Tag: Nurse Education

Kirkpatrick 10 Requirements for an Effective Training Program

Kirkpatrick 10 Requirements for an Effective Training Program

Paul Ross

Learning & Development

Training & Evaluation guidance for delivering quality education programs: ” we strongly suggest that you take the right steps to ensure that training is actually accomplishing what it was intended to do and contributing to the bottom line. Don’t think about evaluation in terms of demonstrating overall value until you are sure you have done all you can to ensure that your training programs are effective” (pg. 3, Kirkpatrick & Kirkpatrick, 2009). 

Ten Requirements for an Effective Training Program

  1. Base the program on the needs of the participants.
    • Needs analysis from the learners on what they need to learn and also what the organisation needs to develop.
    • View from the perspective of managers and the organisation.
  2. Set learning objectives.
    • What is expected to be learned
    • Any behaviour or cultural changes?
  3. Schedule the program at the right time.
    • Best method of delivery and time/day for the learners. Engage a positive mindset from the start.
  4. Hold the program at the right place with the right amenities.
    • Right location for appropriate amenities and travel time.
  5. Invite the right people to attend.
    • Right number, right mix of hierarchy within team members.
  6. Select effective instructors.
    • Internal or external subject matter experts.
  7. Use effective techniques and aids.
  8. Accomplish the program objectives (return to point 2).
  9. Participant satisfaction.
  10. Evaluate the program

Reference

Kirkpatrick, D. L. & Kirkpatrick, J.D. (2009). Implementing the four levels: A practical guide for effective evaluation of training programs. Berrett-Koehler Publishers [exerpt].

Adult Learning

Adult Learning

Paul Ross

Introduce and provide an overview of adult learning:

  • Knowles 4 principles
  • Lifelong learning

This is the second presentation from Nursing Education Network. All based on microlearning, they will be short quick snippets on education topics to provide an introductory overview.

Adult Learning [Powerpoint version]Download

Book Club: Visible learning for teachers: Maximizing impact on learning by John Hattie

Paul Ross

Book Club: Hattie, J. (2012). Visible learning for teachers: Maximizing impact on learning. Routledge.

6 signposts towards education excellence:

  1. Teachers are one of the most powerful learning influencers,
  2. Teachers need to be passionately engaged,
  3. Teachers need to provide effective individualistic feedback,
  4. Both student and teacher need to know and understand the learning intentions,
  5. The learners construction of knowledge and ideas is critical,
  6. Safe learning environments where mistakes are encouraged and exploration of knowledge occurs.

Education Holy Grail improving education and interactions between student and teacher.

What are the core attributes to schooling that make the difference? The focus is not the buildings or programs but on the practice of teaching. Students learn to become their own teacher, to exhibit attributes of self-monitoring, self-evaluation, self-assessment and self-teaching.

Visible teaching and learning occurs when there is feedback given and sought, and when there are active, passionate, and engaging people (teacher, students, peers) participating in the act of learning” (pg 18).

“The act of teaching requires deliberate interventions to ensure that there is a cognitive change in the student” (pg 19).

Safe Environment

Idea rich environment where experimenting can occur and sharing ideas.

“A safe environment for the learner (and for the teacher) is an environment in which error is welcomed and fostered” (pg 19).

The Challenge

“When students become their own teachers, they exhibit the self-regulatory attributes that seem desirable for learners (self-monitoring, self-evaluation, self-assessment, self-teaching)” (pg 19).

Deliberate practice needs to occur and the student to be challenged in this safe environment, to aid the construction of knowledge.

“It is challenge that keeps us investing in pursuing goals and committed to achieving goals” (pg 57).

Preparing Lessons

4 critical parts in planning:

  1. “Students starting levels of performance (prior),
  2. The desired level of performance (target),
  3. Rate of progress (progression),
  4. Teacher collaboration and critique in planning” (pg. 41).

