nurse educator manual.pdf

Nurse Educator Manual: Essential Skills and Guidelines

for Ef fective Practice

hcPro

ADRIANNE E. AVILLION, DED, RN

Nurse Educator Manual: Essential Skills and Guidelines for Effective Practice is published by HCPro, Inc.

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List of figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix

About the author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi

Chapter 1: The evolution of staff development: Response to a changing healthcare environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Origin through World War II (WWII) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

1940s–1960s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

1970s–1990s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

1990s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

The 2000s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Chapter 2: Correlating values, vision, and mission statements with educational programming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Vision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Recommendations for writing a vision statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Mission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Use mission, vision, and values to design and implement education . . . . . . . . . . . . . . . . . . .21

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24

CONTENTS

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Chapter 3: Qualifications and job descriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Qualifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

Job descriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Overview of responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34

Qualifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34

Reporting mechanism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34

Working conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

Competencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

Signatures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

Chapter 4: Applying the principles of adult learning . . . . . . . . . . . . . . . . . . . . . . . . .41

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

Identification and application of adult learning principles . . . . . . . . . . . . . . . . . . . . . . . . . . .42

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Chapter 5: Collecting and analyzing education needs assessments data . . . . . . . . . .53

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53

Preparing for data collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53

Data collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56

Data from program evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56

Data from performance evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58

Data from quality improvement and risk management . . . . . . . . . . . . . . . . . . . . . . . . . .59

Informal data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

Analyzing needs assessment data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

Differentiating learning needs from other issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

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Prioritizing needs and planning education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66

Chapter 6: Planning and implementation of education . . . . . . . . . . . . . . . . . . . . . . .69

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69

Identifying objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70

Selecting and implementing education strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71

Lecture/discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72

Group discussions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72

Role play . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73

Skill demonstration/simulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73

Distance learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73

Audio-visual aids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80

Chapter 7: Recordkeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83

Types of records maintained . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84

Recordkeeping policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89

Chapter 8: Learning styles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91

Auditory learners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91

Visual learners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92

Kinesthetic learners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93

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Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100

Chapter 9: Planning education for multicultural and multigenerational participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103

Cultural diversity and the practice of staff development . . . . . . . . . . . . . . . . . . . . . . . . . . .104

Identifying topics in cultural diversity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110

Education planning for multigenerational learners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110

Veterans (1922–1945) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110

Baby Boomers (1946–1960) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112

Generation X (Xers) (1961–1980) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113

Generation Y (Yers) (1981–2000) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117

Chapter 10: Strategies for dealing with the resistant learner . . . . . . . . . . . . . . . . .121

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121

Why learners are resistant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122

Important questions to answer about the learning activity . . . . . . . . . . . . . . . . . . . . . . . . . .123

Dealing with overt hostility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .129

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .129

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .130

Chapter 11: Tips for planning orientation, inservice, and continuing education . . . .133

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .133

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Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .133

Orientation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134

Inservice education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135

Continuing education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .139

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143

Chapter 12: Quality improvement and evaluation of education effectiveness . . . . . .147

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147

Level I evaluation: Reaction and learner satisfaction . . . . . . . . . . . . . . . . . . . . . . . . . . .148

Level II: Knowledge acquisition (learning) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .148

Level III: Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157

Level IV: Results/impact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157

Level V: Return on investment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .162

Chapter 13: Writing test items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165

Components of well-written test questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165

Tactics to avoid when writing test questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166

Measuring objective achievement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167

Knowledge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167

Comprehension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167

Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168

Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169

Chapter 14: Overview of a staff development business plan . . . . . . . . . . . . . . . . . .171

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171

C O N T E N T S

viii NURSE EDUCATOR MANUAL: ESSENTIAL SKILLS AND GUIDELINES FOR EFFECTIVE PRACTICE

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171

Components of the business plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172

Executive summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172

Departmental description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172

Departmental structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173

Products and services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173

Marketing strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173

Action plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174

Budget overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175

Resource . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176

Chapter 15: Ethical scenarios in staff development . . . . . . . . . . . . . . . . . . . . . . . .179

Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179

Scenarios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181

Final exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .182

Nursing education instructional guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183

Instructions for obtaining your nursing contact hours . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188

Nursing education exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .189

Nursing education evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197

ixNURSE EDUCATOR MANUAL: ESSENTIAL SKILLS AND GUIDELINES FOR EFFECTIVE PRACTICE

Chapter 1

Figure 1.1: The evolution of staff development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Chapter 2

Figure 2.1: Sample values statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Figure 2.2: Sample vision statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Figure 2.3: Sample mission statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

Chapter 3

Figure 3.1: Guidelines for determining qualifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Figure 3.2: Job description template . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Chapter 4

Figure 4.1: Tips for incorporating principles of adult learning . . . . . . . . . . . . . . . . . . . . . . . .46

Chapter 6

Figure 6.1: Education strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75

Chapter 7

Figure 7.1: Sample recordkeeping policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86

Chapter 8

Figure 8.1: Summary of learning styles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96

LIST OF FIGURES

L I S T O F F I G U R E S

x NURSE EDUCATOR MANUAL: ESSENTIAL SKILLS AND GUIDELINES FOR EFFECTIVE PRACTICE

Chapter 9

Figure 9.1: Cultural diversity education planner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107

Chapter 11

Figure 11.1: Inservice documentation form for review of written materials . . . . . . . . . . . . . .137

Figure 11.2: Inservice documentation form for skill training . . . . . . . . . . . . . . . . . . . . . . . .138

Chapter 12

Figure 12.1: Classroom evaluation form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149

Figure 12.2: Distance learning evaluation form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152

Figure 12.3: Skill demonstration form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156

Figure 12.4: Evaluation of behavior (application of new knowledge and skills) . . . . . . . . . .158

Chapter 14

Figure 14.1: Sample action statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175

xiNURSE EDUCATOR MANUAL: ESSENTIAL SKILLS AND GUIDELINES FOR EFFECTIVE PRACTICE

Adrianne E. Avillion, DEd, RN

Adrianne E. Avillion, DEd, RN, is the president and owner of AEA Consulting in York, PA. She

specializes in designing continuing education programs for healthcare professionals and free-

lance medical writing. Avillion also offers consulting services in work redesign, quality improve-

ment, and staff development.

She has published extensively and has served as editor of the first and second editions of Core

Curriculum for Staff Development, published by the National Nursing Staff Development Organ-

ization (NNSDO). She also is a frequent presenter at conferences and conventions devoted to

the specialty of continuing education and staff development. Avillion is the vice president of the

board of directors of NNSDO and holds a master’s degree in nursing and a doctorate in adult

education from Penn State University.

ABOUT THE AUTHOR

1NURSE EDUCATOR MANUAL: ESSENTIAL SKILLS AND GUIDELINES FOR EFFECTIVE PRACTICE

Introduction

In this context, staff development is the process of providing continuing education and training

for people working in organizations that specialize in the delivery of healthcare products and

services. Historical analysis of the evolution of nursing staff development shows that explicit,

repetitive trends indicate the need for specific types of training and continuing education for

healthcare professionals. This chapter traces the history of staff development and identifies

strategies for program planning based on past trends and predictions for the future.

C H A P T E R

1 THE EVOLUTION OFSTAFF DEVELOPMENT:

RESPONSE TO A CHANGINGHEALTHCARE ENVIRONMENT

OBJECTIVES

At the conclusion of this chapter, the learner will be able to

1. describe historical events that influenced the evolution of staff development2. analyze historical trends and use data to plan education programs3. identify specific historical milestones in the history of nursing and staff development response

to these events

Competency: The staff development specialist identifies evolving staff development trends and uses

this information to plan inservice and continuing education programs.

C H A P T E R 1

2 NURSE EDUCATOR MANUAL: ESSENTIAL SKILLS AND GUIDELINES FOR EFFECTIVE PRACTICE

Origin through World War II (WWII)

Nursing staff development began with the efforts of Florence Nightingale during the Crimean

War (1854–1856), a bitter struggle between Russian troops and an alliance of soldiers from

Turkey, Britain, and France. The horrific numbers of ill and injured men lead to a desperate

need for care provided by reputable nurses. Nightingale worked tirelessly to improve the effi-

ciency and adequacy of nursing care for allied troops.

After the war, Nightingale established standards for the nurses’ training schools that she found-

ed, and she worked to improve efficiency and care delivery in hospitals. She championed the

importance of education and, thus, advised nurses to embark on a course of lifelong learning

and to use the acquired knowledge to improve patient care.

Impact on staff development: A major event that threatens geographic or world-wide safety and

causes illness and injury increases the demand for good patient care. Such a demand increases

the need for qualified nurses, which elicits a need for more training and education at the under-

graduate level and for the newly licensed nurse as well.

Throughout the late 1800s and early 1900s, emphasis fell on creating training schools for nurses,

not facilitating lifelong learning. Formal staff development programs for nurses were practically

nonexistent. Hospitals were primarily staffed by nursing students, and the majority of trained

nurses earned their living as private-duty nurses in private practice. However, some early advo-

cates of formal staff development programs began to publish articles in nursing journals describ-

ing the need for ongoing continuing education. In 1912, Edna L. Foley, superintendent of the

Visiting Nurses’ Association in Chicago, proposed that graduate nurses attend inservices and

continuing education programs. In 1928, Blanche Pfefferkorn, executive secretary for the

National League for Nursing, wrote a historical review of nursing inservice education, encourag-

ing its expansion.

Then one major event triggered a dramatic change in the way nurses earned their living: the

Great Depression of the late 1920s and 1930s. The number of patients who could afford private-

duty nurses sharply decreased, forcing many nurses back into the hospital setting for the first

time since their initial training. Equally surprised were the hospital administrators, who found

THE EVOLUTION OF STAFF DEVELOPMENT : RESPONSE TO A CHANGING HEALTHCARE ENVIRONMENT


themselves in the position of hiring graduate nurses in significant numbers. This shift in practice

setting created several education needs. Newly hired nurses required orientation to the hospital

setting and inservice training for on-the-job skills. They also needed to learn to work as part of

a team that provided care to large numbers of patients rather than as solo practitioners who

were rarely responsible for more than one patient at a time.

Impact on staff development: Newly hired graduate nurses required orientation and inservice

education pertaining to on-the-job skills. They also needed training in teamwork and organiza-

tional skills. Because there were no staff development departments to coordinate these programs,

head nurses and nursing supervisors usually were responsible for training and education activi-

ties. Economic and political trends affect healthcare, so staff development specialists had to be

able to anticipate and meet subsequent educational needs.

World War II brought even more changes to the nursing profession. Nurses left hospitals in

large numbers to join the armed forces, which caused a shortage of registered nurses at home.

In an effort to combat the shortage, inactive nurses were encouraged to return to work in the

hospital setting. The number of nonprofessional staff increased in an attempt to compensate for

the lack of registered nurses.

Impact on staff development: Nurses returning to the work force needed refresher courses. Non-

professional staff required training, inservice, and continuing education. These issues sharply

increased the need for staff development services. Today, educators are expected to meet at least

some of these needs via self-learning modules, computer-based learning, etc., to avoid making

nurses leave their units and sit in a classroom.

1940s–1960s

The decades following WWII were periods of great advances in medical technology and treat-

ment and of corresponding opportunities for the advancement of nursing practice. These

advances and opportunities helped to promote staff development as a distinct, viable nursing

specialty because of the educational needs accompanying these trends.

C H A P T E R 1


This era was also a period of self-analysis for the profession. During the 1940s and 1950s, nurses

and other healthcare personnel began to evaluate their responsibilities and mandatory qualifica-

tions against standards set by various professional organizations. Orientation, inservice, and

continuing education needs began to be viewed as priorities by healthcare organizations. In

1953, the Joint Commission for the Improvement of Care of the Patient (a precursor of the Joint

Commission on Accreditation of Healthcare Organizations, or the JCAHO) proposed the estab-

lishment of a distinct department devoted to the training and continuing education needs of the

nursing department.

Impact on staff development: For the first time in its history, the nursing profession was advised

by an accrediting organization to establish a department devoted to meeting the continuing edu-

cation and training needs of nurses. Today, staff development specialists must be aware of new

standards established by accrediting bodies that influence education delivery.

Charge nurses and supervisors began to assume more administrative responsibilities in the

1960s, which sparked a need for leadership and management training. In addition, scientific

inquiry became more important during this decade. The need for an objective, scientific evalua-

tion of nursing care delivery against documented standards of quality became important not

only for the well-being of patients but also to determine how and why nursing is practiced.

Staff development specialists had to deal with the multiple orientation needs that became quite

apparent during the 1960s. Three entry levels of educational preparation—the diploma, the asso-

ciate degree, and the baccalaureate degree—offered varying amounts of clinical exposure for

nursing students. These differences affected the amount and type of orientation required by

newly licensed nurses.

Finally, the advent of critical care units created a need for nurses with highly specialized techni-

cal skills and accurate performance in an atmosphere of extreme pressure.

Impact on staff development: The following continuing education needs became apparent: lead-

ership and management skills, the nursing research process, flexible orientation programs, and

critical care skills. Changes in basic preparation and care delivery alert staff development spe-

cialists to changes in their own practice areas.



Then, a special event occurred in 1969, one that helped to promote staff development as a

viable nursing specialty: The Medical College of Virginia’s Health Sciences Division of Virginia

Commonwealth University sponsored the first national conference on continuing education

for nurses.

1970s–1990s

The 1970s and 1980s were periods of great change in the staff development specialty as well as

in the nursing profession. In the 1970s, the following events helped to establish staff develop-

ment as a distinct healthcare specialty:

• 1970: The Journal of Continuing Education in Nursing was first published

• 1973: The American Nurses’ Association (ANA) established the Council on Continuing

Education

• 1974: The book, The Process of Staff Development: Components of Change was published.

It defined the practice of staff development until the 1980s

• 1978: The ANA published Guidelines for Staff Development

• 1978: The Joint Commission on Accreditation of Hospitals mandated that a position to

oversee and coordinate staff development activities be established in its affiliated hospitals

The 1970s also saw an expansion of the women’s movement, including a broadening of career

opportunities for women. As women took advantage of these changes, enrollment in nursing

programs decreased, as did the number of licensed, working nurses.

Impact on staff development: Writing skills emerged as an educational need because of the advent

of staff development publications. An increase in the number and variety of career options for

women resulted in decreased enrollment in schools of nursing and a decrease in the number of

working RNs. A shortage of RNs required staff development specialists to prepare and implement

refresher courses for RNs, to offer more training and continuing education for nonprofessional

C H A P T E R 1


nursing department personnel, and to think of ways to make learning more convenient as it

became increasingly difficult for staff members to leave their units to attend programs in class-

room settings.

The realization that healthcare truly is a business was acknowledged by both healthcare person-

nel and consumers during the 1980s. Nurses—particularly nurse managers—needed to acquire

business acumen as the healthcare industry took on the characteristics of the for-profit sector.

The initiation of diagnostic-related groups (DRG) resulted in rapidly decreasing lengths of stays

for patients.

Impact on staff development: The need for education pertaining to financial management and

the business aspects of healthcare drove staff development specialists not only to arrange for such

programming but also to improve their own business skills. Financial management skills contin-

ue to grow in importance for nurses.

In 1985, The Journal of Nursing Staff Development (now known as the Journal for Nurses in

Staff Development) began publication. In 1989, the first professional association for nurses in

staff development, the National Nursing Staff Development Organization (NNSDO), was estab-

lished. Additionally, books devoted to the practice of nursing staff development were published

by major healthcare publishing companies.

1990s

The 1990s were years of rapid advances in technology and in the prevention and treatment of

disease. It was also the decade during which the world became widely aware of devastating

“new” diseases such as AIDS (Acquired Immune Deficiency Syndrome). The ’90s also saw the

creation of large health systems as hospitals, outpatient facilities, and long-term care facilities

merged in efforts to reduce competition and to provide “one-stop shopping” for persons need-

ing a variety of healthcare services.

The increasing effects of DRGs, the growing influence of health maintenance organizations

(HMO), and health insurance companies’ restrictions on types of treatments and lengths of stay

combined to make cost reduction a necessary survival mechanism for newly created health



systems. For the first time in decades, healthcare personnel, including nurses, faced layoffs.

“Downsizing” was added to the vocabulary of nearly every American.

Impact on staff development: Distance learning—including computer-based learning (CBL),

self-learning modules, and e-learning—became an important way of providing education to

nurses who were unable to leave their units. Staff development specialists also faced the downsiz-

ing phenomenon, as the first “cuts” were often made in education-related departments. Staff

development specialists were called upon to prove their value to the organization by measuring

education’s impact on organizational effectiveness and by demonstrating a return on invest-

ment (ROI). They also assumed broader responsibilities such as providing housewide education

instead of department-based education and taking on additional roles, including consultant,

researcher, and performance coach. This prompted many organizations to remove the word

“nursing” from staff development and refer to the department simply as staff development.

Additional significant events directly affecting staff development specialists in the 1990s are

summarized below:

• 1992: The ANA published Roles and Responsibilities for Nursing Continuing Education

and Staff Development Across All Settings

• 1992: The American Nurses Credentialing Center (ANCC) offered the first certification

examination for nursing continuing education and staff development

• 1995: The first Core Curriculum for Nursing Staff Development was published

• Emphasis shifted from provision of services to evaluating what impact education had on

organizational effectiveness

• The term “staff development” was replaced in some organizations with other terms such

as “organizational development,” “corporate university,” “education department,” and

“professional development department”

• Qualifications for leadership in staff development focused on education and managerial

experience rather than clinical expertise

C H A P T E R 1


The 2000s

As the healthcare community confronts the challenges of the initial years of the 21st century,

the responsibilities and accountability of staff development specialists continue to grow.

Government regulations such as the Health Insurance Portability and Accountability Act of 1996

(HIPAA) increased the need for mandatory training. Cyclical nursing shortages affected the

delivery of care. But an event that forever changed educational needs, as well as how the

United States functions as a member of the world community, was September 11, 2001 (9/11).

The horrific attacks on the World Trade Center and the Pentagon and the hijacking and subse-

quent crash in Pennsylvania of an airplane, triggered an immediate, ongoing need for rigid

emergency preparedness. This event also made healthcare professionals aware of a need for

knowledge about bioterrorism and the effects of weapons of mass destruction, including radia-

tion and germ warfare. These types of educational needs were not anticipated by many, but

now they are regarded as necessities.

Impact on staff development: In addition to emergency preparedness training and education

concerning bioterrorism and other weapons of mass destruction, staff development specialists

must be aware of new threats, particularly in the germ warfare arena, and plan education

accordingly.

Conclusion

Staff development has changed drastically since the days of the Crimean War, when Nightingale

first advocated lifelong learning. Staff development specialists must learn from their history by

analyzing trends and events that affect staff development and plan educational endeavors

accordingly. The following table summarizes the evolution of staff development, highlighting

significant events and their impact on the practice of staff development.



The evolution of staff development

From nursing’s origin

to WWII

1940s–1960s

Crimean War

Great Depression

WWII

Decades following WWII

Increased demand for formalized, high-quality

training for nurses. Nurses were encouraged to

pursue lifelong continuing education. The num-

bers of “training” schools for nurses increased,

as well as the need for instructors to staff

these schools. Nurses needed opportunities

for lifelong learning.

Nurses moved from private practice to the hos-

pital setting. These nurses needed orientation

to the hospital setting and training in organizing

care for large numbers of patients. Training

was generally provided by head nurses and

supervisors.

RNs joined the armed forces, causing a severe

nursing shortage. Inactive nurses were recruited

to return to work, and the number of nonprofes-

sional staff increased. Refresher courses for

inactive nurses, training, inservices, and continu-

ing education for nonprofessional staff increased

the need for staff development services.

Advances in medical technology and treatment

and expanded roles for nurses increased the

need for continuing education.

F I G U R E

1.1

Time period Event Impact on staff development

C H A P T E R 1


The evolution of staff development (cont.)

1990s

Nurses recognized the

need to define and pro-

mote nursing as a pro-

fessional discipline in

the 1960s

New, virulent disease

processes affected the

worldwide population

Mergers and downsizing

became common events

The numbers of nonprofessional nursing staff

grew, requiring training and continuing educa-

tion for that particular population.

1953: The Joint Commission for the Improve-

ment of Care of the Patient proposed the

establishment of a distinct department devoted

to the training and continuing education needs

of nurses.

1960s: Nursing research assumed greater

importance, critical care units opened, varying

basic preparation programs triggered a need for

flexible orientation, and head nurses required

more management and leadership skills.

Continuing education grew in importance due,

in part, to rapid medical advances and new dis-

ease entities.

Staff development specialists had to prove

their value to the organization by demonstrating

education’s impact on organizational effective-

ness. They also assumed broader role respon-

sibilities such as providing continuing education

to an entire organization instead of just nursing

F I G U R E

1.1




The evolution of staff development (cont.)

2000s

Thanks in part to expand-

ing responsibilities, staff

development assumes a

housewide role

September 11, 2001

HIPAA and other govern-

ment regulations are

enacted

Cyclical nursing

shortages

staff and acting as consultants, researchers,

and performance coaches.

ANCC offered a certification exam for nursing

continuing education and staff development.

Staff development specialists were expected to

prove their value to the organization by demon-

strating education’s impact on organizational

effectiveness and measuring ROI.

First Core Curriculum for Nursing Staff

Development was published.

Emergency preparedness became an education

priority, as did the effects of weapons of mass

destruction.

Types of mandatory training increased.

Education must be delivered at the conven-

ience of staff members. Refresher courses

must be implemented for inactive RNs return-

ing to the work force.

F I G U R E

1.1


C H A P T E R 1


Bibliography

Avillion, A.E. The redesign of nursing staff development. Pensacola, FL: National Nursing Staff

Development Organization, 1996.

Avillion, A.E. A practical guide to staff development: Tools and techniques for effective education.

Marblehead, MA: HCPro, Inc, 2004.

Brunt, B.A., J.T. Pack, and P. Parr. “The history of staff development.” In A.E. Avillion (Ed.),

Core curriculum for staff development. 2nd ed. Pensacola, FL: National Nursing Staff

Development Organization, 2001. 3–17.

DeSilets, L.D., and S.E. Pinkerton. “Looking back on 25 years of continuing education.” The

Journal of Continuing Education in Nursing 35, no. 1 (2004): 12–13.

Nightingale, F. Notes on nursing. London: Harrison and Sons, 1859.

Tobin, H.M., P.S. Yoder-Wise, P.K. Hull, B.C. Scott, and B.C. Clark. The process of staff develop-

ment: Components for change. St. Louis: Mosby, 1974.



1. The event that triggered the beginning of staff development was:

a. The Great Depression

b. The Crimean War

c. World War I

d. World War II

2. The Great Depression’s impact on staff development was to cause a significant need for:

a. orientation to the hospital setting

b. training schools of nursing

c. a distinct department devoted to staff development

d. specialty certification

3. Expanded use of nonprofessional healthcare workers was one of the results of:

a. The Great Depression

b. Florence Nightingale’s nurses’ training schools

c. World War II

d. advances in medical technology

4. Staff development specialists should realize that, in the event of a shortage of active registered

nurses, they must be prepared to:

a. offer fewer education programs for unlicensed personnel

b. offer more continuing education programs in the classroom setting for RNs

c. spend less time orienting inactive nurses who are returning to work

d. develop and implement refresher courses

5. What milestone in the evolution of staff development occurred in 1953?

a. Training needs for nonprofessional staff were first identified

b. The Joint Commission proposed that a distinct department devoted to nursing education

needed be established

c. Nursing research became a mandatory activity within healthcare organizations

d. Journals written specifically for nurse educators and staff development specialists were

published

FINAL EXAM

C H A P T E R 1


6. Amanda is the vice president for staff development in a large, multihospital healthcare system.

One of the organization’s strategic goals is to assume a leadership position in the field of long-

term care within the next five years. Historically, the organization’s emphasis has been on women’s

health issues. Amanda is asked to submit her long-term goals for review by the CEO and his admin-

istrative team. Which of the following goals is the highest priority for long-term planning?

a. Decrease the time spent orienting new employees by 5%

b. Increase the hours of labor and delivery education offered by 10%

c. Facilitate the certification of nurses as geriatric specialists by developing and offering certi-

fication preparation courses at least quarterly

d. Facilitate the transition from LPN to RN by offering state board preparation courses to

LPNs enrolled in RN programs

7. Recognizing that women have more career options suggests that staff development specialists

should make all of the following priorities EXCEPT:

a. refresher courses

b. distance learning programs

c. more training for nonprofessional staff

d. more education programs presented in the classroom setting

8. An increase in continuing education pertaining to financial management was due to:

a. acknowledgment that the healthcare industry is a business

b. the healthcare industry’s movement toward a not-for-profit outlook

c. expansion of the women’s movement

d. a decrease in the number of nurse managers

9. The 1990s were characterized by which of the following?

a. The start of management training for nurse leaders

b. The proposal that staff development should be a distinct department within an organization

c. Downsizing of hospital personnel, including nurses

d. A decrease in the roles of staff development specialists because of budget cuts

10. In the 2000s, which of the following types of education assumed a new, critical importance?

a. Writing skills

b. Inservice training

c. Performance coaching

d. Emergency preparedness


Introduction

The staff development department’s values, vision, and mission statements establish a founda-

tion for the delivery of its products and services. These statements must not only guide the way

education is planned and implemented but also coincide with the organization’s value, vision,

and mission statements.

Staff development specialists are evaluated, in part, on how effectively their programs support

these statements and facilitate the achievement of organizational goals.

C H A P T E R

2 CORRELATING VALUES, VISION, AND MISSION STATEMENTS WITH

EDUCATIONAL PROGRAMMING

OBJECTIVES


1. define the mission, vision, and values of his or her organization/department2. describe the components of staff development mission, vision, and values statements3. plan educational activities that support the mission, vision, and values of the organization and

the staff development department

Competency: The staff development specialist will plan, implement, and evaluate education pro-

grams that reflect the values, vision, and mission of the staff development department.

C H A P T E R 2


Values

A values statement, sometimes referred to as a philosophy, reflects the beliefs and principles

that direct departmental activities. Values must be stated clearly and succinctly and direct the

department’s response to organizational needs. The staff development specialists must support

these values and fulfill their responsibilities accordingly.

Staff development scenario: Victoria is the director of staff development at Mason Health System.

This system consists of two 500-bed hospitals, two hospices, and four long-term care facilities.

Historically, the organization has focused on its oncology and hospice services. However, there

are plans to purchase five outpatient clinics and build two more. The outpatient surgery centers

located within each of the existing three hospitals are marked for significant expansion. Mason

Health System’s values statement has been rewritten to emphasize both the provision of outpatient

services and the meeting of patient and family needs on an outpatient basis. The system also is

giving distance learning new prominence. Due to the extensive education and training needed

for the various outpatient settings, Mason’s administrative team wants the education delivered in

ways that do not require nurses and other staff members to leave their units and sit in classrooms

for long periods of time. Victoria and her staff must review their department’s values statement

and revise it to reflect changes in organizational priorities.

The following values statement reflects organizational changes described in the preceding sce-

nario. In addition to revising the values statement, Victoria must make sure that her staff under-

stand and support the changes affecting Mason Health System and the professional development

department.

CORRELATING VALUES, VISION, AND MISSION STATEMENTS WITH EDUCATIONAL PROGRAMMING


Sample values statementF I G U R E

2.1

Mason Health System staff development department

Mason Health System’s staff development department’s primary responsibility is to offer employees

education programs that enhance their job performances and improve the delivery of high-quality

patient/family care.

In order to fulfill this responsibility, the staff development department adheres to the following principles:

• Learning is a lifelong process

• Teaching/learning is an interactive process between the learner and the staff development

specialist, and it is conducted with mutual respect and regard

• Adults are self-directed learners who bring extensive life experiences to any teaching/

learning activity

• Education activities must be offered in ways that make attendance/participation convenient to

the learner, including but not limited to classroom learning, self-learning activities, computer-

based learning, and other forms of distance learning

The staff development specialist adheres to the values of the organization and the staff development

department. He or she is responsible for

• identifying the educational needs of the organization based on learner feedback and organiza-

tional goals

• providing educational programs that improve organizational effectiveness, meet learner needs,

and enhance job performance

• evaluating the effectiveness of education programs as measured by their impact on organiza-

tional effectiveness and using data obtained to improve educational activities

C H A P T E R 2


Staff development scenario: In the sample values statement, Victoria and her staff write that the

staff development specialist adheres to organizational values, making it clear that they support

Mason Health System’s goals. It is clearly stated that educational needs are identified based not

only on learner feedback but on organizational values as well and that programs are planned to

improve organizational effectiveness, meet learner needs, and enhance job performance.

Incorporating “convenient” ways of acquiring education is part of the organization’s values and

part of the staff development department’s values as well. Learners are responsible for acquiring

education that improves patient care and their job performance. The emphasis is on fulfilling

organizational needs. These needs are further clarified in the department’s vision and mission

statements.

