Module 3 Assignment: Educational Design for Nurses Educators

For Part 1 of the Module 3 Assignment, you will analyze the practice gap, or area for improvement, that you identified in the Week 5 Discussion using the Hospital Compare website. You will identify the potential learning need to address this practice gap and explain approaches that could be used to analyze the identified gap and assess the learning need(s).

Assignment: (1 page)

Use the Educational Plan Template for the gap you identified in the Discussion for this week and complete the following:

• Identify the current state and the desired state to determine the gap, or area for improvement.
• Identify a potential learning need that may be contributing to the practice gap.

The Educational Plan Template will serve as the basis for completing a 1-page paper in which you will complete the following:

• Explain your approach to identifying the practice gap from the scenario.
• Explain your approach to identifying the learning need based on the practice gap.

 

To prepare:

• Based on your Discussion this week and your identified learning outcome and objectives, consider how you will need to refine them in order to meet the learning needs.
• Consider how learning objectives are used to organize and scaffold content and plan activities.
• Review the Educational Plan Template you began for Part 1, and use the areas of the template designated for Week 6 to complete Part 2 of your Module 3 Assignment.

Assignment (2 pages) Update your Educational Plan Template by completing the following:

• Rewrite the learning objective for each of the three domains of learning to address the learning outcome at a higher level (i.e., level 2 and above) based on the feedback received from your colleagues.
• Identify the level within Bloom’s Taxonomy for each learning objective.
• List 3 topics you would teach to address each objective. (Note: You will need 3 topics per learning objective for a total of 9 topics).

The Educational Plan Template will serve as the basis for completing a 2-page paper in which you will respond to the following:

• Explain how the desired learning outcome you developed addresses the learning need.
• Explain how each learning objective addresses the learning outcome.
• Explain how each learning objective addresses the identified domain of learning and level within Bloom’s Taxonomy.
• Explain how you can use learning objectives to organize the content topics you identified and plan activities.

 

Part 3: Evaluation for Nurse Educators

To prepare:

• Review the Resources for this week related to alignment of evaluation to learning objectives/outcomes and Kirkpatrick’s Levels of Evaluation.
• Review your colleagues’ feedback about your evaluation approaches from the Week 7 Discussion.
• Consider ways to apply your colleagues’ feedback to evaluation methods for your other learning objectives and your learning outcome.
• Review the Educational Plan Template and use the areas of the template designated for Week 7 to complete Part 3 of your Module 3 Assignment.

Assignment (1 page)

Complete the Educational Plan Template by including:

• An evaluation method for levels 1–3 of Kirkpatrick’s levels of evaluation for either of your two remaining learning objectives. (Note: The three evaluations you describe do not necessarily have to address the same learning objective.)
• An evaluation method for level 4 of Kirkpatrick’s levels of evaluation for your learning outcome.

Use the Educational Plan Template to complete a 2- to 3-page paper which includes the following:

• Explain how each of the evaluation methods you described addresses a particular level of evaluation.
• Explain how each of the evaluation methods you described addresses the respective domain of learning in your learning objectives.
• Explain how alignment of evaluation methods to learning objectives and learning outcomes ensures cohesive educational design.

 

 

***Discussion for week 5-7 and completed template will be provided via email***

Week 5

Initial post

 

The quality of care a patient receive from a healthcare institute have a great impact on the recovery process. Patients seek help to address acute care needs with the believe that a healthcare organization with a higher rating equivalent to better care. While survey rating is important in analyzing overall quality of a patient care. It is worth mentioning that an individual’s experience from the same institution can be far different based on his or her expectations. Some patients are expected to receive the best quality care beyond the capacity of the institution. Therefore, their ratings for the care and services rendered will never be adequate to match their expectations. Despite the efforts of providing proper care, timing of services is also measured in the quality of care of patient receives.

As part of the largest payer for health care (cms.gov), Medicare hold hospitals accountable for the quality of care provided. Medicare.gov provide statistics that are readily available for patient to educate themselves and identify which hospital will most likely meet their expectations. The overall rating for the hospital in my community is two stars, it is a 365 beds Acute Care Hospital serving the community since 1891. Compared to the state and national average, my community does not fall too far numerically. Some areas for improvement identified are the average time a patient spent in the emergency department and the percentage of patients who received appropriate care for severe sepsis and sepsis shock.

