Personal Class Design Part II
by Alberta E. Gudes, BSN, RN
Grand Canyon: NUR-649E: Nurse Education Seminar II
Professor
Cherryl Llanos, MSN, RN
July 11, 2012
Note from the Author: This academic project was written with inspirations taken from the Michael E. DeBakey Veterans Affairs Medical Center's Employee Education System.
Overview
of Project 1
The project is a 4-hour
training designed for clinicians with extensive exposure to different medical
disciplines. They are physicians, physician assistants, nurse practitioners,
registered staff nurses, program support clerks, and licensed vocational nurses. They are pooled together into a
team to a training program called TEACH in order to assist and improve Patient
Aligned Care Team (PACT) in hospitals or patient-centered public health
centers. TEACH is an acronym for Tune, Explore, Assist, Communicate, and Honor,
hence the training is called TEACH for PACT.
Members of the TEACH
for PACT will provide information and insights to the training based on their
present engagements within their own operating environment. This is based on
the inspirations of Billings & Halstead (2009) quoting that the National
League for Nursing (NLN) stated that in a rapidly-changing environment, where
complex care is being provided in a variety of settings, clinicians must be
offered new educations that are most effective in helping them in their
practice.
LEARNER
OBJECTIVES (Cognitive Domain)
General
Objectives
By the end of the
training, members of the Patient Aligned Care Team (PACT) will comprehend each
module of the TEACH program as a result of attending and actively participating
in the activity sessions, be able to demonstrate learning to the other members
of PACT for comments, and on the basis of these comments, will explain the same
principles in their own words in a real or simulated situation for the training
instructor to assess.
Specific
Objectives
Based on the discussions
during the training sessions, members are able to demonstrate in their own
understanding the learning in each TEACH module.
·
T Module – Tune to the patient.
The PACT members are able to express in
their own words on the processes of effective listening and questioning skills
that would achieve the goal of being able to be attuned to the learner/patient
engagement.
·
E Module – Explore the patient’s
concerns and preferences.
The PACT members are able to explain to
the learner/patient the principles by using examples from other context or
situation so that their needs and preferences can be assessed.
·
A Module – Assist the patient in
behavior changes.
The PACT members are able to apply
health coaching strategies in order to assist learner/patient in coping with behavior
changes using simulated patient scenarios.
·
C Module –Communicate effectively
The PACT members are able to translate
their learning so that it fits to the level of understanding of the
learner/patient, thus enabling the PAC Team handle the patient’s uncertainty
and conflict.
·
H Module – Honor the patient as a
partner.
The PACT members are able to show and explain in
their own words the characteristics of teacher/clinician-learner/patient to
succeed in partnering with patients.
LEARNER
OBJECTIVES (Psychomotor Domain)
General
Objectives
By the end of the
training, members of the Patient Aligned Care Team (PACT) will differentiate
each module of the TEACH program as a result of attending and actively
participating in the activity sessions, by showing their learning through
performance indicators to the other members of PACT for comments, and on the
basis of these comments, will identify the same principles in their own words
in a real or simulated situation for the training instructor to assess.
Specific
Objectives
Based on the activities
during the training sessions, members are able to duplicate in their own
understanding the learning in each TEACH module.
·
T Module – Tune to the patient.
The PACT members are able to execute in
their own style on the processes of effective listening and questioning skills
that would achieve the goal of being able to be attuned to the learner/patient
engagement.
·
E Module – Explore the patient’s
concerns and preferences.
The PACT members are able to draw to the
learner/patient the principles by using examples from other context or
situation so that their needs and preferences can be assessed.
·
A Module – Assist the patient in
behavior changes.
The PACT members are able to design
health coaching strategies in order to assist learner/patient in coping with
behavior changes using simulated patient scenarios.
·
C Module –Communicate effectively.
The PACT members are able to revise
their learning so that it fits to the level of understanding of the
learner/patient, thus enabling the PAC Team handle the patient’s uncertainty
and conflict.
·
H Module – Honor the patient as a
partner.
The PACT members are able to distinguish and explain
in their own words the characteristics of teacher/clinician-learner/patient to
succeed in partnering with patients.
OUTLINE
The following outline
is taken entirely from Exclusive Class Design – Part 1:
Registration/Welcome/Introduction-registration
will be sent by outlook e-mail; staff must register online and must sign in
upon arrival to classroom.
1.
Introduction
2.
Explain TEACH
objectives and expectations
3.
Provide students with a
schedule/timeframe
4.
Patient education:
TEACH for Success workbooks
a.
Distribute workbooks
b.
Explain workbooks and
instructions
I.
Teach
T-Tune to the patient explanation.
This teaches
centers on beginning effective rapport between clinicians and patients. It helps partakers identify behaviors that
help and hinder effective relationship, and it provides opportunities for
partakers to practice effective listening and questioning skills.
II.
Teach
E- Explore the patient’s concerns, preferences, and needs explanation.
This teaches
partakers recognize all basics of a learning assessment. It displays partakers how to use a range of
needs assessment methods, and how to distinguish limits to learning as well as
favorites for learning.
III.
Teach
A- Assist the patient with behavior changes explanations.
This teaches
partakers appreciate and use a health coaching tactic to assisting patients
with behavior change with simulated patient scenarios.
IV.
Teach
C- Communicate effectively explanation.
This teaches
partakers how to fit their message to patients and how to deal with patient
uncertainty and conflict.
V.
Teach
H- Honor the patient as a partner explanation.
This teaches
partakers identify features of real clinician-patient trusts and skills needed
to successfully partner with patients.