Sample values statement (cont.)F I G U R E

2.1Learners are responsible for

• identifying their education needs and achieving their educational goals

• participating in relevant educational activities and contributing to the success of those activities

• maintaining competence

• evaluating the effectiveness of educational activities

• assuming responsibility for their lifelong learning

• using knowledge and skills acquired from educational activities to enhance job performance,

improve patient care, and support the mission, vision, and values of the organization

Organizational leadership is responsible for

• clearly identifying the mission, vision, and values of the organization

• supporting an environment that encourages lifelong learning

• Attending relevant or necessary education programs

• facilitating learners’ ability to participate in educational activities

• participating in the evaluation of education’s impact on organizational effectiveness



Vision

A vision is an image of the staff development department’s future. Staff development specialists

rely on this vision to build a cohesive team that crafts a common identity and future. A vision

motivates employees to work to their maximum abilities. It inspires but remains realistic and

achievable. The following figure offers recommendations for writing a vision statement.

Recommendations for writing a vision statementWhen writing your department’s vision statement, keep in mind the following:

1. Recognize that a vision statement is

• value-driven

• future-oriented

• realistic

• inspiring

• concise

2. Identify the department’s strengths and weaknesses

3. Determine what is inspirational and what is realistic

4. Complement the organization’s value statement with the staff development department’s

vision statement

5. Determine what education and training are expected to accomplish within the

organization

6. Incorporate the staff development department’s vision statement in all departmental activ-

ities, including but not limited to

• needs assessment

• program planning

• program implementation

• program evaluation

• quality improvement activities

7. Review and revise the vision statement based on changes in the organization’s vision

C H A P T E R 2


Staff development scenario: Victoria and her staff need to write a vision statement that reflects the

organization’s new emphasis on outpatient products and services. The following vision statement

meets this requirement.

Mission

A mission statement clearly communicates the purpose and direction of staff development activi-

ties to persons within and outside of the organization. It describes essential functions as well as

the overall reason for the department’s existence. A mission statement must

• reflect and support departmental and organizational values and vision

• specify essential functions and the reason for the department’s existence

• identify what the staff development department does for the organization

• serve as the foundation for departmental goals and objectives

• be reviewed and revised as the organization’s mission evolves and changes

Staff development scenario: The staff development department of Mason Health System must have

a vision that reflects organizational priorities. The sample mission statement in Figure 2.3 sup-

ports the health system’s new emphasis on outpatient services.

Sample vision statementF I G U R E

2.2

Mason Health System staff development department

It is the vision of the staff development department of Mason Health System to be a tri-state leader in

the provision of education that focuses on performance improvement and excellence in the develop-

ment of outpatient services and the delivery of distance education.



Use mission, vision, and values to design and implement education

After writing appropriate mission, vision, and values statements, staff development specialists

must identify goals for program planning based on these statements.

Staff development scenario: Victoria and her staff are planning education priorities based on

needs assessment data that are focused on mission, vision, and values statements. Emily is a

member of the department. She is an excellent educator and a skilled oncology nurse. Emily plans

and implements many of the oncology continuing education courses for Mason Health System.

Based on Mason Health System’s new focus on outpatient services, Emily is asked to plan some of

the educational activities needed for outpatient care provision. Considering Emily’s background

and the department’s mission, vision, and values, what are some appropriate responsibilities to

assign to Emily?

Sample mission statementF I G U R E

2.3Mason Health System staff development department

The staff development department of Mason Health System upholds the mission, vision, and values

of the organization by developing and offering educational activities designed to improve the quality

and appropriateness of patient care.

This department’s purpose is to enhance organizational effectiveness by implementing educational

programs that increase the knowledge and skills of all employees. The staff development department

facilitates the development and accreditation of a broad spectrum of outpatient services by offering

education that helps employees to function effectively in outpatient settings.

Education is delivered in ways convenient for the learner, such as self-learning modules, computer-

based learning, and e-learning.

C H A P T E R 2


Emily’s experience as an oncology nurse is invaluable. Some of her responsibilities may include

• revising current oncology courses so that they are offered via distance learning methods

• adapting existing oncology courses to meet the needs of staff working in outpatient

oncology settings

• adapting existing oncology orientation programs to meet the needs of staff working in

outpatient oncology settings

The preceding suggestions allow Emily to make use of her expertise while meeting department

and organization needs, but the transition may not be as easy for some of Emily’s colleagues.

Staff development scenario: Jeff is a staff development specialist who works primarily with critical care

departments. His background is in emergency room and trauma critical care. He sometimes resists

distance learning activities, believing that teacher–learner personal interaction is necessary for the

provision of quality education. Furthermore, he dislikes the outpatient setting, describing it as “bor-

ing.” Are there problems ahead for Jeff? How can Victoria help defuse a potentially difficult situation?

Jeff will not be able to stop the organization’s foray into outpatient services, but that doesn’t

mean he will not try to do so. His feelings may interfere with the staff development depart-

ment’s ability to function effectively if he indulges in disruptive behavior and negativity. Jeff has

some of the same options as Emily. Here are some suggestions for dealing with Jeff:

• He can continue to work with the critical-care areas but needs to adapt some of his pro-

grams to a distance-learning format.

• The outpatient clinics associated with follow-up trauma care and critical care may be an

appropriate focus for Jeff.

• Jeff may require some help learning to make distance learning more interesting and

challenging. Some of his own continuing education needs involve distance learning

development.



• Jeff may benefit from a frank discussion concerning organizational goals and the staff

development department’s obligation to support those goals reflected in the mission,

vision, and value statements.

• According to the staff development competency identified at the beginning of this

chapter, “The staff development specialist will plan, implement, and evaluate education

programs that reflect the values, vision, and mission of the staff development depart-

ment.” This competency should be part of Jeff’s job description and reiterated in his

performance evaluations. Ultimately, it is up to Jeff to fulfill his job responsibilities.

• Victoria’s responsibility is to help Jeff adapt to organizational changes and facilitate his

ability to acquire necessary continuing education. However, it is also Victoria’s responsi-

bility to ensure that the staff development department meets the needs of the organiza-

tion. If Jeff is not able to demonstrate competency in this particular area, disciplinary

action may be necessary.

Conclusion

The mission, vision, and values statements are the foundations of the staff development depart-

ment’s practice. These statements must reflect the mission, vision, and values of the organization

and serve as the foundation of all departmental activities.

Bibliography


Development Organization, 1996.



Brunt, B.A. “Philosophy, mission, and goals.” In A.E. Avillion (Ed.), Core curriculum for staff

development. 2nd ed. Pensacola, FL: National Nursing Staff Development Organization, 2001.

19–30.

C H A P T E R 2


1. Mark is writing a first draft of a values statement for the staff development department. It is

important that this statement:

a. concentrates on the individual preferences of the staff development specialists

b. identifies essential functions of the department

c. reflects the philosophy of the organization

d. focuses on the future

2. The administrative team at Community Hospital has announced that the hospital will expand its

services to include physical medicine and rehabilitation, with an emphasis on neurological reha-

bilitation. Due to Community Hospital’s recent merger with a pediatric facility, pediatric services

at Community Hospital will be phased out. This may lead to downsizing of nurses currently work-

ing on the pediatric unit of Community Hospital. Based on these issues, all of the following pro-

grams are appropriate priorities EXCEPT:

a. care of the spinal cord patient

b. job interviewing skills

c. stroke rehabilitation

d. developmental characteristics of the toddler

3. An inspiring, future-oriented statement about the staff development department is a:

a. vision

b. mission

c. value

d. principle

4. Which of the following statements qualifies as a vision?

a. Learning is a lifelong process

b. Learners are responsible for identifying their education needs

c. The staff development department of Maplewood Health System strives to be a statewide

leader in pediatric oncology

d. The staff development department of Maplewood Health System is responsible for the

provision of education that enhances organizational effectiveness

FINAL EXAM



5. The statement that describes essential functions as well as the reason for the staff development

department’s existence is the:

a. vision

b. values

c. principles

d. mission

6. Which of the following statements qualifies as part of a mission statement?

a. The staff development department desires to be a national leader in the provision of edu-

cation services that focus on excellence in mental health services

b. Staff development specialists realize that adults are self-directed learners

c. The staff development exists to enhance organizational effectiveness by providing educa-

tion offerings designed to improve the knowledge and skills of all employees

d. Staff development specialists are responsible for identifying their own education needs

7. Samantha is the sole staff development specialist in a 300-bed community hospital located in rural

Montana. Which of the following is a realistic/appropriate vision for her department?

a. The staff development department exists to provide education and training that enhances

job performance

b. It is the vision of the staff development department to assume a national leadership posi-

tion in the delivery of continuing education

c. It is the vision of the staff development department to develop distance learning programs

appropriate for healthcare professionals within the organization and throughout rural

Montana

d. The staff development department supports the concept that learning is a lifelong process

8. Dixon Hospital is purchased by a large, for-profit healthcare corporation. Which of the following

might be stressed as part of the hospital’s staff development mission considering the new for-profit

status?

a. Developing free blood pressure screening education

b. Designing education activities that generate income

c. Offering education to nonlicensed personnel

d. Developing programming that supports lifelong learning

C H A P T E R 2


9. Lucas P. Simpson Memorial Medical Center’s management team has the reputation of adhering to

an autocratic, directive management style. Managers generally believe that they must exert strict

control over their employees. Which of the following statements coincide with these types of values?

a. Adults are self-directed learners

b. Teaching/learning is a dynamic, interactive process between teacher and learner

c. Employees adhere to the direction of management when participating in education activities

d. Learners participate in evaluating the effectiveness of education

10. Which of the following statements accurately describe the importance of mission, vision, and values

statements?

a. A vision must be practical and oriented to the present healthcare environment

b. A mission describes the purpose of the staff development department

c. Values have little to do with basic organizational philosophy

d. Staff development mission, vision, and values are independent of those of the organization


Introduction

Qualifications of the staff development specialist vary depending on specific roles and responsi-

bilities. Some may be full-time employees within the department, while others may fulfill dual

roles of educator and direct patient care provider, each on a part-time basis. A common require-

ment for all such specialists is that they be highly skilled educators.

This chapter provides guidelines for writing staff development department job descriptions and

identifying necessary qualifications for those who assume the role of staff development specialist.

C H A P T E R

3 QUALIFICATIONS ANDJOB DESCRIPTIONS

OBJECTIVES


1. describe qualifications for the staff development specialist2. write competency-based job descriptions for the staff development specialist

Competency: The staff development specialist will fulfill the roles and responsibilities identified in

his or her job description.

C H A P T E R 3


Qualifications

Qualifications for the staff development specialist depend on the role that he or she fulfills with-

in an organization. Regardless of the role assumed, however, the most important qualification

for a staff development specialist is excellence in program planning and implementation.

Consider the following questions when writing or revising job descriptions:

• Is the staff development department responsible for education throughout the organiza-

tion or for a specific department(s)?

• Is the staff development department a centralized or decentralized department?

• Do staff development specialists represent one or various clinical disciplines?

• Do staff development specialists have clinical backgrounds, or are some of them coming

from nondirect patient care backgrounds?

• To whom does the director/manager of staff development report?

The preceding questions help to clarify the responsibilities and organizational structure of the

staff development department. There is no single way of structuring a staff development depart-

ment because there is no single delivery mechanism for training and continuing education.

However, guidelines do exist for the identification of qualifications that meet the needs of indi-

vidual departments and adhere to legal standards. Such guidelines include the following:

1. Qualifications for the same role and responsibilities are identical regardless of

whether the individual works full-time or part-time. Managers still make the mistake

of holding full-time employees to higher standards/qualifications than part-time employ-

ees. If an employee is hired to fulfill the role and responsibilities of a staff development

specialist, qualifications are the same regardless of hours worked per pay period.

2. Qualifications should reflect the standards of the profession. Most professionals in

staff development possess a minimum of a bachelor of science degree. This is changing

QUALIFICATIONS AND JOB DESCRIPTIONS


rapidly, however, and many organizations require a master’s degree in a clinical or non-

clinical area of specialization. But as educational expertise and knowledge become the

benchmark for staff development specialists, a graduate degree in adult education is

often desirable, if not required.

Caution: Remember that staff development specialists are not necessarily nurses (unless

the department is solely responsible for the nursing department). Staff development

specialists working in departments within large hospitals or health systems may come

from a variety of clinical backgrounds. Some may come from nonclinical backgrounds as

well and are responsible for training and continuing education activities in nonclinical

departments.

3. Qualifications should reflect the standards of the organization. For example, if the

director/manager of staff development in a large organization has responsibilities and

accountability equal to that of the vice presidents of the organization, his or her title

should also be vice president (VP) (e.g., vice president of education) and should possess

similar educational credentials. In fact, staff development specialists at the VP level often

are expected to hold doctoral degrees.

Suppose the leader of staff development is at the middle manager level. If the usual standard of

educational preparation for middle managers within an organization is a master’s degree, the

manager of staff development must also possess a master’s degree.

Staff development specialists holding positions at the staff level (nonmanagement level) should,

at least, possess a baccalaureate degree. This is especially important because most staff develop-

ment specialists plan and implement educational activities for employees from various disci-

plines, most of which require a bachelor’s degree at entry practice level (e.g., PT, OT, computer

specialists). Holding similar degrees lends credibility to individuals responsible for the training

and educational activities of an organization.

Caution: Preparation at the master’s level is rapidly becoming standard for staff develop-

ment specialists. Geographic location is no longer an obstacle to obtaining a graduate

degree—it is possible to earn a graduate degree from an accredited university online with-

out ever setting foot on campus.

C H A P T E R 3


4. Minimum qualifications should be upheld impartially. If the standard for staff devel-

opment specialists within an organization is preparation at the master’s level, that stan-

dard should be upheld when hiring or promoting staff members. If the organization is

willing to hire someone without such preparation, the job description must identify a

specific period of time (e.g., 18 months) within which the employee must earn the speci-

fied degree.

Staff development scenario: Samantha and Denise are part-time employees in a large staff devel-

opment department. They work part time as direct patient care providers and part time as “clini-

cal educators” within the staff development department. Both hold baccalaureate degrees and

are working to earn master’s degrees in adult education—a requirement for promotion to full-

time staff development specialists. Because of their exceptional job performances, Samantha and

Denise are promoted under the condition that they earn their graduate degrees within 12

months, according to written policy.

At the end of the 12 months, Samantha is in the process of completing her thesis and will earn

her degree in another six months. Samantha is demoted to the position of clinical educator until

her degree is successfully earned. Denise needs another year to complete her degree. She is given

an extension and is allowed to remain in the position of staff development specialist.

Both Samantha and Denise have performed well in the role of staff development specialist.

Neither has received any disciplinary action, and their performance evaluations have been

excellent. Samantha is single, without children. Denise is married and has two children, ages

two and six. Samantha asks her manager why she has been demoted but Denise has not.

Samantha is told that Denise has a family and children and more responsibilities at home.

Denise is single and, therefore, should have been able to complete her degree in the allotted

time period.

Was this situation handled appropriately? What are the potential consequences from these events?

Samantha has good reason to file a grievance based on discrimination. Unfortunately, some

managers still fail to understand that preference cannot be given solely on the basis of family

responsibilities. Standards must be upheld consistently and without partiality. The manager also



may be subject to disciplinary action because she has failed to perform her management duties

appropriately.

The potential consequences of these events also are significant. Other staff members who must

earn degrees based on this written policy will investigate whether they have been unfairly held

to standards that are not upheld impartially. It is likely that more grievances will be filed.

The lesson learned from this scenario: Adhere to written policies without partiality or discrimina-

tory actions.

5. Mandatory qualifications include demonstrated ability and experience in the

adult education field. Staff nurses—and professionals from other disciplines at the staff

level—are often promoted to management positions based on their clinical expertise.

They often have little or no management experience, however, so this is a disservice to

both the person promoted and to the organization in which he or she works. Instead,

staff nurses should be groomed for management positions with leadership and manage-

ment training, as well as with gradual involvement in management activities before an

actual promotion occurs.

The same holds true for persons assuming the role of staff development specialist. Employees

who demonstrate exceptional clinical skill or expertise within a nonclinical discipline are some-

times promoted to staff development positions based on these skills and not on their ability to

plan, implement, and evaluate educational activities. This is unfair to the new staff development

specialist as well as the organization. Staff development specialists need to be groomed, just as

new managers do. Therefore, persons interested in assuming an educator role should be given

opportunities to plan and implement training and continuing education with the assistance of

staff development specialists and the approval of their managers. Of particular importance is

their ability to facilitate knowledge acquisition using a variety of teaching methods. Persons who

are interested in successfully pursuing the role of staff development specialist must demonstrate

interest in the continuing education process and actively seek out opportunities to participate in

the planning and delivery of continuing education.

Staff development scenario: Brittany is a registered nurse with extensive critical care experience.

C H A P T E R 3


She currently works in the emergency room of a large metropolitan hospital and has the reputa-

tion of being “tough” but the best nurse in the emergency department. She has written several

self-learning modules in conjunction with the staff development department. Brittany applies for

and is hired as one of the staff development specialists for the critical care areas within the

organization. After a few weeks, her staff development preceptor, Morgan, asks to talk to the

director of staff development. It seems that Brittany is alienating the employees who work on the

various critical care units. She is abrasive and impatient with staff members who do not have her

level of expertise. Her teaching style is autocratic, and she makes her colleagues so uncomfortable

that they have trouble demonstrating successful knowledge acquisition and are starting to avoid

continuing education activities that involve her. Morgan tries to help Brittany improve her inter-

active skills and teaching style, but Brittany says to Morgan, “You don’t understand how the crit-

ical care mind works. You were only a med-surg nurse and wouldn’t be able to do my job or

teach what I can teach.”

What were some actions that should have been taken prior to hiring Brittany as a staff develop-

ment specialist?

Brittany was hired primarily due to her clinical expertise. Although she did participate in the

development of self-learning modules, her ability to interact as a staff development specialist was

not assessed. The ability to facilitate learning—the most important skill—was not evaluated.

Brittany had the reputation for being the best emergency department nurse, but she also is con-

sidered “tough” to work with by her colleagues. The development of self-learning modules

required clinical expertise, but it did not give Brittany much opportunity to fulfill the educator

role using the principles of adult education. Did Brittany understand the qualifications necessary

for a staff development specialist? Given Brittany’s behavior, it is doubtful that the qualifications

were explained to her.

When considering persons for a staff development specialist role, remember the following key points:

• Do not rely primarily on clinical or specialty expertise

• Teaching ability and the ability to facilitate knowledge acquisition are of primary importance



• The candidates should have the opportunity to interact with and deliver education to

colleagues in person, as well as via distance-learning methods

• The candidates should have the opportunity to review and discuss competency-based

job descriptions and qualifications for the staff development specialist role before apply-

ing for the position

Figure 3.1 summarizes important guidelines for determining staff development specialist qualifi-

cations.

F I G U R E

3.1 Guidelines for determining qualifications

1. Qualifications for the same role and responsibilities are identical regardless of whether the indi-

vidual is a full-time or part-time employee.

2. Qualifications should reflect the standards of the profession.

3. Qualifications should reflect the standards of the organization.

4. Minimum qualifications should be upheld impartially.

5. Mandatory qualifications include demonstrated ability and experience in the adult education field.

Job descriptions

Job descriptions must contain certain types of information. The following sections offer some

recommendations to follow when writing job descriptions for staff development specialists.

TitleTitles are consistent for persons fulfilling the same role. Suppose a staff development depart-

ment hires part-time employees to act as clinical educators (orienting new employees to the

C H A P T E R 3


clinical setting, providing inservices, etc.) who work under the direction of persons who have

experience in and possess graduate degrees in adult education. These are two distinct levels of

staff and should not hold the same title or function under the same job description. Titles

should reflect qualifications and job responsibilities.

Overview of responsibilities An overview of responsibilities is a one-paragraph description of essential duties. For example,

an overview of responsibilities may read as follows: “The staff development specialist is respon-

sible for planning, implementing, and evaluating continuing education activities incorporating

the principles of adult education. He or she must demonstrate competency in each of the criti-

cal competencies identified in this job description. The staff development specialist is responsi-

ble for delivering services that are consistent with the mission, vision, and values of the organi-

zation and the staff development department.”

QualificationsQualifications must be explicit and consistently enforced. Examples of qualifications include

• necessary licensure or certification

• necessary educational preparation

Reporting mechanism

Briefly but clearly identify to whom this position reports. If this particular job description has super-

visory responsibilities, it must delineate what types of staff are supervised by someone in this role.

Caution: If someone is hired with a provision to complete education requirements within a

specified time frame, this condition must be in writing and enforced consistently. Include the

following information:

• Amount (in years) and type of experience needed

• Any specific requirement or condition (e.g., an emergency flight nurse must be able to

arrive at the emergency department within 20 minutes of receiving notification that his or

her presence is required)



Working conditions

Identify the following factors:

• Working hours (e.g., whether flexible hours including weekends, holidays, and shift

work are required)

• Any lifting or moving requirements (e.g., patients, desks, AV equipment) including the

minimum amount of weight the employee must be able to lift or move (e.g., 50 pounds

on a regular basis)

• Any potential exposure to infectious diseases or injury

Competencies

A process of measuring a professional’s ability to perform or demonstrate explicit behaviors

according to established, specific criteria is competency-based evaluation. These behaviors are

delineated in job descriptions. Competency-based job descriptions should be developed for all

employees within the organization, for clinical and nonclinical departments alike.

Sample staff development competencies are identified at the beginning of each chapter in this manual

and serve as a guideline for competency development within healthcare organizations. Remember

that competency statements should be explicit. For example, consider the following competency:

The staff development specialist plans, implements, and evaluates training and continuing edu-

cation according to the principles of adult education. These principles are that

• adults are self-directed learners

• adults bring a variety of valuable life experiences to any learning situation

• adults focus on acquiring knowledge and skills that will benefit them as they conduct

their activities of daily living

C H A P T E R 3


• adults are responsive to both intrinsic and extrinsic motivators

Why is it necessary to specify the principles of adult learning? Because not all staff development

specialists (or potential staff development specialists) focus on—or are even aware of—the same

principles. By clearly identifying these principles, confusion and doubt as to the competency

requirements are reduced. Consider the second principle: Adults bring a variety of valuable life

experiences to any learning situation. This statement helps educators acknowledge that various

life experiences are valuable, enhance learning situations, and command respect.

SignaturesJob descriptions must be approved, signed, and dated by the department manager and the

human resources director. Additionally, the employee should sign and date two copies of his or

her job description. One copy is maintained in the employee’s personnel file, and the other

copy is given to the employee.

Figure 3.2 contains a suggested template for job descriptions.



Conclusion

Qualifications and job descriptions must be developed and administered fairly and consistently.

These issues are subject to legal scrutiny, and it is necessary that managers and employees be

aware of the implications of proper administration and the consequences of failure to implement

their responsibilities appropriately and legally.

F I G U R E

3.2Job description template

Title: Accurately reflects qualifications and responsibilities

Overview of responsibilities: General summary of responsibilities

Qualifications: Explicit and consistently enforced

Reporting mechanism: Clearly identify to whom this position reports. If this is a job description for

someone who has supervisory responsibilities, identify the roles this position supervises.

Working conditions: Include work hours, the minimum weight the employee must be capable of lifting

and the frequency with which objects must be lifted or moved, and any potential exposure to infec-

tious diseases.

Competencies: Specific behaviors the employee must demonstrate in order to successfully fulfill roles

and responsibilities. Be as explicit as possible to reduce confusion and doubt.

Signatures: Job descriptions are signed and dated by the responsible manger and human resources

representative. The employee signs and dates two copies of his or her job description. One copy is

maintained in the employee’s personnel file, and the other copy is given to the employee.

C H A P T E R 3


Bibliography

Avillion, A.E. A practical guide to staff development: Tools and techniques for effective educa-

tion. Marblehead, MA: HCPro, Inc, 2004.

Bradely, D., and S. Huseman. “Validating competency at the bedside.” Journal for Nurses in

Staff Development 19, no. 4 (2003): 165–175.



1. Which of the following statements concerning staff development specialist qualifications is accurate?

a. Minimum education requirements vary depending on the role fulfilled

b. The most important qualification is clinical expertise

c. Persons who work full-time must possess different qualifications than those who work

part-time, even though they fulfill the same role

d. Responsibilities are the same for all staff development specialists even though they fulfill

different roles

2. Dominic is the manager of staff development in a 700-bed teaching hospital. His peers hold master’s

degrees. Which of the following statements about Dominic is most likely to true in this situation?

a. Dominic’s job description mandates that he possess a doctorate in adult education

b. Dominic is qualified to manage the staff development department because of his excel-

lence in clinical practice

c. Dominic demonstrates expertise in management skills

d. Dominic is required to possess a graduate degree only if he works a minimum of 40

hours per week

3. Which of the following actions violates legal principles concerning job performance?

a. Requiring the manager of staff development to possess a master’s degree because this is

the standard for all middle managers within the organization

b. Establishing criteria that give preferential treatment to staff members who have children

c. Requiring staff development specialists to have experience in adult education instead of

clinical expertise

d. Establishing criteria that mandate the baccalaureate degree as the minimum educational

preparation for nurses working in staff development

4. Which of the following persons is best qualified to fulfill the role of staff development specialist?

a. David, who has a master’s degree in business administration and extensive patient educa-

tion experience

b. Lisa, who is a certified critical care nurse and a recognized leader on her unit

c. Brian, who is a computer specialist and successfully assists with the delivery of continu-

ing education for various nonclinical departments

d. Emily, who is pursuing a bachelor’s degree in adult education but has no practical expe-

rience in the planning and delivery of continuing education

FINAL EXAM

C H A P T E R 3


5. Paula is a staff development specialist with a master’s degree in adult education. She is responsi-

ble for the design, implementation, and evaluation of continuing education activities, as well as the

supervision of part-time employees who help with inservice and orientation on clinical units. Ron is

one of these part-time employees. Based on this scenario, which of the following statements is

most accurate?

a. Paula and Ron have the same title within the staff development department

b. Paula holds a higher position within the staff development department

c. Ron must possess the same qualifications as Paula

d. Ron is able to fulfill the same role as Paula

6. “A minimum of five years of successful healthcare management experience and the demonstration

of effective leadership skills” is an example of a:

a. title

b. competency

c. qualification

d. responsibility

7. All of the following factors must be included under “working conditions” EXCEPT:

a. working hours

b. specific moving and lifting requirements

c. potential exposure to infectious diseases

d. minimal educational preparation

8. Which of the following statements about competencies is accurate?

a. Competency statements explicitly describe behaviors that must be demonstrated

b. Competency statements provide a general guide for behavior

c. Competency statements are primarily useful for clinical job descriptions

d. Competency statements describe minimal education preparation requirements

10. When identifying qualifications and writing job descriptions, remember that:

a. lifting and moving requirements are essential for direct patient care providers but are not

mandatory for staff development specialists

b. educational preparation should reflect the standards of the profession

c. qualifications are based on professional requirements not on organizational standards

d. managers can be flexible when applying standards to staff members depending on indi-

vidual circumstances


Introduction

It is assumed that any educator responsible for the training and continuing education of adults

is familiar with the principles of adult learning. However, identifying these principles is very dif-

ferent from actually applying them in staff development practice. The purpose of this chapter is

to assist the staff development specialist in the application of the principles of adult learning as

he or she plans, implements, and evaluates training and continuing education.

C H A P T E R

4 APPLYING THE PRINCIPLES OFADULT LEARNING

OBJECTIVES


1. identify the principles of adult learning2. apply the principles of adult learning to his or her staff development practice

Competency: The staff development specialist plans, implements, and evaluates training and con-

tinuing education according to the principles of adult education. These principles are that

• adults are self-directed learners

• adults bring a variety of valuable life experiences to any learning situation

• adults focus on acquiring knowledge and skills that will benefit them as they conduct

their activities of daily living

• adults are responsive to both intrinsic and extrinsic motivators

C H A P T E R 4


Identification and application of adult learning principles

1. Adults are self-directed learners. Adults determine what they want to learn and how

they want to learn it. They also want to be respected as both adults and learners. Thus,

adults may attend a mandatory program, but if they feel it is a waste of their time, they

probably will not acquire much new knowledge. Adults know that their time is valuable

and expect education to be offered at times and in ways that are convenient for them.

Adult learners also like to know why it is important for them to participate in an educational

activity. Developing measurable learning objectives does not necessarily explain why a program

is important, so staff development specialists also must be able to explain why an educational

activity is important to employees and to the organization. Consider the following example:

Staff development scenario: County Hospital’s patient satisfaction surveys and quality improve-

ment data show a significant decrease in patient satisfaction. Among the complaints are

• “Nurses act as though I am stupid if I ask a question.”

• “My physical therapist talks and laughs with the other therapists when he or she is giv-

ing me therapy. I never have a chance to ask about my progress. If I interrupt them,

they ignore me.”

• “My mother’s call light was on for 20 minutes before anyone answered it. When the nurs-

ing assistant came in, she rudely told us that she was very busy and had gotten there as

fast as she could. I know she was busy. But she could have been polite about saying so.”