Best Practice Lesson Plans

  1. Know the learning intentions (the teacher),
  2. Understand expected standards of performance (the student),
  3. Build commitment and engagement in the learning task.
  4. Guide for the teacher on best delivery of the lesson (guided delivery),
  5. Guided practice for students to complete a task and receive constructive feedback,
  6. Closure provides clear cues when students are at important points in learning,
  7. Independent practice follows mastery of a topic.

Structured of Observed Learning Outcomes (SOLO)

SOLO taxonomy: Levels of understanding can be grouped as surface, deep and conceptual and the use of SOLO taxonomy can integrate them into learning intentions and achievement criteria.

Starting The Lesson

The climate of the classroom is a critical factor in promoting learning. A high level of relational trust and respect for each person’s role in learning. The classroom is a place for the student to dominate, not the teacher where there is a “need to talk, listen and do”.

Learning

Start with the desired results and then work backwards, the focus is then on the gap. This knowledge gap is where the teachers focus on the student and how they learn. The importance of motivation on goal setting and strategies to close the gap, and to recognise motivation varies at any given time.  Deliberate practice allows learning to meaningful and a meta-cognitive approach to instruction allows multiple opportunities for practice.

Visual Learning Infographics

Resources

Hattie, J. (2012). Visible learning for teachers: Maximizing impact on learning. Routledge. [GoodReads review]

Hattie, J. (2008). Visible learning: A synthesis of over 800 meta-analyses relating to achievement. Routledge [sample].

Nursing Education Network. (2017). John Hattie and Visible learning for Teachers.

 

Teamwork and team training in the ICU: Where do the similarities with aviation end?

Paul Ross

Journal Club Article: Reader, T. W., & Cuthbertson, B. H. (2011). Teamwork and team training in the ICU: Where do the similarities with aviation end?. Critical care, 15(6), 313.

Background

Comparing the lessons learnt and development of team training approaches in the aviation industry to the complex needs of the Intensive Care Unit (ICU). The importance of teamwork and the coordination of behaviours in terms of patient care provided and subsequent outcomes. Higher levels of doctor-nurse collaboration improve safety and mortality rates. The recognised importance of poor communication which has been identified as a factor in medical error.

Team input and team processes = team output

  • Teamwork

“Team skills are important for maintaining safety in both domains, as multidisciplinary teams must work effectively under highly complex, stressful, and uncertain conditions. ”

  • Active & Latent Failures

“team-related ‘active failures’ (for example, failures to communicate the proximity of nearby aircraft) and ‘latent failures’ (for example, lack of team training, poor ergonomic design, and organizational culture) that influence behavior and error in the cockpit.”

  • Decision Making Under Stress

“Techniques include exposing teams to high-stress situations, training pilots to facilitate team discussions before and after stressful team activities, and cross-training aircrew team members to understand the demands and needs of one another’s role. Teams are trained in a multidisciplinary environment…….”

  • Hierarchical Team Structures

The ability to understand other roles, so in stressful events still work together as a team and negative behaviours and attitudes don’t effect performance.

  • Environmental Factors

“Fatigue and stress are known to negatively influence performance in the ICU, and non-technical factors such as team communication, situation awareness, and decision making frequently underlie error.”

Developing a workplace culture based upon safety requires supporting and valuing staff in the high risk environment of ICU, with models of training and supervision that focuses not only on the norms of practice (normative) and educative training, but on restorative and supportive resources to improve stress and burnout, and aid personal development.

Keywords: Intensive Care Unit; Team Performance; Human Factors; Team Training; Aviation Industry; Cognitive Load; Situation Awareness.

Relevant additional resources around some of the themes identified in this articles to aid collaborative educational teamwork:

 

 

 

Nursing & Democratic People’s Republic of Korea

Paul Ross

This post is one of curiosity and interest in a socialist country that is largely a mystery of what occurs in everyday life. How is the healthcare system, what sort of technology and resources are available, what training do the nurses receive, is it hospital or university based? This post is not based on any knowledge other than searches from the internet and healthcare databases (Cinahl, Embase and Medline). It is also not a political post, so please add helpful and insightful resources focusing on healthcare into the comment’s section to build on the below resources. If anyone has any links to nursing schools in North Korea it would be amazing to hear about nurse training.