CLASS TIME FRAME
Learner Objective
|
Timeframe
|
Teaching Strategy
|
Evaluation Method
|
T
Module – Tune to the patient.
|
T
Agenda 15 minutes -Review of key concept of
teach T Module
10 minutes –
Listening exercises
5 minutes -Applying
learning to practice
Required time 30
minutes
|
Participants are
grouped by three’s. One acts as the Listener, the second as the Talker and
the third is Observer. Then, after the activity, the observer will report to
the group what he/she observes.
|
The evaluation method
to be applied in the activity is Plan-Do-Study-Act (PDSA) model for the
entire process.
Also, another tool to
be used is the PACT Compass. It is a data resources for primary care, which
can be accessed at http://vssc.med.va.gov
Primary Care Almanac
can also be utilized as an evaluation method for this activity.
|
E
Module – Explore the patient’s concerns and preferences.
|
E
Agenda 15 minutes-Review of key concept of
teach E
10 minutes- Needs
assessment practice
5 minutes – Applying
learning to practice
Required time 30
minutes
|
Integrating elements
of assessment by providing participants 2 different colored sticky notes.
Participants would write factors that would lead them achieve their goals
using the pink sticky note and the blue sticky note would be used for factors
that hinder them from achieving their goals. After accomplishing the 2
colored sticky notes, participants are asked to read the notes before the
class and let them place the notes corresponding to the parts of the human
body like the head, heart and gut, arm and leg for the skills. Below the
human body sketch is the environment, wherein participants could also put the
sticky notes if it corresponds to the situation.
|
|
A
Module - Assist the patient with behavior
changes explanations.
|
A
Agenda 15 minutes-Review of key concepts of
teach A
10 minutes- Health
coaching practice
5 minutes - Applying
learning to practice
Required time 30
minutes
|
Participants are
asked to create an action plan that would support them in coaching the
patient’s life goals and values. They will distribute the action plan to
other participants for feedback and discussion in front of the class.
|
|
C
Module –Communicate effectively.
|
C
Agenda 15 minutes- Tailoring messages
10 minutes – Dealing
with patient uncertainty
5 minutes- Applying
to practice
Required time 30
minutes
|
Participants are
asked to list down and enumerate words and languages that would be used to
communicate with the patients. They will role play the words to their fellow
participants and determine how these words and languages affect them.
|
|
H
Module – Honor the patient as a partner.
|
H
Agenda 15 minutes-Review of key concepts of
teach H
10 minutes-Partnering
skills practice
5 minutes- Applying
learning to practice
Required time 30
minutes
|
Participants are
asked to group themselves in two’s. One will act as the Patient and the other
is the Clinician. They will do an open dialogue on things that matter to the
patient and the clinician that will build their trust with each other.
|
|
RATIONALE:
The
writer chooses to use three evaluation methods namely the Plan-Do-Study-Act
(PDSA), PACT Compass and Primary Care Almanac with the hope that by using these
methodologies, the objectives of the training can be met. According to Billings
& Halstead (2009), “a variety of teaching strategies can be used to appeal
to different learning styles and thus maximize student learning”. From this concept, the best tool to be able
to evaluate the outcomes of the different learning styles is to employ a
combination of evaluation strategies as reflected in the class timeframe. As Stavropoulou & Kelesi (2012) said that
“Evaluation is becoming a necessary part of education, particularly in present
times, when educational systems are subjected to continuous criticism and
debate”. Henceforth, a combination of evaluation approaches becomes a necessary
evil to ensure that outcomes are deeply rooted from evidence-based studies to
make the training design and its processes reliable and solid.
The
PDSA model is deemed to be an essential evaluation approach if taking into
account the statement from the Institute of Innovation and Improvement of the
National Health Services (NHS) in the United Kingdom saying that, “Using PDSA
cycles enables one to test out changes before wholesale implementation and
gives stakeholders the opportunity to see if the proposed change will work”.
The NHS further said that “One may not get the results he expects when making
changes to the processes, so it is safer and more effective to test out improvements
on a small scale before implementing them across the board”. Thus, in this kind
of training design, the writer believes that the PDSA model is just apt and
appropriate.
The
PACT Compass is also utilized as an evaluation tool in this training design because
PACT Compass contains provider panel management, wherein all data relevant to
patient care such as better access, better patient, satisfaction, better staff,
the right care by the right person at the right time, can be found. This can be
used to guide and check whether data achieved in the training can be improved
by benchmarking the data from PACT Compass.
Likewise,
the Primary Care Almanac is another helpful evaluation tool in the training
since this resource contains data of patients for identification and management
including one’s specific PACT-teamlets. Also, it is database of disease
management like High risk, volume, and cost, Hypertension, Diabetes, Ischemic
heart disease, Asthma, Depression, Obesity, Chronic Renal Failure and many
more.
With
all of the above approaches combined, there is a high percentage that the
training design will achieve its intended goals successfully.
References
Billings, D. M., &
Halstead, J. A. (2009).Teaching in
nursing: A guide for faculty. St. Louis,
Mo: Elsevier/Saunders.
Johnson,
P., & Raterink, G. (2009). Implementation of a diabetes clinic-in-a-clinic
project in a family practice setting: using the plan, do, study, act model. Journal
Of Clinical Nursing, 18(14), 2096-2103. doi:10.1111/j.1365-2702.2008.02774.x
MacKeracher,
D. & Gross, P. (n.d.) Writing
Learning Objectives. Retrieved on July 11, 2012 at http://www.unb.ca/fredericton/cetl/_resources/pdf/writinglearningobjectives.pdf
National
Health Services (NHS).(n.d). Institute of Innovation and Improvement.
Retrieved July 11, 2012 at http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/plan_do_study_act.html
Stavropoulou,
A., & Kelesi, M. (2012). Concepts and methods of evaluation in nursing
education--a methodological challenge. Health Science Journal, 6(1),
11-23.