The preceding comments are part of a trend at County Hospital. The staff development depart-

ment is asked to plan and implement a series of mandatory customer satisfaction programs, with

an emphasis on communication skills. Staff members are overhead making comments such as,

“These programs will be a real waste of time. I already know how to talk to patients!”

What can the staff development specialists do to help promote the importance of this program to

self-directed learners?

APPLYING THE PRINCIPLES OF ADULT LEARNING


Consider doing the following:

• Publicize the program by explaining the rationale. Use statements such as “customer sat-

isfaction is our business,” and identify a target percentage for customer satisfaction (e.g.,

98%, 100%). If programs are advertised on bulletin boards and in areas accessible to

patients and families, do not use examples of risk management data or survey results.

However, at the beginning of the program, such data can be presented, as long as confi-

dentiality of staff and patients involved is maintained. Ask the marketing or public rela-

tions department for help in writing good promotional materials. Answer questions from

staff members honestly and openly—they may not realize the seriousness of the problem.

• Explain the consequences of poor customer satisfaction. Relate these consequences to

patient outcomes, organizational effectiveness, and job security. Poor patient satisfaction

may lead to a decrease in admissions and even downsizing. Staff members need to

understand that their actions influence the financial solvency of the organization.

• Offer the program at times and in ways convenient for the learners. Acknowledge that

employees’ time is valuable.

• Identify program objectives clearly. Adults need to know what is expected of them and

why.

• Measure the impact of education, and share results with employees. If patient satisfac-

tion increases following the educational program, make sure that the employees are

notified. They need to know that education makes a difference.

2. Adults bring a variety of valuable life experiences to any learning situation.

Learners’ life experiences can enhance any learning situation and should be treated with

respect. Such experiences may not directly relate to the specific topic of the program,

but they can still complement learning. For example, nearly everyone has received both

good and bad customer service in various settings. Allow participants to share their

experiences from both the customer and provider perspectives, and incorporate these

C H A P T E R 4


experiences into the educational activity. If the education is provided via a distance

learning method, solicit relevant anecdotes from staff and use the stories to illustrate

good and bad customer service. You may wish to acknowledge learners’ assistance by

including a statement such as, “The staff development department would like to thank

Tracey Stevens, RN, and David Weber, PT, for their assistance in developing this pro-

gram.” This gives credit to employees but does not violate confidentiality by identifying

exactly what anecdotes, stories, or feelings are theirs. Encourage the sharing of relevant

experiences, but do not allow any one participant to dominate the discussion in a public

setting.

Caution: Do not publicly acknowledge staff members by name in any educational setting or deliv-

ery method without their permission.

3. Adults focus on acquiring knowledge and skills that will benefit them as they con-

duct their activities of daily living. Adults want to know how the acquisition of skills

and knowledge will benefit them. These benefits can be work-related or related to their

personal lives. Adults are task-oriented, problem-centered, or life-oriented in their approach

to learning. Remember that adults are self-directed and are more likely to go through the

learning process enthusiastically if they believe that it will improve some aspect of their

lives. For example, classes on retirement programs and benefits offered by the organization

will help employees to prepare for living a comfortable retirement. The bottom line is that

adult learners need to know how to apply information to their own lives.

Consider the preceding customer safety scenario. Staff development specialists must explain how

customer service education will help them. Such factors might include the following:

• Enhanced communication skills can be used with colleagues as well as with patients and

can help improve workplace communication, interpersonal interactions, and patient out-

comes because information is transferred more quickly and more accurately.

• Better communication with patients and families improves patient outcomes because it

encourages efficient gathering of information and better transfer of such information to

other members of the healthcare team.



• Customer service is an issue of great importance to accrediting agencies. The hospital’s

continued existence depends on maintaining accreditation and the quality of patient

outcomes.

Adults are also impatient with learning activities that they believe waste their time. Consider the

following example:

All pediatric nurses must demonstrate ongoing competency in their ability to insert intravenous

(IV) lines. Some organizations require that these nurses attend a review course and demonstrate

acceptable technique in a skills lab, but doing so is a waste of time for experienced nurses who

frequently insert IVs without difficulty. Instead, why not offer a time-saving alternative that

acknowledges the expertise of these nurses? Develop a “challenge” exam that measures didactic

knowledge. If nurses successfully pass this test, they are exempt from attending the course. A skills

lab demonstration may be necessary for nurses who have had little or no opportunity to insert IV

lines or who are having difficulty with this task. If nurses have had no problem with this skill,

establish a minimum number of successful “starts” per year, and ask preceptors to observe col-

leagues insert an IV as part of competency demonstration. This approach avoids asking compe-

tent nurses to waste time sitting in classrooms or completing self-learning modules.

4. Adults are responsive to both intrinsic and extrinsic motivators. All principles of

adult learning complement each other. As mentioned earlier, adults are motivated by fac-

tors that improve some aspect of their lives. This supports the principle that adults focus

on acquiring knowledge and skills that help them improve their lives.

Examples of extrinsic motivators include promotions, salary increases, better job opportunities,

and better working conditions. Intrinsic motivators include enhanced self-esteem, increased abil-

ity to manage stress, and enhanced job satisfaction.

Learners benefit from the incorporation of such motivators as part of the teaching/learning

process. Scenarios that illustrate how education can help learners achieve goals triggered by

motivators enhance learning activities.

Figure 4.1 explains the ways in which the principles of adult learning can be incorporated as

part of education planning and delivery.

Tips for incorporating principles of adult learning

F I G U R E

4.1

C H A P T E R 4


Adults are self-directed learners

Adults bring a variety of life experiences to any

learning situation

Adults focus on acquiring knowledge and skills

that will benefit them as they conduct their

activities of daily living

Adults are responsive to both intrinsic and

extrinsic motivators

Adult learning principle Incorporation tips

• Promote the program using objective data

• Answer questions honestly

• Provide a specific rationale for learning

activities

• Explain the consequences if education is not

received

• Respect and acknowledge that employees’

time is valuable

• Identify program objectives clearly

• Measure the impact of the education, and

share results with staff

• Treat adults’ life experiences with respect

• Acknowledge learners’ contributions to the

educational activity

• Explain how the knowledge and skills

acquired will enhance job performance

Tips for incorporating principles of adult learning (cont.)

F I G U R E

4.1



• Extrinsic motivators include promotions,

salary increases, better job opportunities, and

better working conditions

• Intrinsic motivators include enhanced self-

esteem, increased ability to manage stress,

and enhanced job satisfaction

• Incorporate a variety of scenarios into learn-

ing activities that help identify these motivators

and how education will help achieve desired

results

Adults are responsive to both intrinsic and

extrinsic motivators

Adult learning principle Incorporation tips

C H A P T E R 4


Conclusion

Most staff development specialists can identify the principles of adult learning easily. However,

planning, implementing, and evaluating learning activities in accordance with these principles is

not so easily accomplished. Staff development specialists must analyze these principles and

apply them to all facets of the teaching/learning process.

Bibliography



Bland, G., and L.C. Hadaway. “Principles of adult learning.” In A.E. Avillion (Ed.) Core curricu-

lum for staff development. 2nd ed. 31–64. Pensacola, FL: National Nursing Staff Development

Organization, 2001.

Merriam, S.B., and R.G. Brockett. The profession and practice of adult education: An introduc-

tion. San Francisco: Jossey-Bass, 1997.



1. Adults are self-directed learners. This implies that:

a. adults refuse to participate in education unless they want to

b. adults need to understand why a particular leaning activity is important to them and to

the organization

c. adults want someone else to be responsible for identifying their learning needs

d. adults will learn only if the learning activity is mandatory

2. Ways to incorporate the principle that adults are self-directed learners into program planning

include all of the following EXCEPT:

a. mandate programs that may be unpopular

b. share information that explains why the program is important to staff and the organiza-

tion

c. use survey and quality improvement data to illustrate the impact of failure to attend the

program

d. respect the learners’ input and answer questions honestly

3. Which of the following is an appropriate strategy to use when meeting the needs of self-directed

learners?

a. Do not share any quality improvement data with employees, as this may make them feel

as though they are not doing a good job

b. Allow them to refuse to participate in mandatory education

c. Measure the impact of education, and share results with learners

d. Avoid answering questions about the need for the program if learners are resentful

4. Rose Ann is a nursing assistant with more than 25 years of experience in pediatrics. She is attend-

ing a program on generational learning and shares some of her experiences from her generation’s

viewpoint as well as from a pediatric perspective. The staff development specialist should:

a. thank Rose Ann and attempt to take back control of the program

b. thank Rose Ann and use the anecdotes to help illustrate critical learning activities

c. use Rose Ann’s anecdotes as part of a self-learning module without mentioning her name

d. ask Rose Ann’s supervisor whether her stories about pediatric development are true

FINAL EXAM

C H A P T E R 4


5. Which of the following violates the rights of the employee?

a. Encouraging learners to participate in classroom discussions

b. Asking staff members to assist in the development of a computer-based learning program

c. Using an anecdote that an employee shared in a classroom setting in the development of

a self-learning module without the employee’s permission

d. Asking an employee who has dominated the classroom setting by relaying personal opin-

ions for 10 minutes to allow other learners an opportunity to contribute their thoughts

6. Which of the following adheres to the principle that adults must be able to use acquired knowledge

and skills to benefit their daily living activities?

a. Mandating that emergency room nurses attend a program on chronic neurologic disorders

b. Mandating that a nurse who administers a dose of oral antibiotic an hour late attend a

program on the five rights of medication administration

c. Demonstrating how a mandatory program on improving hospital security can reduce

workplace violence

d. Reducing the amount of mandatory programs employees must attend

7. All of the following statements about adult learning principles are correct EXCEPT:

a. adults respond to external and internal motivators.

b. adults use their life experiences to enhance learning.

c. adults are more responsive to education when they understand the rationale for the edu-

cation being offered.

d. adults must deal with a variety of responsibilities, which can sometimes be overwhelming.

Therefore, they need educators to identify and direct their leaning needs.

8. Louisa is planning a staff development program and is focusing on intrinsic motivators. Which of

the following qualifies as a program that is an intrinsic motivator?

a. CPR recertification

b. Relaxation training

c. HIPAA training

d. Critical care certification preparation course



9. Robyn is the preceptor for a new staff development specialist. She is trying to explain why it is

important to incorporate the principles of adult education into learning activities. Which of the fol-

lowing examples should Robyn use to help illustrate this point?

a. Adults benefit from attending all orientation classes, even if they are already competent in

certain skills

b. Adults resent mandatory training because they believe it is a waste of time

c. Adults focus on applying new knowledge and skills to enhance job performance

d. Adults are motivated only by tangible, extrinsic motivators

10. The intensive care unit staff are troubled by stress and are concerned about the increase in the

number of minor illnesses they are experiencing. Classes on stress management and relaxation

breathing are offered and attended enthusiastically. How does this type of programming correlate

with the principles of adult learning?

a. These programs focus on a coping need and will help staff members in their working

lives

b. These programs are offered in response to intrinsic motivators and are not priorities

c. These programs were offered without learner input, and adults will not be motivated to

attend

d. These programs allow the intensive care unit staff to acquire technical skills to improve

patient care


Introduction

Conducting needs assessments can become an exercise in futility. For example, endless surveys

or open-ended questions at the end of program evaluations provide a disorganized amount of

data that often has little or no practical use. For that reason, build needs assessments into exist-

ing processes—and avoid wasting time and effort developing methods of data collection that

duplicate existing processes.

Preparing for data collection

The purpose of needs assessments is to identify and prioritize learning needs, assess the level of

interest in particular education topics, differentiate learning needs from systems or performance

C H A P T E R

5 COLLECTING ANDANALYZING EDUCATION NEEDS

ASSESSMENTS DATA

OBJECTIVES


1. identify sources for the identification of learning needs2. gather data for the identification of learning needs3. analyze data to prioritize learning needs

Competency: The nursing staff development specialist collects and analyzes education needs

assessment data to help identify and prioritize learning needs.

C H A P T E R 5


problems, and meet accreditation standards. Because data come from so many different sources,

it is essential to gather them in a logical, concise manner. Take the following steps before data

collection:

1. Establish a computerized system of monitoring and documenting education needs.

Most large hospitals and health systems have purchased or developed systems for their

in-house network to track human resource data, including program attendance. These

types of systems may include (or be adapted to include) mechanisms for recording and

tracking needs assessment data.

If such a system is not in place, the staff development department may need to establish its

own system by using departmental computers to record and track data. First do the following:

• Identify who is responsible for recording data and who will have access to such data

• Determine a system of categorizing education topics

• Determine how often data will be reviewed

There is no need for a complicated tracking and retrieval system, especially if the staff devel-

opment department creates its own system. The system must be accurate, easily accessible,

and swiftly retrievable, but it can be as simple as a spreadsheet that lists topics and data

source (e.g., survey, performance evaluations, etc.) and can calculate the number of responses

per topic.

Caution: Do not attempt to develop a tracking and retrieval system without the assistance of the

information systems department.

2. Identify sources of data collection. Some organizations conduct elaborate needs assess-

ment surveys on an annual basis, using techniques such as advisory groups, brainstorm-

ing, focus groups, and the Delphi technique—a technique for obtaining written ideas

from persons considered to be experts in designated areas that involves asking partici-

pants to complete three consecutive rounds of questions. There is nothing wrong with

such surveys, but they tend to take considerable time and effort to implement.

COLLECTING AND ANALYZING EDUCATION NEEDS ASSESSMENTS DATA


Also, the JCAHO mandates that needs be assessed at least annually, but an ongoing system of

data collection is efficient and more practical than an annual written survey for several reasons:

written surveys are time-consuming to distribute, the return rate for such surveys is historically

low, and such surveys often fail to identify important learning needs that are crucial for per-

formance improvement. Thus, it is more time-efficient and practical to gather data from process-

es that already exist. When creating an evaluation, remember the following:

• Include specific learning-needs questions at the end of all program evaluations

• Develop a system to identify learning needs based on performance evaluations

• Develop a system to identify learning needs based on risk management and quality

improvement data

• Create a mechanism to identify learning needs based on informal interviews

3. Establish a mechanism for the consistent categorization of education topics.

Because needs are collected from so many different sources, develop an easy way of cat-

egorizing the education topics. To help with this categorization, consider dividing topics

into the following four main categories: mandatory training, clinical inservice/continuing

education, nonclinical inservice/continuing education, and employee health and wellness.

These topics can then be subdivided further, as follows:

Data collection

If the staff development department conducts a housewide needs assessment survey,

look for events that large numbers of employees attend. Events such as Nurses’ Week

activities or employee appreciation days allow the staff development department to reach

large numbers of employees without depending on “return mail” responses. If surveys are

distributed at these events, offer a simple reward when the survey is completed and

returned, such as pens, discount coupons, or mugs. Incorporating the survey as part of a

major event saves time and increases the response rate.

TIP

C H A P T E R 5


• Mandatory training: JCAHO mandates, government mandates, and safety and security

(e.g., patient falls, workplace violence, and medical error reduction)

• Clinical inservice/continuing education: This area can be subdivided into specific

specialties, such as neurology/neurosurgery, orthopedics, pediatrics, etc.

• Nonclinical inservice/continuing education: This area can be divided into specific

nonclinical department needs

• Employee health and wellness: Includes topics such as stress management, smoking

cessation, weight reduction, etc.

The preceding suggestions are certainly not all-inclusive. Each organization must categorize

learning needs in a manner appropriate to its products and services. Regardless of how you

organize it, categorizing needs is a more logical means of data collection and documentation.

Data collection

Data from program evaluationsMost (if not all) education activities require learner feedback via a program evaluation tool.

These tools must be incorporated in all settings, whether in the classroom or as part of distance

learning. As programs end, evaluations should be completed and returned to the staff develop-

ment department. Here are some suggestions to encourage that process:

• The classroom setting: Evaluations are collected by the staff development specialist or

another educator responsible for program facilitation.

• Self-learning modules: Evaluations are part of the written packet. They are completed

and returned to the staff development department either in person or via intraorganiza-

tion mail.

• Computer-based learning or e-learning: Evaluations are completed, printed out, and

returned/e-mailed to the staff development department.



• Video or DVD: A supply of evaluations is kept with the video or DVD in use and are

easily accessible to learners. Forms are completed and returned to the staff development

department.

How do you word the questions pertaining to learning needs? Determine what information you

seek. Identify what the learner needs to know v. what he or she would like to know, and in

what setting education should be offered. Consider using or adapting the following statements

as part of program evaluation tools:

• Identify three education programs that would help you improve your job performance

• Identify three education programs that you would enjoy attending

Caution: Each of the two preceding prompts elicits quite different data. These types of statements

help to retrieve information that is “need to know” v. “nice to know.”

• Identify three education programs that would help you improve your personal

health/fitness

Also determine what learning methods are preferred. Most participants state that they prefer to

learn in a classroom setting while interacting with friends and colleagues. However, staff devel-

opment specialists know that learners are unlikely to be able to leave their units or departments

long enough to attend such programs. Therefore, consider adding/adapting the following ques-

tions to program evaluation tools:

C H A P T E R 5


Data from performance evaluationsStaff development specialists do not have access to performance evaluations because those docu-

ments are confidential. Therefore, they must depend on managers to inform them of educational

needs identified during the performance evaluation process. Consider the following scenario:

The manager of the physical therapy (PT) department is writing 10 performance evaluations,

which must be discussed with employees this month. During each evaluation session, the employ-

ee and manager jointly identify employee learning needs. The PT manager e-mails the needs to

the manager of staff development. However, the PT manager is tired of sending endless e-mails.

Considering your job responsibilities, which of the following methods is the most con-

venient way for you to receive education and training?

Classroom setting _____ Skills lab _____ E-mail updates ______

Computer-based learning ______ Video/DVD _____

Self-learning packets ___ Audiotapes or audioconferences _____

On-the-job demonstration _____

Other ___________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Are you able to use the following pieces of equipment to obtain education?

Computer ___Yes ___No

Video/DVD player ___Yes ___No

E-mail ___Yes ___No

If you answered “no” to any of the preceding questions, please list below what you

need to help you use this equipment for educational purposes.

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________



Despite her best intentions, she often forgets to inform the staff development department of the

staff needs identified during performance evaluations. The staff development manager is having

trouble keeping track of similar e-mails sent to him by managers throughout the organization.

How can this problem be solved?

It’s never easy to ask busy managers to remember to communicate additional information on a

regular basis. Thus, here are some suggestions for handling such situations:

• Develop a computerized form that identifies the established categories of education

needs. Explain these categories to managers so that they know how to record data.

This method preserves confidentiality because only needs—not names—are recorded

on the form.

• Ask managers to submit the information to the staff development department on a regu-

lar (e.g., quarterly) basis. Identify due dates, and send out a housewide e-mail reminder.

Managers can record needs using their computers and simply forward the form via e-

mail. This avoids asking managers to send a constant “flow” of e-mail to staff develop-

ment and reduces the number of e-mails the staff development department receives.

Caution: Some managers always will be late to or forgetful of educational programs. They

are more likely to cooperate if administration supports the process. Also, don’t forget that

adults need to know why they are learning (or doing) something. Be sure to explain why this

information is needed and how the staff development department is going to use it.

• Share a summary of educational needs with managers. Doing so helps them understand

how the data is being used and how educational priorities are set.

Data from quality improvement and risk managementA member of the staff development department must be a member of the quality improvement

and risk management committees. The information discussed at such committee meetings is an

essential source of education needs data, which is especially important because needs identified

from these sources are often of critical importance.

C H A P T E R 5


For example, trends in the number of falls, employee back injuries, or patient complaints must

be analyzed to determine whether these problems are due to a system flaw or indicate learning

needs. Unless an immediate, urgent training need arises, such data can be summarized quarterly

for planning purposes.

Caution: Data collection is ongoing. However, it cannot be reviewed daily. Instead, set aside

specific days at regular intervals (e.g., quarterly) to analyze data and plan programs.

Informal data A staff development specialist is eating lunch in the cafeteria. A group of nurses from the neurosur-

gical unit join her. They share some excellent ideas for education programs and explain why these

programs are important to them. How do these suggestions “fit” into the needs assessment process?

Informal suggestions can be very valuable, as can having a system to track them. Categorize

these ideas, and add them to the database maintained by the staff development department.

Ideas obtained informally should also be discussed during the staff meetings of the staff devel-

opment department, and the meetings’ minutes should be recorded. Other means of data collec-

tion include focus groups, brainstorming sessions, and interviews. Regardless of the source of

data, remember to

• categorize and record all identified needs and their sources in an organized fashion

• maintain confidentiality, as required

• recognize the value of both formal and informal sources of data

• facilitate the collection process as much as possible

Data collection

In addition to categorizing and recording education topics, record the source of the identi-

fied education needs (e.g., performance evaluations, informal discussion, quality improve-

ment meeting, etc.). TIP

Analyzing needs assessment data

Develop a logical, organized method of data analysis that includes differentiating between a

learning need, a performance problem, and a systems flaw; prioritizing needs; and planning

program delivery.

Differentiating learning needs from other issuesStaff development specialists are often asked to provide education to solve problems that are

not true learning needs. They must be able to differentiate learning needs from performance

problems and systems flaws. They also must be able to help managers and colleagues under-

stand that education is not an automatic solution to the organization’s problems.

Performance issue

Bernadette is a registered nurse. She has worked on a surgical oncology unit for the past three years,

and in that time, she has received positive performance evaluations and provided her patients with

excellent care. She had no history of committing medication errors until fairly recently.

Bernadette has committed four errors in the past five months. These errors included administer-

ing medications late and failing to initiate a change in a medication order according to the

timetable identified by the physician. There were no adverse patient effects. When discussing these

errors with her manager, Bernadette stated, “I am tired of working so hard and not getting any

recognition. I’m not going to exhaust myself just to give medications at the exact time they are

ordered. The meds were only a little late, and nobody was hurt.” Bernadette’s manager asks the

staff development department to provide Bernadette with remedial education concerning the

proper administration of medications. Is this situation characterized by a learning need? Is edu-

cation going to solve the problem?

Analyze this situation according to the following questions:

• Is Bernadette aware of performance expectations based on her job description?

• Has Bernadette’s manager made it clear that her current performance fails to meet per-

formance expectations?



C H A P T E R 5


• According to the information provided, does Bernadette have a history of administering

medications correctly prior to the past five months?

If the answer to these questions is “yes,” this situation does not represent a learning need.

Rather, it represents a performance issue that needs to be addressed by Bernadette’s manager.

The situation may also represent an administrative issue if Bernadette’s manager fails to clearly

communicate performance expectations/initiate appropriate counseling when Bernadette fails to

fulfill her job responsibilities appropriately.

Systems flaw

Norah works the evening shift on a neurologic rehabilitation unit. Primary patient populations

include spinal cord-injured, stroke, and traumatic brain-injured patients. These patients require

extensive care, and a great deal of lifting and positioning is required. During the past month,

patient falls have increased significantly on the evening shift, especially during the hours from

4:30 p.m. to 6:30 p.m. These hours are meal times for both staff and patients.

The evening shift also has five vacancies: two RNs, one LPN, and two nursing assistants. Norah

and her peers have suggested having patient supper trays delivered earlier and staff meal breaks

scheduled later to avoid some of the staffing issues, but these suggestions have been ignored. The

nurse manager of the unit asks the staff development department to provide education on fall pre-

vention to staff members working the evening shift. Does this situation represent a learning need?

The answer to the preceding question is “probably not.” Consider the following questions:

• Are staff members initiating patient transfers and positioning appropriately?

• Do the falls occur because of insufficient numbers of staff members available to transfer

and position patients?

• If barriers to performance (e.g., staffing and timing of meals) are removed, would the

number of falls decrease?

• Have new staff members been hired who do not know how to correctly transfer and

position patients?



• Are there new patient issues pertaining to transfers and positioning that have not been

explained to staff?

If staff members have demonstrated the ability to transfer and position patients correctly and

safely, and if it is determined that barrier removal would decrease the number of falls, then this

is a systems flaw issue not a learning need.

Learning need

Alicia is one of five RNs recently hired to work on the cardiac care unit. The other four nurses

have cardiac care experience, but Alicia does not. Alicia has an extensive background in med-

ical-surgical nursing and is regarded as an excellent clinician. She is having difficulty identifying

the various cardiac arrhythmias. What does this situation represent?

This is a learning need. Alicia is new to the practice of cardiac care and needs education and

training to identify arrhythmias.

Prioritizing needs and planning education

There are several descriptors used when discussing the prioritization of education needs.

However, such needs typically fall into similar broad categories:

1. Life saving. These education needs must be met swiftly; if they are not, patients, visitors,

and employees are in danger of significant harm or even death. Examples of such priori-

ties include fire safety, dealing with workplace violence, and response to a respiratory or

cardiac arrest. These needs are of the highest priority.

2. Basic needs and inservices. These needs are basic to the performance of job duties and

responsibilities (e.g., medication administration, rhythm-strip interpretation) but are not as

time-critical as life-saving needs. Note that some organizations choose to include accredit-

ing agencies’ mandated training in this category rather than classify such training under a

separate category. These needs are essential, but the potential for harm and the rapidity

with which employees must respond to them is less than for life-saving needs.

C H A P T E R 5


3. Continuing education needs. These needs are essential to the professional growth and

development of employees. Education keeps employees abreast of advances and

changes in their respective disciplines, as well as how to respond to particular events. Its

ultimate goal is to improve patient outcomes.

4. Employee health and wellness. These needs pertain to issues of health and wellness,

such as stress reduction, smoking cessation, and relaxation training.

Caution: The priority of an education topic also is influenced by the number of employees in

need of training and education. For example, suppose a large community hospital has one

oncology nurse practitioner on its staff. She may have some important and even life-saving edu-

cation needs unique to her role. In this case, it would be cost and time effective to have this

nurse attend programs outside the organization that are designed to meet her needs.

Another category of needs might be described as “administrative directives.” All staff devel-

opment specialists ultimately deal with urgent training and education needs triggered by

administrative directives or changes in the organization’s mission, vision, and values. These

needs generally take precedence over all other needs, with the exception of life-saving

needs. For example, it is doubtful that orientation of critical care nurses would be cancelled

because administration has mandated customer service training. Typically, education that

meets administrative directives must be offered simultaneously with other categories of

needs. Staff development specialists must be experts in flexibility.

Another training need that frustrates most staff development specialists occurs when an issue

arises that is not, in reality, a learning need but is mandated as one by the organization’s

administration.

Consider Norah’s situation on the neurologic rehabilitation unit. She and her colleagues identi-

fied a systems flaw as the primary causative factor behind the falls on the unit. Suppose that

Norah’s manager, with the backing of administration, insists that Norah and her colleagues on

the evening shift receive remedial training in fall prevention. Should staff development specialists

design and implement training and education? Is there a way to justify the belief that this is a

systems flaw without alienating Norah’s manager and the administration?



Develop pretests to assess knowledge during orientation, and use these tests when such

situations arise. For example, the principles of safe medication administration, transfer and

positioning techniques, and fall prevention techniques all can be assessed with pretests and

demonstration. Such tests are useful during orientation because they allow experienced nurses

to omit certain aspects of classroom orientation, thus acknowledging their experience and

making orientation more efficient.

Pretests are also useful when staff development specialists are asked to provide remedial

training for nonlearning needs situations. Having a number of pretests available for common

problem areas (e.g., medication errors) saves staff development specialists time and effort

and eliminates the costs of developing periodic remedial training. Successful completion of

pretests/accurate skill demonstration helps illustrate that the problem is not a learning need.

These findings facilitate analysis of the problem and, hopefully, the accurate cause of adverse

occurrences will be identified and resolved.

Conclusion

After collecting data and prioritizing education needs, the staff development specialists select the

programs that must be offered, developed, or revised during a given period. Data collection

should be incorporated into existing systems to facilitate the process and maximize its value.

Appropriate data analysis allows for the identification of learning needs and program develop-

ment that will enhance organizational performance.

Bibliography


Marblehead, MA: HCPro, Inc., 2004.

Fennel, V. “Learning needs assessment.” In A.E. Avillion (Ed.). Core curriculum for staff devel-

opment. 2nd ed. pp. 170–197. Pensacola, FL: National Nursing Staff Development

Organization. 2001.

