Skills Training Programs

Teach staff first for success with patients

Train-the-trainer sessions spread knowledge

(Editor’s note: Most patient education managers agree that it is not enough to give health care professionals resources to teach. Staff must be taught teaching skills in order to use the resources effectively. Last month, we launched a series on teaching staff how to teach with a profile on a patient education workshop at the University of Utah Hospitals and Clinics in Salt Lake City. This month, we conduct an in-depth analysis of a train-the-trainer program at Santa Clara Valley Medical Center in San Jose, CA. Our goal is to offer a comprehensive overview of skills training programs from time to time throughout the year 2000.)

At Santa Clara Valley Medical Center in San Jose, CA, a committee was hard at work developing patient education materials at a sixth-grade literacy level to ensure that consistent, reliable teaching tools were available to staff. During the process, it became clear that tools were not enough.

In addition, staff needed hands-on training in teaching techniques. They also needed to learn how to deal with such teaching barriers as reduced hospital stays, tight staffing ratios, and an overall lack of time to teach.

To remedy the situation, a workshop was designed to give patient education liaisons from all the medical areas throughout the health care system skills for teaching patients and the ability to train their colleagues.

Liaisons take information back to units

"It would be impossible for everyone throughout the whole system to attend this eight-hour class, so the idea was to do a train-the-trainer day. One person working as a liaison would learn the information and take it back to their units so everyone got the same basic information," explains Janet Sohal, RN, MSN, the staff developer in educational services who coordinated the workshop.

To select a liaison, Sohal sent an e-mail message to managers at clinics and on hospital units, asking them to choose a representative to attend the workshop. The staff members selected were those who had an interest in patient education issues and in teaching.

Approximately 55 people attended the class last November. The liaisons were given until February 2000 to conduct inservices for all their colleagues. A member of the subcommittee that organized the workshop was available to assist them with the first inservice if they wanted help.

Also, the last activity at the workshop was assembling a poster board to aid the attendees when they conducted the inservices on their units. The subcommittee had created a sample poster board and laminated print materials on the key points of each area of the curriculum covered, such as tips for teaching, to make the project simple. By assembling the board, the liaisons reinforced what they needed to talk about during the 20- to 30-minute sessions they would conduct on their units, says Sohal.

Curriculum designed to be issue-driven

The patient education committee had determined what the curriculum would cover, based on issues they had observed in the clinics and on the units where they worked. For example, lack of documentation of teaching and the education of culturally diverse patient groups were two areas where instruction was needed. The curriculum covered the following topics:

• Lessons on cross-cultural teaching.

A local group specializing in cultural diversity was brought in to teach the first part of the workshop. To help show the liaisons how to bridge cultural barriers to patient education, they split into small groups to discuss case scenarios and came back together as a class to go over solutions. The teaching made the liaisons aware of cultural issues, such as showing respect for the head of the family. "It helped them understand that maybe they wouldn’t just teach the patient, but educate the leader of that family as well, such as the mother-in-law," says Sohal.

• JCAHO requirements for patient education.

A nurse from the quality improvement department discussed the patient education standards set by the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL. This included the documentation of patient education. (For information on how teachers were selected and what teaching methods were used, see article on p. 17.)

• Roadblocks to patient education.

During this session, participants were split into groups to discuss problems they had encountered on their units and in their work environment and ways to deal with them, such as finding enough time to teach. "For this problem, we tried to make them aware that they didn’t have to sit down with a patient for five to ten minutes, but just telling the patient to turn over onto the left side because breathing would be easier might be good instruction," says Sohal.

• Tips for effective teaching.

This session covered techniques for teaching that would enhance learning, such as highlighting the important information on a handout as it is discussed with a patient or simply explaining the three main survival skills needed upon discharge rather than going over the entire information sheet.

Effective education requires teaching skills

Staff often complained they don’t have enough time to teach. "But I tried to explain that even with enough time, if they don’t have the skills or the tools, they won’t be an effective educator," says Susan Karlins, MPH, director of health education for Valley Health Plan in San Jose, CA, and the instructor for the session on teaching tips. "I tried to give them skills they could use within the time they have," she explains.

• The role of a patient education liaison.

The liaisons were given instruction on the duties they would be expected to perform, which includes teaching staff on their unit what they learned by conducting inservices and attending quarterly meetings of the patient education committee. They are to bring patient education issues from their unit to the meetings so the committee can address them. "This wasn’t just a classroom exercise. We want to continually cover these issues and work on them," says Sohal.

For more information on creating train-the-trainer sessions to teach staff how to teach, contact:

Susan Karlins, MPH, Director of Health Education, Valley Health Plan, 3003 Moorpark Ave., San Jose, CA 95128. Telephone: (408) 885-4038. Fax: (408) 885-5921. E-mail: susankarlins@hhs.CO.Santa-Clara.CA. US.

Janet Sohal, RN, MSN, Staff Developer, Educational Services, Santa Clara Valley Medical Center, 751 South Bascom Ave., San Jose, CA 95128. Telephone: (408) 885-5677. Fax: (408) 885-5192. E-mail: sohaljan@hhs. CO.Santa-Clara.CA.US.