Healthcare reforms: implications for the education and training of acute and critical care nurses

Opportunities and barriers to successful learning transfer: impact of critical care skills training

AIM

This paper is a report of a study to assess the impact on nursing practice of critical care skills training for ward-based nurses.

BACKGROUND

Following a government review in the UK of adult critical care provision, new ways of working were advocated to ensure that critical care services depended on the needs of the patient, not their location in the hospital. A re-conceptualization beyond service provision in high dependency units and intensive care units was required in order to deliver an integrated service. This has ramifications for training requirements.

METHODS

Semi-structured interviews were used to explore perceived learning and learning transfer from a range of courses. The data were collected from course attendees (n = 47) and line-managers (n = 19) across two sites between 2005 and 2006.

FINDINGS

Learning was closely associated with the clinical application of new skills and knowledge. Commonly, course attendees and line-managers quoted increased knowledge and confidence, better assessment skills and improved interprofessional working. Time with competency assessors, availability of expanding roles, and supernumerary time were key factors for successful learning transfer. Barriers were financial pressures on hospitals, lack of perceived relevance of the course to staff or nursing practice, and lack of time to practice skills or work with clinical skills facilitators.

CONCLUSION

Course design should be a collaborative activity between education providers and commissioners to ensure the impact of training on practice. Relevance of material, time to practise skills and new learning, and organizational, rather than merely individual, support are essential for successful training interventions.

The interaction between policy and education using stroke as an example

This paper discusses the interaction between healthcare policy at the European, UK and Scottish levels and the funding of education that underpins specific health policy priorities. Stroke is used throughout to illustrate the relationship between a designated European and UK health priority and the translation of that priority into clinical delivery. The necessity to build a responsive and sustainable culture to address the healthcare education that underpins changing healthcare policies is emphasized.

Online educational tools developed by Heart improve the knowledge and skills of hospital doctors in cardiology

We conducted this study to find out if online learning packages in cardiology enabled users to increase their knowledge and skills. We also looked at how acceptable users found these packages. The journal Heart in association with BMJ Learning produced a series of modules on common cardiology problems. The modules involved a pre-test, a number of interactive cases and a post-test. A total of 1786 users completed these modules. Doing the modules enabled users to improve their score from the pre-test to the post-test by a significant amount (p<0.001). Feedback to the modules was very positive.

Leadership Development: Applying New Learning in an Organisational Context

This paper presents findings from a qualitative study evaluating the impact of a leadership development intervention. The evaluation was designed to look beyond individual learning, but explore organisational learning once participants rejoined their organisations. A range of interviews were conducted with participants and their line managers to elicit perceptions about what participants learned, how interviewees thought the learning was used in practice and what organisational procedures are in place to integrate new learning into work practices within the organisation. The evaluation shows that individual learning took place, but little organisational learning transpired. The research found that lack of time to practice new learning and fragmented organisational support are the factors that influence learning transfer. Additional factors influencing the identification of learning transfer are the non‐alignment of organisational strategy/need with the education agenda supporting this strategy/need and the limited understanding of measurable benefits ‐ financial or behavioural ‐ that such training may provide.