C H A P T E R 5


1. Prior to data collection, all of the following steps are essential EXCEPT:

a. categorizing education topics

b. identifying sources for data collection

c. arranging to have access to individual employees’ performance evaluations

d. developing a computerized system of documenting educational needs

2. When collecting needs assessment data from program evaluations, it is helpful to:

a. differentiate between “need to know” and “nice to know” education programs

b. inform learners that they must participate in computer-based learning

c. focus solely on programs that will improve job performance

d. include needs assessment questions on program evaluation tools only when the program

is offered in a classroom setting

3. Performance evaluations are important sources when identifying education needs. Anna is the

manager of the surgical pediatric unit and is concerned about maintaining employee confidentiali-

ty when she identifies learning needs for the staff development department. Which of the follow-

ing best helps Anna to preserve confidentiality?

a. Anna meets privately with the manager of staff development and discusses individual

employee performance evaluations with her

b. Anna refuses to share information from performance evaluations with anyone

c. Anna provides education herself in order to maintain confidentiality

d. Anna summarizes employee education needs and relays this information to the staff

development department but does not identify employees by name

4. Which of the following is a “must” when collecting needs assessment data?

a. Establish a computerized system of recording and tracking needs assessment data

b. Distribute a needs assessment survey to all employees annually

c. Ask the quality improvement manager to meet monthly with the staff development direc-

tor to discuss education needs

d. Organize a yearly survey using the Delphi technique

FINAL EXAM



5. The most efficient way to collect data from quality improvement and risk management findings is to:

a. have the manager of staff development review all adverse occurrence reports

b. appoint a staff development specialist to act as a member of the quality improvement and

risk management committees

c. ask the organization’s risk manager to summarize education needs based on adverse

occurrence reports, and relay this information to the staff development department

d. implement education only if the need is indicated after analysis of a sentinel event

To answer questions six and seven, review the following scenario:

Amy has made three medication errors this month. Two of the medication errors were errors

of omission (i.e., she forgot to administer two medications), and one occurred as a result of

Amy administering the wrong dose of an oral antibiotic. Prior to this month, Amy has admin-

istered medications for two years without error. Amy is not too concerned about these errors,

because she says the unit on which she works is really busy, and no patients were injured due

to the errors.

6. Which of the following phrases best describes this situation?

a. A learning need

b. A systems flaw

c. A performance issue

d. A reason for termination

7. Who is the person best suited to intervene in this situation?

a. The staff development specialist

b. The director of nursing

c. Amy’s peers

d. Amy’s manager

8. David is an RN with five years of experience as an intensive care nurse. He recently accepted a

position on a spinal cord rehabilitation unit. David is having difficulty correlating the degree of

spinal cord injury to the neurological deficit and appropriate nursing interventions, something with

which he has little experience. Which of the following best describes this situation?

a. A learning need

b. A performance issue

c. A systems flaw

d. An administrative issue

C H A P T E R 5


9. Susan accepts a position as charge nurse on an Alzheimer’s disease unit in a long-term care facility.

Her manager, Ms. Cane, tells her that she really does not need much orientation because her back-

ground is in intensive care. Susan lacks experience working with Alzheimer’s patients and is having

difficulty providing adequate nursing care. In addition to a learning needs issue, this situation is:

a. a performance issue

b. grounds for Susan’s dismissal

c. an administrative issue

d. a systems flaw

10. A Washington, DC, health system located close to the White House and Capitol building has been

placed on alert as an organization at high risk for a bioterrorism attack. Continuing education must

be developed, implemented swiftly, and regularly updated. This education is best described as:

a. life-saving

b. basic

c. continuing education

d. professional development

PLANNING AND IMPLEMENTATION OF EDUCATION


C H A P T E R

6 PLANNING ANDIMPLEMENTATION

OF EDUCATION

OBJECTIVES

1. identify objectives for education activities2. identify effective program delivery methods3. select appropriate teaching strategies4. facilitate learner participation in educational activities

Competency #1: The staff development specialist plans training and continuing education based

on needs identified from a variety of sources, including but not limited to needs assessment sur-

veys, performance evaluations, risk management data, quality improvement data, and the mis-

sion, vision, and values of the organization.

Competency #2: The staff development specialist implements training and continuing education

by identifying effective program delivery methods, selecting appropriate teaching strategies, and

facilitating learner participation.

Introduction

Planning includes identifying objectives, selecting teaching strategies, writing content, preparing

the physical learning environment, and establishing a system of program evaluation. Also,

because of advances in distance learning and the urgent need to enhance learning convenience,

the steps of the planning process must incorporate a variety of teaching methods that, until

recently, were not an issue for staff development specialists.


C H A P T E R 6


Identifying objectives

Behavioral objectives must describe the behavior a learner will demonstrate as an outcome of

learning. These objectives also must reflect the manner in which the learner acquires knowl-

edge and skills. For example, a learner cannot demonstrate a psychomotor skill at the conclu-

sion of a distance learning program unless either arrangements have been made for a skills lab

or the organization possesses equipment to allow a virtual, simulated demonstration.

Objectives must tell the participant exactly what he or she must demonstrate to prove that

learning has occurred. They must be written at the level appropriate for the desired outcome.

Most staff development specialists begin with an introduction such as, “At the conclusion of this

program the learner will be able to . . .” This wording informs participants that something is

expected of them at the conclusion of the learning activity. Following this introduction, an

objective contains a measurable action verb and a description of the desired behavior. The fol-

lowing analysis of well-written objectives includes application of distance learning standards:

1. Each objective contains a verb describing the behavior that is to be observed and

measured. These verbs are precise and explicitly describe the behavior expected of the

learner. The verbs measure knowledge, comprehension, application, analysis, synthesis,

and evaluation.

2. Knowledge is the most fundamental type of objective. Verbs that measure knowl-

edge include “define,” “list,” “recall,” and “name.” Knowledge focuses on the memoriza-

tion of facts. An example of a knowledge objective is, “Define congestive heart failure.”

3. Comprehension includes knowledge plus the ability to interpret that knowledge.

Verbs that measure comprehension include “discuss,” “explain,” “translate,” and “determine.”

An example of a comprehension objective is, “Describe the effects of a narcotic overdose.”

4. Application takes place when knowledge is applied in specific situations. Verbs

that measure application include “demonstrate,” “operate,” “perform,” and “apply.” An

example of an application objective is, “Demonstrate the safe, accurate administration of

medication via intramuscular injection.”



5. Analysis involves reducing information into components and explaining the

relationship among these components. Verbs that measure analysis include “differen-

tiate,” “compare,” “contrast,” and “distinguish.” An example of an analysis objective is,

“Compare the side effects of tricyclic antidepressants prescribed for major depressive dis-

order.”

6. Synthesis focuses on the production of new information by combining and

arranging various facts and knowledge. Verbs that measure synthesis include “design,”

“formulate,” “develop,” and “organize.” An example of a synthesis objective is, “Design a

distance learning program that includes a virtual simulation of a bioterrorist attack.”

7. Evaluation is the judgment of an event based on defined, objective criteria. Verbs

that measure evaluation include “assess,” “evaluate,” “critique,” “measure,” and “validate.”

An example of an evaluation objective is, “Evaluate the impact of patient satisfaction

training as measured by a decrease in patient complaints.”

8. Identify learning objectives based on the needs and levels of participant expert-

ise. For example, newly licensed nurses just beginning their careers are orienting to a

medical oncology unit. It would be appropriate to ask them to describe pain manage-

ment procedures used on the unit; it would not be appropriate to ask them to evaluate

two distinct pain management strategies for terminally ill patients.

Conversely, it would not be appropriate to ask a group of experienced oncology nurses to simply

identify pain management strategies. This is too basic, and any education program focusing on

that objective would probably bore these nurses. Their objectives should be established at a high-

er level, and asking them to analyze, synthesize, or evaluate would be much more appropriate.

Selecting and implementing education strategies

Should programs be offered in a classroom setting, as computer-based learning (CBL), as a

DVD/video, as a skills lab, or as a combination of any of the dozens of options available to

staff development specialists? Should the format be lecture/discussion, skill demonstration, or

case study? Consider the following when selecting and implementing education strategies:

C H A P T E R 6


• Match the strategy and the content to the level of the objectives and the expertise of the

audience

• Consider the time and cost of the strategies available

• Determine how many employees need to attend a learning activity

• Assess the ability of learners to have access to and operate equipment necessary for dis-

tance learning activities

• Assess the ability of faculty to facilitate learning effectively

Staff development specialists must choose from a variety of strategies. Arguably, the most effec-

tive teaching/learning strategy combines two or more methods or settings. The following options

describe some critical aspects of each choice.

Lecture/discussionLecture/discussion is probably one of the most common education strategies. It allows for the

presentation of information in an orderly manner, can be used with large groups, and allows for

interaction among participants and the presenter. The presenter must be a highly skilled public

speaker for lecture/discussion to succeed. He or she must encourage participation and must

respect varying points of view. An unskilled lecturer may limit or discourage interaction, fail to

adhere to the principles of adult learning, or actually bore the learners. Others value their ability

to entertain over the effectiveness of the learning activity. A skilled classroom presenter facili-

tates learning and is both enthusiastic and entertaining.

Group discussions Group discussions are objective-driven meetings between two or more persons who assemble to

share knowledge, exchange information, develop a process, or critique options regarding specif-

ic issues, problems, or other topics of concern. Discussion may be formal or informal and is

generally conducted with the aid of a facilitator.



Some advantages of group discussion include excellent opportunities for staff input and the abil-

ity to interact with members of other departments. Disadvantages include the reluctance of some

persons to express their opinions and others’ attempts to dominate the discussion. Unexpected

hostility or competitiveness may become evident, and minority viewpoints may be suppressed

or ridiculed.

Role playRole play is the enactment of work-related reality situations. Learners are encouraged to impro-

vise and react as they feel the role they are assuming requires. Role play is especially useful for

interpersonal skills such as communication skills, dealing with angry patients or colleagues, and

interacting with grieving or frightened patients and families. The advantages of role play include

the opportunity to practice skills and behaviors in a risk-free environment, to rehearse responses

to situations that are challenging, and to acquire insight into personal values, beliefs, and atti-

tudes. Disadvantages include adult learners’ reluctance to participate in role-play activities in

front of others. Learners often feel that role play is too contrived. It is not an effective teaching

strategy by itself.

Skill demonstration/simulationSkill demonstrations and simulations provide opportunities to acquire new skills and behaviors

and to practice them in environments that duplicate specific settings. These education strategies

are especially useful when skills and behaviors require practice and mastery before being per-

formed in the patient environment or when actual work-related experiences are difficult to pro-

vide. Learners gain experience without the potential of dangerous consequences to patients or

to themselves. The primary disadvantage to skill demonstration and simulations is that these

experiences demonstrate behavior in a controlled setting and cannot predict staff’s behavior dur-

ing a live situation.

Distance learningMany, if not most, learners identify live, interpersonal, face-to-face classroom settings as their

preferred learning environment. Despite this preference for personal interaction, however, staff

development specialists know that it is quite difficult for learners to leave their work settings to

attend programs. Thus, the most logical option for program planning and implementation is to

identify the right mix of classroom, distance, and self-learning strategies. Such a mix is referred

C H A P T E R 6


to as “blended learning.” Blended learning is the combination of many types of learning strate-

gies to best meet learners’ needs.

Consider the following distance learning recommendations as strategies for blended or “stand-

alone” learning:

Determining the appropriateness of distance learning

To help determine whether distance learning is appropriate, answer the following questions:

1. Who are your participants? Do they have the skills necessary to participate in distance

learning (e.g., reading and writing ability, computer skills)? Do they have access to nec-

essary equipment (e.g., computers, video/DVD players)?

2. Can identified objectives be achieved via distance learning? Is distance learning appropri-

ate? For example, demonstration of competency in a psychomotor skill is not usually

appropriate for distance learning.

3. What are the costs associated with distance learning development? Can the organization

afford it? Is the content consistent enough that extensive, expensive revisions will not

need to be made frequently?

4. Have learning objectives been clearly identified at the beginning of the distance learning

activity? The objectives must be stated (e.g., in a video), written, computer-based, etc.

Consider the following distance learning strategies:

• Printed self-learning modules. Often found in professional journals, these articles with

exams can be a cost-effective strategy for specific groups of distance learners. To use

this method, learners must be self-motivated and able to read and write proficiently.

• Audioconferences. Audioconferences are most effective for auditory learners. They

should be accompanied by handouts for clarity of content.

Education strategiesF I G U R E

6.1



• Video conferences. They are helpful because the learner can both see and hear speak-

ers. Viewing video conferences requires sophisticated and often expensive equipment.

• Computer-based learning (CBL). CBL can allow for visual stimulation with graphics,

learner interaction, and immediate feedback. CBL facilitates attendance records.

• Web-based courses. Web-based courses are generally provided by universities and

health systems affiliated with universities. They require significant commitments of time

and money.

The following table summarizes the advantages and disadvantages of each education strategy.

Strategy Advantages Disadvantages

Lecture/discussion

Group discussion

• Allows information

to be presented in

an orderly manner

• Can be used with

large groups of

learners

• Allows for interac-

tion among learn-

ers and between

learners and the

presenter

• Excellent opportu-

nities for staff

input

• Requires a highly skilled public speaker

• Lecture/discussion format is often evalu-

ated on the presenter’s ability to enter-

tain rather than the effectiveness of the

learning activity

• Reluctance of some persons to express

their opinions

Education strategies (cont.)F I G U R E

6.1

C H A P T E R 6


Strategy Advantages Disadvantages

Group discussion

Role play

Skill demonstrations

and simulations

Distance learning

• Good opportuni-

ties for interaction

among members

of different

departments

• Useful for acquir-

ing/improving

interpersonal

skills and learning

to respond to

challenging

situations

• Provides opportu-

nities to acquire

and demonstrate

new skills and

behaviors in risk-

free settings

• Convenient; avail-

able 24/7

• Potential for one or more persons to

dominate the group

• Expressions of hostility or competitiveness

• Suppression of minority viewpoints

• Learners may be reluctant to participate in

role play

• Learners may feel that role play is too con-

trived

• Role play is not an effective teaching strat-

egy by itself

• These experiences measure behaviors in a

controlled setting but do not predict what

behaviors will be applied in the work setting

• Lacks interpersonal interaction

• Does not typically have the opportunity for

immediate feedback from faculty



Audio-visual aids

Caution: Copyright laws regarding the use of printed materials, audiovisuals, music, etc., govern

your use of these resources as education tools. Classroom use and the use of materials in dis-

tance education are considered separate and different by United States copyright law. Access the

U. S. Copyright Office Web site to print guidelines regarding these laws at www.copyright.gov.

Many staff development specialists have limited budgets and rely on flip charts, overhead trans-

parencies, and slides—all of which can be effective. Below are some elements to keep in mind

when developing and using various audio-visual (AV) aids.

Handouts

When creating handouts, remember the following:

• Do not exceed a length of 10 pages

• Write as a content outline with space for note-taking not a verbatim script of a presentation

• Offer relevant tables, charts, etc.

• Include a bibliography

• Type on clean white paper

• Select a font size no smaller than 12 point

• Select a font style that is easy to read, such as Arial or Times New Roman

• Number each page

• Adhere to copyright laws (e.g., don’t duplicate graphics without permission)

Flip charts

When creating flip charts, remember the following:

• Make sure that the flip chart and stand are sturdy

• Use a pad with grid lines to align text

• Put no more than six lines on each page

• Use dark markers to make it easier for participants to read the writing

Transparencies

When creating transparencies, remember the following:

• Do not exceed 10–12 words per transparency

C H A P T E R 6


• Put transparencies in order, and number them

• Keep the transparency clean and uncluttered

• Use half-inch–high bold letters and numbers on transparencies

• Use a light shade for the background color, and use a dark shade of text for contrast

35 mm slides

When creating 35 mm slides, remember the following:

• Do not exceed 10–12 words per slide.

• Keep slides clean and uncluttered.

• Keep information brief and to the point.

• Keep the font size at 14–16 point for 35 mm slides.

• Avoid using a white or light-colored background.

• Colors like green or blue serve as good background colors. Use a dark background

color, and put text and accents in light colors. White text on a dark blue or black back-

ground is a good choice.

• Keep a consistent color and style scheme for all slides.

• Use a font such as Arial that is easy to read on screen.

PowerPoint presentations

When creating PowerPoint presentations, remember the following:

• Use a font size of 20–22 point.

• Keep the colors simple.

• Experiment with different fonts and graphics before developing the entire presentation.

• Don’t go overboard with animation or video clips. These techniques are appropriate

when used for emphasis and to add interest. Avoid using them to the extent that they

distract from the content.

• Remember that not all organizations can afford to facilitate the development of numer-

ous PowerPoint presentations.



Conclusion

The education strategy selected must be the one that best facilitates learning. Strategies must not

only be effective but user-friendly and cost effective. Staff development specialists must plan

and implement their programs by focusing on the needs of the learner and the organization as

well.

Bibliography

Avillion, A.E. A practical guide to staff development: tools and techniques for effective education.


DiMauro, N.M. “Integrating technology choices into practice.” In B.E. Puetz and J.W. Aucoin

(Eds.). Conversations in nursing staff development. Pensacola, FL: National Nursing Staff

Development Organization, 2002. 287–302.

Fennimore, L.A. “Delivering distance learning.” In B.E. Puetz and J.W. Aucoin (Eds.).

Conversations in nursing staff development. Pensacola, FL: Pohl Publishing, 2002. 317–328.

O’Connor, M.G., and G. Virgil. “Teaching/learning methodologies.” In A.E. Avillion (Ed.). Core

curriculum for staff development. 2nd ed. Pensacola, FL: National Nursing Staff Development

Organization, 2001. 231–260.

Puetz, L., and S.A. Zuel. “Educational planning.” In A.E. Avillion (Ed.). Core curriculum for staff


199–229.

C H A P T E R 6


1. As part of an extensive course on new oncology chemotherapeutic agents, the learner must be

able to distinguish between two drugs (referred to here as Drug A and Drug B) with similar names

and actions but that cause quite different side effects. Which of the following objectives best

explains what the learner must accomplish?

a. Define Drug A and Drug B

b. Discuss Drug A and Drug B

c. Contrast the side effects of Drug A and Drug B

d. Determine the side effects of Drug A and Drug B

2. A group of experienced critical care nurses are updating their pharmacology knowledge. As part

of the education program, these nurses will select and administer these drugs during a mock

code situation. Which of the following objectives is most appropriate for this group of learners?

a. Recall the side effects of new critical care drugs

b. Discuss the action of new critical care drugs

c. Administer new cardiac drugs accurately and safely during a simulated code

d. Identify potentially lethal interactions among the new cardiac drugs

3. Nursing students entering their junior year are learning to assess the respiratory system. They

have just begun to study abnormal breath sounds today. Which of the following objectives is most

appropriate for achievement at the conclusion of their 60-minute class?

a. Describe three different abnormal breath sounds

b. Demonstrate accurate lung auscultation

c. Demonstrate accurate percussion of the lungs

d. Critique the respiratory assessment capabilities of a peer

4. The clinical departments must design and implement a fall prevention program to which all direct

patient care providers adhere. All clinical departments should have input into the program. Which

of the following education formats is most appropriate to accomplish this project?

a. Role play

b. Group discussions

c. Simulation

d. Lecture/discussion

FINAL EXAM



5. All housekeeping staff must be trained in the use of a new cleaning solution that has the potential

for harm if not used correctly. They also need training to use equipment to dispense the solution

and to protect themselves from harm while using the solution. Which of the following is the best

teaching option?

a. Distance learning

b. Lecture/discussion and return demonstration

c. Role play and self-learning modules

d. Group discussion

6. The orientation of nurses hired to work on the cardiac care unit includes assessment of their abili-

ty to interpret rhythm strips and to demonstrate the correct clinical intervention (including psy-

chomotor skills). Because this group includes both experienced and inexperienced cardiac nurses,

what is the best education strategy to use?

a. Lecture/discussion

b. Role play

c. Blended learning

d. Self-learning modules

7. The ability to perform accurately and swiftly during a code is part of advanced cardiac life support

(ACLS) certification. Which of the following strategies is most appropriate to measure this need?

a. Skill demonstration

b. Lecture discussion

c. Group discussion

d. Self-learning module

8. Which of the following is a good recommendation when developing handouts?

a. Do not make handouts more than 20 pages in length

b. Use a minimum font size of 8 point

c. Avoid including charts in handouts

d. Include a bibliography

9. All of the following are appropriate when creating slides EXCEPT:

a. placing a maximum of 10–12 words on each slide

b. keeping the font size to 14–16 point

c. varying styles and color schemes among the slides

d. using a dark background color

C H A P T E R 6


10. Martha works within the limits of a small budget. She is using overhead transparencies for a pres-

entation. Which of the following is a good recommendation for Martha?

a. Use a maximum of 20 words per transparency

b. Use a dark transparency background

c. Copyright laws do not affect information on transparencies

d. Use half-inch–high bold letters and numbers


C H A P T E R

7 RECORDKEEPING

OBJECTIVES


1. discuss the types of records the staff development department must maintain 2. write a policy for the confidentiality of educational records

Competency: The staff development specialist establishes and maintains a recordkeeping system.

Introduction

Establishing and maintaining a recordkeeping system allows the staff development specialist to

access attendance records, program evaluation data, and the planning and implementation processes

of learning activities. Accrediting agencies such as the Joint Commission on Accreditation of

Healthcare Organizations (JCAHO), the Occupational Safety and Health Administration (OSHA), and

the American Nurses Credentialing Center (ANCC) also mandate the maintenance of such a system.

Many organizations have established their own password-protected computerized recordkeeping sys-

tems, which allow authorized personnel easy access to necessary data. The challenge is in determin-

ing the identity of the authorized individuals and ensuring that these same people do not divulge

passwords or share confidential information. This chapter provides information on the development

and maintenance of a recordkeeping system, including how to maintain confidentiality.

C H A P T E R 7


Types of records maintained

The following records are mandatory components of the staff development department’s record-

keeping system:

1. Attendance lists: A record of the learning activity, faculty, teaching/education strategy,

date and time of the activity, number of contact hours (if offered), and the names and

signatures of participants. If the program is offered via distance learning, the date and

time requirement may be met by noting the activity format and the date and time when

the learner engaged in the activity.

2. Competency validation: A record of required competencies, how they were validated,

and the date and time of validation.

3. Orientation checklists (can be combined with competency validation): A record

that provides evidence that essential procedures, policies, routines, and job expectations

were provided to the employee upon hire or transfer to a different unit/department.

4. Individual employee records: Each employee must have a record of his or her educa-

tion participation, including but not limited to mandatory training, orientation, and atten-

dance at inservices and continuing education events.

5. Meeting minutes: Documentation of what happened at staff development department

meetings. Maintain meeting minutes to show the processes of educational planning,

implementation, and evaluation.

6. Needs assessment process: An explanation of the needs assessment process and main-

tenance of documentation showing how education was planned and implemented based

on identified needs. Documentation evidence includes surveys, meeting minutes, quality

improvement meeting minutes, and risk management data.

7. Learning activity records: The following items must be included in the records of all

learning activities:

RECORDKEEPING


• How it was determined that a need existed for a particular program

• Education activity calendars

• Evidence of who planned the activity

• Explanation of how faculty were involved in the planning process

• Evidence that the faculty were qualified to teach the program

• Objectives

• Target audience

• Teaching/education strategies

• Content

• Handouts

• Audio-visual aids (e.g., copies of videos, slides)

• Physical facilities (e.g., classroom and computer availability)

• Number of contact hours, if applicable

• Sample of certificate awarded or written verification of participation

• Copy of pre- and post-tests, skill verification, etc.

• Program evaluations

• Any materials used to advertise the program

• Attendance checklists

• Analysis of how the education affected organizational effectiveness, if applicable

These learning activity records may be filed alphabetically, chronologically, or by activity code

number. They are used as permanent files and resources when repeating, updating, or revising

learning activities.

Recordkeeping policy

A recordkeeping policy should look similar to the example in Figure 7.1.

Sample recordkeeping policyF I G U R E

7.1

C H A P T E R 7


The Staff Development Department of Myers Health System maintains education records in accor-

dance with the mission, vision, and values of Myers Health System and according to the standards

of Joint Commission on Accreditation of Healthcare Organizations .

Records are maintained for a period of two years.

(Note: Base number of years on organizational and certification requirements.)

The following records are maintained:

• Attendance lists

• Competency validation

• Orientation checklists

• Individual employee education records

• Staff development department meeting minutes

• Needs assessment process

• Learning activity records including, but not limited to, the following:

- Needs identification

- Education activity calendars

- Planning committee members

- Faculty, how they were involved in the planning process, and their qualifications

- Objectives

- Target audience

- Teaching/education strategies

- Content

- Handouts

- Audio-visual aids

- Physical facilities

- Number of contact hours, if applicable

- Sample of certificate awarded or written verification of participation

Sample recordkeeping policy (cont.)F I G U R E

7.1

RECORDKEEPING


- Copy of pre- and post-tests, skill verification, etc.

- Program evaluations

- Any materials used to advertise the program

- Attendance checklists

- Analysis of how the learning activity affected organizational effectiveness

Learning activities are filed alphabetically and used as permanent files and resources when repeat-

ing, updating, or revising learning activities.

The recordkeeping system is automated and housed in the health systems computer network. Data entered

as part of the recordkeeping system are “backed up” via CDs by the information systems specialists.

Access to the records is limited to protect the confidentiality of the employee and faculty.

Confidentiality is maintained in the following ways:

- All files are password protected.

- Employee records are filed alphabetically by unit/department. Each unit/department’s

records are password protected. The only persons with access to these records are the

respective managers of the units/departments and the staff development specialists.

Sharing confidential information, including sharing passwords with other managers or unau-

thorized personnel, is forbidden, and persons who do so are subject to disciplinary action.

- The records do not contain performance evaluations, disciplinary actions, grievances filed,

or health data concerning individual employees. Such information is accessible only to the

employee’s managers and the human resource specialists. Staff development specialists

have no access to this type of information.

- Back-up CDs of education records are maintained in a locked, fire-proof file cabinet in the

staff development office. The only persons who have access to the file cabinet are the

staff development specialists.

C H A P T E R 7


Conclusion

Recordkeeping is mandated by various accrediting organizations. Keeping up-to-date records is

one way of tracking program attendance and effectiveness. A written policy that focuses on

records collected and on maintaining confidentiality is necessary. The development of an auto-

mated system facilitates record retrieval and saves both time and effort.

Bibliography

Jones, D., and C. Little. “Recordkeeping.” In A.E. Avillion (Ed.). Core curriculum for staff devel-

opment. 2nd ed. Pensacola, FL: National Nursing Staff Development Organization, 2001.

435–445.

RECORDKEEPING


1. Which of the following statements about recordkeeping systems is accurate?

a. Only agencies that deal exclusively with nursing personnel can mandate a recordkeeping

system

b. All managers throughout the organization should have access to the staff development

department’s recordkeeping system.

c. Program evaluation data must be maintained in the recordkeeping system

d. Attendance records are primarily the responsibility of the individual employee’s manager

2. Helen transfers to the pediatric oncology unit after working for five years on an adult oncology

unit. Staff development records maintained must include:

a. orientation to the pediatric oncology unit

b. rationale for transferring to the pediatric oncology unit

c. Helen’s most recent performance evaluation

d. any disciplinary action that affected Helen’s performance record

3. Which of the following is an accurate statement concerning recordkeeping?

a. Minutes of the staff development department are not considered essential to the record-

keeping system unless they refer to mandatory training activities

b. Each employee must have a record of his or her participation in learning activities

c. Dates of participation in distance learning activities are not essential

d. Competency validation is under the jurisdiction of middle management, and staff devel-

opment specialists generally are not involved in the process

4. Which of the following is NOT an acceptable way to file learning activity records?

a. Alphabetically

b. Chronologically

c. Per activity code number

d. According to evaluation results

5. A written policy governing recordkeeping should include:

a. the length of time for which records must be maintained

b. disciplinary action taken for employees who fail to attend mandatory training

c. personnel files of staff members who serve as faculty

d. qualifications of staff development specialists

FINAL EXAM

C H A P T E R 7


6. Melanie is the manger of the intensive care unit. She allows one of her senior primary nurses,

Bonnie, to access the confidential education records of all her colleagues so Bonnie can help

Melanie write performance evaluations. Which of the following statements is correct about

Melanie’s actions?

a. Melanie has the authority to delegate this type of responsibility

b. Bonnie has the authority to share this information with her colleagues in Melanie’s

absence

c. Melanie is subject to disciplinary action for violating confidentiality standards

d. Bonnie needs to have access to this information in the event that Melanie is ill or unable

to work

7. The rationales for keeping education include all of the following EXCEPT:

a. adherence to accrediting standards

b. revision of learning activities

c. tracking disciplinary action taken against employees

d. recording orientation of new employees

8. It is imperative that records concerning the faculty member include:

a. his or her date of birth

b. his or her qualifications to teach

c. the length of time he or she has worked for the organization

d. his or her performance evaluations

9. Which of the following helps maintain confidentiality of education records?

a. Password-protected automated system

b. Maintaining back-up CDs of records in the organization’s education library

c. Decentralized written records maintained on individual units/departments

d. Written files accessible to departmental secretaries

10. A JCAHO surveyor is reviewing the education record of a nurse who recently transferred from the

medical intensive care unit to the emergency room. Which of the following must be part of this

nurse’s education record?

a. Most recent performance evaluation

b. Any disciplinary actions taken against this nurse

c. Evidence of orientation to the emergency room

d. The nurse’s reasons for transferring to the emergency room


C H A P T E R

8 LEARNING STYLES

OBJECTIVES


1. differentiate between the three basic learning styles, which are visual, auditory, and kinesthetic2. incorporate teaching methods that facilitate learning for persons of each learning style

Competency: The staff development specialist will plan and implement programs in accordance

with the various learning styles of the participants.

