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Question: "What techniques do you use to educate staff? Which have worked the best and why? Does the technique to be used depend upon the topic or do other factors affect its selection? Please give a detailed description of one of your best staff education efforts, and explain why you believe it worked."
Answer: "We have found that case-based scenarios are the best way to facilitate critical thinking skills when educating staff," says Jean A. Just, RN, MS, CS, director of nursing staff development and patient education at The James Cancer Hospital and Solove Research Institute in Columbus, OH.
This teaching technique initiates lots of involvement and interaction with staff. It promotes discussion. When staff problem-solve the case presented, it shows instructors that staff have learned how to apply the information, says Just.
To select appropriate cased-based scenarios, Just looks at her learning objectives. It’s important to make sure that the case that is covered relates back to the learning objectives, she says. For example, if the lesson is about identifying restraint alternatives, the case used would need to provide opportunities for staff to identify alternatives for restraint use. During the exercise, staff would demonstrate critical thinking throughout the process, says Just.
Computer-based training modules also have been used and are good for staff education because each person can fit it into his or her schedule. The health care facility has purchased commercial programs and developed its own. Yet if the training modules are developed commercially, a health care facility must have the option of customizing the information, says Just.
"Computer-based training can be effective because it is self-paced, and the learner can go back and repeat information or review information depending on how it is set up. There is continual reinforcement," says Just.
Several techniques are used to educate staff at New York Presbyterian Hospital Weill Cornell Campus in New York City. The decision on which method would be appropriate depends on the topic, the amount of content to be covered, whether it is a topic that must be taught hospital wide, and the length of time the teaching might take, says Barrie F. Friedenberg, BSN, MA, an instructor in nursing education at the institution.
Formal, scheduled classes are mandatory and usually are lecture and discussion but may include a group activity. Such a class would be warranted for something like a new piece of equipment. For example, when the hospital got new blood glucose monitors, there were lengthy new policies the staff had to learn, and everyone had to do a return demonstration. So, a formal, mandatory class was scheduled.
"Sometimes, we do short, quick inservices unit-to-unit, but it has to be information that can be given in 15-minutes or less," says Friedenberg. With this method, the educator would go to a unit and quickly gather the nurses or just talk to one person at a time. The short unit-to-unit inservices usually are used for topics that are not complicated such as a new procedure or a new piece of equipment that is simple to explain like a new specimen container.
Another quick inservice that sometimes is used is the read-and-sign’ method. With this method, information such as a new policy is posted and staff are responsible for reading it and signing their name to show that they saw it. As with the unit-to-unit inservices, the information must be something that is simple and doesn’t warrant an hour-long class.
Several creative methods have been used to reach busy staff. Sometimes inservices are given throughout the day, every hour on the hour, or the information might be gotten out via a poster session. "If we have a lot of different things for the staff to learn, we will set up stations, and staff can go from one station to another on their own time," says Friedenberg.
To get information to staff about patient teaching, Dorothy A. Ruzicki, PhD, RN, director of the educational services department at Sacred Heart Medical Center in Spokane, WA, has found that the best method is to include the information in a clinical conference. Nurses may not attend a conference devoted to patient teaching, but they will go to one on current clinical topics, she says. "If patient teaching in that specialty is covered in a breakout session or part of the presentation of the main speaker, the nurses will be a captive audience," says Ruzicki.
Determining how to have learning occur, yet make it fun, is the creative part of staff education, says Just. During the month of October, staff in the education department at James Cancer Hospital set up stations that related to all the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations chapters on standards. Instructors at the stations dressed in costume and gave treats to all who participated.
"The stations were interactive where staff would need to either complete a puzzle or do a game, and as a result, there would be some learning that would take place related to the specific standard," says Just. The stations were staffed for a 24-hour period to reach all shifts.
An inservice fair worked well for several years at New York Presbyterian Hospital. The hospital would rent the gym at Cornell University and invite 50 representatives from equipment companies who would demonstrate their product throughout the day and supply giveaways for raffles. "It was fun and educational," says Friedenberg. Although the equipment wasn’t new to the hospital, it provided an opportunity for review.
The fair always had a theme with the appropriate decorations and food, and all instructors dressed to fit the theme. For example, for a carnival theme Friedenberg dressed as a clown. The event was advertised on every unit, including bringing balloon bouquets onto each floor with a lot of signage.
Last summer as part of a Joint Commission standards focus, Ruzicki e-mailed a diabetic teaching situation to all nurses and gave simple prizes for their correct responses.
"Educators must be able to identify the best teaching methodology for the overall goals and objectives they are trying to accomplish within their educational program. Then they need to look at leveraging the resources they have available to them," advises Just.
For more information on techniques for teaching staff, contact:
• Barrie F. Friedenberg, BSN, MA, Instructor, Nursing Education, New York Presbyterian Hospital, Weill Cornell Campus, 525 E. 68th St., Box 174, New York, NY 10021. Telephone: (212) 746-1228. E-mail: firstname.lastname@example.org.
• Jean A. Just, RN, MS, CS, Director, Nursing Staff Development & Patient Education, The James Cancer Hospital and Solove Research Institute, The Ohio State University Medical Center, 1375 Perry St. Bldg. #13, Columbus, OH 43201. Telephone: (614) 293-3258. E-mail: email@example.com.
• Dorothy A. Ruzicki, PhD, RN, Director, Department of Educational Services, Sacred Heart Medical Center, W. 101 Eighth Ave., TAF-C9, Spokane, WA 99220-4045. Telephone: (509) 474-3392. E-mail: RuzickD@shmc.org.