Implementing professional development activities

Hopefully we have convinced you that using the ADDIE model as a guide for developing educational activities is a must. After examining the results (likely from multiple sources) in the Analysis phase, learning activities are designed and developed. The American Nurses Credentialing Center states that identifying learning needs through data collection is crucial to the preplanning of any learning activity (ANCC, 2014). The following steps demonstrate how the ANCC organizes this pre-implementation work:

1. Review available data sources (qualitative and quantitative) that can assist in preparing the needs assessment.
2. Conduct a needs assessment to identify the gap or verify a known gap in knowledge, skill, or attitude (behavior).
3. Design and develop the learning activity based upon the results of the needs assessment.

Performing these steps consistently will not only lay a solid foundation for a successful learning activity, but also prepare you to share the rationale for the activity with learners and other stakeholders.

When a knowledge gap has been identified, staff educators must be sure to incorporate the rationale behind the need for education into the learning activity itself. Adult learners link knowledge with past experiences and are problem centered. As a result, in order for learners to “buy into” or integrate new knowledge into current practice, they must find value in the identified knowledge gap. By showing the data used to help identify the gap as part of the learning activity, the educator is providing the learners with rationale for why content was designed and developed to close the gap. The educator desires that the learner values the education in order to apply the new knowledge, skill, and attitude into daily practice. Ways to provide the rationale for education include:

1. Use the data to market the upcoming activity. Disseminate the pre-education data findings, and the goal for post-education findings.
2. Include pieces of data in the content itself.
3. Demonstrate how the data is connected with patient outcomes.

Sometimes, the rationale for requiring learners to complete a learning activity is as simple as including a one-sentence statement with the activity’s announcement. For example, completing yearly Occupational Safety and Health Administration (OSHA) and Disaster Preparedness Review to meet The Joint Commission (TJC) requirements doesn’t necessitate a lengthy rationale because this is a requirement to maintain compliance with a regulatory body. The rationale could be as simple as “Complete for OSHA/TJC yearly required education/review.” Other times (especially if the activity is time-consuming or in other ways burdensome), you might need to describe the need to complete this activity as it relates to patient care. For example, if there is an issue on the unit with increased pressure ulcer rates, you could describe downward trends in a performance improvement monitor (like pressure ulcer prevention compliance) and how this affects patient outcomes.
 

DESCRIBING THE WHY OF A LEARNING ACTIVITY

 Let’s say you just asked learners to complete a newly developed learning activity for preventing pressure ulcers. In response, one of the experienced nurses in your area shows her resistance by making a comment like, “I have done at least a hundred education modules in my career on pressure ulcers, and I think I know how to do this by now.” Although there are a couple options for dealing with this scenario (including an assessment of the staff member’s attitude and the need to consider whether other work environment factors could be bothering this person), when it comes to explaining a rationale you could try the following statements:

• If quality indicators had identified practice gaps—“If I could show you our pressure ulcer rates over the last few audits, you’ll see we have had an increase in trends. We are trying several interventions, and we want to be certain that all of our staff members are aware of the current policies and procedures on these interventions. Will you help us with these efforts?”
• If staff interviews had identified that several nurses were unfamiliar with the guidelines—“We checked in with staff members in our most recent staff meeting, and there seemed to be a high level of concern regarding everyone’s comfort level with what is and isn’t found in the prevention guidelines. Although it seemed like the greatest concern was among those who haven’t been working in the unit a very long time, we weren’t sure where to make a cut-off of who should and shouldn’t complete the activity. If you feel pretty comfortable with the guidelines, would you be willing to help us out by serving as a unit resource for inexperienced staff members?”
  

One external source that highlights the importance of many learning activities is within the Quality and Safety Education for Nurses (QSEN) competencies. As many new nurse learners will be familiar with (and the experienced learners can begin to understand from where the millennials are gathering their ideas in academia), QSEN and another more recent initiative, the Campaign for Action, highlight the need for transforming healthcare delivery.

To illustrate how this helps with understanding the why of a learning activity, let’s say there is a need to provide a repeated learning activity for a documentation issue. Cronenwett et al. (2007) in Nursing Outlook is the basis for the work QSEN developed regarding the knowledge, skill, and attitudes the learner requires to document successfully. If you were to review the QSEN competency on informatics, for example, you would find informatics to be defined as using “information and technology to communicate, manage knowledge, mitigate error, and support decision making” (Cronenwett et al., 2007). The nursing professional would need to employ the following skills:

• Navigate the electronic medical record (EMR).
• Document and plan patient care in an EMR.
• Employ communication technologies to coordinate care for patients.
• Understand the EMR serves as the legal document of care provided.

For staff educators, reinforcing the knowledge nurse learners should already have is always an important piece of assisting them in integrating additional knowledge. For example, a learning activity is developed for a central venous catheter dressing change procedural guideline. By reinforcing each step of the dressing change procedure in the development of the learning activity, nurse learners can identify steps that they may have not been following during patient care and focus on incorporating these missed steps into their practice.

Check out Table 4.1 for a summary of the questions to consider for the first W—why.

