Stephanie Clubbs, MSN, RN-BC
Provided by Ohio Nurses Association
© ONA, 2014
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Objectives
 Identify different methods of assessing learning
needs
 Discuss the selection of teaching strategies to meet
the learner’s identified needs
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Disclosures
 Requirements for successful completion: Listening to
entire webinar and completing the post-test and
evaluation form.
 Conflict of interest: Planners & faculty have declared no
COI
 The Ohio Nurses Association (OBN-001-91) is accredited
as a provider of continuing nursing education by the
American Nurses Credentialing Center’s Commission on
Accreditation.
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The process by which a discrepancy between
what is desired and what exists is identified
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Needs Assessment
 Specific to your target audience
 Why do they need this content? (what evidence
do you have?)
 Who are the expected learners? (target audience)
 When do we need it? (tomorrow afternoon?)
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What is the Evidence of a Learning Need?
 How do you know what the learners need?
 What are the reasons they need to know the
information?
 What are some sources of information that
can help guide you?
 Helps you focus on the problems or
opportunities for improvement when
designing education
 Is the problem an educational need?
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Sources of Data to Determine Need
 External Examples of Need
 Government - NIH, CDC
 Accrediting Bodies, CMS
 Professional Standards – Association Standards,
NDNQI data
 Health Depts
 Legislative Initiatives
 Professional Literature
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Sources of Data to Determine Need
 Internal Examples of Need
 Performance/quality data or improvement initiatives



Dashboard Data, Competitive Data
HR Data/Reports, Recruitment/retention data
New Equipment, New teaching resources (LMS, social
media, etc)
 Incident Reports
 Organizational Mission/Goals
 Annual Survey/Summative Evaluations
 Requests – phone, verbal, e-mail

From management, staff, other customers/stakeholders
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Why Do a Needs Assessment?
 Make sure you spend time providing what is really
needed
 More likely to achieve the outcome you want to achieve
 More satisfying to learners
 More likely to result in behavior changes
 Lets you select appropriate teaching strategies to
best meet the need and achieve your
outcome/goal
 Is there a lack of knowledge, skill
or practice?
 Not just for CE programs
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Determining the Gap
 What is gap analysis?
 Comparison of learners current state
of knowledge, skills, or practice to the
desired state of knowledge, skills, or
practice.
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Determining the Gap
 Is there a gap in:
 Knowledge – doesn’t know how
 Skill – does not know how
 Practice – not able to show or do
during practice
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Able to
apply in
practice
Able to
demonstrate
Able to explain,
discuss (use)
Able to identify, define,
state (knowledge)
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Determining Purpose
 What the learner will achieve by the end
of the activity
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Outcome Measures
 How will you evaluate if the activity
achieved its desired purpose?
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Current State
Desired State
Majority of nurses Vast majority of nurses
surveyed held the
surveyed would
belief that as long positively state that
as they did not
any type of patient
disclose PHI during info related disclosures
facebook posts, on a social media site
they were not are inappropriate and
violating HIPPA can lead to violation of
laws.
practive and privacy
laws.
Identified Gap
Nurses do not know
that even non PHI
disclosures can lead
to patient
identification and
privacy disclosures
when shared on
social media sites.
Gap due to
knowledge, skills, or
practice
Knowledge Gap
Purpose
Outcome Measure
Increase the knowledge
Nurses will not share
level of nurses related to
patient related
the dangers of sharing
information on social
patient information on
media sites.
social media sites.
Outcome Measure: The
hospital will not receive
any complaints of
inappropriate posting by
its nurses.
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Teaching for Knowledge
 Lecture
 Discussion
 Case Scenario Method
 Active Learning
 Distance Learning
 Pre/Post Tests
 Long term evaluation re use of gained
knowledge
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Teaching Strategies or Methods Need to
Support Your Being Able to Meet Your
Identified Outcomes
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Scenario
 The director for one of your units asks for your help.
Their PI indicators shows an increase in infection rates
on the unit. She asks you to set up a competency
review for the staff.
 What additional information do you need to have?
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Definitions
 Competency: “An expected level of performance
that integrates knowledge, skills, abilities and
judgment.”
 Competency Program: “A group of activities
designed to support an ongoing dynamic process
of assessment and evaluation of performance.”
 Core Compentency: “A fundamental level of
knowledge, ability, skill or expertise that is
essential to a particular job.”
ANPD 2010
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Competency Needs Assessment
 What infections rate(s) have increased?
 HAI, CAUTI, Central lines…?
 Has anything changed in the last 3-6 months?
 New staff? New equipment? New policy/procedures?
 What has staff said about the increased infection
rates?
 Is this something staff should know and be able
to make critical decisions about in their typical
practice?
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Scenario
 Infection rates related to central IV lines maintenance
have increased over the last 3 months. Central IV lines
are commonly seen on this unit.
 A. Four months ago a new central line maintenance
bundle was introduced and education provided to the
staff. No new equipment or practices were introduced.
Five primary steps in the care of a central line, to be done
with every patient with a central line, were emphasized
as a best practice requirement of care.
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Scenario (con’t)
 B. Four months ago a new central line flush procedure
and new central line caps were introduced. Inservice
education was provided at that time.
 C. This unit recently expanded in size, requiring hiring
of approximately 12 new RN staff members. 8 of the
new hires are new graduate nurses. These nurses also
expressed lack of comfort with addressing patient
education related to central lines.
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Competency Gap Analysis
 Is there a need to test for knowledge, skill, or
practice?
 Scenario A?
 Scenario B?
 Scenario C?
 What strategy(s) would work best to verify
what you are testing?
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Strategies to Measure Knowledge
 Tests – written or verbal?
 T/F or Multiples choice vs short answer or case study
evaluation
 Paper/pencil or Computer?