The average time a patient spent in the emergency department is 247 minutes compared to national average of 162 minutes and state at 167 minutes. The second area for improvement identified is appropriate for sepsis and sepsis shock scoring at 54% compared to 57% nationally and 65% statewide. For such I would apply the learning need assessment to gather date and perform a root cost analysis to identify gaps. The information will them be used to improve patient outcomes, thus result in better survey ratings. Educators often identify the purpose for an LNA to gain further clarification of a current problem, to help in planning curriculum, or to improve practice and safety (Pilcher, 2016).

 

References

Center for Medicare and Medicaid Services. (n.d.). Medicare. Retrieved from https://www.cms.gov/Medicare/Medicare

Dickerson, P. S., & Graebe, J. (2018). Analyzing gaps to design educational interventions. The Journal of Continuing Education in Nursing, 49(1), 4-6. doi:http://dx.doi.org/10.3928/00220124-20180102-02

Pilcher, J. (2016). Learning Needs Assessment. Journal for Nurses in Professional Development, 32 (4), 185-191. doi: 10.1097/NND.0000000000000245.

 

U.S. Centers for Medicare and Medicaid Services. (n.d.). Hospital compare. Retrieved from http://www.medicare.gov/hospitalcompare/search.html

 

 

Week 6

Initial post

 

During week 5 discussion we had the opportunity to review the Medicare website to learn about our community hospital ratings based on patient’s experience. As expected, I learned that my community hospital benchmark score for sepsis and patient left without being seen in the emergency room is below compared to the state and national score. Perhaps, the reason this does not surprise me is because I attend leadership safety huddle and often, I do hear about the percentage of patients leaving the ED without being seen. But I never know the ‘why’ patients were not seen before being attended too. Dickerson (2015) mentioned that while addressing the practice gap, we must evaluate the situation contributing to it. The treatment team may have the knowledge and skills but for some reason are not able to translate that ability into practice. The challenge for that is the rush hours between 5pm and 11pm when the ED typically has a range of 50-60 patients but only able to accommodate about 36 with some placed in the hallway. Patients are triaged according to the acuity of their chief complaints.

The identified gap is ED treatment team efficiency in triaging, treatment, and release. The core of the problem arises when there is a lack of acuity for an admission. Yet, treatment team are not able to determine the course of the plan base on the presented complaints. There are many factors related to the reason why patients leave without. One that aligned with my believe cosigned with Khalifa (2016), that “competency of attending physicians in ER, in terms of skills and efficiency, and lack of, or slow, responsiveness of ER nurses has been associated, in many studies, with patients leaving without being seen or leaving before complete treatment” (Khalifa, 2016). I know from when I cover the ED as a Case Manager, the physicians rely on my evaluation to confirm whether to admit or discharge a patient. The case management utilization team is equipped with Interqual, an evidence-based criteria and technology to support appropriate clinical decisions (changehealthcare.com). This application helps determine what level of care a patient meets based on the clinical presentation. Thus helps us decide if a patient should be triaged, treated, and released or admit.

 

References

 

Bastable B. B., & Quigley L. G. (2019). Behavioral objectives and teaching plans. In S. B. Bastable (Ed.), Nurse as educator. Principles of teaching andlearning (pp. 428–432). Burlington, MA : Jones and Bartlett Learning.

https://www.changehealthcare.com/clinical-decision-support/interqual

Dickerson, P. S. (2015). How to write an outcome statement. The Journal of Continuing Education in Nursing, 46(9), 381-383. doi:http://dx.doi.org/10.3928/00220124-20150821-11

KHALIFA, M. (2016). Utilizing Health Analytics in Improving Emergency Room Performance. Studies in Health Technology & Informatics, 225, 138–142. https://doi.org/10.3233/978-1-61499-658-3-138

Walden University. (2019b). Case study: Program outcomes and learning objectives: Practitioner’s perspective [Video file]. Baltimore, MD: Author.

 

 

Week 7

Initial Discussion

 

The emergency department (ED) can be a very intrigued but an intimidated place to work due to vast variety of patient patrolling daily. The ED requires highly reliable skilled staff to efficiently assess and make a determination with limited allotted time. I’ve always had an interest in learning about the workflow in the ED and protocol in place. For this discussion, the learning objective for the ED is that all staff will utilize a workflow that is patient-centered designed to minimize the time patient spent from door to doctor, then doctor to disposition from 247 minutes to 180 minutes. Although, this time is still greater compared to the national average of 162 and 167 minutes for the state of New Jersey. A patient-centered focus workflow that is uniform throughout the ED will promote better understanding of the barriers that require intervention.

Donald Kirkpatrick, a professor who published a four-level training evaluation model in 1959 as a sequence of ways to evaluate the effectiveness of training programs.