Search terms: Nursing and (North Korea or Democratic People’s Republic of Korea).

The formal searches yielded only one relevant article. Many articles exist but they focus on ethical and political viewpoints. Google search was more successful, but it is the unknown of the quality or true picture they provide. See below for resources.

WHO Stats:

  • Health System: Free access for all
  • Life Expectancy: Male 67/Female 74

Remember its very easy to get caught up in ‘our health system is the best’ mentality. When we look outside our own walls, there are some healthcare systems where the principles of ‘healthcare for all’ exist. An example is the Cuban healthcare system and also the work they do in training healthcare professionals in other nations. DPRK 360 provide a different perspective to North Korea, than portrayed in the media.

BBC Panorama: Inside North Korea (2017)

Resources

Barrett, J. (2011). The North Korean Healthcare System: On the Fine Line Between Resilience and Vulnerability.

Cha, J. (2015). Scenes from a North Korean Hospital. The Guardian.

DPRK 360. (2018) A different perspective to North Korea.

Kim, H. K., Lee, O. J., & Baumann, S. L. (2011). Nursing Practice with Families Without a Country. Nursing science quarterly, 24(3), 273-278. [abstract]

Kim, S. (2016). Comparison of North and South Korea Nursing Workforce Training System and Integration Plan. Advanced Science and Technology Letters. Vol.132 (Healthcare and Nursing 2016), pp.233-236.

Wikipedia (2017). Health in North Korea.

Wikipedia (2017). Pyongyang Maternity Hospital.

World Health Organisation. (2018). Democratic People’s Republic of Korea.

NNEC2018 Notes & Thoughts (Day 2)

Paul Ross

Session: Changing World, Change in Clinical Practice

Focus: Overcoming the theory-practice gap

Research translation: slow process of change, translation of evidence

Deimplementation of Practice

The transition from hospital nurse education to Tertiary (university) sector.

Nurse researching and impact by Florence

Difficulty staying up to date through impact of information overload: volume of research, guidelines.

Value of systematic review- to make research manageable. Resources such as:

Resources

Donaldson, M. S., Corrigan, J. M., & Kohn, L. T. (Eds.). (2000). To err is human: building a safer health system (Vol. 6). National Academies Press.

Greenhalgh, T. (2014). How to read a paper: The basics of evidence-based medicine. John Wiley & Sons.

Greenhalgh, T., Howick, J., & Maskrey, N. (2014). Evidence based medicine: a movement in crisis?. Bmj, 348, g3725.

Grol, R., & Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients’ care. The lancet, 362(9391), 1225-1230.

McGlynn, E. A., Asch, S. M., & Kerr, E. A. (2003). Quality of health care delivered to adults in the United States-Reply. New England Journal of Medicine, 349(19), 1867-1868.

Niven, D. J., Mrklas, K. J., Holodinsky, J. K., Straus, S. E., Hemmelgarn, B. R., Jeffs, L. P., & Stelfox, H. T. (2015). Towards understanding the de-adoption of low-value clinical practices: a scoping review. BMC medicine, 13(1), 255.

 

Session: Educating With The Brain in Mind

Sustainable transformational processes: thinking, practice and culture.

Neuroscience & collaboration (Rock & Cox, 2012): The SCARF® model stands for

  • Status,
  • Certainty,
  • Autonomy,
  • Relatedness and
  • Fairness

Challenge/support framework (Mariani, 1997).

The way the brain forms thoughts by Kahneman: System 1 and 2 (Thinking, fast and slow)

Resources

Kahneman, D. (2011). Thinking, fast and slow. Macmillan.

