When HCTR editor Tim Rowan travels to Albuquerque next month to address the 4-state Southwest Regional Home Care Conference about home care technology, he will make the five-hour drive from Colorado Springs instead of flying. Ask him why and he answers without hesitation, “Two-hour advance arrival times, TSA security lines, airport parking fees, cramped seats, $5 for dry sandwiches, damaged luggage and taxi “fuel surcharges” long after gasoline prices dropped back a buck and a half. You fly and I’ll drive and I bet I’ll get there at the same time you do.”
The hassle of post-9/11 flying is only one reason conference attendance has been down across all industries for nearly nine years. Cost-conscious executives may consider the advantages of networking with peers an important reason to put up with travel themselves but they look hard for alternatives to sending staff. At the same time, webinars and other online training systems have advanced to the point where some of the reasons to go can be simulated online.
Compare the cost of today’s online learning systems with the sum of conference admission fees, airfare, lodging, parking, ground transportation and meals per person and the decision is easy. In home care, no one sends their entire staff to national or state association conferences. Less obvious but also clear is that no one sends more than one or two staff members even to local live educational events.
One reason is simple to understand. Clinicians cannot put their patients on hold while they take two or more days to sit in a hotel auditorium, no matter how excellent the instructor. The other reason might be more subtle. Many people, including executives, believe that one person can attend a lecture, take notes, return and disseminate the exact same content to the rest of the staff.
All theories of adult learning disagree with that belief.
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In “Best Practice in Professional Development for Sustained Educational Change, ” Marsha Speck, Clinical Professor of Educational Leadership at Arizona State University, notes that the following important points of adult learning theory should be considered when professional development activities are designed for educators: – Adults will commit to learning when the goals and objectives are considered realistic and important to them. Application in the ‘real world’ is important and relevant to the adult learner’s personal and professional needs. –Adults want to be the origin of their own learning and will resist learning activities they believe are an attack on their competence. Thus, professional development needs to give participants some control over the what, who, how, why, when, and where of their learning. – Adult learners need to see that the professional development learning and their day-to-day activities are related and relevant. –Adult learners need direct, concrete experiences in which they apply the learning in real work. –Adult learning has ego involved. Professional development must be structured to provide support from peers and to reduce the fear of judgment during learning. –Adults need to receive feedback on how they are doing and the results of their efforts. Opportunities must be built into professional development activities that allow the learner to practice the learning and receive structured, helpful feedback. – Adults need to participate in small-group activities during the learning to move them beyond understanding to application, analysis, synthesis, and evaluation. Small-group activities provide an opportunity to share, reflect, and generalize their learning experiences. – Adult learners come to learning with a wide range of previous experiences, knowledge, self-direction, interests, and competencies. This diversity must be accommodated in the professional development planning. –Transfer of learning for adults is not automatic and must be facilitated. Coaching and other kinds of follow-up support are needed to help adult learners transfer learning into daily practice so that it is sustained. |
In the case of spoken lessons, a lecturer must repeat a fact six times before he or she can assume two-thirds of the audience has heard it. Calculate the success rate of the delegated workshop attendee who hears information one time and tries to relay it to co-workers a few days later.
Marcia L. Conner, writing in “The Ageless Learner,” asserted, “In today’s business environment, finding better ways to learn will propel organizations forward. Strong minds fuel strong organizations. We must capitalize on our natural styles and then build systems to satisfy needs. Only through an individual learning process can we re-create our environments and ourselves.”
Conference lectures cannot be designed to accommodate individual learning styles. Even books, CDs that can be played in cars and DVDs with video-recorded lectures only address one learning style each. For this reason, many home care executives are turning to the Internet.
Online training systems have a number of advantages, not the least of which is their 24/7 availability. Gathering clinicians together at the same time is a near-impossible task. They also eliminate
Not All eLearning Systems Created Equal
A number of “elearning” systems have surfaced in the last decade. The ones that have experienced the most success offer choices of learning formats for the same material. Those that have limited themselves to one format or another tend to be struggling and may not survive.
- Static text on screen. Some adult learners do well reading book-length material on a computer display, others do not. Many prefer to just have the book in their hands. However, paper cannot be updated with new information as needed. These systems may be offered for online access or distributed on CD, though CDs have the same update restriction that books do.
- Voice-accompanied text. Some systems read the text to you while you are reading it on the screen. Others have a voice reading different text, with the screen text supplementing but not matching the spoken words. This covers two adult learning styles at once.