Use of Learning Management Systems
 Posters/Review Stations
 Is this something that must be known for accurate
everyday practice?
 What constitutes “passing”? What if they don’t pass?
 Scenario A – Need to reinforce information in
“maintenance bundle”
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Strategies to Measure Skill
 Demo/Return Demo
 Done on unit – group vs one on one
 Skills stations
 Low tech manikins/task-trainer simulators
 Scenario B – need to ensure staff can
correctly flush lines and work with new caps
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Strategies to Measure Practice
 Simulation
 High Fidelity
 Computer Based programs
 Virtual Reality simulation
 Low Fidelity Simulation
 Role Play
 Low tech manikins/simulators
 Scenario C – Provide opportunity for new staff to
practice skill and utilize available resources (pt
educ)
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Strategies to Measure Practice
(con’t)
 Observation of Practice
 By Management/Professional Development?
 By Peer?
 Chart audits
 Tools for the auditors to evaluate same criteria
 How will feedback be provided?
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Simulation
 Imitation working environment to demonstrate
procedural techniques, decision-making, and
critical thinking (NCSBN 2005)
 Use pre-developed case scenarios, or develop your own
 Build in debriefing time (structured plan)
 Allows application of knowledge, skills and attitudes
required in practice
 Interactive, realistic
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Simulation (con’t)
 Helps develop/evaluate a variety of skills/practice
 Interpersonal communication (with patients,




colleagues), teamwork
Critical thinking, decision-making, prioritizing
Patient education, history taking, interviewing
Physical/psychosocial assessment
Others
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HighFidelity Simulation
Advantages
Disadvantages
 Interactive & realistic
 Cost of high-tech
 Risk free learning environment
equipment
 Specialized training to
run/maintain equipment
 Case scenario
development can be time
consuming
 Time – testing one at a
time or small groups
 Helps develop clinical reasoning/
decision making
 Can evaluate multiple
competencies simultaneously in
short period of time
 Learners can view their own
performance via video/audio
recordings
 Scenarios/responses more
consistent
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Computer Web-based Simulation
 Interactive, can receive immediate feedback
 Can work independently or in groups
 Navigation options to customize to learner role
 Navigation options to allow branching (of responses)
based on learner choices in the scenario
 Cost vs free
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Computer Web-based Sim. Example
 Healthcare Associated Infections –
Health.gov
 Partnering to Heal
 http://www.health.gov/hai/training.asp#pa
rtneringtoheal
 http://www.health.gov/hai/training.asp#pa
rtneringtoheal
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Low Fidelity Simulation – Role Play
 Design a realistic scenario
 What are the key competency needs?
 Consider location (on or off unit?)
 Develop the roles (patient, others?)
 Scripting standardized patients (&/or other characters) –
everyone gets the same experience
 Develop the debriefing
 Key competencies to be evaluated– checklist
 Key take-away points
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Low Fidelity Simulation – Role Play
 Training for actors/evaluators (trial run?)
 Expectations for consistent scenario, evaluation,
debriefing
 Knowledge of the skills tested, teaching methods &
evaluation skills
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Low Fidelity Simulation – Role Play
 Gather equipment, resources
 Evaluation of participants
 In groups or individually?
 Evaluate overall effectiveness
 Staff satisfaction, improvement in confidence
 Changes in practice
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Low Fidelity Simulation
Advantages
 More comfortable learning