Mariani, L. (1997). Teacher support and teacher challenge in promoting learner autonomy. Perspectives: A Journal of TESOL Italy, XXIII (2). 

Rock, D. (2010). The neuroscience of leadership (Doctoral dissertation, Middlesex University).

Rock, David, and Christine Cox. “SCARF in 2012: Updating the social neuroscience of collaborating with others.” NeuroLeadership Journal 4, no. 4 (2012): 1-16.

Session: Technology and online learning

  • CPD,
  • readiness to learn
  • core competencies
  • alignment between objectives and content (standardisation)

Resources

Blended Learning

Blended Synchronous Learning

Bower, M., Kenney, J., Dalgarno, B., Lee, M. J., Kennedy, G. E., Carter, H., … & Hedberg, J. (2013). Blended synchronous learning: Patterns and principles for simultaneously engaging co-located and distributed learners. Electric Dreams. Proceedings ascilite.

Prensky, M. (2001). Digital natives, digital immigrants part 1. On the horizon, 9(5), 1-6.

Session:  Undergrad Systematic Review on Appraisal 

4 Themes of the review:

Systems Approach

 

Session: Preparing for Practice

  • Self efficacy

Babenko-Mould, Y., Andrusyszyn, M. A., & Goldenberg, D. (2004). Effects of computer-based clinical conferencing on nursing students’ self-efficacy. Journal of Nursing Education, 43(4), 149-155.

  • Preference for online learning & Task value

Artino Jr, A. R., & Stephens, J. M. (2009). Academic motivation and self-regulation: A comparative analysis of undergraduate and graduate students learning online. The Internet and Higher Education, 12(3-4), 146-151.

Some data analysis statistics: Cronbach’s alpha

Session: The Future of Nursing

Changing world of practice and graduate capabilities.

Missen, K., McKenna, L., & Beauchamp, A. (2014). Graduate nurse program coordinators’ perceptions of role adaptation experienced by new nursing graduates: A descriptive qualitative approach. Journal of Nursing Education and Practice, 4(12), 134.

Missen, K., McKenna, L., & Beauchamp, A. (2016). Graduate nurse program coordinators’ perspectives on graduate nurse programs in Victoria, Australia: A descriptive qualitative approach. Collegian, 23(2), 201-208.

Missen, K., McKenna, L., Beauchamp, A., & Larkins, J. A. (2016). Qualified nurses’ rate new nursing graduates as lacking skills in key clinical areas. Journal of clinical nursing, 25(15-16), 2134-2143.

End of day thought

Social Media: Low #SoMe engagement use across the conference, organisors and attendees included. Set up Symplur conference hashtag https://www.symplur.com/healthcare-hashtags/nnec2018/

 

 

NNEC2018 Notes & Thoughts (Day 1)

Paul Ross

Session: Safer Care Victoria

Importance and power of storytelling and the narrative for learning in nursing.
Emojione 1F4D6

 

 

 

 

Aims and approaches for safer care:

  1. Targeting zero avoidable harm,
  2. Sharing excellence,
  3. Collecting and sharing data to improve patient care.

Resources

Session: Assessment & Learner Engagement

Impact of assessment- impact on learning, the need to make a positive impact.

Consider how can we use assessment for learning and for competency (rather than something that is merely done to us).

That assessment can influence the teaching focus and student behaviour just by the choice of assessment.

What assessment needs to do:

  1. Certify learners performance (summative assessment)
  2. Provide learners with info to aid learning (formative)
  3. Build students capacity judge their own learning (sustaniable assessment)

Build capacity to judge good work, and need to look at optomising the timing of assessments in courses (look at student workload), and to encourage good habits not rote learning.

Distractions can occur through a focus on marks or grades instead of focusing on achievements and the quality of work. Intended learning outcomes and the difficulty measuring by grades, instead mark by outcomes not numbers (what is the expectation for the minimum standard).

Feedback: What does or doesn’t the student do to meet the learning outcomes. Provide more descriptive assessment terms, not classified/standarsied rubric terms (such as good/satisfactory/excellent).