Introduction

Most experts recognize three distinct styles of learning: auditory, visual, and kinesthetic. Some

staff development specialists develop and implement programs by focusing—often unconscious-

ly—on their own preferred learning style, but they must recognize the characteristics of the oth-

ers as well and incorporate strategies that meet the needs of all participants.

Auditory learners

Auditory learners learn by relating sounds to knowledge. They learn predominantly by hearing

and respond best to verbal instructions. Auditory learners hum or talk to themselves or others

C H A P T E R 8


(even in classroom settings) when they are bored or restless, and they often read aloud to

acquire knowledge. Such verbalization helps them remember important facts—as they speak,

their brains are stimulated to assimilate knowledge and skills.

Auditory learners position themselves wherever they best can hear (but not necessarily see) the

person presenting information. Many even use auditory words, such as “I hear what you’re say-

ing” or “That sounds good to me,” in their everyday speech. Also, their emotions can be

revealed from the tones of their voices.

Because they learn by hearing or speaking, auditory learners learn best from lecture/discussion

formats, audiotapes, audioconferences, and discussion groups. They do not enjoy visual aids or

written handouts.

Visual learners

Visual learning is the predominant learning style for adults. Those who learn in this way prefer

to position themselves where they can see the presenter or visual aids. They take detailed, copi-

ous notes, like verbal discussions to contain lots of imagery, and like handouts and visual aids

that are colorful, contain graphics, and are visually stimulating. Visual learners may close their

eyes to visualize what they are learning. They express their emotions via facial expressions.

Staff development

Consider these factors when facilitating the auditory learners’ education experience:

• Allow auditory learners to talk through problems and procedures and to express their

solutions verbally whenever possible.

• Provide excellent verbal explanations.

• Assess learner satisfaction by listening to tone of voice. Auditory learners may say that

everything is “fine,” but their tones of voice may indicate otherwise.

TIP

LEARNING STYLES


Staff development scenario: Sheila is a nurse new to the staff development specialty. She is facili-

tating a course on advanced respiratory pathophysiology. During the lecture/discussion portion

of the course, Shelia notices that Maxine seldom looks at her and often appears to be muttering

under her breath. However, Maxine frequently contributes to the discussion. Michael sits quietly

in the front of the classroom, takes detailed notes, and seldom contributes to verbal discussions.

However, both of these participants score well on the post-test. Shelia asks her manager for help in

understanding the behaviors of these participants. What is the manager likely to say?

Shelia does not recognize the characteristics of the various learning styles. Maxine, the auditory

learner, prefers auditory stimulation and often repeats facts aloud to memorize them. Michael,

the visual learner, dislikes auditory stimulation and prefers visual stimulation. Their behaviors

are typical of these two learning styles.

Kinesthetic learners

Kinesthetic learners, sometimes called “hands-on” learners, acquire knowledge and skill by

direct, physical involvement. They learn best by doing, so they must be active participants in

the session, and they require frequent breaks. Kinesthetic learners speak with their hands and

display feelings through body language. Their favorite phrases include, “Keep in touch,” “We

need to touch base,” or “I can’t grasp this information.” They may struggle to remember infor-

mation that is relayed visually or verbally, but they remember activities performed physically

without difficulty.

Staff development

Consider these factors when facilitating visual learners’ education experience:

• Provide handouts or other visual aids that are illustrated and colorful

• Ensure that these learners can see the presenter or visual aids easily

• Make sure that written materials are easy to readTIP

C H A P T E R 8


Staff development scenario: Teresa is an experienced staff development specialist. She knows that

the participants in her pain management pharmacology course represent three different learning

styles. In order to meet the needs of visual, auditory, and kinesthetic learners, what concepts

should she incorporate into her program?

To meet the needs of visual learners, Teresa uses visual aids such as handouts, videos, and

graphics because they are colorful, and explicit, and easy to see. She also positions herself dur-

ing lectures/discussions so participants can see her.

For the auditory learners, Teresa facilitates discussion, encourages participant input, and gives all

directions clearly and concisely. She also avoids an overabundance of auditory stimulation and

visual distraction, which helps to maintain a comfortable learning environment for visual learn-

ers, who are distracted by too much noise, and for auditory learners, who may find too much

visual stimulation distracting.

For the kinesthetic learners, Teresa builds frequent breaks into the program. She also displays

equipment used to administer pain medication, as well as outdated samples of the drugs being

discussed. These learners appreciate the chance to move around and to handle the equipment

and drug samples.

Staff development

Consider these factors when facilitating kinesthetic learners’ education experience:

• Provide opportunities for skill demonstration

• Allow time for breaks at regular intervals

• Use demonstration (whether in person, on DVDs, or during computer-based learn-

ing) as much as possible

• Learners may say that everything is “fine,” but their tones of voice may indicate

otherwise.

TIP

LEARNING STYLES


Conclusion

Experienced staff development specialists recognize their own learning styles as well as the

styles preferred by participants in their learning activities. Acknowledging learner characteristics

and incorporating a variety of teaching strategies into learning activities makes education enjoy-

able and effective for all types of learners.

Figure 8.1 summarizes learning style characteristics and preferred teaching strategies.

Summary of learning stylesF I G U R E

8.1

C H A P T E R 8


Learning style Learner characteristics Preferred teaching strategies

Auditory • Learn best from verbal

instruction

• Need to hear but not

necessarily see the

presenter

• Read aloud to acquire

knowledge

• Hum or talk to themselves

when bored

• Remember by verbalizing

facts

• Use auditory words in their

every day speech, such as,

“I hear what you mean” or

“That sounds good to me”

• Conduct business effective-

ly via telephone or audio-

conference

• Reveal emotions through

tone of voice

• Lecture/discussion

• Audio tapes

• Audioconferences

• Group discussions

Summary of learning styles (cont.)F I G U R E

8.1

LEARNING STYLES



Visual • Sit where they can best

see the presenter or

observe visual aids

• Often close their eyes to

visualize or remember

something

• Respond to visual aids

such as slides, graphics,

and written handouts

• Prefer written or spoken

language filled with

imagery

• Find auditory and kinesthet-

ic stimuli distracting

• Prefer passive

environments

• Take copious notes

• Reveal emotions through

facial expressions

• Handouts that are well-illustrated

and colorful

• Visibility of presenter or visual aids

• Written materials that are easy to

read

• Give the opportunity to read

through learning materials

Summary of learning styles (cont.)F I G U R E

8.1

C H A P T E R 8



Kinesthetic • Sometimes referred to as

“hands-on” learners

• Display emotion through

body language

• Remember what activities

are performed but have

trouble remembering what

was said or seen

• Use phrases such as,

“Keep in touch” and

“I can’t grasp this

information”

• Direct, hands-on involvement

• Return demonstrations

• The opportunity to move around at

frequent intervals

• Directions accompanied by demon-

stration

LEARNING STYLES


Bibliography



Miller, S. “Three different learning styles.” The University of South Dakota,

www.usd.edu/trio/tut/ts/style.html (Accessed on April 28, 2003).

C H A P T E R 8


1. Mark is a staff development specialist responsible for facilitating a lecture/discussion group on

cardiac pathophysiology. One participant, Miranda, seldom looks at Mark and often repeats

important facts softly after Mark presents them. Mark believes that she is uninterested in the

topic. To his astonishment, however, she scores 100% on the post-test and compliments Mark on

his teaching ability. It is probable that Miranda is:

a. a visual learner

b. a kinesthetic learner

c. an auditory learner

d. a learner who is already familiar with the program content

2. Lauren is having trouble grasping the basics of physical assessment of the respiratory system.

During a lecture presentation, she hears about the various lung sounds and the techniques of

auscultation, percussion, and palpation. During a return demonstration skills lab, Lauren sudden-

ly recognizes what she needs to do and accurately demonstrates the necessary physical assess-

ment skills. What type of learner is Lauren?

a. Auditory

b. Kinesthetic

c. Visual

d. Verbalizing

3. Scott is an RN who has recently transferred from the neurosurgical unit to the spinal cord injury

rehabilitation unit. He successfully completes a computer-based learning program on the rehabili-

tation of the spinal cord patient. The program contained a significant amount of graphics, charts,

and patient illustrations. Scott is probably:

a. a visual learner

b. a kinesthetic learner


d. a verbalizing learner

FINAL EXAM

LEARNING STYLES


4. Donna is a staff development specialist who prepares colorful, well-illustrated handouts. Which of

the following learners will best appreciate these handouts?

a. Dan, who learns a new procedure by reading the steps aloud

b. Josephine, who prefers return demonstration as an education strategy

c. Adam, who is easily distracted by auditory stimuli

d. Laura, whose favorite phrase is, “That sounds good to me!”

5. Deborah has created a distance learning activity via a series of audio tapes. Which of the following

learners will most enjoy this format?

a. Marie, who reads textbooks aloud when studying

b. Jeremy, who prefers to take detailed notes

c. Ray, who likes to participate in role play and simulations

d. Adrian, who prefers to sit where he can easily see the presenter

6. Allison likes to sit in the front of the classroom. She learns best when handouts are detailed, color-

ful, and contain graphics. Allison is:

a. a kinesthetic learner

b. a visual learner


d. a hands-on learner

7. Amy likes to talk through new procedures and verbalize solutions. Amy is:

a. a visual learner

b. an auditory learner

c. a kinesthetic learner

d. a hands-on learner

8. Maxine notices that one of the participants attending her critical care course often closes her eyes

for a moment when an important point is made. This participant sits in the front of the classroom

and takes copious notes. Maxine is afraid that the participant is bored. In reality, the participant’s

learning style is probably:

a. auditory

b. kinesthetic

c. visual

d. hands-on

C H A P T E R 8


9. Ben is responsible for facilitating the code simulation portion of advanced cardiac life support

recertification. He should keep in mind that simulations and demonstrations are the preferred

learning strategy for which of the following people?

a. Ray, who prefers a quiet learning environment

b. Pat, who likes group discussions

c. Hailey, who thinks of herself as a kinesthetic learner

d. Kelly, who thinks of herself as a visual learner

10. Anticipate that emotions are expressed through body language with what type of learner?

a. Kinesthetic

b. Visual

c. Auditory

d. Verbal


C H A P T E R

9 PLANNING EDUCATIONFOR MULTICULTURAL

AND MULTIGENERATIONALPARTICIPANTS

OBJECTIVES


1. incorporate cultural diversity into learning activities2. identify common cultural factors that influence participants’ behaviors 3. describe the common characteristics among specific generations of learners4. plan and implement learning activities that meet the needs of multi-generational learners

Competency: The staff development specialist plans and implements learning activities in accor-

dance with the needs of multicultural and multigeneration participants.

Introduction

For the first time in the history of the United States, four different generations of Americans are

working alongside each other in various work settings. Each generation has specific values, atti-

tudes, and expectations that sometimes enhance, but often disturb, the workplace. The staff

development specialist must meet the learning needs of these four generations simultaneously.

In addition to recognizing differences among generations, the staff development specialist must

provide learning activities that account for the diverse cultural backgrounds of employees.

Likewise, these employees must be able to work together and serve patients and families from

many cultures.

C H A P T E R 9


This chapter offers suggestions to enhance the learning environment of employees from differ-

ent generational perspectives and cultural backgrounds.

Cultural diversity and the practice of staff development

Knowledge of cultural customs can help to avoid misconceptions and misunderstandings and,

ultimately, can enhance both patient care and the workplace environment. However, there is a

danger of stereotyping persons of the same cultural background. To believe that “all Muslims do

this” or “all Catholics believe that” is impractical, incorrect, and often offensive. Therefore, the

staff development specialist must distinguish between stereotyping and generalizing cultures.

For example, suppose a nurse is assigned to provide postoperative care for an Italian man. The

nurse assumes that he will be excitable, will want pain medication, and will have many emo-

tional family members at his bedside. Making such assumptions is stereotyping. On the other

hand, suppose the nurse recognizes that Italians may be emotionally expressive and rely on the

overt emotional support of family members. She is prepared to help both the patient and his

family as needs arise. This nurse recognizes certain possible behaviors but does not make auto-

matic assumptions about how the patient and his family will behave. This is referred to as mak-

ing a generalization. The difference between stereotyping and generalizing may seem slight, but

it is in fact quite significant.

Staff development scenario: Gayle is a staff development specialist who recently accepted a posi-

tion at an organization with a large Chinese and Chinese-American population. Gayle meets

with a 65-year old nurse manager of Chinese descent to discuss learning needs for the manager’s

unit. The manager has the reputation of being one of the best managers in the hospital, and

Gayle looks forward to working with her. Throughout the meeting, Gayle attempts to make eye

contact with the manager, who consistently avoids doing so. Gayle is offended and thinks that the

manager is not interested in discussing educational needs. Later, Gayle learns that her attempt to

make eye contact was offensive to the nurse manager, because for her, refusal to make eye con-

tact is a sign of respect.

Gayle vows never to make the same mistake again. During one of her group discussion learning

activities, Gayle interacts with all of the participants but avoids making eye contact with Kevin, a

PLANNING EDUCATION FOR MULTI-CULTURAL AND MULTI-GENERATIONAL PARTICIPANTS


young intensive care nurse of Chinese ancestry. After the discussion ends, Kevin approaches

Gayle and asks what he has done to offend her. “You looked at everyone else when you talked to

them, but not to me!” Gayle learns that Kevin is a fourth-generation Chinese-American, does not

speak a word of Chinese, and has an American cultural perspective.

Despite her best intentions, Gayle has stereotyped Kevin based on her experience with the

nurse manager and based on Kevin’s appearance. If Gayle had actively observed Kevin’s inter-

actions with the rest of the group, however, she would have noticed that he did not avoid eye

contact with others. Recognizing the possibility that eye contact might be offensive was appro-

priate. Behaving as if that was automatically true for all persons of Chinese descent was not.

The previous example shows how easy it is to mistake stereotyping for cultural sensitivity. Staff

development specialists not only must deliver education to help employees care for patients of

various cultures but also must meet the needs of culturally diverse staff members. Here are

some suggestions for meeting this challenge:

1. Identify predominant cultures among the patient and employee population. It is

impossible to educate staff about all cultures. Therefore, begin by identifying those that

are most common in the populations you serve and focusing on these cultures during

diversity education and training.

2. Consider offering a course in English for speakers of other languages. It may be to

an organization’s benefit to offer such a course: Employees whose native language is not

English are at a disadvantage when communicating with their English-speaking col-

leagues and patients. In addition, it is impossible to understand diverse cultures if

healthcare providers and patients are unable to speak with each other. Many colleges

and universities offer this type of course, so consider negotiating with them to have a

course brought on-site to your organization.

3. Consider offering a course about the language(s) other than English that are most

common among patients and staff. For example, if Spanish-speaking patients make

up a significant portion of an organization’s patient population, negotiate with a local

college or university to provide a conversational Spanish course for employees.

C H A P T E R 9


4. Include American culture as part of diversity training. Although Americans span a

variety of ethnic and racial backgrounds, there are cultural distinctions that are typically

American. For example, most Americans value eye contact as an indicator of attention

and concentration. Members of Asian and Middle Eastern cultures often avoid eye con-

tact, considering it to be rude or an indication of sexual promiscuity. Therefore, a nurse

who has just arrived from Japan must learn the significance of eye contact to Americans.

Another example is that Americans are often perceived by other cultures as being loud and

boisterous, while Americans view their behavior as enthusiastic and friendly. Consider this

scenario:

An American is dining in a Parisian restaurant with her husband, a Frenchman. At the next

table, a group of Americans are talking about the upcoming Super Bowl. The woman introduces

herself as a fellow American, and she is soon engaged with them in animated conversation. The

American notices that her husband is becoming increasingly uncomfortable and a bit embar-

rassed. When asked, her husband explains that in France, people do not have conversations sim-

ply because they are from the same country. It just isn’t done.

When planning cultural diversity learning activities, discuss American characteristics as well as

the characteristics of other cultures.

5. Include cultural diversity training in the orientation of all employees. Most organi-

zations include some type of cultural diversity education when orienting direct patient-

care providers. All employees from all departments can benefit from such training. At

one time or another, most employees interact with patients, visitors, and colleagues, so

they all should receive cultural diversity education.

6. Incorporate cultural sensitivity into the organization’s competency education and

training. A combination of written pre- and post-tests, role play, and on-the-job behav-

iors can help you assess cultural competency.

Cultural diversity education plannerF I G U R E

9.1



Identifying topics in cultural diversity

What facets of a culture are important to include in cultural diversity training and education?

The following diversity education planner identifies important topics to include in learning activ-

ities. The form is a template that you can complete and use to compare and contrast two or

more cultures.

Characteristics CultureCulture Culture

Family and gender roles• Head of household/family• Role of women• Role of elderly• Role of extended family• Family structure• Decision-maker regarding

care, if other than patient• Role of children• Importance of children,

including gender value

Staff development

Use work-related case studies and scenarios to teach cultural diversity. Present the study

or scenario from two distinct cultural viewpoints. For example, write a case study about

pain management for a Mexican patient and then present the same case study with a

patient who is a native of Vietnam. This excercise allows participants to consider care

provision for the same problem (i.e., pain) but from two distinct cultural viewpoints.

TIP

Cultural diversity education planner (cont.)F I G U R E

9.1

C H A P T E R 9



Communication• Body language• Tone of voice• Facial expression• Eye contact• Gestures• Posture• Spokesperson, if other

than patient

Sexuality• Gender roles• Sex outside of marriage• Homosexual relationships• Celibacy• Male circumcision• Female circumcision• Menstruation• Birth control• The birth process

Pain• How pain is expressed• How pain is perceived

(e.g., punishment, divinewill, etc.)

• Accepted measures torelieve pain

Diet/nutrition• Preparation• Restrictions• Religious mandates

Cultural diversity education planner (cont.)F I G U R E

9.1




Religion• Role in daily life• Specific practices• Clergy representation• Influence on perceptions

of illness and injury• Treatment issues (e.g.,

blood transfusions, needfor same-sex caregivers)

Health practices• View of illness (e.g., pun-

ishment, divine will, etc.)• Home remedies• Herbal remedies• Cultural remedies• Trust or lack of trust in

medical technology• End-of-life issues (e.g.,

organ donation, whetherthe patient is informed ofhis or her terminal status)

Work ethic• Gender issues• Financial needs• Respectability of specific

occupations

Other

C H A P T E R 9


ConclusionOngoing cultural diversity training and education is necessary. An excellent resource for up-to-

date information about numerous cultures is Geri-Ann Galanti’s Web site, www.ggalanti.com/

articles.html. It is updated frequently and offers information about diverse cultural healthcare

issues.

Education planning for multigenerational learners

Consider the following example of generational differences: If asked to identify a significant

national event that occurred during their lifetimes, how will members of different generations

respond? “Veterans” (born between 1922 and 1945) may talk about the death of President

Franklin D. Roosevelt, the president who was elected to an unprecedented four terms and led

the country during the Great Depression and World War II. Later generations are unlikely to

think of Roosevelt’s death when asked this question. For example, most “Baby Boomers” (born

between 1946 and 1960) are likely to discuss the assassination of President John F. Kennedy.

However, if the name Kennedy is brought up in the presence of “Generation Xers” (born

between 1961 and 1980), the death of John F. Kennedy, Jr. may come to mind. Xers and

“Generation Yers” (born between 1981 and 2000) (as well as the two previous generations) may

cite the horrific events of September 11, 2001, in New York and Washington, DC, as the national

events having the greatest impact on their lives. This example shows the wide gap in experi-

ences that affect the generations.

Staff development specialists must recognize the general characteristics of each generation, how

these characteristics affect the learning process, and what implications these characteristics have

for education planning and implementation.

Caution: As with cultural diversity, it is important to generalize, not stereotype. The characteristics pre-

sented in this chapter are generalities and may not be displayed by all members of a given generation.

Veterans (1922–1945)Veterans experienced first-hand two of the most critical events of the 20th century: the Great

Depression and World War II. These events have shaped how they view themselves and the world

in which they live. To better understand the Veteran learner, consider the following characteristics:



• Veterans have vivid memories of parents and grandparents who came to the United

States as immigrants. They value cultural traditions and the wisdom and wit of their

remembered elders.

• Veterans prefer formal learning environments and dislike sharing experiences that they

deem to be too personal.

• Veterans treat authority figures with respect.

• Veterans view educators as authority figures.

• Veterans are the least likely of all learners to confront you directly if they disagree with

you. Staff development specialists may not be aware that Veterans are dissatisfied with a

learning experience until program evaluations are completed.

The following recommendations to facilitate learning for Veterans are based on the preceding

characteristics:

• Because Veterans prefer a formal learning environment, allow for lecture/discussion time.

Do not ask personal questions, and do not force Veterans to share personal experiences.

Show that their life experiences are valued, and provide a nonthreatening environment

for the sharing of those experiences if they so desire.

• Veterans view educators as authority figures. They expect educators to both be dressed

in and behave in a business-like fashion. Avoid profanity and the extensive use of slang.

• Veterans like organized structured activities. Make sure that objectives are clearly stated

and understood. Provide organized handouts that summarize key points of the education

activity.

• When developing written materials and visual aids, avoid small print. Use at least 14-

point font and a style, such as Arial, that is easy to read.

C H A P T E R 9


• Distance learning is not a favorite with Veterans. If distance learning is the teaching

strategy, make sure that Veterans have contact information for the staff development

specialist facilitating the distance learning activity (which is a good idea regardless of

the participant’s generation but may be especially important for veterans). Veterans and

Baby Boomers may prefer face-to-face clarification, while Xers and the Generation Y

members may rely more heavily on e-mail communication.

• Treat Veterans with respect at all times.

• Never presume that Veterans are computer illiterate.

• Veterans dislike activities that may show their lack of skill or knowledge in front of

younger colleagues. Therefore, establish nonthreatening learning environments.

Baby Boomers (1946–1960)Baby Boomers, generally raised by doting Veteran parents, grew up believing that they were

entitled to the best the world had to offer. They also believe that they must change the world

for the better. Here are some common Baby Boomer characteristics:

• Baby Boomers have a passionate work ethic

• Financial success is of great importance to Baby Boomers

• Baby Boomers invented the phrase, “Thank God it’s Monday,” and the 60-hour work week

• Baby Boomers value teamwork

• Baby Boomers value personal gratification in the workplace

• Baby Boomers are dedicated learners and initiated the self-help book craze

• Baby Boomers do not respond well to authority figures

• Baby Boomers are often perceived to have a “know it all” attitude

The following are teaching considerations for Baby Boomers:

• Baby Boomers respond best to educators who treat them as equals and share personal

accounts of their own knowledge

• Baby Boomers want to know how learning activities will enhance job performance



• Baby Boomers enjoy team learning activities, icebreakers, and group discussions

• Baby Boomers do not like role play

• Baby Boomers do not like to display a lack of knowledge or skill in front of others

• Baby Boomers are the first generation to use the Internet and to make information easily

accessible

Generation X (Xers) (1961–1980)Xers are known as the latchkey generation. They are the first generation to predominantly expe-

rience single-parent families or families with two working parents. Computers are considered a

part of their daily lives. Here are some common Xers characteristics:

• Xers value a reasonable balance between work and personal time.

• Xers value flexibility.

• Xers dislike close supervision and prefer self-directed activities.

• Xers are comfortable with change and view it as normal.

• Xers are accustomed to changes in their family structures.

• Xers know about downsizing through their parents’ experiences and are not motivated to

work for one organization throughout their careers.

• Xers are not loyal to an employer; rather, they are loyal to themselves. Having seen the

ramifications of downsizing, they are concerned about protecting themselves.

• Xers are motivated to save money and secure their financial futures.

Teaching considerations are plentiful for Xers. Baby Boomers and Xers view the world quite

C H A P T E R 9


differently. There are often interpersonal conflicts between these generations due to differences

in work ethics and world views.

When teaching Xers, consider the following:

• Xers prefer self-directed learning. They are born distance learners. They prefer to partici-

pate in learning activities at a time and place convenient for them.

• Xers dislike having to be in a specific place at a specific time to participate in education.

• Xers like to have fun during learning activities.

• Xers enjoy role playing and simulations. They are not as worried as Baby Boomers and

Veterans are about making mistakes in front of others.

• Xers enjoy discussion. They are enthusiastic learners and ask lots of questions. If dis-

tance learning is the teaching method, clearly identify how questions should be

answered (e.g., e-mail, office appointments, etc.)

• Xers prefer immediate feedback and reward.

• Xers do not automatically respect authority figures. Their respect must be earned by

demonstrating knowledge, expertise, and enthusiasm.

• Xers generally prefer lots of visual stimulation, such as pictures, graphics, and tables.

They prefer these types of visual aids to the printed word.

Generation Y (Yers) (1981–2000)Generation Y will replace the Baby Boomers in the workplace and redefine the working envi-

ronment. Some characteristics common to Yers include the following:

• Yers have grown up in the age of technology and, therefore, take computers and the

Internet for granted.



• Yers grew up with DVD players, CD players, and cell phones.

• Yers value diversity.

• Yers are accustomed to sharing the workload and usually held part-time jobs in high

school and college.

• Yers are globally oriented. They do not assume geographic isolation or geographic

protection.

• Most Yers are comfortable with single-parent families, families with stepparents and

stepsiblings, and same-sex unions. Grandparents are often the primary parent figures.

• Yers have even less company loyalty than Xers. They view downsizing as typical of busi-

ness and have witnessed a constant stream of mergers, takeovers, and closings.

• Yers focus more on what they do than on where they work.

• Yers respect persons who demonstrate knowledge and skill. They generally respect

Veterans and value their life experiences.

When teaching learners from Generation Y, consider the following:

• Yers are comfortable with the tools associated with distance learning

• Yers enjoy the opportunity for interaction with colleagues during learning activities

• Yers look for fun as well as structure in the workplace and during learning activities

• Yers are comfortable with the technology of distance learning but prefer interactive

opportunities

• Yers benefit from mentor programs and often admire Veterans

• Yers have a strong work ethic and share many of the values of Veterans

• Yers value education

• Yers enjoy reading

C H A P T E R 9


Conclusion

Meeting the needs of the various generations is an ongoing challenge. The apparent differ-

ences can lead to conflict, especially between the Veterans and the Baby Boomers, as well as

between the Xers and Yers. Therefore, incorporate a variety of teaching methods and flexibili-

ty into education planning. Staff development specialists must also be aware of their own gen-

erational characteristics and avoid allowing them to interfere with helping members of other

generations learn.

Bibliography

Alch, M.L. “Get ready for the Net Generation.” Training & Development 37, no. 2 (2000): 32–33.



Galanti, G.A. “An introduction to cultural differences.” Culture and Medicine 172, no. 5 (2000):

335–336. www.ggalanti.com/articles/Intro.pdf

Galanti, G.A. “Filipino attitudes toward pain medication.” Culture and Medicine 173, no. 10

(2000): 278–279.

Hammill, G. “Mixing and managing four generations of employees.” FDU Magazine Online.

www.fdu.edu/newspubs/magazine/05ws/generations.htm (Accessed on May 17, 2005).

News Digest. 2001. “Baby boomers.” Training. (Electronic version) (Accessed on August 24,

2002.)

News Digest. 2001. “Generation Xers.” Training. (Electronic version) (Accessed on August 24,

2002.)



