Monday, December 28, 2015

Assessing Progress on the IOM Report "The Future of Nursing"

The Institute of Medicine (IOM) released the report “The Future of Nursing: Leading Change, Advancing Health” in 2010, which made a series of recommendations for the roles of nurses in the new health care landscape. Now, five years later, the IOM, in addition to its sponsor the Robert Wood Johnson Foundation (RWJF), has revisited the report to gauge the progress made in implementing the report’s recommendations.

The report included six target areas:
  •       Advancing education transformation
  •       Leveraging nursing leadership
  •       Removing barriers to practice and care
  •       Fostering interprofessional collaboration
  •       Promoting diversity
  •       Bolstering workforce data

The committee has found that significant progress has been made, including the creation of 51 state Action Coalitions. However, the committee points out that more work still needs to be done, particularly in addressing challenges related to scope of practice, education, collaboration, leadership, diversity and data. The committee suggests continuing the advancement of the nursing profession by driving activity in the following three areas:

  •      Build a broader network to increase awareness of nurses’ ability to full engage in health professions practice, education, collaboration and leadership
  •      Continue to prioritize diversity in the nursing workforce
  •      Harness better data to assess and drive progress

These advancements aren’t going to happen on their own, and, as leaders in the healthcare environment, NPD specialists should take a strong interest in promoting these goals. Advance education and residency programs, call for philanthropic organizations to support programs, give recommendations for collegiate partnerships, create educational pathways, move the bar on generic entry-level programs and more are all endeavors NPD specialists can take on to promote progress.

Read more about the IOM report and watch the webinar. Also, be sure to read the ANPD position statement about this report.


Tuesday, December 15, 2015

Tips from an Instructional Designer

Michael Dalessandri, MEd, RN is the instructional designer in the Organizational Development Department for HonorHealth in Phoenix, AZ

When I was a clinical educator in the acute care hospital setting, I always felt a gap existed between ‘what’ education was delivered to staff and ‘how’ the education was delivered to staff.  I initially followed the routines and methods that my fellow clinical educators did for creating and delivering instruction, which included annual mandatories, orientation, and everything else.  However, these did not fill my gap.  I didn’t really know if my delivery was effective to improve outcomes or meet strategic initiatives; I didn’t really measure anything beyond staff’s initial reaction to my content and delivery.  Then one day, I received an email from the Director of the Organizational Development Department.  She asked all of the Clinical Educators if partnering with an instructional designer would be helpful to us in our work.  We all basically responded with, “What’s an instructional designer?”  She summarized, “This is usually a Masters of Education level prepared professional whom creates instruction.  You would give him/her the content and he/she creates the instruction.” The majority of the Clinical Educators answered, “No.  We can do it ourselves.”  However, I was intrigued, and after researching about instructional designers and instructional design academic programs, I was excited!  This would fill my gap!
Time has passed since then, and I filled that gap.  I possess a Masters of Education in Instructional Design, and I have been the Instructional Designer in Organizational Development for the past several years.  I work with both nursing and non-nursing areas to design, develop, implement, and evaluate instructional programs.  However, I will never be done with learning.  I am always looking for new projects and teams to work with to apply instructional design, and I am always looking for inspiration for new and creative ways to design instruction.  The following are ten instructional design tips that may help fill gaps within the Nursing Professional Development (NPD) work that you do.
1.    Apply the elements of instructional design first, then use design tools second.  Design tools include multimedia and print media.  Always do the front-end planning work first before creating the instruction.  Retrofitting instruction around a plan usually fails to be effective, efficient, and measureable.
2.    Become multifaceted.  Apply the same vigor you support using evidence-based practice toward using instructional design.  Include the psychology of learning, learning technology, gamification, eLearning, synchronous and asynchronous learning, videography, and assessment and evaluation techniques.  Explore how other industries use those techniques and apply them to your work within NPD.
3.    Hone your writing and storytelling skills. 
4.    Develop your own philosophy of design, your own ‘rhythm and style’.  There is no one-way or best way to design instruction.  Incorporate best practices, science, anecdotes, learner preferences, and your previous attempts. 
5.    When presented with the statement, “We need training/education on…” accept it and spend some time analyzing the problem/situation.  Sometimes a problem requires instruction, but sometimes it’s something else, like the need for a job aid, a process change, or an accountability issue.
6.    Listen to the needs/preferences of the ‘client’ and work collaboratively on a solution.  The initial solution or the one that is ‘given’ to you to expand or develop might not be ideal.  Ask a lot of questions to help get to the root of the issue to focus your efforts.
7.    Learn how to create sequential, progressive learning that pertains to the learner.  These range from quick, simple designs to long, complex designs.  Use sound learning and design theories to prevent you from getting lost or off track during development.
8.    Learn how to evaluate the learners more than just their reaction to the design and delivery of instruction.  Evaluation begins with analyzing the learner’s preferences for learning, e.g. eLearning, lecture, simulation, and their requisite knowledge and experience.  Context should be included, which are the settings where the instruction and performance occurs.  Then evaluate if they learned or if performance improved.
9.    Don’t spend time developing content that is already known by the learners.  This is a waste of time for you and them.  Use only the ‘new knowledge’ within the content and create learning activities that require the learners to combine their old knowledge with the new knowledge.
10. Begin with the end in mind; how outcomes are measured.  What exactly would learners be doing if they were accomplishing the goal successfully?  Then work backwards to design the instruction.
A lot of overlap exists between instructional design and curriculum design, especially with what instruction is delivered - the content.  The standards are basically the same between the two; however the chief difference is that instructional design is mainly utilized in the workplace and focuses on how instruction is delivered, while curriculum design applies more to the academic setting and focuses on why instruction is delivered.  Instructional designers use how people learn and retain information in designs to influence their performance that can be measured as outcomes. 
Instructional design is both an art and a science – an art because of the creativity involved in designing instruction, and a science because it is based on learning and design theories.  It is also referred to as Instructional Systems Design, because it takes a systematic approach to creating effective instruction.  Then of course, there are one’s own experiences that are mixed in.  Remember, the ultimate goal of instruction is really to influence and/or change performance to solve or improve a problem. 
How does your instruction influence and/or change performance to solve or improve a problem?

 *Editor's Note: Michael will be teaching a workshop on instructional design at the 2016 ANPD Annual Convention in Pittsburgh, PA.