Emojione 1F649

Opportunities for feedback – be selective in what we do and when we do it.

Empower student to be more assertive and to seek feedback. Students to think about what they think is good criteria, think about how they did or did not meet the criteria.

Resources

Assessment Design Decisions

Assuring Learning

Boud, D., & Molloy, E. (2013). Rethinking models of feedback for learning: the challenge of design. Assessment & Evaluation in Higher Education, 38(6), 698-712.

Boud, D., & Molloy, E. (Eds.). (2013). Feedback in higher and professional education: understanding it and doing it well. Routledge. [link to Ch. 13]

Cradle: Centre for Research in Assessment and Digital Learning

Feedback for learning.org: Closing The Assesment Loop

Other Educational Ideas

  • Blended On-line and Digital (BOLD) Learning 

Develop curriculum and build critical thinking when using a blended online approach. Reduced face to face teacher time (online theory, but miss the applying critical thinking, apply theory into practice). Solution – innovative online lesson “apply your knowledge”, linked to learning content, relevant to the theory, instant feedback from case based scenarios.

Resource: Blended On-line and Digital (BOLD) Learning 

  • Steps towards Innovation 

    • Be courageous and embrace vulnerability. authenticity.
    • Be realistic.
    • focus on your goal.
    • think outside the triangle (content, educator, participant)
    • implement, assess, adapt – new ideas, feedback and evaluate

Resource: Brené Brown: The Power of Vulnerability

  • TRACS Video Resource Project 

Process in resource, planning and colaboration for a video resource.

  • key stakeholders,
  • logistical planning, learning objectives, cost, time frames,
  • real clinicians and patients (consent) in a real clinical setting (capture the experience of the patient journey),
  • story boarding key messages,
  • use of multi-media resources for video production,
  • ongoing project management, supporting facilitator guides,
  • Learning resources to go along with the video resources.

Resource: TRACS (TRAining Centre in Subacute care) videos

  • Teaching for 2020 and Beyond. 

Wicked health problems and how nursing education can influence and impact society.

  1. Inequality: rising social injustice.
  2. Empathy deficit: empathy in nursing (learning others experience, cultural skills)
  3. Robotic Nurses: healthcare technology
  4. Battling ourselves: workforce culture, budget, targets

The pedagogy (transformative learning)

  • students to become agents of change,
  • awakening empathy

Nurses as co-creators of healthcare environments. Nursing focus historical on health and well-being. Solution focused nursing being at the forefront of advancing health care with technology and the adaption of technology.

  • AI- clinical decision making
  • Telehealth
  • Digital capacity and technology.

Robo-nurse (Dystopian view of the future)

 

The Answer: Develop optimistic actions, change agents. Modelling of ethical, courageous, and admirable problem solving.

  • Open the VALT (Visually authentic learning tools) 

Simulation on a small budget and small space, following principles of:

  • authentic learning environments
  • immersion
  • sim on a budget,
  • hands on,
  • case scenario,
  • sim on the go,
  • transportable
  • Cost effective
  • Recyclable materials

Resources:

Open the VALT

Tilbrook, V. A. (2017). Open the VALT™(Visually authentic learning tools): Using play to facilitate knowledge and collaborative practice. Women and Birth, 30, 39-40.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Blog It: Free Open Access to Nursing Education (#FOANed)

Paul Ross

This poster was submitted to the 17th National Nurse Education conference (#NNEC18) and is based around Free Open Access to Nursing education (#FOANed) and specialist online communities of practice (eCOP) that can develop with social media. The blog metrics to measure the global reach of Nursing Education Network, are a method for showing the impact of social media and the numbers of interactions related to the blog. Analytics from WordPress.com and Google analytics can be used to demonstrate analysis of post views, users, blog views, visitor city and country data to show the potential global reach.