1. Filipinos are often stoic when dealing with pain. They may not express that they are suffering con-

siderably. Janet, an RN working on a surgical unit, recognizes this characteristic. She is taking

care of a middle-aged Filipino man who has had surgery because of a bowel obstruction. Which of

the following actions indicates a generalization of his cultural characteristics?

a. Janet assumes that he is hiding his suffering and insists that he take his pain medication

b. Janet asks him whether he is in pain

c. Janet recognizes that he may not verbally complain of pain and assesses both verbal and

nonverbal indications of pain

d. Janet assumes that all Filipinos hide their suffering

2. Vicki is planning to teach a pain management course for a group of culturally diverse partici-

pants. Which of the following statements indicates that Vicki is sensitive to cultural differences?

a. Vicki assumes that all of the Italian-American participants believe that all patients need

maximum amounts of pain medication

b. Vicki plans to ask a British nurse to explain to the class why patients of British descent

are too reserved to ask for pain medication

c. Vicki believes that all of the participants will agree that pain medication should be given

as often as possible

d. Vicki plans to share generalized beliefs about pain and suffering among various cultures

3. Nicole is in charge of planning cultural diversity training for her organization. All of the following

are appropriate steps to take EXCEPT:

a. avoiding teaching about American culture because doing so may offend some participants

b. offering a course on English for speakers of other languages for employees whose native

language is not English

c. identifying predominant cultures of the patient and staff populations

d. making cultural diversity part of the organization’s competency training program

4. Ashley is responsible for the general orientation of all new employees. Today’s group of orientees

includes persons from physical therapy, nursing, maintenance, and information systems. Which of

the following actions is appropriate?

a. Allow maintenance and information systems employees to report to their departments

when offering cultural diversity training

b. Incorporate cultural diversity training throughout the orientation program for all orientees

FINAL EXAM

C H A P T E R 9


c. Confine cultural diversity training to a brief lecture about tolerance

d. Make cultural diversity training optional for those persons who do not provide direct

patient care

5. Jack is a staff development specialist responsible for customer satisfaction training. Elizabeth, an

outpatient surgery nurse, is extremely polite and appears interested throughout the program. She

treats Jack with respect and appears comfortable with the lecture format. After the program con-

cludes, Jack reads Elizabeth’s program evaluation comments with surprise. She found the program

a waste of time and was generally dissatisfied with the experience. Based on this scenario,

Elizabeth is most likely a member of which generation?

a. Generation Y

b. Generation X

c. Baby Boomer

d. Veteran

6. Cassie has planned a learning activity that requires a great deal of teamwork and discussion.

Participants from which of the following generations are most likely to like this approach?

a. Baby Boomer

b. Veteran

c. Generation X

d. Generation Y

7. Mark is a member of the Veteran generation. Which of the following learning activities will he most

likely prefer?

a. Computer-based learning

b. Role play

c. Lecture/discussion

d. Simulation

8. Jennifer designs a handout with a great deal of visual stimulation. She has kept the number of

printed words to a minimum and prefers to teach via graphs, tables, and pictures. Jennifer is prob-

ably a member of which generation?

a. Baby Boomer

b. Generation X

c. Veteran

d. Generation Y



9. The generation that has come to view downsizing as normal is:

a. Generation Y

b. Generation X

c. Veteran

d. Baby Boomer

10. Sandra is a newly licensed RN. She has a strong work ethic and enjoys participating in mentoring

activities. She accepts computer technology as the norm and is comfortable with all types of dis-

tance learning. However, she prefers the opportunity to interact with her colleagues. A member of

which of the following generations is best suited to mentor Sandra?

a. Baby Boomers

b. Xers

c. Yers

d. Veterans


C H A P T E R

10 STRATEGIES FORDEALING WITH THE

RESISTANT LEARNER

OBJECTIVES


1. discuss issues that trigger resistance to learning2. evaluate education offerings during which resistance is evident3. describe ways to defuse the resistant learner

Competency: The staff development specialist identifies coping strategies to use when dealing with

the resistant learner.

Introduction

Nancy is teaching the return skills demonstration portion of an education program designed to

reduce workplace violence. As part of the program, various codes are discussed (i.e., Code 44

indicates a violent patient or family outburst). Lisa, a long-time employee of the labor and deliv-

ery unit, is obviously bored. She rolls her eyes, loudly whispers derogatory comments to col-

leagues, and frequently interrupts Nancy and other participants during discussions to ask ques-

tions or to complain about the procedures being taught. Finally, she asks Nancy, “Why do we

need all these stupid code numbers? It’s just one more thing to worry about and wastes our time

learning pointless facts.”

C H A P T E R 1 0


Nancy has had enough. She asks Lisa, “If you were an ill or injured patient confined to bed,

what would you rather hear paged, ‘Code 44, labor and delivery unit,’ or ‘There’s a violent visitor

throwing things at nurses in the labor and delivery area?’ And wouldn’t you want to get help

quickly if you were the nurse he was throwing things at?” The rest of the class applauds, and Lisa

is quiet for the remainder of the learning activity.

Does this scenario sound familiar? All staff development specialists face the challenge of dealing

with learners who do not want to participate in specific learning activities. These learners are

restless, sometimes rebellious, and often sullen. Their verbal comments and body language let

everyone involved in a classroom, discussion group, or skills demonstration know that they def-

initely do not want to be there. Learners resistant to certain distance learning programs do their

best to spread negative comments about the activities, sometimes derailing what could have

been a highly effective education experience. The attitudes and behaviors of such learners affect

others, making it difficult to establish and maintain a positive learning environment.

Staff development specialists must recognize and accept that resistant learners aren’t going to go

away. There are always employees who seem to make it their vocation to complain and disrupt

learning activities. This chapter discusses the issues that often trigger resistant learners and ways

to defuse them.

Why learners are resistant

No one can make someone else want to learn. Staff development specialists are responsible for

planning learning activities that benefit employees and the organizations in which they work—

they are not responsible for an adult’s refusal to learn.

Staff development specialists must not blame themselves for a learner’s lack of motivation.

There are times when learning activities are ineffectively designed or conducted, but in most

cases, educators are not to blame for a colleague’s unwillingness to learn.

What should staff development specialists do when confronted with resistant learners? Ignoring

or accepting the resistant learners’ attitudes and behaviors is not an option. Doing so will only

encourage inappropriate behaviors, interfere with the other participants’ abilities to learn, and

STRATEGIES FOR DEALING WITH THE RESISTANT LEARNER


hamper the staff development specialist’s ability to lead learning activities effectively. The fol-

lowing suggestions for dealing with resistant learners are not always easy to perform, and

they are not 100% effective, but they can help to diffuse the negative atmosphere created by

resistant learners.

Important questions to answer about the learning activity

Learners may be resistant due to the nature or presentation of a learning activity. However,

this reason for resistance does not mean that the program is poorly planned and implemented

or that the staff development specialist is ineffective. Rather, it means that some important fac-

tors may not have been addressed or adequately investigated. For that reason, the staff devel-

opment specialist should evaluate the effectiveness of learning activities by asking the follow-

ing questions:

1. Do learners understand why they are participating in the learning activity?

Resistance is sometimes due to a lack of understanding about the importance of educa-

tion. No matter how effectively the program is advertised or its purpose explained, not

all employees have equal access to information. Part-time employees, prn employees,

and employees who generally work only weekends are often out of the communication

loop. Therefore, determine how thoroughly the program’s purpose has been disseminat-

ed and how clearly the objectives have been identified.

Staff development

Remember that personal problems affect both attitudes and behaviors. Resistance to

learning may have nothing to do with the learning activity or the staff development special-

ist responsible for the initiation of the activity. The staff development specialist may be the

target of misplaced anger, so avoid taking a learner’s resistance personally.TIP

C H A P T E R 1 0


2. Is the learning activity offered in response to a learning need or a systems flaw?

Most staff development specialists have been asked to use education to correct a prob-

lem that is a systems flaw rather than a learning need. Mandating that employees attend

such a program almost always guarantees a great deal of resistance. If, despite the staff

development department’s best efforts, this type of program is still mandated, try to make

the training as concise and convenient as possible. Consider developing pre- and post-

test options. If employees successfully pass a pretest, proof exists that knowledge deficit

is not the problem. The same concept can be used with skill demonstration. If employ-

ees accurately demonstrate a particular skill, further training is unnecessary, and knowl-

edge deficit is not the problem.

3. Is the program designed to meet the needs of diverse groups of learners?

Staff development specialists must do their best to get to know their learners. They can

do so in several ways:

• Establish a friendly rapport with colleagues. Observe their learning styles, and get to

know them in a nonlearning environment. For example, have lunch with different

groups of employees and talk with them about topics other than education. Learners

are more likely to provide honest feedback and to cooperate during learning activi-

ties if they know and respect educators.

• Pay particular attention to learning styles, cultural characteristics, and generational

characteristics.

• Offer education in formats that are convenient and effective. For example, don’t

expect employees who have little or no access to computers to be enthusiastic about

computer-based learning.

4. Are learners afraid of repercussions if the learning activity is not completed

successfully?

Most organizations have certain knowledge requirements that employees must meet to

keep their jobs or receive promotions. Fear of adverse consequences often makes learn-

ers behave negatively. Staff development specialists cannot alter the consequences, but

they can ensure that learning activities are designed for maximum effectiveness.



5. Do the staff development specialists responsible for implementing learning

activities have credibility in the minds of the learners?

A staff development specialist who plans and implements leadership and management

training must have a record of successful managerial experience if he or she wants the

respect and cooperation of learners. All learners need to believe that the person teaching

them possesses practical experience as well as theoretical knowledge.

6. Will learners have the opportunity to apply the new knowledge and skills in

their work settings?

Acquiring new knowledge and skills without the opportunity to apply them in the work-

place violates one of the basic principles of adult learning. Learners resent devoting time

and effort to pursue knowledge they cannot apply. Therefore, an organization must not

only support training and continuing education but also help employees apply the

acquired knowledge and skills.

7. Do learners feel comfortable in the learning environment?

Is the learning environment appropriate for the activity and for the needs of the learners?

The environment is easier to control in a classroom or demonstration setting than it is

for distance learning. Do learners have access to and the ability to operate necessary

equipment? If not, why not? Whatever the format, learners must not feel threatened, and

both the physical and emotional learning environments must be comfortable.

8. Is the staff development specialist enthusiastic about the learning activity?

The staff development specialist facilitates (or inhibits) learning through tone of voice,

body language, and enthusiasm. An upbeat, positive attitude is usually contagious.

Dealing with overt hostility

Staff development scenario: Emergency preparedness training is mandatory for all nurses work-

ing in a large medical center in downtown Washington, DC. Wendy is responsible for planning

and leading this training. She adheres to principles of adult learning, uses a variety of teaching

methods, and is enthusiastic and knowledgeable.

C H A P T E R 1 0


Most participants are interested and attentive throughout the training. However, Amanda and

Rachel, two nurses from the respiratory care unit, are overtly hostile. They whisper and giggle

and roll their eyes at comments made by colleagues during group discussions. Immediately

before a scheduled break, Amanda says, “We don’t have to sit through this. Francis will get us

out of here.”

Francis is the vice president of nursing. She is also Amanda’s cousin and a close friend of

Rachel’s, and rumor has it that these two nurses are treated with considerable favoritism because

of their friendship with Francis. How does the staff development specialist respond?

This type of situation is frustrating and not all that uncommon. However, two people can not be

allowed to disrupt the learning experience for the rest of the participants. The staff development

specialist calls for a break or initiates a small group activity in order to speak privately with

Amanda and Rachel. Privacy is important to avoid embarrassment to Wendy or the two other

nurses. Wendy tells them that obviously they are upset and don’t want to participate. She asks

them if there is anything she can do to improve the learning experience for them. They

respond, “Sure there is. Just let us leave!”

Wendy tells them that the choice is theirs to make: They can either stop disrupting the class and

show some consideration for their colleagues or they can return to their work setting. They must

take responsibility for their actions.

The nurses choose to return to their work setting. The next day Wendy is summoned to the

Francis’s office and asked to explain why she asked Rachel and Amanda to leave the training

session. Wendy is prepared for this question, and she explains as objectively as possible what

happened. She makes it clear that she gave the women a choice and that the decision to leave

was theirs.

Staff development scenario: Orthopedic nursing staff members are required to participate in a

computer-based learning course about pain management for the surgical amputee patient.

Participants routinely enjoy the course, and it has proven to be quite effective. Jeremy, a newly

hired orthopedic nurse, has been making derogatory comments about distance learning in

general and about this course in particular. His frequent comments are starting to affect his



colleagues. Some who have yet to take the course are beginning to respond negatively to the idea

of distance learning. What should be done to rectify this situation?

Several questions to answer:

1. Does Jeremy know how to participate in computer-based learning? If he does not, he may

be reluctant to admit to his lack of knowledge about it.

2. Are there consequences for failing to complete this course successfully? Jeremy may be

fearful of disciplinary action if he performs poorly.

3. Does Jeremy understand the importance of the course and how the knowledge he gains

will be applied in the work setting?

4. Has the staff development specialist talked to Jeremy about Jeremy’s concerns?

The answers to these questions will help to identify the reasons for Jeremy’s resistance and will

help the staff development specialist help Jeremy learn.

Staff development scenario: Diane is a staff development specialist with a background in rehabilita-

tion nursing. She is waiting for Pauline, a staff nurse on the spinal cord injury rehabilitation unit,

to arrive. Pauline has been having difficulty applying her knowledge of spinal cord pathophysiology

to the rehabilitation setting, and her manager has asked Diane to design some self-learning mod-

ules for her. Such modules have been a great help to other nurses with similar difficulties.

Pauline arrives 15 minutes late and is obviously angry. She refuses to sit down and says, “I’ve

been a nurse for seven years and never had any problems before. It’s the way this stupid hospital

is run. You don’t have any right to tell me how to be a nurse!” Diane asks Pauline to sit down

and tries to explain that she wants to make this experience less frustrating for Pauline and to help

her use her rehabilitation skills. Pauline responds by reaching across the desk, grabbing both of

Diane’s arms, and shouting, “I don’t need you to interfere in my business!”

Dealing with violence is frightening. Whether the hostility is expressed verbally or physically,

C H A P T E R 1 0


the staff development specialist must take steps to protect himself or herself and to help the

violently resistant learner. Here are some suggestions when dealing with violent learners:

• Ask them to sit down. Assuming a sitting posture often has a calming effect. The staff

development specialist should sit down as well. Doing so puts the two at equal eye

level and helps defuse anger.

• Never allow an angry person to block the exit from the room. Always make sure

that the exit is easily accessible. If the staff development specialist feels that he or she is

in danger, the angry learner is asked to leave. If the learner does not comply, the staff

development specialist should leave the area at once.

• Never make a threatening gesture (e.g., grabbing the angry person’s arms). Doing

so causes the situation to escalate, may cause an outburst of physical violence, or may

trigger an accusation of assault and battery against the staff development specialist.

• Use a calm, measured tone of voice. Do not speak loudly or let body language indi-

cate fear or anger.

• Do not take anger personally. In such situations, the staff development specialist is

generally the target of displaced anger. This knowledge doesn’t make the situation any

less frightening, but it does make it easier to maintain self-control.

• Listen actively. Maintain eye contact. Explain that the purpose of the meeting is to help

him or her but that shouting or threats will not be tolerated. Learners need to know that

they are free to express concerns and that they will receive all available help as long as

they treat others with respect.

• Know how to get help quickly. Don’t be afraid to call for help if the threat of danger

exists. Know how to summon security personnel. If it is anticipated that a meeting has

the potential for violence, ask another colleague to be present or a security officer to

remain nearby.



• Report all incidents of violence, whether verbal or physical. Never allow violence

to go unreported. Follow organizational policies and procedures for reporting these

incidents.

Conclusion

Resistant learners are an ongoing issue for most, if not all, staff development specialists. The

staff development specialist must do everything possible to help such learners acquire knowl-

edge; however, he or she must not allow disruptive behaviors to compromise the learning expe-

rience for others. Although the staff development specialist cannot make someone want to learn,

he or she can facilitate learning as best as possible. To do so, rely on the principles of adult

learning and respect differences of learning style, culture, and generational perspectives to pro-

mote enthusiasm for the learning process.

Bibliography



Dickerson, P.S. “Ten tips to help learning.” Journal for Nurses in Staff Development, 9/10 (2003):

244–250.

Hequet, M. “Training no one wants.” Training, 41, no. 1 (2004): 22–28.

Mulvihill, C. “Dealing with the difficult patient.” University of Pittsburg, www.pitt.edu/

~cjm6diff.html. (Accessed on August 6, 2002.)

Trainingmag.com (1998) “Stand up: Defusing the hostile trainee.” Training (Electronic version),

August 6, 2002.

C H A P T E R 1 0


1. Which of the following statements about resistant learners is accurate?

a. It is up to the staff development specialist to successfully motivate resistant learners

b. A learner’s resistance may actually have little or nothing to do with the staff development

specialist

c. Learners usually are resistant because the learning activity is poorly planned or imple-

mented

d. The problem of resistant learners will decrease as distance learning opportunities

increase

2. Carolyn is a nursing assistant on the orthopedic unit of a small community hospital, and she is

scheduled to attend mandatory classroom training today. She is in the midst of divorce proceed-

ings. Before she leaves for work, her lawyer informs her that her husband is suing for full custody

of their children. Carolyn is frightened and angry. She arrives at work feeling upset and longs to

express her fears and frustration. Throughout the training, she is restless and frequently makes

derogatory comments about the instructor and the learning activity. Carolyn is most likely

expressing:

a. dissatisfaction with an unqualified instructor

b. frustration with a poorly planned learning activity

c. misplaced anger

d. fear of failure

3. The nurse managers at Metropolitan Hospital want medication administration training to be man-

dated for all nurses due to an increase in the number of medication errors. The nurses say that

the errors are due to changes in pharmacy policies and the timing of meals and treatments that

conflict with medication times. What does this situation best indicate?

a. A systems flaw

b. A learning need

c. Insubordinate nurses

d. Misplaced anger

4. Which of the following situations is most likely to trigger learner resistance?

a. Mandatory ACLS certification for critical care nurses

b. Emergency preparedness training for military healthcare personnel

FINAL EXAM



c. A staff development specialist who asks to work part-time on the pediatric unit before

planning pediatric continuing education

d. A staff development specialist with a background in orthopedic nursing is assigned to

develop and implement orientation programs for emergency department personnel

5. Maxine is attending a program on the prevention of workplace violence. She is obviously angry

about having to attend this program. She whispers to the person sitting near her and is overheard

making comments such as, “This is such a waste of time!” and “We should all walk out!” Which

of the following is an appropriate action for the staff development specialist to take?

a. Stop the lecture/discussion and tell Maxine to be quiet

b. Call for a break, privately tell Maxine that her behavior is distracting to the other partici-

pants, and say that if she is unable to participate appropriately, she should return to her

work area

c. Ask to speak to Maxine privately, and ask her to please stop complaining

d. Ignore Maxine’s behavior, and continue with the program

6. Serena is facilitating a skills demonstration lab that requires her to certify employees after they

have mastered the skill. One of the participants is the CEO’s daughter-in-law, Shelly. Shelly per-

forms poorly and does not seem to care whether she demonstrates skills accurately. She tells the

staff development specialist, “You just better not make me do this over and over. It doesn’t matter

anyway. My father-in-law will make you certify me. If you don’t, I’ll see that you get fired!” What

should the staff development specialist do?

a. Explain to Shelly why it is important to master this skill and that she will not be certified

until she achieves competency

b. Privately ask Shelly not to discuss education issues with the CEO

c. Ask Shelly to leave the skills demonstration

d. Report Shelly to the CEO and file a grievance with her immediate supervisor

7. Matthew storms into Cindy’s office in the staff development department. He has failed a distance

learning pharmacology update course and must now attend additional educational programs. He is

angry and blames Cindy for his failure. What should Cindy do?

a. Ask Mark to sit while she remains standing. Doing so gives her a position of authority.

b. Realize that Mark dislikes her and is using the course failure as an excuse to verbally

abuse her.

c. Make sure that Mark does not position himself between her and the exit to the office.

d. Avoid telling anyone else that Mark is angry.

C H A P T E R 1 0


8. All of the following statements about dealing with angry colleagues are accurate EXCEPT:

a. do not take anger personally

b. speak in calm, measured tones

c. report all incidents of violence, whether verbal or physical

d. be sure to meet with the angry person privately to respect his or her confidentiality

9. Pediatric nurses in a small community hospital must participate in continuing education that deals

with pain management for pediatric patients. The unit is short-staffed, and every bed is continu-

ously occupied. The nurses are enthusiastic learners and are eager to participate in this learning

activity. There is one computer available for the purpose of computer-based learning. To avoid

resistance, what learning strategy is best suited in this situation?

a. Classroom learning

b. Self-learning modules

c. Computer-based learning

d. Audioconferences

10. Jason is confronted in his office by a nursing assistant who is angry because she has failed the

written CPR recertification exam. The nursing assistant is verbally abusive and is clenching and

unclenching her fists. What is an appropriate action for Jason to take?

a. Grasp the nursing assistant gently by the arm and ask her to leave

b. Tell the nursing assistant that she is out of control and that he is calling security

c. Move behind his desk so that the nursing assistant is between Jason and the doorway

d. Speak in calm, measured tones; maintain eye contact; and attempt to calm the nursing

assistant


C H A P T E R

11 TIPS FOR PLANNING

ORIENTATION, INSERVICE, AND

CONTINUING EDUCATION

OBJECTIVES

At the conclusion of the chapter, the learner will be able to

1. develop orientation strategies that reduce the time and number of staff required to orientemployees

2. implement a mechanism for inservice training that facilitates the delivery of “just in time”training

3. design continuing education programs that meet learner needs and adhere to accreditingagency standards

Competency: The staff development specialist will plan and implement orientation, inservice,

and continuing education using time-saving strategies that enhance the efficiency of educa-

tion delivery.

Introduction

Staff development specialists are constantly asked to deliver education in ways that are faster,

more efficient, take less work time, and improve job performance. It is often an overwhelm-

ing task. This chapter offers the experienced staff development specialist tips for meeting

these challenges.

C H A P T E R 1 1


Orientation

One of the few certainties of staff development practice is that orientation is in a state of con-

stant review and revision. There is no such thing as a “perfect” orientation program. However,

an orientation program can be flexible and can complement existing processes.

1. Assign responsibility for orientation to specific staff development specialists.

Someone must be in charge of the project, but that does not mean that only these indi-

viduals deliver orientation. To the contrary, in most organizations, the entire staff devel-

opment department participates to some extent. However, assigning primary responsibili-

ty for orientation ensures that orientation efforts are scrutinized constantly.

2. Arrange orientation activities in conjunction with other programs as often as pos-

sible. For example, if rhythm-strip interpretation is a component of orientation as well as

a competency for critical care nurses, arrange to offer competency assessment/reassess-

ment on a regular basis and have it coincide with orientation. Depending on the number

of nurses involved, offer the pretests/posttests twice a month on the same day that new

critical care orientees perform this task. Distinct learning opportunities (e.g., orientation

and ongoing competency assessment) are offered simultaneously, thus saving time and

money. This method is a huge time-saving strategy when it comes to mandatory training

and skill demonstration, so combine education efforts whenever possible.

3. Establish preceptor programs for all departments, not just those involved in direct

patient care. A manager should not assume the role of primary preceptor. Rather, staff

members who show an interest and aptitude for the role should be groomed as precep-

tors. The role of preceptor should be accompanied by a salary differential when precep-

tor duties are performed. Offering all employees such an opportunity enhances morale.

Here are some specific tips for a preceptor program:

• Identify specific qualifications for the preceptor role, including education and length

of job experience.

• Avoid assigning the role of preceptor to all employees. This role requires special

skills and strengths.

TIPS FOR PLANNING ORIENTATION, INSERVICE, AND CONTINUING EDUCATION


• Do not force anyone to become a preceptor. Candidates for this role must want to

assume the accompanying responsibilities.

• Select individuals who demonstrate not only job expertise but a genuine desire to

help colleagues excel at their jobs, as well as a flair for teaching.

• All candidates for the preceptor role must attend training and education programs

designed to groom employees as preceptors. The following topics should be includ-

ed in any preceptor curriculum:

- Principles of adult education

- Learning styles

- Generational differences

- How to offer constructive criticism

- How to deal with a resistant learner

- How to evaluate job performance objectively

- Leadership principles

- Communication skills

4. Incorporate the organization’s competency requirements into orientation. Initial or

ongoing competency assessment generally requires some time set aside for taking pre-

and posttests and for skill demonstration. Offer all three for both orientees and estab-

lished employees within the same period. Doing so provides an option for both groups

to avoid classroom or distance learning hours if they demonstrate competency success-

fully right away. Persons who need additional education and training may then attend

classroom or other means of instruction to achieve competency. Avoid setting up sepa-

rate competency assessment mechanisms and teaching sessions for orientees alone;

doing so is often an inefficient use of time.

Inservice education

Inservice education generally refers to training delivered to meet an immediate need. Also

known as on-the-job or “just in time” training, such education must be delivered swiftly,

accurately, and concisely. Typically, inservices must be delivered around the clock so that

C H A P T E R 1 1


employees working different shifts receive adequate training. Most organizations do not have

enough staff development specialists to deliver inservice training to all employees without

assistance. Here are some suggestions to meet inservice needs efficiently:

• Use distance learning techniques whenever possible. For example, the implementation of

a revised policy may require proof that employees have read and accepted the revisions.

Do not waste time and money setting up classroom training for such simple inservices.

E-mail distribution is an efficient way to disseminate such information quickly, and e-sig-

natures are acceptable as proof that the policy has been read and accepted. If employees

do not have access to unit/department e-mail, their managers can post a copy of the pol-

icy, along with a sign-in sheet indicating acceptance.

• Note that some managers of small departments may choose to present new information

during a staff meeting. Regardless of methodology, training must be documented. A sim-

ple template that can be customized and distributed quickly saves time when training

must be quick and concise. Consider using such a template for all inservices that consist

primarily of reading information. Another example is reviewing background information

on a rarely seen illness affecting a recently admitted patient.

• Use available resources outside the staff development department. For example, suppose

staff on a particular unit need to learn quickly how to use a new piece of equipment.

Contact the vendor leasing or selling this equipment. Most vendors have preprinted

guidelines for equipment use and often are willing to provide inservice training.

Preceptors should be among the first to be trained and to demonstrate accurate use of

such equipment. In turn, because preceptors have already demonstrated their ability to

facilitate learning, they can help train their colleagues.

Such inservice training must be documented and maintained. If questions arise about the proper

use of equipment (e.g., family complaint, patient injury, accreditation review), such documenta-

tion is essential. Again, develop and maintain a template for such training to allow for swift cus-

tomization and distribution.



Inservice documentation formfor review of written materials

F I G U R E

11.1

Date:_____________________________

Department/unit: __________________

Information distributed: __________________________________________________________________

(e.g., new/revised policy, update on evolving health hazards, background information on a rarely

seen illness, etc.)

The attached document(s) indicate a change or a new way of providing products and services to our

patients, families, visitors, and/or employees. After you have read these document(s), indicate that

you comprehend and accept changes in policies, organizational directives, and relevant new patient

information by dating and signing below. If you have any questions, please contact your department

manager.

It is required that all employees read the attached documents and sign their names by the following

date: _________________

Date: _______________Signature: _____________________________Title: ________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

C H A P T E R 1 1


Inservice documentation form for skill training

F I G U R E

11.2

Date: ___________

Time: ___________

Objective: __________________________________

Skill acquired: ______________________________

Trainer:_____________________________________

After observing accurate demonstration of __________________________________________________,

the following learners demonstrated competence in __________________________________________

________________________________________________________________________________________

________________________________________________________________________________________(Trainer’s signature, time, and date)

Date: _________ Time: _________ Learner’s signature and title: ________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________



Clinical staff members are often expected to learn basic information about a disease process or

treatment when patients are admitted with unusual or rarely seen illnesses. Here are some use-

ful Web sites to use when confronted by these types of challenges:

Centers for Disease Control: www.cdc.gov

According to the CDC’s Web site, “The Centers for Disease Control and Prevention (CDC) is

recognized as the lead federal agency for protecting the health and safety of people—at home

and abroad, providing credible information to enhance health decisions, and promoting health

through strong partnerships. CDC serves as the national focus for developing and applying dis-

ease prevention and control, environmental health, and health promotion and education activi-

ties designed to improve the health of the people of the United States.”

National Institutes of Health: www.nih.gov

According to NIH’s mission statement, “The National Institutes of Health is the steward of med-

ical and behavioral research for the Nation. It is an Agency under the U.S. Department of Health

and Human Services.”

American Association for Clinical Chemistry: www.labtestsonline.org

The American Association for Clinical Chemistry’s Web site offers information on a wide variety

of lab tests (including rarely ordered tests) and how to interpret findings.

Federal Food and Drug Administration: www.fda.gov

The Federal Food and Drug Administration’s Web site offers a wealth of information about drug

trials, approvals, warnings, and cautions.

PubMed: www.pubmed.gov

According its Web site, PubMed is a service of the National Library of Medicine and includes

millions of citations for biomedical articles—dating back to the 1950s. The citations are from life

science journals.

Continuing education

Continuing education is defined as a learning activity designed to enhance an employee’s

C H A P T E R 1 1


professional growth and development. Experienced staff development specialists have

planned and implemented many such programs. However, offering continuing education

programs that also allow professionals to obtain specific numbers of contact hours or contin-

uing education credits is increasingly important. Many states and healthcare organizations

mandate that certain types of professionals obtain a specific number of continuing education

credits annually. Many licensed professionals must earn such credits in order to maintain

licensure/specialty certification. Here are some suggestions when applying for continuing

education credit from a professional association or other accrediting body:

1. Obtain instructions for completing the application and follow them exactly. If

there are questions or concerns about any facet of the process, call the accrediting

agency and follow its directives. Some parts of the application may appear to be redun-

dant, but do not attempt to avoid repetition by using such statements as “Refer to page

55 for this answer” or “This information has already been presented on page two.” Make

it as easy as possible for the people reviewing the application. These reviewers do not

want to (nor will they) flip through an application searching for information. If you are

asked to do so, repeat information accordingly.

2. Meet deadlines. All accrediting agencies ask that applications be submitted within a spe-

cific period before offering the program. If the accrediting agency wants the application

in six weeks before program implementation, you must submit it then.

3. Meet the accrediting agency’s qualifications guidelines. If two RNs, one of whom

must hold a graduate degree in nursing, is the standard for the committee planning the

program, then it is necessary to meet that standard. When identifying faculty, whether

for classroom or distance learning activities, make sure that they are qualified experts in

the content field. It’s generally required that a brief résumé be submitted by all members

of the planning committee, including faculty.