For this discussion, the first three levels of the evaluation model will be implied. Each program needs to be assessed at this level to help improve the model for future use (Serhat, 2018).

Level 1-Reaction

ED staff will provide a short survey to complete after their first time working utilizing the new patient-centered workflow to gain their perception and overall feeling. On this level, I would gain insight into whether the new concept was relevant to their job responsibilities, was it useful and valuable to their day to day operations of the ED.

References

 

Hcahps: Patients’ perspectives of care survey. (n.d.). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS

Sayah, A., Rogers, L., Devarajan, K., Kingsley-Rocker, L., & Lobon, L. F. (2014). Minimizing ED Waiting Times and Improving Patient Flow and Experience of Care. Emergency Medicine International, 2014, 981472. https://doi.org/10.1155/2014/981472

Serhat, K. (2018). Kirpatrick Model: Four Levels Learning Evaluation. Retrieved from https://educationaltechnology.net/kirkpatrick-model-four-levels-learning-evaluation/

 

 

Student’s response

Venande,

            I am a hospice nurse, but I can appreciate the importance of your learning gap regarding the emergency department (ED); moreover, your specific learning objective is “ All staff will utilize a workflow that is patient-centered designed to minimize the time patient spent from door to doctor, then doctor to disposition from 247 minutes to 180 minutes”. Healthcare should always be patient centered, but sadly that just is not always the case, so it is imperative to approach this issue and I commend you for choosing it. Next, this nurse will provide feedback in terms of how your evaluation approaches align with your learning objective and Kirkpatrick’s levels of evaluation.

            The reactive level of evaluation is a measurement of the participants satisfaction with the educational program and may include faculty effectiveness, learning environment, and resource learning (Dickerson, 2017). Your evaluation approach for your aforementioned objective includes having the ED staff provide a short survey that gives insight to their perception and overall feeling of using the newly adapted patient centered approach; furthermore, utilizing the survey would allow you to evaluate relevance to their job and if the new program is useful. This is a perfect demonstration of how to evaluate on the reactive level of Kirkpatrick’s levels of evaluation, so excellent job!

            The learning level of evaluation measures learners’ achievement of outcomes and demonstrates what the learner has and has not learned; moreover, it measures what the learner feels they can do differently in practice as a result and how confident they are (Mindtools, n.d.). You stated that evaluation at the learning level “would provide insight of how the staff feels about the new workflow, assess their knowledge, and their understanding of the new process to minimize the time the patient spends in the ED.”  This is a wonderful goal for the evaluation of the learning level; however, you do not specifically state how you are going to achieve that goal utilizing a measurable tool (Dickerson, 2017). For instance, evaluation at the learning level can include the following: pre and posttests, observations of participants, group discussions, questions and answers, role-plays and return demonstration (Dickerson, 2017). Therefore, you could have the ED staff take pre and posttests regarding the new process of the ED, have them role-play and you observe how they are participating, and have them do return demonstrations of the new ED patient centered process for you, so that you can have measurable tools that validate they have learned the content provided (Dickerson, 2017).

            Lastly,the behavior level of evaluation relates to what learners apply when they go back to the practice setting; moreover, this would need to be conducted with a post class survey and observation done by the NPD (Dickerson, 2017). Your evaluation at the behavior level stated “ This is the level to assess if staff apply their new learned skills to their working process. Since the pandemic, most hospitals rely heavily on agency/travel staff to staffing needs. Are the trained ED staff able to teach these agency/travel staff the new workflow to continue the momentum?.”  Again, this a good goal to reach in the evaluation process at the behavior level; however, you do not specifically state how this is going to occur with measurable tools. For instance, the following tools can be utilized to measure whether the learning changed their behavior, and these tools would need to be performed post-learning and when they are back in the ED environment: chart audits, observations from peers and the NPD Practitioner, patient reports and patient surveys, HCAHPS scores, etc. (Dickerson, 2017). In this way, you would have measurable tools that demonstrate validity when evaluating the learning in the behavior level. Thank you so much for your post and your learning gap is one that is an issue Nationwide, and it really needs to be addressed, so I commend you for choosing it!      

           

References

Dickerson, P. (2017). Core curriculum for nursing professional development (5th ed.). Chicago, IL: Association for Nursing Professional Development. 

Mindtools. (n.d.) Kirkpatrick’s Four-Level Training Evaluation Model: Analyzing Learning Effectiveness. Retrieved on 4/13/22 from https://www.mindtools.com/pages/article/kirkpatrick.htm