This post has also been shared as part of the #WeNurses and #WeCommunities project #70nursebloggers & #70midwifebloggers.  The aim is to inspire 70 nurses / student nurses / midwives / student midwives to blog in order to raise profile of what nurses and midwives do and nurses & midwives blogging and to celebrate 70 years of the NHS. If anyone wants to write a blog post, more than happy to upload into this site.

References

Rozenblum, R. and Bates, D. W. (2013). Patient-centred healthcare, social media and the internet: the perfect storm?. BMJ Quality & Safety.

DeCamp, M., Koenig, T. W., & Chisolm, M. S. (2013). Social media and physicians’ online identity crisis. JAMA, 310(6), 581-582.

Carroll, C., Bruno, K., & Vontschudi, M. (2016). Social Media and Free Open Access Medical Education: The Future of Medical and Nursing Education? American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses, 25(1), 93-6.

Moorley, C. R., & Chinn, T. (2014). Nursing and Twitter: creating an online community using hashtags. Collegian, 21(2), 103-109.

Royal College of Nursing (RCN). (2016). Every nurse an e-nurse. Digital capabilities for 21st century nursing. Retrieved from https://www.rcn.org.uk/clinical-topics/ehealth/current-work

Digging For Dinosaurs: Change Idea

Paul Ross

Presentation: Digging For Dinosaurs

Resource: Brown, C. E. (2012). Digging for Dinosaurs Contest: A Novel Strategy to Engage Nurses in Questioning Practice.

Change Management Strategy:  used a competition format to drive interest and engagement for ideas on removing ritualistic practices.

A strategy to engage nurses in practice change and the translation of evidence into practice.

Change ideas for nurses to reflect on clinical practice:

  • Why am I doing it this way????
  • Does it add value?
  • Improve quality of care?
  • Improve satisfaction?
  • Improve productivity?
  • Improve communication?
  • Improve motivation?

The aim was to aid nurses driving the change, engagement in research and evidence based practice.  Support is required from senior nurses to assist in the literature review process and any subsequent research projects. Setting up a project and completing ethics can be a time consuming process that the clinical nurse may require assistance.

This project is a great way to engage staff and encourage questioning of practice and aiding translation of evidence.

References

Brown, C. E. (2012). Digging for Dinosaurs Contest: A Novel Strategy to Engage Nurses in Questioning Practice.

Brown, G. H. (1993). The sacred cow contest. The Canadian Nurse, 89(1), 31-33.

Learning to Unlearn

Paul Ross

Learn-Unlearn-Relearn

To move into new domains of learning and knowledge there is a need for revolutionary thinking to be confident enough to rise to the challenge of moving into the unknown. Education from school to university and then into workplace, is normally planned and structured around a developmental trajectory as a persons skills, knowledge and experience increase. But what about the future and learning, if we don’t know the skills or knowledge that we will require, how do we unlearn any irrelevant information? This could be termed as a deimplementation process of learning. The process of unlearning becomes an important process in our learning skills repertoire.

From the organisation viewpoint comes the focus on becoming ‘learning organisations’, but maybe this could be supported with seeking new logic and a process of unlearning. “Unlearning is not about forgetting. It’s about the ability to choose an alternative mental model or paradigm” (Bonchek, 2016). The skill is recognising mental models that are no longer relevant or effective. This reflexivity of working with uncertainty could be benefited by utlising already well used practices such as self reflection, which could focus on considering any of our biases we hold and allowing change to occur as we move forward.

This post was inspired by the Twitter conversation below, thanks to @precordialthump.

Keywords: Unlearning; Reflexivity; Transformation; learning.

Resources

Bonchek, M. (2016).Why the Problem with Learning is Unlearning. Harvard Business Review.

Klein, E. J. (2008). Learning, unlearning, and relearning: Lessons from one school’s approach to creating and sustaining learning communities. Teacher Education Quarterly, 35(1), 79-97.

McGregor, A. (2018). Unlearning: The key to the unlock 21st Century problems? International Teacher Magazine (ITM).