4. Avoid conflicts of interest. Most accrediting agencies frown on a program that is imple-

mented to advertise or promote specific products or businesses, such as a pharmaceuti-

cal agency or physician practice. Follow all standards concerning this issue carefully.



5. Make sure that objectives are explicit and measurable. The objectives also must coin-

cide with content offered—some staff development specialists write wonderful objectives

that have little or nothing to do with actual or relevant program content. Instead, objec-

tives should help the learner identify the important aspects of the program. For example,

an objective that mandates that learners identify anatomical structures in the lungs is not

of primary importance when the content focuses on the pathophysiology of myocardial

infarction. That doesn’t mean participants should ignore the lungs—it just means that the

lungs are not the focus of this program.

6. Content must allow for the achievement of objectives. The content must reflect the

objectives, and the objectives must reflect the content. If the content presented does not

provide adequate information to achieve the objectives, the focus of the program is mis-

directed.

7. Participant attendance must be verified. Verification options include sign-in sheets, e-

signatures, completion of pre- and posttests, etc.

8. Achievement of objectives must be evaluated. Evaluation strategies include posttests,

skill demonstration, role play, simulation, etc.

9. Participants must have an opportunity to evaluate the program. These evaluations

must be kept on file, and the information obtained must be used to enhance future

learning activities.

Conclusion

Staff development specialists are required to offer and evaluate many different types of program-

ming. Emphasize ease of delivery, attendance, and facilitating maximum competency in a short

amount of time. Practical, creative use of resources can help you fulfill staff development

responsibilities in an efficient, constructive manner.

C H A P T E R 1 1


Bibliography



Ellis, K. “Top training strategies.” Training, 7/8 (2003): 31–35.

Fennimore, L.A. “Delivering distance learning.” In B. E. Puetz and J.

W. Aucoin (Eds.) Conversations in nursing professional development. Sudbury, MA: Jones and

Bartlett Publishers, 2002. 317–328.

Gloe, D. 2001. “Implementation of learning activities.” In A.E. Avillion (Ed.) Core curriculum for

staff development. 2nd ed. Pensacola, FL: National Nursing Staff Development Organization,

2001. 261–302.

Puetz, L., and S.A. Zuel. “Educational planning.” In A.E. Avillion (Ed.) Core curriculum for staff


199–229.



1. Simone is responsible for the orientation program at Kane Health System. She believes that a pre-

ceptor program will benefit new employees and enhance the efficiency of orientation. Which of

the following actions should Simone take?

a. Facilitate the development of preceptorships within all departments

b. Arrange for the managers of housekeeping and maintenance to act as the preceptors for

all new employees

c. Avoid associating monetary rewards with the role of preceptor

d. Note that job expertise is the only important requirement for the preceptor role

2. It is essential that all of the following be included in a preceptor curriculum EXCEPT:

a. learning styles

b. communication skills

c. return demonstration of clinical skills

d. how to evaluate job performance

3. Cardiac care nurses at Community Hospital must demonstrate ongoing competency in the inter-

pretation of cardiac arrhythmias. A logical way to do so is to:

a. develop a self-learning module that all nurses must complete annually

b. mandate classroom instruction on this topic for all nurses orienting to the cardiac care

unit

c. mandate that both orientees and established employees attend the same classroom

instruction concerning interpretation of cardiac arrhythmias

d. develop pre- and posttests that, if successfully completed, validate competency for both

new employees and established employees and that allow them to bypass classroom

instruction

4. A new policy concerning workplace security must be disseminated and reviewed by all employees

as soon as possible. Which of the following is the most efficient, appropriate strategy for this type

of “just in time” training?

a. E-mail will be distributed, with electronic signature indicating that employees have read

and accepted the new policy

b. Staff development specialists will review the policy with staff members on designated

units/departments during all shifts

FINAL EXAM

C H A P T E R 1 1


c. Classroom training will be planned and implemented

d. Staff development specialists will videotape a reading of the policy highlighting essential

changes and make the video available to all department managers

5. A newly admitted patient requires the use of an IV pump never seen by the majority of the nursing

staff on the admitting unit. They need inservice training. Which of the following approaches is most

efficient and ensures the highest degree of competency?

a. Formal classroom inservice

b. Inservices provided by the equipment vendor around the clock on the unit

c. Mandatory inservice training for all nurses in the organization

d. Mandate that all nurses watch a video about the new IV pump

6. Mrs. Temple is admitted to Metropolitan Hospital. She is receiving an innovative treatment that

requires the use of equipment rarely seen in this facility. All of the following statements pertaining

to inservice training in this situation are accurate EXCEPT:

a. vendors leasing or selling this equipment may be of valuable assistance in the training

process

b. this is a good example of “just in time” training and, as such, formal documentation of

training is not an important issue

c. preceptors are often able to facilitate inservice training

d. distance learning is not appropriate for immediate skill demonstration

7. Which of the following is an example of inservice training?

a. Instruction regarding the use of a new patient-lifting device

b. Pathophysiology of spinal cord injury and its treatment

c. Oncology pharmacology course focusing on new chemotherapeutic agents

d. Staff development course focusing on innovative teaching techniques

8. Which of the following is an example of continuing education?

a. CPR certification

b. Review of new patient care policy

c. Identification and discussion of professional liability issues

d. Demonstration of accurate use of new type of patient restraints



9. Miranda is planning a continuing education program focusing on the pathophysiology of breast can-

cer. Which of the following is an appropriate goal?

a. Participants will understand the manifestations of invasive breast cancer

b. Participants will describe the pathophysiology of invasive ductal breast cancer

c. Participants will identify structures of the female reproductive tract

d. Participants will discuss the impact of breast surgery on breast feeding

10. The most effective evaluation strategy for a continuing education program focusing on pharmaco-

logical advances in pain management is:

a. discussion

b. role play

c. pre- and posttests

d. e-signature


C H A P T E R

12 QUALITY IMPROVEMENTAND EVALUATION OF

EDUCATIONAL EFFECTIVENESS

OBJECTIVES


1. identify learner satisfaction2. measure knowledge acquired as a result of a specific learning activity3. evaluate changes in job performance as a result of a specific learning activity4. assess the impact of education on organizational effectiveness5. measure return on investment (ROI) from specific learning activities

Competency: The staff development specialist will evaluate the success of learning activities by

measuring their impact on learner behavior and organizational effectiveness.

Introduction

Staff development specialists are responsible for the quality and effectiveness of their learning

activities. There must be documented evidence that education improves job performance,

enhances patient outcomes, and contributes to the financial solvency of the organization. To col-

lect this evidence, an objective system of data collection and analysis must be part of the quality

improvement efforts of the staff development department.

C H A P T E R 1 2


If a staff development specialist is consistently rated as “highly qualified” and an “excellent”

presenter, those ratings are nice but do not prove that education increased organizational effec-

tiveness. On the other hand, a 40% decrease in patient falls following fall prevention training

shows that education has improved patient safety. This chapter concentrates on various evalua-

tion strategies that are useful as quality improvement monitors and that help demonstrate the

worth of the staff development department.

Level I evaluation: Reaction and learner satisfaction

Level I evaluation is used to describe the learner’s reaction to and satisfaction with a learning

activity. It includes the learner’s response to the presenter and to the learning environment.

Sometimes referred to as the “happiness” index, Level I evaluations generally are forms that par-

ticipants complete at the end of learning activities. Not long ago, such evaluations dealt almost

exclusively with classroom learning, but today, Level I evaluations must address the distance

learning environment as well. The following templates (featured in Figures 12.1 and 12.2) offer

suggestions for Level I evaluations from classroom and distance learning formats.

Such reaction data are always useful. They help identify presenter strengths and weaknesses,

environmental problems, and learner satisfaction. However, Level I evaluation alone is insuffi-

cient—the staff development department must be able to determine, at the very least, whether

knowledge gain occurred.

Level II: Knowledge acquisition (learning)

Level II measures whether learning actually occurred. Its evaluation mechanism is based on pro-

gram objectives. In most cases, for example, simple knowledge acquisition is measured via a

pre- and posttest or skills demonstrated in a controlled setting, such as a skills lab. Comparison

of pre- and posttest scores, or appraisal of skill proficiency before and after training, can help

measure knowledge gained.

Remember that pre-testing, whether in written or demonstration form, must be conducted tact-

fully. That is, emphasize that assessment of the learner’s level of knowledge prior to the learn-

ing activity is simply a way to demonstrate and measure knowledge gained by comparing its

QUALITY IMPROVEMENT AND EVALUATION OF EDUCATION EFFECTIVENESS


Classroom evaluation formF I G U R E

12.1

Date: _________

Time: _________

Name (optional): ___________________________

Profession: ________________________________

Department/unit:___________________________

Program title: ______________________________

Instructor(s): _______________________________

Objectives:

Please answer the following questions: (Note: N/A stands for not applicable.)

1. How well did the program content meet the stated objectives?__Excellent __Very Good __Good __Fair __Poor __N/A

2. Based on the program content, how well were you able to achieve the objectives?a. Objective #1___________________________________________

__Excellent __Very Good __Good __Fair __Poor __N/A

b. Objective #2_____________________________________________Excellent __Very Good __Good __Fair __Poor __N/A

c. Objective #3______________________________________________Excellent __Very Good __Good __Fair __Poor __N/A

1._____________________________2._____________________________3._____________________________

C H A P T E R 1 2


Classroom evaluation form (cont.)F I G U R E

12.1

3. Was the instructor(s) an effective teacher?__Excellent __Very Good __Good __Fair __Poor __N/A

4. Was the instructor(s) knowledgeable and well-prepared to teach this program?__Excellent __Very Good __Good __Fair __Poor __N/A

5. Was there enough time for discussion and to ask questions?__Excellent __Very Good __Good __Fair __Poor __N/A

6. Did the instructor show respect for the participants?__Excellent __Very Good __Good __Fair __Poor __N/A

7. Were the handouts useful?__Excellent __Very Good __Good __Fair __Poor __N/A

8. Were you able to read the handouts without difficulty?__Excellent __Very Good __Good __Fair __Poor __N/A

9. Were the audio-visuals useful?__Excellent __Very Good __Good __Fair __Poor __N/A

10. Was the temperature of the classroom comfortable?__Excellent __Very Good __Good __Fair __Poor __N/A

11. Were the seating arrangements comfortable?__Excellent __Very Good __Good __Fair __Poor __N/A

12. Were you able to see and hear the instructor without difficulty?__Excellent __Very Good __Good __Fair __Poor __N/A

13. Were you able to see and hear the A/Vs used without difficulty?__Excellent __Very Good __Good __Fair __Poor __N/A



Classroom evaluation form (cont.)F I G U R E

12.1

14. Would you like to make any other comments?________________________________________________________________________________________________________________________________________________________________________________

15. For future program planning purposes, please identify three specific education topics that wouldimprove your ability to do your job.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

16. What would be the easiest, most efficient way for you to attend programs focusing on the top-ics you identified in #15 above?Classroom ______Self-learning modules ___________Video or DVD _____________Audioconference ______________Computer-based learning ________________Other: (Please identify) ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

C H A P T E R 1 2


Distance learning evaluation formF I G U R E

12.2

Date:_________

Time: ________

Name (optional): ___________________

Profession: ________________________

Department/unit:___________________

Program title: ______________________

Teaching method (Please check all that apply):

__Computer-based learning __Video __Self-learning packet

__Audiotape __Teleconference

Objectives:

Please answer the following questions: (Note: N/A stands for not applicable)

1. How well did the program content meet the stated objectives?


2. Based on the program content, how well were you able to achieve the objectives?

a. Objective # 1_________________________________________________


1._____________________________2._____________________________3._____________________________



Distance learning evaluation form (cont.)F I G U R E

12.2

b. Objective #2______________________________________________


c. Objective #3______________________________________________


3. Was the teaching method effective?


4. How well were you able to use the equipment for this distance learning experience?


5. How well did the program explain how to receive help or to ask questions if you need to do so?


6. Were the handouts useful?


7. Were you able to read the handouts without difficulty?


8. Was the location of this distance learning experience comfortable? In other words, was it quiet

and comfortable?


9. Did the quality of the graphics, videos, or audiotapes help you to learn?


C H A P T E R 1 2


Distance learning evaluation form (cont.)F I G U R E

12.2

10. Would you like to make any other comments? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

11. For future program planning, please identify three specific education topics that would improve

your ability to do your job. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12. What would be the easiest, most efficient way for you to attend programs focusing on the top-

ics you identified in #11 above?

Classroom ______

Self-learning modules ___________

Video or DVD _____________

Audioconference ______________

Computer-based learning ________________

Other: (Please identify) __________________________________



results to those achieved after receiving the education. Assure participants that pre-education

performance will not be shared with anyone other than the learner and the staff development

specialist. No penalties are associated with pre-education performance.

When using written pre- and posttests, consider the following questions:

1. Are instructions for completing pre- and posttests clear and learning objectives under-

stood? It is particularly important that they be so for distance-learning activities, for

which the staff development specialist is not present.

2. Are tests appropriate for the participant’s reading level?

3. Are written materials appropriate for participants whose native language is not English?

4. Can employees whose native language is not English follow verbal instructions during

psychomotor demonstrations?

5. If staff members other than staff development specialists observe skill demonstration in the

controlled setting, how do you ensure that evaluation and documentation are consistent?

Evidence of learning in addition to the reaction data demonstrate program value to a certain

extent, but it is more important to obtain evidence that the learner applied knowledge gained in

the work setting.

Staff development

Remember that successful completion of a pre-test or accurate skill demonstration prior to

education may indicate that the learner is already competent in certain skills and does not

need additional education and training. TIP

Staff development

Persons evaluating skill demonstration in the controlled setting should follow a consistent

template for documentation, such as the sample shown in Figure 12.3. This template pro-

vides consistency and may be adapted for competency assessment.TIP

C H A P T E R 1 2


Skill demonstration formF I G U R E

12.3Date: ________

Objectives: ____________________________________________________________________________________________________________

Skill demonstration:

Step 1 _______________________________________________________

Step 2 _______________________________________________________

Step 3 _______________________________________________________

Step 4 _______________________________________________________

Observer comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Skill was successfully demonstrated: ________________________________________Observer’s signature

________________________________________Learner’s signature

Skill was not successfully demonstrated : ____________________________________Observer’s signature

The following steps will be taken by the learner to achieve successful skill demonstration:________________________________________________________________________________________________________________________________________________________________________________

_____________________________Learner’s signature



Level III: Behavior

Level III involves assessing the learner’s behavior (i.e., the actual use of new knowledge/skills)

during the performance of job-related duties. Application of new knowledge and skills requires

the support of managers and administrators. When evaluating behavior, consider the following

questions:

• How has performance of job-related duties been affected by new knowledge or skills

acquired during a learning activity?

• Has the impact of the learning activity on job performance been clearly communicated

to learners, management, and administration?

• Does the work environment encourage the application of new knowledge and skills

acquired during a learning activity?

Behavior may be evaluated by direct observation, documentation review, and assessment of the

appropriateness of patient care interventions. Regardless of the method chosen, however, evalu-

ation must be performed consistently. The template in Figure 12.4 may be adapted as a tool for

Level III evaluation.

Level IV: Results/impact

Level IV assesses the actual impact education has on the organization. Doing so takes consider-

able effort, so programs evaluated at Level IV should be selected carefully. Examples of impact

findings include the following:

• Improvement of patient outcomes

• Decreased lengths of stay

• Decrease in hospital-acquired infections

• Increase in health insurance reimbursement

• Decrease in staff turnover

• Decrease in employee injuries

C H A P T E R 1 2


Evaluation of behavior (application of new knowledge and skills)

F I G U R E

12.4

Date: _____________

Time: _____________

Objectives: _______________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Evaluation

Medical record review:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Use of equipment:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Direct observation: ______________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Evaluator’s comments:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

____________________________________

Evaluator’s signature



Level IV data must be presented to the organization’s leadership and staff to demonstrate educa-

tion’s impact on the organization. The following example is based on an employee health and

wellness course that includes such components as stress reduction, smoking cessation, exercise,

and nutrition:

1. Calculate the number of employee sick days and work-related injuries

2. Create a course on health and wellness for employees

3. Perform Level I, II, and III evaluations on this course

4. Compare the number of employee sick days and work-related injuries at three months,

six months, and 12 months after course implementation (which helps measure long-term

impact)

5. Present findings to the organization

Level V: Return on investment

The purpose of Level V evaluation is to demonstrate education’s effect on the organization’s bot-

tom line. Because a return on investment (ROI) requires a cost-benefit analysis, which is time-

consuming, ROI should be calculated only for programs that have a significant financial impact

on the organization.

The following example demonstrates how to perform a Level V evaluation:

Employee orientation has been reviewed and revised for the purpose of decreasing the length of

orientation, the turnover rate for new employees, and the dollars spent to orient staff. First,

Staff development

Do not use the word “proof” when presenting findings. This word is too easily challenged

by persons who say that it is impossible to remove all other variables that may have lead

to the Level IV results. To “prove” an exact cause-and-effect relationship between educa-

tion and results, you must eliminate all other factors that might influence findings, which is

a nearly impossible task. Therefore, use the word “evidence” instead.

TIP

C H A P T E R 1 2


determine the cost of orientation under the “old” system.

• How long did orientation take?

• How much overtime was needed to pay the employees who had to work additional

hours until new employees successfully completed orientation?

• How much staff development and preceptor time was spent orienting new employees?

(Use hourly wages to determine costs.)

• How much preparation time did it take to plan and implement orientation? (Determine

costs in salary for preparation time.)

• How much did the supplies, equipment, etc., used for orientation cost?

• What was the turnover rate for employees within the first six months of their employment?

Next, answer the same questions based on the findings from the “new” orientation program.

Calculate ROI as a percentage for both the old and new orientation programs and compare the

findings. Divide the dollar value of the program (net program benefits) by the total cost of train-

ing. Net program benefits are the program benefits minus the program costs.

ROI (%) = Net program benefits

Program costs X 100

Conclusion

All five levels of evaluation are important to the survival of the staff development department.

Judicious use of evaluation techniques can demonstrate education’s impact on organizational

effectiveness and justify the existence of the staff development department.



Bibliography

Abdulhadi, L., and E. Hull. “Program evaluation and return on investment.” In A.E. Avillion (Ed.)

Core curriculum for staff development. Pensacola, FL: National Nursing Staff Development

Organization, 2001. 343–360.


Development Organization,1998.



Kirkpatrick, D.L. “Great ideas revisited.” In D.L. Kirkpatric (Compiler) Another look at evaluating

training programs. Alexandria, VA: ASTD, 1998. 3–8.

Kirkpatrick, D.L. “Evaluating training programs: Evidence vs. proof.” In D.L. Kirkpatrick

(Compiler) Another look at evaluating training programs. Alexandria, VA: ASTD, 1998. 9–11.

C H A P T E R 1 2


1. Hannah is reviewing evaluation data from a particular learning activity. Data focus on ability to

achieve objectives, the effectiveness of the presenter, and the physical environment of the class-

room. What type of evaluation data is Hannah reviewing?

a. Reaction

b. Behavior

c. Learning

d. Impact

2. Jean scores 70% on a pharmacology pretest. After participating in a pharmacology course, Jean

scores 98% on the same test. This situation can be used as part of which level of evaluation?

a. Level I

b. Level II

c. Level III

d. Level IV

3. Marjorie enjoys computer-based learning (CBL) and participates in a CBL course that focuses on

stroke rehabilitation. Which of the following feedback is part of Level I evaluation?

a. Return demonstration of patient transfer techniques

b. Using new patient positional skills on the stroke unit

c. Stating that there were insufficient numbers of computers available

d. Calculating that the cost of the program outweighed the benefits

4. Following a course on pain management initiatives, nurses are observed as they interact and

intervene with patients suffering from chronic pain prior to the course and after its completion.

What type of evaluation is this?

a. Behavior

b. ROI

c. Reaction

d. Learning

5. Which of the following demonstrates Level II evaluation?

a. Reviewing adverse occurrence data to determine whether there has been a decrease in

patient falls following a fall prevention course

FINAL EXAM



b. Reading learners’ comments about the physical comfort of the classroom

c. Comparing the cost of a learning activity to its effect on the finances of the organization

d. Observing demonstration of a skill in a controlled setting before and after participating in

a learning activity

6. Health insurance reimbursement has increased following a course on documentation of patient

outcomes. Reimbursement and documentation were analyzed prior to and after the program. This

is an example of:

a. Level I evaluation

b. Level II evaluation

c. Level III evaluation

d. Level IV evaluation

7. Level III evaluation is performed by which of the following?

a. Implementing pre- and posttests

b. Reviewing medical records to assess the documentation of infection control interventions

before and after a course on preventing hospital-acquired infections

c. Analyzing the impact of an education program on patients’ lengths of stay

d. Calculating return on investment

8. Level V evaluation requires:

a. calculating ROI

b. assessing learning satisfaction

c. observing behavior

d. evaluating impact on the organization

9. Which of the following illustrates Level IV evaluation?

a. Observing that the number of hospital-acquired infections decreases after a course on

infection control is implemented

b. Comparing scores on pre- and posttests during a pharmacology course

c. Demonstrating safe use of new equipment during a skills lab

d. Calculating the cost of a learning activity and comparing it to monetary impact on the

organization

C H A P T E R 1 2


10. Marjorie calculates the cost of hospital-acquired infections in terms of additional patient days and

interventions used to treat the infections. She compares these findings before and after a course

that focuses on preventing hospital-acquired infections. Marjorie has assessed:

a. knowledge

b. behavior

c. ROI

d. learning


C H A P T E R

13 WRITING TEST ITEMS

OBJECTIVES

At the conclusion of the chapter, learners will be able to

1. identify the components of a well-written test question2. discuss tactics to avoid when writing test questions3. write test questions that measure knowledge, comprehension, application, and analysis

Competency: The staff development specialist will write test items that measure knowledge, com-

prehension, application, and analysis.

Introduction

It is not easy to write “good” test questions. The staff development specialist must write ques-

tions that measure achievement of objectives and avoid tactics that do not measure knowledge.

Components of well-written test questions

A multiple-choice test can be an effective assessment of knowledge, provided that the test ques-

tions are based on the course objectives and are well-constructed. Here are some tips for writ-

ing test questions:

C H A P T E R 1 3


• The stem of a test question is the partial statement (incomplete stem), brief scenario, or

question that must be addressed in order to correctly answer it. When writing a stem,

always give enough information that the student can choose a reasonable option from

the answers provided.

• An incomplete stem is always punctuated with a colon. For example:

Learners born between 1922–1945 are referred to as:

A. Veterans

B. Baby Boomers

C. Generation Xers

D. Generation Y

• If the statement is a direct question, make sure that a question mark appears at the end

of the stem. For example, “Which generation of learners was born between 1922–1945?”

• Ask questions that require more than knowledge of facts whenever possible. Instead of

asking which generation was born between 1922 and 1945, describe a learning strategy

and ask learners to identify which generation would most prefer that strategy.

• A correctly written test item consists of a well-written stem and four choices. Make sure

that the best choice is the correct answer. The remaining three distractors should be

plausible but clearly incorrect. For example:

If drug Y is administered to a patient with kidney failure, that patient’s potassium level will:

A. increase

B. decrease

C. stay about the same

D. fluctuate erratically

Tactics to avoid when writing test questionsWhen writing test questions, keep the following in mind:

• Don’t include unnecessary information in the stem of a test question. For example,

“Differences among generations affect learning. Which of the following strategies is best

suited for Generation Xers?” Although differences among generation do affect learning,

WRITING TEST ITEMS


this statement does not provide information essential to the test question. Therefore, cut

the sentence.

• Avoid writing true/false items. They do not provide opportunities to assess high levels of

learning.

• Avoid the use of “multiple multiples.” Examples of multiple multiples include “all of the

above,” “none of the above,” and combinations of choices such as “c and d.”

Measuring objective achievement

KnowledgeTest items that measure knowledge include terms that represent basic levels of knowledge

acquisition. Therefore, if a program objective is “Define Level I evaluation,” then an appropriate

test item might be as follows.

Level I evaluation is defined as:

a. assessment of learner satisfaction

b. measurement of knowledge acquisition

c. calculation of ROI

d. evaluation of behavioral change in the work setting

ComprehensionComprehension involves translation and interpretation of knowledge. An objective that requires

demonstration of comprehension is, “Describe learning styles that best meet the needs of Baby

Boomers.” The corresponding test question might read as follows:

Which of the following learning styles best meets the needs of Baby Boomers?

a. Role-play

b. Lecture

c. Self-learning modules

d. Team activities

C H A P T E R 1 3


ApplicationYou apply knowledge when you use it in concrete situations. Verbs such as “apply” and

“demonstrate” indicate application. Suppose a learning objective requires the learner to

“Demonstrate safe and accurate intramuscular injection (IM) technique.” A test item might be

written as follows.

When administering IM injections in the buttocks, insert the needle:

a. slowly and remove it rapidly

b. using the deltoid muscle as a guide

c. using the sacrum as an anatomical landmark

d. in the abdominal rectus

AnalysisAnalysis involves explaining the relationships between the components of a situation. Words

such as “analyze,” “distinguish,” and “compare” measure analysis. An objective that requires the

leaner to “distinguish between Stage III and Stage IV breast cancer” is analytical. A test item

might be written as follows.

A major difference between Stage III and Stage IV breast cancer is:

a. the presence of cancer in the ducts of the breast

b. the presence of cancer in the lymph nodes

c. bone metastasis

d. sites and degree of metastasis

Bibliography

Aucoin, J.W. “Writing better test items.” Journal for Nurses in Staff Development, 21, no. 1 (2005):

6–9.

WRITING TEST ITEMS


1. An incomplete stem is always followed by a:

a. colon

b. period

c. question mark

d. exclamation point

2. Which of the following is a well-written stem?

a. Cultural sensitivity is influenced by personal values. Which of the following statements

describes dietary practices of Muslims?

b. Are all of the following choices accurate?

c. Generation Xers prefer to learn by:

d. Which is (are) characteristics of Baby Boomers?

3. Distractors are:

a. poorly written choice options

b. written in negative terms

c. designed to confuse the learner

d. incorrect options offered along with the single correct option

4. Which of the following choices may appropriately be used as a distractor?

a. All of the above

b. d and c

c. None of the above

d. Distance learning

5. True/false items are:

a. appropriate when assessing application

b. poor examples of test items

c. used to evaluate critical thinking

d. useful only for assessing skill demonstration

FINAL EXAM

C H A P T E R 1 3


6. Which of the following stems helps to measure knowledge?

a. Major depressive episode is defined as:

b. Which of the following distinguishes drug X from drug Y?

c. Which of the following evaluation levels measures organizational impact?

d. Administering lidocaine in the presence of premature atrial contractions demonstrates:

7. “Which of the following statements describes the action of drug A when administering during the

manic phase of bipolar disorder?” This stem measures:

a. knowledge

b. comprehension

c. application

d. analysis

8. Application is measured by which of the following objectives?

a. Recall the side effects of Zoloft

b. Discuss the characteristics of Generation Xers

c. Define multiple sclerosis

d. Demonstrate safe administration of IV Lasix

9. Consider this stem: “Drug X and drug Y are both administered to bipolar disorder patients. Which

of the following is more appropriate for a patient under the age of 15?” It measures:

a. analysis

b. application

c. comprehension

d. knowledge

10. The choice “all of the above” represents:

a. comprehension

b. multiple multiples

c. knowledge

d. an incomplete stem


C H A P T E R

14 OVERVIEW OF ASTAFF DEVELOPMENT

BUSINESS PLAN

OBJECTIVES


1. discuss the components of a business plan2. identify specific elements of the business plan that demonstrate the value of staff develop-

ment to the organization

Competency: The staff development specialist will write (or contribute to) a business plan that

coincides with the organization’s strategic plan and upholds the mission, vision, and values of

the organization.

Introduction

A strategic plan is a long-range guide that forecasts fiscal and operational objectives for an

organization for a period of no less than three years and as long as 10 years or more. The orga-

nization’s strategic plan is the foundation for the staff development’s business plan and reflects

the organization’s mission, vision, and values; its goals and objectives; its allocation of resources;

and its marketing strategies. Therefore, when writing or revising the staff development depart-

ment’s business plan, keep a copy of the organization’s strategic plan nearby, and use it to fore-

cast the future of the department. A well-written plan should be no longer than 20 pages. It

C H A P T E R 1 4


should allow the reader to grasp both the essentials of the staff development department and

how the department contributes to organizational effectiveness.

Components of the business plan

Executive summaryThe executive summary is a concise overview of the business plan and is the first component

presented to the reader. It is arguably the most important part of the plan. The executive sum-

mary should be no more than two pages long and should “grab” the reader’s attention.

The easiest way to write an executive summary is do so after the rest of the plan is complete.

Write summary or opening paragraphs of all the plan’s components and compile them as your

executive summary.

The executive summary is often the only portion of a business plan read by executive level staff

so it must be concise, effective, and impressive.

