Unit-Based Nursing Education: Overcoming Obstacles to GrowthCreated by:
Implementing a peer-assisted learning program has been an interesting journey into competency management in the outpatient nursing setting. With past experience in peer-assisted competency management as an Emergency Department nurse, the program was to be piloted as a new method of staff development coordination.
Included in the foundation of the program were definitions of the peer educator role as a qualified evaluator of staff, as well as the structure of the program in terms of training and ongoing education. As the program has evolved since its inception, there were some areas identified that proved successful and could likely be replicated for another unit or nursing department.
With the successes, there were also issues that could have gone differently to make processes easier or more efficient. Following will be a presentation of several different components of the program and how they will continue or be modified in the future.
Implementation of the Program
Monthly training was held on campus with the sum total of the peer educators, and included several different topics compiled from ongoing assessment of learning needs. Generally, the agenda consisted of policy review, any procedural changes or updates, and components of ongoing competencies that required education or training. Those clinical sites who were able to send their peer educator each month consistently saw the most benefit, when the model was performed correctly.
After meeting on campus for a full day, the successful peer educator would meet regularly with staff throughout the month to offer education and training. Frequency of offerings varied depending on the needs and capabilities of the clinical sites.
Given the time-consuming nature of the role, it was very important that nurses volunteered for the role, as opposed to being appointed. Of the seven sites who elected to use peer-assisted learning as their primary method of competency management, one was not able to supply a volunteer, which we will be discussed later.
Four areas had nurses who volunteered for the role. Because several of the nurses were traveling from remote clinical sites, travel reimbursement was necessary as a part of the mandatory training. A blanket approval was able to be secured for the entire fiscal year of travel and would be submitted each month with travel orders for those who were able to travel.
The peer-assisted learning program was given recognition as a component of shared governance, and aligned under the council for staff development and education. This offered the chance to communicate progress regularly with nursing leadership, seek feedback from leadership regarding educational needs of staff based on quality improvement metrics, and formalized the program and its purpose.
A modified Kirkpatrick method (2011) was applied, using anecdotal feedback, to evaluate the reaction of the peer educators to the program, behavior changes in the peer educators as a result of participating, and program results that could be directly or peripherally linked to its implementation.
Four of the nurses volunteered for the program pilot and three were able to participate consistently. Two of the nurses were appointed to pilot the program in their areas; however, despite consistent attendance, the onsite follow up was unfortunately not a clear priority and therefore was not as productive. One site was unable to provide or appoint a peer educator, and staff later reported that they “…felt disconnected from the hospital…education was disjointed and not consistent… staff fell behind with competency evaluation…” (personal communication with staff, 08/2016).
In the beginning planning stages, documents were created to track exactly what write my essay learning took place and what teaching was conducted by the peer educators, in an effort to illustrate the results of attendance. Very early on, the documents were removed from requirement due to the potential for creating a much more time-consuming process.
Several months after program implementation, the data tracking clearly would prove beneficial in showing quantitative progress of the program. Additionally, going forward it would be beneficial to have much closer monitoring of the educational activities conducted by the peer educators, to ensure more consistency in the process from those who volunteered as compared to those who were appointed. Still in its infancy, the program has demonstrated promise to the goal of competency management for nurses in remote practice areas and offsite clinics. As we learn more about the benefits of the program, it will continue to grow and evolve.