protected]

qi is our niche: a scaﬀolded approach to teaching data-informed healthcare quality...

Documents