- Alternating lessons and exercises. With or without voice, some text-on-screen systems offer brief instructions followed by hands-on practice examples. Most experts insist that this is a critical component in successful adult learning.
- Streaming video. Some online educational services have locked themselves into the “talking head” format, where a live lecture atmosphere is recreated online, sometimes with accompanying Powerpoint slides, sometimes without. This is an effective learning method that works for some adults.
Note that each company that elects to serve one adult learning style and eschew the rest rarely reaches its forecasted potential in terms of number of students and gross revenue. In fact, some of them are currently suffering financially from this chosen path and have seen their long-term survival put into jeopardy because of their choice. Customers tell each of them, “Some of my staff likes your format and some do not.” Clearly, learners’ stated preferences are influenced by each individual’s distinct learning style needs.
Though this is not a comprehensive list, here are some of the online learning systems offering home health care and hospice content today.
Silverchair
This privately-owned company, founded in 2002, falls in the category of text-on-screen but with some interesting options. A voice
track, reading word-for-word from the displayed content, can be turned on or off by the learner. Another switch allows the student to see and hear the lesson in Spanish or English. More languages are in the works.
Courses are offered for clinical staff in home care, hospice, long term care and assisted living facilities, with many titles pertinent across these categories. Examples include infection control, blood-borne pathogens, HIPAA compliance, safe-lifting guidelines, HHABN, wound care and others for a total of 127 course titles.
An online, hosted system, management has granular control over course assignments and reports. Certificates of completion are awarded after a student passes each course’s post-test. Silverchair is approved by the American Nurses Credentialing Center and, for administrator content, the National Association of Boards.
Pricing is determined based on an organization’s size. Over 50 employees, the cost is $53 per employee per year. Smaller customers pay a flat $2,500 per year. Users also gain access to an “author and manage content” tool, which designated system administrators use to create their own courses. Since the Silverchair system is primarily text-based, it works on all Internet connections, including dial-up.
The Corridor Group
A pure text-on-screen system, Corridor Home Care & Hospice eLearning Exchange (CHEX) comes from one of home care’s preeminent consulting firms. It offers course content and a comprehensive and easy-to-use learning management system that provides management reports and granular control over the student experience.
CHEX has courses for administrators, professional clinicians, para-professionals and support staff. For those whose learning style needs match, this screen-reading system can be quite effective. As in all online programs, courses are available 24/7. CHEX courses cover safety, organization performance, social responsibility, clinical development and leadership skills.
Unlike Silverchair, CHEX
content is entirely home care and hospice specific, the areas of expertise The Corridor Group has honed since 1989. CE credits are provided and are accepted in 50 states. Outside the CHEX catalog, the system can host customer-produced content, including recorded video streams. A typical CHEX subscription runs approximately $22,000.
The Home Care Information Network
Founded in 2005, HCIN selected a video system for its preferred learning style. Learners comfortable with this format will benefit from the systems ability to simulate the experience of sitting at a conference lecture. Those who learn better reading than listening may want to consider one of the previous alternatives.
Students login to their account in HCIN’s proprietary learning management system and see the list of courses their supervisors have purchased and selected for them. Any PC or Mac with a high-speed broadband connection can access streaming video courses 24/7. Most streaming presentations are accompanied by Powerpoint slides. The recording system is capable of producing voice-only over Powerpoint though that option is rarely used.
Customers purchase courses separately or in pre-packaged collections. Each course or collection is priced
differently, depending on its length and the renown of its instructor. Prices are often custom-quoted based on customer staff size and course popularity, leading to an assortment of pricing for the same material that compares to the range of prices various passengers pay for the same airline seat.
Online streaming rich media touches a number of different learning styles, accommodating more individual needs than text alone or voice alone or even text and voice combined.
Learners will appreciate the ability to view from home at any time and to pause presentations and come back to them later. HCIN suffers most significantly from the lack of an online e-commerce system. Customers have to print an order form, fill it out and fax it to a central office, where someone manually enters the order into a spreadsheet.
The Hospice Education Network
HEN is a venture of Weatherbee Resources. Owner Heather Wilson, Ph.D., a longtime and well-respected hospice consultant, uses the same technology as HCIN and rents space on that company’s equipment to host and distribute its streaming video courses. Most of what has been said about HCIN technology is therefore also true of HEN, including its lack of a credit card payment system, but the comparison ends at the camera lens. Wilson told HCTR that the online payment problem will be corrected soon.
