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This four-part implementation series explores expected challenges healthcare organizations may encounter when adopting an improvement initiative. Each article provides tips for effective implementation based on our experience working with organizations to successfully execute an advance care planning initiative. The first installment takes a closer look at clinician training for developing the skills necessary to effectively carry out a new initiative, and its associated challenges. Future installments will explore challenges related to workflow, inpatient settings, and outpatient settings.

Overcoming Clinician Reluctance

While healthcare providers have the desire to improve patient care, they are struggling with bigger patient loads, higher-acuity patient populations, new regulations and requirements, and a host of other pressures related to delivering care in a value-based environment. Given all of this, it is understandable why clinicians may be reluctant to participate in the quality improvement process, particularly if it involves learning and applying new skills.

Successful performance improvement requires the full engagement of front-line clinicians. The Institute for Healthcare Improvement has a framework of six strategies to encourage physician buy-in for a quality improvement initiative. One of the key elements is to provide education on both the goals of the initiative, as well as on the skills and competencies necessary for carrying out the improvement.

The Need for Effective Clinician Training

Clinicians are an essential part of many quality improvement initiatives, particularly those that involve patient encounters. To ensure that providers have the relevant expertise and skills to apply to clinical practice, an initiative should incorporate opportunities for professional development.

Effective training will not only help clinicians be more engaged in new quality processes but will also advance their ability to provide better care and improve the likelihood the initiative will meet its goals.

It can be easy to take for granted that healthcare providers know how to learn, especially considering they have successfully gone through years of schooling. However, when developing a training program for practitioners, it’s important to understand the specific qualities of adult learners – like their eagerness to learn relevant material, their need to connect with experience, and their motivation to improve themselves.

The application of adult learning principles is an effective way to equip providers with the knowledge and clinical skills for delivering care within a new quality improvement program.

How to Apply Adult Learning Principles

How can you make training something that the participants want to take part in, and how can you make it effective?  For an education program to be as impactful and engaging as possible, it is important to understand how the adult learner’s mind works.

Adult Learning Theory highlights distinct ways adults respond best to learning. Malcom Knowles, who pioneered the field of adult learning, identified general characteristics of how adults perceive learning and how they prefer to train. His theory is based on the assumptions that adults:

1. Are self-directed in the planning and evaluation of their learning
2. Learn through experience
3. Have a problem-solving approach to learning
4. Learn best what is relevant and useful to them

Keeping these characteristics in mind, here are six teaching strategies you can use to help improve the effectiveness of your clinician training program.

• Use Real-World Learning Examples: Adult learners prefer to connect with experience and will gain more when they can pull past experiences into the learning process. Relate clinicians’ experiences to the skills or theories being taught and engage them in sharing their knowledge.
• Promote Self-Directed Learning: Most adult learning happens outside the context of formal training. By creating a more self-directed, independent learning environment, and allowing clinicians to be responsible for their own learning, they are more likely to be motivated and engaged in the training process.
• Allow for Active Learning: The generally accepted wisdom is that adults retain about 10% of what they see; up to 40% of what they see and hear; and close to 90% of what they see, hear, and do. Using active participation through role-playing and teach-backs can result in longer-term recall and more developed problem-solving skills than through visual and verbal instruction only.
• Give Trainees a “Why”: When adults choose to learn something, it is because they see value in it. Learning must be applicable to their work or other relevant responsibilities. Clinicians will want to know how they can use newly acquired information and how it will help them be better at their job. Take the time to explain what they are doing and why it matters.
• Use a Variety of Teaching Methods: Different people learn in different ways. Some are primarily visual learners, who benefit from diagrams and written instructions. Others are auditory learners, who prefer to learn via verbal instruction. Kinesthetic learners prefer hands-on practice materials. For most effective training, find ways to appeal to different learning styles.
• Segment Training When Necessary: Although some degree of standardization is important, there is not always a “one size fits all” approach. Sometimes it makes sense to develop separate programs based on clinician role and the target patient population. For example, the ACP Decisions video library offers clinician training modules for advance care planning that apply to specific clinician and patient scenarios.

Interested in learning more about our advance care planning resources and video library? Contact us today!

 

 

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