engaging clinicians in their learning experience

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  1. 1. Engaging Clinicians in their Learning Experience Patricia Mulberger, MSN, RN-BC Val Inmee, RCP
  2. 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 Meditechs NAC (Nurse Advisory Council) Val Inmee RCP Working in informatics since 1998 Jacobus Consulting 6.x Ready Certified 2
  3. 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. 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. 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. 6. Whats 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. 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. 8. Constructivism Traditional Learning Knowledge transmitted and external to user Teachers can impart information but doesnt mean students will learn Constructivism Key Concepts Learning occurs when learner uses information to think Knowledge is constructed by learners actions, experience, and perceptions Learning is active, authentic and resembles real life experiences 8
  9. 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. 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. 11. Flipped Classroom Increased adoption driven by Poor learning outcomes Prevalence of online videos http://www.knewton.com/flipped-classroom 11
  12. 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. 13. Trends in Other Sectors Addressing Digital Literacy Minnesotas 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. 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. 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. 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. 17. Where to Begin? Whats right is whats left after everything else youve done is wrong. Robin Williams 17
  18. 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. 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. 20. Tips Teaching-Learning Process Draw on learners experience Icebreaker opening Dont preach Active Group discussions esp. w/ high value workflows Relevant workflows Get feedback and work the flow actively 20
  21. 21. Tips Teaching-Learning Process Vary techniques to appeal to different learning styles Use of blended learning Technology Classroom Self-paced Group 21
  22. 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. 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. Im glad you did that. 23
  24. 24. Developing Content - Basics Lesson Plan Template Organizes Your Thinking Audience Purpose Objectives Aids and Materials Course Contents 24
  25. 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. 26. From Objective to Content Set / Focus / Motivation: General Interest Activate Prior Knowledge Share Purpose and Objectives 26
  27. 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. 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. 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. 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. 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 Rxs 31
  32. 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. 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. 34. Intranet / SharePoint Repository of Instruction Manuals Tips & Tricks Searchable by keyword Announcements Upgrades New functionality/routines Todays Hot Topic Blog / Submit Questions feature 34
  35. 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. 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