Disadvantages
 Time consuming (maybe) –
environment
testing one at a time or
small groups
Time for reflective debriefings
 Time for training for
Helps learners make
standardized patients
connections
 Time to develop case
Easy to use
scenarios and debriefing
Very helpful for affective domain
content
learning, communication skills,
 Challenge to maintain
problem solving, decisionconsistent experiences and
making, collaboration
evaluation
Low cost
Realistic, interactive highimpact learning
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Peer Evaluation of Competency?
 Can significantly influence behaviors
 Magnet/Professional expectation
 Become expert “go to” person in their area
 Accessible, and have established credibility
 Can become the “champions” in their area
 Pre-determined expectations
 Proctors need to know specifically what is expected
 Train-the-trainer programs – how to teach/evaluate
 Need to know resources (technical, informational,
personnel)
 Incentives for peer teachers/evaluators
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SCENARIO
 The manager of a unit contacts you to set up an
inservice for his staff regarding use of the
emergency pacemaker.
 What additional information do you need to have?
 Is the equipment new?
 How often does the staff use this equipment?
 Was there an incident?
 How complex is the process to use the equipment?
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INSERVICE EDUCATION
 Definition - activities intended to assist the
professional nurse to acquire, maintain, and/or
increase competence in fulfilling the assigned
responsibilities specific to the expectations of the
employer.
 Recognition of the need
 Patient safety or quality? High-risk, low-volume skill?
New equipment/process? New practice
standards/models?
 What is the gap and outcome you want to achieve?
 How often is the skill needed in practice?
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Strategies to Provide Inservice
Education
 Face-to-face – group or one on one
 Good if need to have hands-on time
 Skills station – demo/return demo
 Simulation
 Time commitment
 Ability to reach all staff?
 Teachers? NPD, specialists, staff peers?
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Strategies to Provide Inservice
Education (con‘t)
 Asynchronous learning
 Read-n-sign
 Computer learning module
 Poster
 Ability to reach all staff at all times
 Available for review after inservice
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Computer Web-based Example
 Preceptor Podcasts – Palmer Healthcare
Foundation
 http://www.palmhealthcare.org/nursingpreceptor-podcasts
 Video scenarios
 Attitude Problems
 Inability to Demonstrate Knowledge
 Unprofessional Behavior
 Poor Communication
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Orientation
 Classroom? On-the-job? Combination?
Other methods?
 What is the minimum they need to begin
practicing on their own?
 Preceptors/mentors?
 Training for Preceptors
 www.RealityRN.com
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Orientation – Considerations for
Millenials
 Clear, structured, provide feedback
 More focused on learning/participating as teams
 May be overly confident, lack fear or hesitancy
 More visually oriented, learn by doing
 Prefer to learn for themselves, rather than being told
 Consider classroom design (lecture vs group tables,
computers, interactive devices; teaching from the middle
vs front lecture)
 Prefer learning that is relevant, active, instantly
useful
 vs just in cased teaching
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More Thoughts on Education
 Try more learner centered methods of teaching
 Consider learner preferences
 Consider when/how education is provided
 Make sure the strategy is meaningful to the
outcomes
 Try using more/new technologies
 Evaluate nursing practice to evaluate education
 Enjoy teaching!
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Questions?
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References
 Billings, D. M., Kowlaski, K. (2012). Role-Play Revisited. The
Journal of Continuing Education in Nursing, 4(5), 201-202.
 Chappell, K., Koithan, M. (2012). Validating Clinical
Competence. The Journal of Continuing Education in
Nursing, 43(7), 293-294.
 Chappell, K., Koithan, M. (2012). Developing a Skills-Based
Competency Course. The Journal of Continuing Education
in Nursing, 43(12), 535-536.
 Churchouse, C., McCafferty, C. (2012). Standardized Patient
Versus Simulated Patients: Is There a Difference? Clinical
Simulation in Nursing, 8(8), e363-e365.
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References
 Decker, S., Sportsman, S., Puetz, L., Billings, L. (2008). The
Evolutions of Simulation and Its Contribution to
Competency. The Journal of Continuing Education in
Nursing, 39(2). 74-80.
 DeSilets, L. D., Dickerson, P. S., Lavin, S. (2013). More on
Gap Analysis. The Journal of Continuing Education in
Nursing, 44 (10), 433-434.
 Garside, J. R., Nhemachena, J. Z. Z. (2011). A Concept
Analysis of Competence and It’s Transition in Nursing.
Nurse Education Today, 33, 541-545.
 Herrman, J. W. (2011). Keeping Their Attention: Innovative
Strategies for Nursing Education. The Journal of
Continuing Education in Nursing, 42(10), 449-456.
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References
 Kim-Godwin, Y. S., Livsey, K. R., Ezzell, D., Highsmith, C.
(2013). Home Visit Simulation Using a Standardized
Patient. Clinical Simulation in Nursing, 9(2), 355-361.
 National Nursing Staff Development Organization,
American Nurses Association (ANA) 2010. Scope and
Standards of Practice for Nursing Professional
Development. Silver Springs, MD: Nursbooks.org
 Parkin, Vera. (2006). Peer Education: The Nursing
Experience. The Journal of Continuing Education in
Nursing, 37(6), 257-264).
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References
 Reese, C. E. (2011). Unfolding Case Studies. The Journal of
Continuing Education in Nursing, 42(8), 344-345.
 Yoder, S. L. (2012). “Beam Me Up, Scotty”: Designing the
Future of Nursing Professional Development. The Journal of
Continuing Education in Nursing, 43(12), 456-462.
 Zabar, S., Hanley, K., Stevens, D. L., Ciotoli, C., Hsieh, A.,
Criesser, C., Anderson, M., Kalet, A. (2010). Can Interactive
Skills-based Seminars with Standardized Patients Enhance
Clinicians’ Prevention Skills? Measuring the Impact of a
CME Program. Patient Education and Counseling, 80, 248252.
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