Departmental descriptionThe department description describes the organization of the department and why the organiza-

tional structure enhances the delivery of products and services. Include the following in the

department description:

• Mission, vision, and values statements

• Description of the department’s customers

• The setting of the staff development department (e.g., centralized, decentralized, within

a health system, in a community hospital)

• Departmental responsibilities

• A brief overview of the department’s products and services (details are provided in

another component of the business plan)

OVERVIEW OF A STAFF DEVELOPMENT BUSINESS PLAN


• Some recent, major accomplishments supported by objective evaluation data (e.g., 40%

decrease in sick days following implementation of employee health and wellness course)

Departmental structureThe departmental structure includes

• the department’s organizational chart

• reporting mechanism

• job descriptions

• qualifications

• Roles and responsibilities

Products and servicesThis section of the plan describes, in detail, the products and services that are provided and to

whom. Include not only current but also potential products and services. Consider the following

types of products and services that the staff development department offers or may plan to offer:

• Orientation

• Inservice education

• Continuing education

• Student affiliations

• Patient education

• Seminars and conferences

• Research

• Performance coaching

• Consultative services

• Publishing

• Employee health and wellness

Marketing strategiesMarketing strategies focus on customer and competitor identification, how products and services

are developed and promoted, and the costs of marketing the department and the products and

services it provides. Consider the following questions when writing the marketing component of

a staff development business plan:

• Who are the department’s internal and external customers?

C H A P T E R 1 4


• Who are the department’s “best” customers?

• What are the department’s most popular products and services?

• What are the department’s least popular products and services?

• What marketing strategies have increased use of or purchase of products and services?

• What marketing strategies have failed to increase the use of products and services?

• What are the costs of marketing the department’s products and services?

The answers to these questions form the basis of the marketing component of the business

plan. They guide the department’s efforts to promote its products and services, and they predict

the need for future products and services

Action planThe action plan identifies objectives, actions taken to achieve them, and evaluation of objective

achievement from previous fiscal years. Consider the following when preparing the action plan:

• Objectives must be written in measurable terms

• Objectives must include target achievement dates

• Persons responsible for objective achievement must be identified specifically

• Objectives must be quantifiable

• Objectives must be evaluated, achievement documented, or corrective actions identified

if objectives are not achieved

See Figure 14.1 to view a sample action plan.

Actions include

1. consulting with employee health department

2. identifying percentage of employee sick days within the past six months

3. planning education based on employee demographics (e.g., number of smokers)

4. implementing education using a variety of education strategies

Budget overviewThe budget is generally a separate component. It can be attached in its entirety to the plan or

maintained as a separate document according to organization policy. If it is maintained as a

separate document, provide an overview of the budget in the business plan. Include the follow-

ing in such an overview:



• Personnel budget

• Capital budget

• Operating budget

• Profit and loss statements

• Summarize major sources of income and expense

• Include examples of programs that had a significant ROI

Conclusion

Most organizations have their own format of business plan development. This chapter offers

general guidelines for the development of such a plan and specific components to include.

Bibliography

Avillion, A.E. Writing a staff development plan: Business strategies for the 21st century. Pensacola,

FL: National Nursing Staff Development Organization, 2003.

Sample action statementF I G U R E

14.1Objective

Employee sick

days will decrease

by 10% within six

months of imple-

mentation of

employee health

and wellness

course

June 30, 2005 S. Keller, RNJ. Kane, RN

Course planned andimplementation startsJanuary 7, 2005

Target achievement date

Responsible party Status

C H A P T E R 1 4


1. The executive summary is:

a. written before the rest of the business plan

b. composed of summary or opening paragraphs from the plan’s other components

c. seldom read by executive level staff

d. a concise summary of the financial statement

2. A guide that forecasts objectives for a period of no less than three years and for as many as 10

years is the:

a. executive summary

b. departmental description

c. action plan

d. strategic plan

3. Mission, vision, and values statements are part of the:

a. departmental description

b. marketing strategies

c. goals and objectives

d. budget

4. When writing the departmental structure component of the business plan, include:

a. an action plan

b. goals and objectives

c. a reporting mechanism

d. a budget

5. The foundation for the staff development plan is:

a. the department’s goals and objectives

b. the organization’s strategic plan

c. the organization’s financial forecast

d. the department’s roles and responsibilities

FINAL EXAM



6. It is important to include which of the following in a departmental description?

a. Goals and objectives

b. Marketing strategies

c. Mission, vision, and values

d. Job descriptions

7. Include job descriptions as part of the:

a. action plan

b. organizational structure

c. marketing strategies

d. financial component

8. When developing a marketing plan, identify all of the following EXCEPT:

a. external customers

b. competitors

c. most popular products and services

d. roles of staff development specialists

9. Which of the following is an appropriately written action plan objective?

a. Number of falls will decrease by 10% within one month of the implementation of a fall

prevention training course

b. Increase participation in distance learning activities

c. Decrease number of hospital-acquired infections by 15%

d. Number of certified critical care nurses will increase after implementation of a critical care

certification review course

10. Significant ROI examples are part of:

a. goals and objectives

b. action plan

c. budget overview

d. strategic plan


C H A P T E R

15 ETHICAL SCENARIOS INSTAFF DEVELOPMENT

OBJECTIVES


1. describe staff development ethical dilemmas

2. propose solutions to staff development ethical dilemmas

Competency: The staff development specialist will identify staff development ethical dilemmas and

possible solutions to those dilemmas.

Introduction

Ethical dilemmas occur frequently in the healthcare arena, and such dilemmas also confront staff

development specialists. This chapter focuses on common staff development dilemmas and

potential solutions to them.

The term “ethics” indicates a formal process for making logical and consistent decisions based

upon moral beliefs. An “ethical dilemma,” therefore, occurs when conflicts exist among various

moral value claims. Moral values are internal beliefs about the nature of good and bad and right

C H A P T E R 1 5


and wrong. Conflicts arise when one person is asked to participate in an action that is at odds

with moral beliefs. The following scenarios illustrate some common staff development dilemmas.

Scenarios Staff development scenario: A JCAHO surveyor arrives at Memorial Medical Center to conduct an

announced survey. Janice, the manager of staff development, is summoned to the director of

nursing’s office. The director of nursing has not attended mandatory training and education for

more than three years. He asks Janice to falsify attendance records to make it look as though he

complied with organizational standards. Janice believes that such an action would be immoral

and compromise her own professionalism. What should she do?

Janice has several options. To refuse outright may affect Janice’s continued employment status.

At the very least, it may make working at Memorial Medical Center an unpleasant experience

and compromise its accreditation status.

However, to agree to a blatant falsification of records is wrong and possibly illegal.

One compromise may be to offer to conduct essential training immediately and record atten-

dance date and time honestly.

None of these solutions is completely free of risk or deception. Regardless of Janice’s ultimate

decision, her interaction with and feelings about the director of nursing are probably tainted for

the foreseeable future.

Staff development scenario: In order to complete orientation, all RNs must pass a pharmacology

exam. Hospital policy dictates that failure results in the termination of the orientee. Two RNs fail

the examination. One of these nurses, Ann, is single, without family obligations, and the other,

Kay, is a single mother of three children. The staff development specialist feels sorry for Kay and

allows her to take the exam numerous times until she achieves a passing score. Anne is terminat-

ed. Ann discovers that Kay was allowed to repeat the exam numerous times. She files a discrimi-

nation lawsuit, citing both the hospital and the staff development specialist. The staff development

specialist is consequently fired. Was this fair?

ETHICAL SCENARIOS IN STAFF DEVELOPMENT


Yes. The staff development specialist chose to discriminate against Anne in favor of Kay because

Kay is a single mother. Although the staff development specialist may indeed have been justified

in her concern for the single mother of three, that did not give her the right to violate legal stan-

dards and hospital policy.

Angela is a staff development specialist in charge of emergency preparedness training. Randy

and Joyce are RNs participating in the course. Angela and Randy are good friends, but Angela

does not get along with Joyce. The nurse who earns the highest score in emergency preparedness

training will be awarded a prestigious critical care award. Joyce has commented publicly that she

will file a grievance if Randy wins because, “Angela will help Randy and make sure I look bad.”

What should Angela do?

Angela has several options to avoid facing an ethical dilemma. She can ask to have another staff

development specialist assume responsibility for training. If no one else is qualified, Angela can

ask that her manager or a staff development peer observe and monitor the class and evaluation

of the learner’s achievements. Angela could also choose to take no additional action but to eval-

uate both nurses objectively. She must identify the tactic that best reduces the potential for an

ethical dilemma to occur.

Conclusion

The preceding scenarios are only a few of the ethical dilemmas a staff development specialist

may face. When confronted by such problems, he or she must identify options for the resolution

of the dilemma and choose the one that best adheres to legal, professional, and personal stan-

dards of professional behavior.

Bibliography

Burkhardt, M.A. Ethics and issues in contemporary nursing. 2nd ed. Clifton Park, NY: Delmar

Thomson Learning, 2002.

C H A P T E R 1 5


1. Jordan believes that the death penalty is wrong. Allison does not agree. The women’s views are

examples of:

a. ethics

b. moral values

c. dilemmas

d. prejudice

2. An ethical decision is characterized by:

a. logic and consistency

b. prejudice

c. irregularities

d. unfounded beliefs

3. Terry is the critical care staff development specialist. Her best friend fails to achieve advanced

cardiac life support certification, which is a job requirement. The friend asks Terry not to report

the results to administration and to give her time to take the test again. Such an action is against

hospital policy and would put Terry’s job at risk. What should Terry do?

a. Agree to her friend’s request

b. Allow Terry to take the certification exam again in private

c. Report the results to administration

d. Ask the CEO to change the hospital policy

4. Two nurses apply for the position of charge nurse. The ultimate deciding factor for earning the

promotion is the successful completion of a management and leadership course. Kate is the staff

development specialist in charge of the course. Her best friend is one of the nurses applying for

promotion. The other nurse and Kate have never gotten along. What is the best course of action

for Kate to take?

a. Refuse to implement the course

b. Recommend her friend for the promotion

c. Report the behavior of the nurse with whom Kate doesn’t get along to the director of

nursing

d. Ask for an objective observer to monitor course implementation and evaluation

FINAL EXAM

hcPro

NURSING EDUCATION

INSTRUCTIONAL GUIDE


Nursing education instructional guide

Target audience:

Staff development specialists, directors of education, and nurse managers

Statement of need:

This manual offers busy staff development specialists off-the-shelf, ready-to-use tools and templates for

assessing staff ’s learning needs, planning curricula, and creating, marketing, leading, and evaluating their

education programs.The advice and tools within the manual help educators adapt education pro-

grams/inservices to the new challenges associated with their role, incorporate new technology, and

use evidence-based teaching strategies.

The American Nurses Credentialing Center (ANCC) is recognizing the importance of the staff educa-

tor role and stressing the need for qualified experienced clinicians to fill this position.Therefore, this

manual prepares the staff educator for certification and also counts as credit toward it.

Educational objectives:

Upon completion of this activity, participants should be able to

• describe historical events that influenced the evolution of staff development

• analyze historical trends and use data to plan education programs

• identify specific historical milestones in the history of nursing and staff development’s response to

these events

• define mission, vision, and values

• describe the components of staff development’s mission, vision, and values statements

• plan educational activities that support the mission, vision, and values of the organization and the

staff development department

• describe qualifications for the staff development specialist



• write competency-based job descriptions for the staff development specialist

• identify the principles of adult learning

• apply the principles of adult learning to his or her staff development practice

• identify sources for the identification of learning needs

• gather data for the identification of learning needs

• analyze data to prioritize learning needs

• identify objectives for education activities

• identify effective program delivery methods

• select appropriate teaching strategies

• facilitate learner participation in educational activities

• discuss the types of records the staff development department must maintain

• write a policy for the confidentiality of educational records

• differentiate among the three basic learning styles: visual, auditory, and kinesthetic

• incorporate teaching methods that facilitate learning for persons of each learning style

• incorporate cultural diversity into learning activities

• identify common cultural factors that influence participants’ behaviors

• describe the common characteristics among specific generations of learners

• plan and implement learning activities that meet the needs of multigenerational learners



• discuss issues that trigger resistance to learning

• evaluate education offerings during which resistance is evident

• describe ways to defuse the resistant learner

• develop orientation strategies that reduce the time and number of staff required to orient employees

• implement a mechanism for inservice training that facilitates the delivery of “just in time” training

• design continuing education programs that meet learner needs and adhere to accrediting agency

standards

• identify learner satisfaction

• measure knowledge acquired as a result of a specific learning activity

• evaluate changes in job performance as a result of a specific learning activity

• assess the impact of education on organizational effectiveness

• measure return on investment (ROI) from specific learning activities.

• identify the components of a well-written test question

• discuss tactics to avoid when writing test questions

• write test questions that measure knowledge, comprehension, application, and analysis

• discuss the components of a business plan

• identify specific elements of the business plan that demonstrate the value of staff development to

the organization

• describe staff development ethical dilemmas

• propose solutions to staff development ethical dilemmas



Author

Adrianne E. Avillion, DEd, RN

Accreditation/designation statement:

This educational activity for 10 contact hours is provided by HCPro, Inc. HCPro is accredited as a

provider of continuing nursing education by the American Nurses Credentialing Center’s Commission

on Accreditation.

Disclosure statements

Adrianne E. Avillion, DEd, RN, has declared that she has no commercial/financial vested interest in

this activity.



Instructions for obtaining your nursing contact hours

In order to be eligible to receive your nursing contact hour(s) for this activity, you are required to do

the following:

1. Read the book

2. Complete the exam

3. Complete the evaluation

4. Provide your contact information in the space provided on the exam and evaluation

5. Submit the exam and evaluation to HCPro, Inc.

Please provide all of the information requested above and mail or fax your completed exam, program

evaluation, and contact information to

Robin L. Flynn

Manager, Continuing Education

HCPro, Inc.

200 Hoods Lane

P.O. Box 1168

Marblehead, MA 01945

Fax: 781/639-0179

If you have any questions, please contact Robin Flynn at 781/639-1872 or [email protected].



Nursing education exam

1. The event that triggered the beginning of staff development was:

a.The Great Depression c.World War I

b.The Crimean War d.World War II

2. The Great Depression’s impact on staff development was to cause a significant need for:

a. orientation to the hospital setting

b. training schools of nursing

c. a distinct department devoted to staff development

d. specialty certification

Name: _________________________________________________________________________

Title: __________________________________________________________________________

Facility name: ___________________________________________________________________

Address: _______________________________________________________________________

Address: _______________________________________________________________________

City: _________________________________ State: __________________ ZIP: ____________

Phone number: ________________________ Fax number: _____________________________

E-mail: __________________________________________________________________________

Nursing license number: ________________________________________________________

(ANCC requires a unique identifier for each learner)



3. Mark is writing a first draft of a values statement for the staff development department. It is impor-

tant that this statement:

a. concentrates on the individual preferences of the staff development specialists

b. identifies essential functions of the department

c. reflects the philosophy of the organization

d. focuses on the future

4. The administrative team at Community Hospital has announced that the hospital will expand its

services to include physical medicine and rehabilitation, with an emphasis on neurological rehabilita-

tion. Due to the Community Hospital’s recent merger with a pediatric facility, pediatric services at

Community Hospital will be phased out. This may lead to downsizing of nurses currently working on

the pediatric unit of Community Hospital. Based on these issues, all of the following programs are

appropriate priorities EXCEPT:

a. care of the spinal cord patient

b. job interviewing skills

c. stroke rehabilitation

d. developmental characteristics of the toddler

5. Which of the following statements concerning staff development specialist qualifications is accurate?

a. Minimum education requirements vary depending on the role fulfilled

b.The most important qualification is clinical expertise

c. Persons who work full-time must possess different qualifications than those who work part-time, even though

they fulfill the same role

d. Responsibilities are the same for all staff development specialists even though they fulfill different roles

6. Dixon Hospital is purchased by a large, for-profit healthcare corporation. Which of the following

might be stressed as part of hospital’s staff development mission considering the new for-profit

status?

a. Developing free blood pressure screening education

b. Designing education activities that generate income

c. Offering education to nonlicensed personnel

d. Developing programming that supports life-long learning



7. Adults are self-directed learners. This implies that:

a. adults refuse to participate in education unless they want to

b. adults need to understand why a particular learning activity is important to them and to the organization

c. adults want someone else to be responsible for identifying their learning needs

d. adults will learn only if the learning activity is mandatory

8. Ways to incorporate the principle that adults are self-directed learners into program planning include

all of the following EXCEPT:

a. mandate programs that may be unpopular

b. share information that explains why the program is important to staff and the organization

c. use survey and quality improvement data to illustrate the impact of failure to offer the program

d. respect the learners’ input and answer questions honestly

9. Amy has made three medication errors this month. Two of the medication errors were errors of omis-

sion (i.e., she forgot to administer two medications) and one occurred as a result of Amy administer-

ing the wrong dose of an oral antibiotic. Prior to this month, Amy has administered medications for

two years without error. Amy is not too concerned about these errors because she says the unit on

which she works is really busy and no patients were injured due to the errors. Which of the following

phrases best describes this situation?

a. A learning need c. A performance issue

b. A systems flaw d. A reason for termination

10. Performance evaluations are important sources when identifying education needs. Anna is the man-

ager of the surgical pediatric unit and is concerned about maintaining employee confidentiality when

she identifies learning needs for the staff development department. Which of the following best helps

Anna to preserve confidentiality?

a. Anna meets privately with the manager of staff development and discusses individual employee performance

evaluations with her

b. Anna refuses to share information from performance evaluations with anyone

c. Anna provides education herself in order to maintain confidentiality

d. Anna summarizes employee education needs and relays this information to the staff development department,

but does not identify employees by name



11. As part of an extensive course on new oncology chemotherapeutic agents, the learner must be able

to distinguish between two drugs (referred to here as Drug A and Drug B) with similar names and

actions, but that cause quite different side effects. Which of the following objectives best explains

what the learner must accomplish?

a. Define Drug A and Drug B

b. Discuss Drug A and Drug B

c. Contrast the side effects of Drug A and Drug B

d. Determine the side effects of Drug A and Drug B

12. A group of experienced critical care nurses are updating their pharmacology knowledge. As part of

the education program, these nurses will select and administer these drugs during a mock code situ-

ation. Which of the following objectives is most appropriate for this group of learners?

a. Recall the side effects of new critical care drugs

b. Discuss the action of new critical care drugs

c. Administer new cardiac drugs accurately and safely during a simulated code

d. Identify potentially lethal interactions among the new cardiac drugs

13. Which of the following statements about recordkeeping systems is accurate?

a. Only agencies that deal exclusively with nursing personnel can mandate a recordkeeping system

b. All managers throughout the organization should have access to the staff development department’s record-

keeping system.

c. Program evaluation data must be maintained in the recordkeeping system

d. Attendance records are primarily the responsibility of the individual employee’s manager.

14. Which of the following helps maintain confidentiality of education records?

a. Password-protected automated system

b. Maintaining back-up CDs of records in the organization’s education library

c. Decentralized written records maintained on individual units/departments

d.Written files accessible to departmental secretaries



15. Mark is a staff development specialist responsible for facilitating a lecture/discussion group on car-

diac pathophysiology. One participant, Miranda, seldom looks at Mark and often repeats important

facts softly after Mark presents them. Mark believes that she is uninterested in the topic. To his

astonishment, however, she scores 100% on the post-test and compliments Mark on his teaching

ability. It is probable that Miranda is:

a. a visual learner c. an auditory learner

b. a kinesthetic learner d. a learner who is already familiar with the program content

16. Donna is a staff development specialist who prepares colorful, well-illustrated handouts. Which of

the following learners will best appreciate these handouts?

a. Dan, who learns a new procedure by reading the steps aloud

b. Josephine, who prefers return demonstration as an education strategy

c. Adam, who is easily distracted by auditory stimuli

d. Laura, whose favorite phrase is, “That sounds good to me!”

17. Filipinos are often stoic when dealing with pain. They may not express that they are suffering consid-

erably. Janet, an RN working on a surgical unit, recognizes this characteristic. She is taking care of

a middle-aged Filipino man who has had surgery because of a bowel obstruction. Which of the follow-

ing actions indicates a generalization of his cultural characteristics?

a. Janet assumes that he is hiding his suffering and insists that he take his pain medication

b. Janet asks him whether he is in pain

c. Janet recognizes that he may not verbally complain of pain and assesses both verbal and nonverbal indications

of pain

d. Janet assumes that all Filipinos hide their suffering

18. Cassie has planned a learning activity that requires a great deal of teamwork and discussion.

Participants from which of the following generations are most likely to like this approach?

a. Baby Boomer

b.Veteran

c. Generation X

d. Generation Y

(

2



19. Which of the following statements about resistant learners is accurate?

a. It is up to the staff development specialist to successfully motivate resistant learners

b. A learner’s resistance may actually have little or nothing to do with the staff development specialist

c. Learners are usually resistant because the learning activity is poorly planned or implemented

d.The problem of resistant learners will decrease as distance learning opportunities increase

20. Pediatric nurses in a small community hospital must participate in continuing education that deals

with pain management for pediatric patients. The unit is short-staffed, and every bed is continuously

occupied. The nurses are enthusiastic learners and are eager to participate in this learning activity.

There is one computer available for the purpose of computer-based learning. To avoid resistance,

what learning strategy is best suited in this situation?

a. Classroom learning

b. Self-learning modules

c. Computer-based learning

d. Audioconferences

21. Simone is responsible for the orientation program at Kane Health System. She believes that a pre-

ceptor program will benefit new employees and enhance the efficiency of orientation. Which of the

following actions should Simone take?

a. Facilitate the development of preceptorships within all departments

b. Arrange for the managers of housekeeping and maintenance to act as the preceptors for all new employees

c. Avoid associating monetary rewards with the role of preceptor

d. Note that job expertise is the only important requirement for the preceptor role

22. A new policy concerning workplace security must be disseminated and reviewed by all employees as

soon as possible. Which of the following is the most efficient, appropriate strategy for this type of

“just in time” training?

a. E-mail will be distributed, with electronic signature indicating that employees have read and accepted the new

policy

b. Staff development specialists will review the policy with staff members on designated units/departments dur-

ing all shifts



c. Classroom training will be planned and implemented

d. Staff development specialists will videotape a reading of the policy highlighting essential changes and make the

video available to all department managers

23. Marjorie enjoys computer-based learning (CBL) and participates in a CBL course that focuses on

stroke rehabilitation. Which of the following feedback is part of Level I evaluation?

a. Return demonstration of patient transfer techniques

b. Using new patient positional skills on the stroke unit

c. Stating that there were insufficient numbers of computers available

d. Calculating that the cost of the program outweighed the benefits

24. Following a course on pain management initiatives, nurses are observed as they interact and

intervene with patients suffering from chronic pain prior to the course and after its completion.

What type of evaluation is this?

a. Behavior

b. ROI

c. Reaction

d. Learning

25. An incomplete stem is always followed by a:

a. colon

b. period

c. question mark

d. exclamation point

26. The choice “all of the above” represents:

a. comprehension

b. multiple multiples

c. knowledge

d. an incomplete stem



27. The executive summary is:

a. written before the rest of the business plan

b. composed of summary or opening paragraphs from the plan’s other components

c. seldom read by executive level staff

d. a concise summary of the financial statement

28. Significant ROI examples are part of:

a. goals and objectives

b. action plan

c. budget overview

d. strategic plan

29. Terry is the critical care staff development specialist. Her best friend fails to achieve advanced car-

diac life support certification, which is a job requirement. The friend asks Terry not to report the

results to administration and to give her time to take the test again. Such an action is against hospi-

tal policy and would put Terry’s job at risk. What should Terry do?

a. Agree to her friend’s request

b. Allow Terry to take the certification exam again in private

c. Report the results to administration

d. Ask the CEO to change the hospital policy

30. Two nurses apply for the position of charge nurse. The ultimate deciding factor for earning the pro-

motion is the successful completion of a management and leadership course. Kate is the staff devel-

opment specialist in charge of the course. Her best friend is one of the nurses applying for promo-

tion. The other nurse and Kate have never gotten along. What is the best course of action for Kate

to take?

a. Refuse to implement the course

b. Recommend her friend for the promotion

c. Report the behavior of the nurse with whom Kate doesn’t get along to the director of nursing

d. Ask for an objective observer to monitor course implementation and evaluation



1. This activity met the following learning objectives:

• Describe historical events that influenced the

evolution of staff development

• Analyze historical trends and use data to plan education

programs

• Identify specific historical milestones in the history of nurs-

ing and staff development response to these events

• Define mission, vision, and values

• Describe the components of staff development mission,

vision, and values statements

• Plan educational activities that support the mission, vision,

and values of the organization and the staff development

department

Nursing education evaluation

Name: _________________________________________________________________________

Title: __________________________________________________________________________

Facility name: __________________________________________________________________

Address: _______________________________________________________________________

Address: _______________________________________________________________________

City: _________________________________ State: __________________ ZIP: ____________

Phone number: __________________________ Fax number: __________________________

E-mail: __________________________________________________________________________

Nursing license number: ________________________________________________________

(ANCC requires a unique identifier for each learner)

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 51 2 3 4 5

1 2 3 4 5

Strongly

disagree

Strongly

agree



• Describe qualifications for the staff development

specialist

• Write competency-based job descriptions for the staff

development specialist

• Identify the principles of adult learning

• Apply the principles of adult learning to his or her staff

development practice

• Identify sources for the identification of learning needs

• Gather data for the identification of learning needs

• Analyzes data to prioritize learning needs

• Identify objectives for education activities

• Identify effective program delivery methods

• Select appropriate teaching strategies

• Facilitate learner participation in educational activities

• Define “negative pressure wound therapy,” and list two

factors to consider about the patient before adminis-

tering this therapy

• Discuss the types of records the staff development

department must maintain

• Write a policy for the confidentiality of educational

records

• Differentiate among the three basic learning styles:

visual, auditory, and kinesthetic

• Incorporate teaching methods that facilitate learning

for persons of each learning style

• Incorporate cultural diversity into learning activities

• Identify common cultural factors that influence partici-

pants’ behaviors

• Describe the common characteristics among specific

generations of learners

• Plan and implement learning activities that meet the

needs of multigenerational learners

• Discuss issues that trigger resistance to learning

• Evaluate education offerings during which resistance is

evident

1 2 3 4 5

1 2 3 4 5

1 2 3 4 51 2 3 4 5

1 2 3 4 5

1 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 51 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 51 2 3 4 5

Strongly

disagree

Strongly

agree



• Describe ways to defuse the resistant learner

• Develop orientation strategies that reduce the time

and number of staff required to orient employees

• Implement a mechanism for inservice training that facil-

itates the delivery of “just in time” training

• Design continuing education programs that meet

learner needs and adhere to accrediting agency stan-

dards

• Identify learner satisfaction

• Measure knowledge acquired as a result of a specific

learning activity

• Evaluate changes in job performance as a result of a

specific learning activity

• Assess the impact of education on organizational

effectiveness

• Measure return on investment (ROI) from specific

learning activities

• Identify the components of a well-written test question

• Discuss tactics to avoid when writing test questions

• Write test questions that measure knowledge, compre-

hension, application, and analysis

• Discuss the components of a business plan

• Identify specific elements of the business plan that

demonstrate the value of staff development to the

organization

• Describe staff development ethical dilemmas

• Propose solutions to staff development ethical

dilemmas

2. Objectives were related to the overall purpose/goal

of the activity

3. This activity was related to my nursing activity

needs

1 2 3 4 51 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 51 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 51 2 3 4 51 2 3 4 5

1 2 3 4 51 2 3 4 5

1 2 3 4 51 2 3 4 5

1 2 3 4 5

1 2 3 4 5

Strongly

disagree

Strongly

agree



4. The exam for the activity was an accurate test of the

knowledge gained

5. The activity avoided commercial bias or influence

6. This activity met my expectations

7. Will this learning activity enhance your professional nursing practice?

Yes No

8. This educational method was an appropriate delivery tool for the nursing/clinical audience

9. How committed are you to making the behavioral changes suggested in this activity?

a. Very committed

b. Somewhat committed

c. Not committed

10. Please provide us with your degree

a. ADN b. BSN c. MSN d. Other, please state _____________________________

11. Please provide us with your credentials

a. LVN b. LPN c. RN d. NP

e. Other, please state _____________________________

12. The fact that this product provides nursing contact hours influenced my decision to buy it

Strongly disagree 1 2 3 4 5 Strongly agree

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

Strongly

disagree

Strongly

agree



13. I found the process of obtaining my continuing education credits for this activity easy to complete

Strongly disagree 1 2 3 4 5 Strongly agree

14. If you did not find the process easy to complete, which of the following areas did you find the most

difficult?

a. Understanding the content of the activity

b. Understanding the instructions

c. Completing the exam

d. Completing the evaluation

e. Other, please state:

15. How much time did it take for you to complete this activity (including reading the book and complet-

ing the exam and the evaluation)? _______

16. If you have any comments on this activity, process, or selection of topics for nursing CE, please note

them below.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

17. Would you be interested in participating as a pilot tester for the development of future HCPro nurs-

ing education activities?

Yes No

Thank you for completing this evaluation of our nursing CE activity.

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