PLANNING

Education is a key part of providing health care – we educate ourselves, our patients, our colleagues and the wider community. Education is the mainstay of our work and the key to positive change, whether it is health based patient education, community education or planning a community health centre. Like leadership, education is a core surgical skill.

Planning

Everyone in the hospital needs to have access to teaching and learning opportunities. Health care is constantly changing and developing and it is no longer possible to learn in a few short years all that will be needed over the course of a career. Medical or nursing school is just the beginning of a career- long education. Continuing medical education and professional development are important ways of investing in hospital staff and improving patient care as well as challenging and stimulating the interest of staff.

Planning, implementation and evaluation are the keys to successful educational initiatives. In addition to organizing structured in-service training on new technology, medications or treatment regimens, education can also take place alongside and during the active provision of patient care through:

Poor performance can be related to knowledge, skills or attitudes.

You can plan an educational programme with learning outcomes and activities to teach knowledge, skills or attitudes. In-service training should be directly related to the work people do and the care they provide; this will help people to do their job better and improve patient care as well as boosting staff morale and motivation. Educational efforts are more effective if they are clearly applicable and relevant.

It is helpful to use clinical problems as a basis for learning. Learning outcomes are a useful way of stating what you expect people to be able to do as a result of training. For example:

In a teaching session, you could discuss some patients who have had post-operative wound infections and review possible causes of these infections. This could involve reviewing the course of the patient’s illness and care in hospital and highlighting all the opportunities for infection to be introduced. Involve the participants in developing this list of possibilities. Review procedures for each of these situations (e.g. hand washing, dressing changes, the role of antibiotics for prophylaxis and treatment and how to recognize infection early). Rather than simply giving a lecture, try to include activities and time to practise skills being reviewed. Give everyone a chance to present information and ask questions.

Learning can occur in many ways and individuals differ in the ways they learn best. For example, some people can learn by reading, while others need to hear an explanation or be shown something before they can understand it. These different ways of learning can be called learning styles:

It is important to provide information in a variety of ways to take into account different learning styles and different educational levels.

People can learn by watching others and benefit from seeing and discussing how others have managed a specific situation. By discussing cases and problems, everyone can learn from everyone else. Design and organize learning experiences that involve the participants. Allow people to practise new skills under supervision, until they are able to apply them. People tend to forget what they are told, but remember what they do. Providing supportive supervision reinforces learning and enables the teacher to evaluate the effectiveness of his or her teaching.

In addition to clinical skills, staff also need to learn information that relates to specific tasks. For example, while learning how to start an intravenous infusion, it is equally important to understand the indications for an intravenous drip and to know what to do if the attempt does not work and how to manage complications.

Do not neglect your own professional education. Take part in educational activities at your hospital and in your region. Get together with colleagues and form a journal club to read and review articles published in the medical literature. If you are the sole medical officer, start an independent study programme to explore questions arising from your practice and then present your findings to other members of your staff. Spend time with visiting colleagues or make time to go to another hospital for some further instruction. Take advantage of any educational opportunity available to you; there will always be too much work to do and it will never be completed so you must make your own education a priority when opportunities present themselves. Make an educational plan and stick to it.

There are many educational programmes and initiatives which are called “distance learning”. In this way, people can use printed materials, video, audiotapes or even computer networks to learn together, even though they may be geographically separated. If programmes of this kind are available, consider making use of them yourself or offering them to others in your organization.

If you are the most senior person in the hospital, who will help you learn? You can learn a great deal from your patients, colleagues in other fields and co-workers, but it may also be necessary to find someone to act as your mentor and help you think through problems or develop new skills. This person need not necessarily be close at hand, but should be available to you when needed through the post, by telephone or in person. We all need colleagues and support. It is an important part of your job to find and maintain these connections.