• Contracting with a speaker and, if the speaker is coming from out of town, making travel and lodging arrangements
• Making arrangements for classroom assignment or conference hall
• Completing the continuing education (CE) application and coordinating procurement of required CE documents
• Printing CE evaluations and certificates
• Creating and distributing flyers that advertise the learning activity
• Registering participants
• Printing any materials to be distributed to learners
• Creating a registration/sign-in sheet and greeting participants
• Setting up catering (if food will be provided)
• Making arrangements for and setting up and assisting with audiovisual equipment
• Assisting with setting up equipment needed for the learning activity (for example, pumps, simulation materials, and so on)
• Assisting with any activities that will be completed during the learning activity

Table 4.2 summarizes considerations for the who of a learning activity.

TABLE 4.2     ASKING THE WHO OF A LEARNING ACTIVITY

Click to enlarge figure.

Click to enlarge figure.

FIGURE 4.2
Sample Timeline for Planning a Large Conference
Source: Cincinnati Children’s Hospital Medical Center (2014).

Unfortunately, there are times when planning a learning activity simply isn’t possible (for example, a serious patient care error occurred, and the organization’s staff requires immediate training). In these instances, staff educators must work with the manager and/or scheduling personnel to determine how to provide coverage for current patient care needs while assisting staff members in attending a learning activity. In some cases, the educator might need to cover a learner’s patient assignment while the learner attends the activity. (Although this isn’t ideal, it can have the unintended benefit of demonstrating to staff members that the educator values professional development and patient care and that these are not mutually exclusive activities.)

Some thought needs to be put into planning the advertisement of a learning activity. When creating a flyer or a brochure for the learning activity, include the following details:

• A clear description of the learning activity
• A description of the target audience, including required and optional attendees
• A brief explanation of the educational program, including associated learning objectives
• An agenda
• Information on whether contact hours are offered (if so, include a state board-approved CE statement)
• Any fees required of attendees
• A clear indication of registration deadlines
• The procedure for canceling registration
• Complete contact information

If the learning activity provides CE hours, then all of the preceding information is required in the flyer or brochure. If the educational program is more than one day in length, you should also include a complete multi-day agenda. If learners external to your organization will attend, it’s beneficial to include information on travel, lodging, and recreational activities.

• Honorarium for speakers
• Travel, lodging, and dining expenses for out-of-town speakers
• Program materials and supplies (handouts, folders, jump drives, and so on)
• Printing of posters and graphics
• AV rental or other equipment rental costs
• Catering expenses
• Office supplies (name tags, pens, pencils, paper clips, staplers, receipts)
• Cost of paying staff to attend required learning activities (non-clinical time) and any overtime costs to cover patient care on the nursing unit
• Sponsors or vendors providing financial support for the educational program

In addition to considering the items in the preceding list, also take into account whether staff or unit budgets will be required to pay for the educational opportunity. If so, what will that fee cover and how much will the fee be?

If an activity is planned early enough, the staff educator can determine approximate expenses for the above items. The staff educator can then work with the manager to incorporate expenses for learning activities in the yearly budget. Worksheet 4.1 shows a budget template that you can modify to meet your needs.

Click to enlarge worksheet.

WORKSHEET 4.1     SAMPLE BUDGET WORKSHEET FOR LEARNING ACTIVITY

And speaking of a yearly budget, the professional development specialist shouldn’t limit budget thinking simply to how much can be spent on individual learning activities. The staff educator might need to have his or her own budget to manage, especially if data can be used to demonstrate return on investment. While you’re thinking about implementation, jot down guesstimates for the amount of time you spend planning, implementing, and evaluating as well as the time learners spend in class along with their materials, refreshments, and so on (we’ll talk more about this in Chapter 6, “Evaluating an Educational Program’s Performance”).

When considering what will be needed for a learning activity, organize needs into buckets and create a checklist of items needed for the learning activity. Examples of buckets include AV Equipment, Registration Needs, Participant Tools, Classroom Needs, Phone Numbers, Office Supplies, and Extras. Examples of supplies needed for each bucket are included in Table 4.6.

We would encourage you to use this table as a checklist at your next learning activity. Feel free to add to it or modify it to meet your needs.

Checklists are actually useful for far more than simply implementing a learning activity. In fact, the importance of checklists cannot be overstated. Checklists for every aspect of the ADDIE model and the resulting education should be created and used every time. If you use checklists for the mundane as well as the complex activities for which you are responsible, then you are free to think. You can be innovative, take risks, and be able to spend time figuring out how to integrate new education into current practice, strategic goals, and even meeting the Triple Aim. When you spend your mental energy trying to remember all the supplies to bring to a learning activity, you get bogged down in all of the minutiae and end up not being productive.

 

Click to enlarge worksheet.

WORKSHEET 4.2    ASKING THE 5 W’S OF A LEARNING ACTIVITY

Questions for reflection/discussion

1. What tools do you have at your disposal to assist you in meeting all of the development details when designing a learning activity?

2. What resources as far as location, equipment, and materials do you have available to design a learning activity?

3. How can you develop learning activities utilizing multiple formats to meet differing learning styles?
 

KEY TAKEAWAYS 

• Adult learners link knowledge with past experiences and are problem centered. Providing rationale related to the learning activity allows learners to “buy in” or integrate new knowledge into their practice. This rationale is especially relevant when the learning activity relates to patient safety.
• Consider your target audience—one learning activity does not meet all multidisciplinary needs. Consider creating individualized education for each discipline so the information is succinct and applicable to practice.
• You, as the educator, do not need to be the subject matter expert (SME) for every learning activity. Use your resources and your “true” SMEs to develop and deliver the content. You, as the educator, can use your expert skills in the planning of the learning activity.