HEN’s far broader course list puts it in the lead as the most comprehensive educational offering for hospices.
Among HEN’s 140 hospice-specific courses for all levels of hospice staff are subjects as diverse as
Workplace Safety, Sexual Harassment, Nutrition at End-of-Life and Grief and Loss. There is also an entire course section devoted to volunteer training. CE’s are awarded to nurses, social workers and counselors. HEN courses are taught by a variety of nationally-known instructors with years of hospice experience.
HEN has a partnership with the End of Life Nursing Education Consortium (ELNEC), providing eight of their core curriculum and, recently recorded for a spring release, nine programs from their pediatric palliative care curriculum. Plans have been confirmed to add ELNEC’s geriatric curriculum to the list, which will appeal to skilled nursing facility staff as well as to hospices. According to Heather Wilson, whose doctorate is in Pastoral Psychology, HEN has just agreed to partner again with ELNEC to provide an end-of-life care curriculum for all VA hospitals.
Course prices are set low for smaller organizations and increase based on a hospice’s average daily census. One course, for example, begins at $60 for one year of unlimited us by the entire staff but rises to $300 for hospices with more than 500 patients. Additional volume discounts are available for multiple title purchases.
MED-PASS, Inc.
The paper forms company dipped its toe in the training ocean by contracting with nationally recognized coding expert, attorney and nurse Lisa Selman-Holman, JD, BSN, RN, HSD-D, COS-C. The company offers Selman-Holman’s expertise in coding and other topics in much the same way HEN does, by contracting with HCIN to use its video recording technology and the same learning management system with its fax-based ordering system.
Each module provides online testing and CE credits. Pricing is determined by organization size, calculated by number of offices or branches and number of clinicians per site in this case rather than by patient census. A single-office home care agency will pay $895 per year for unlimited use of the Selman-Holman OASIS course. Large organizations, e.g. 7-10 locations, will pay as much as $699 per office for a 12-month subscription.
Carosh Media & Marketing
There is one newcomer to the pack. Carosh Media & Marketing, an HCTR affiliated company, throws its hat into the ring next month with an OASIS-C course taught by RBC Limited’s Patricia W. Tulloch, RN, BSN, MSN, HCS-D.
According to Carosh president Roger Shindell, the startup has based its philosophy and technology around current theories of adult learning styles. Most courses will be offered in a variety of formats, including text, Powerpoint, voice and video. Students will be able to gravitate toward the learning style that suits them best and management will be able to purchase many courses in different formats to accommodate differing adult learning preferences.
As a startup, the Carosh lineup is in its infancy but will soon feature home care and hospice clinical content as well as basic instruction for home health aides. “We decided to break out of the gate with OASIS-C because there is such a need,” said Shindell. “Our hope is that the home care community will find it both affordable and an effective learning method.”
Carosh will incorporate an industry-standard learning management system capable of providing management reporting and customized course lists for similar groups of staff. It will be linked to an online ordering system that will accept credit card and PayPal payments. The new company also plans to offer its learning production and management system to organizations, from vendors to multi-site agencies, that wish to use it to produce their own educational programs to reduce wear and tear on their own training staff.
Summary
Online learning systems are all improvements over the waste of allocating substantial portions of agency training budgets to planes, trains and automobiles…and hotel rooms. Which brand an agency chooses will be determined by a number of factors, not the least of which is effectiveness of the learning style offered. The wise manager will include staff in online demonstrations, letting them experience each candidate’s look and feel and weigh in on the final decision.
Price may be less of a differentiator, since the range from lowest to highest is not wide. Surprisingly, simple text-on-screen is priced approximately the same as streaming video, which one would think is more costly to produce. Some organizations will find the availability of CE credits important where others will be less concerned.
Lastly, this reporter must acknowledge HCTR’s longtime bias in this regard. Simply stated, training is infinitely consequential. As important as the choice of a specific online learning system partner might be, it pales in importance against the choice to provide training at all. Historically, home care as a whole has seen staff training as an expense with little return, a budget item easily cut with no consequences when cash flow is strained. Nothing could be farther from the truth. Nothing can be more wasteful, not to mention potentially fatal to the business, than deploying an inadequately trained clinical and office staff.
Editor’s note: for one example of how inadequate training can cost far more than the amounts saved by skimping on a training budget, see our sister publication “RAC Assistance” at http://www.homehealthnews.org.
