Curbside Consult with Dr. Jayne 5/22/23

I’m a big fan of experiential learning, especially after having just finished teaching some Outdoor Classroom sessions for a local youth organization. It’s great to see people use the skills you’re teaching as they interact with each other and try to solve problems. It works best, however, when you have a good blend of instructional time with practical or application time.

Having hands-on time can be great if you at least understand the concepts that are being presented and the goal is to either learn them at a deeper level or become more capable in performing them. I liken it to a surgical skills lab. First, you learn about wound repair, and make sure you understand how skin will heal depending on the repair technique and how different types of sutures will work in different ways. Then, you actually practice either with a simulator, or back in the dark ages, we practiced with pigs’ feet. You don’t just start throwing stitches into live patients without understanding the fundamentals.

I have a couple of certifications on EHR products that I rarely use, but for which I like to stay up to speed. One of the vendors rolled out a new product that I’ve not been certified on. Given my past work with the application, they offered me the opportunity to take the certification classes for the new product.

I was excited about the opportunity and ready to prepare for the classes. Unfortunately, there wasn’t any kind of preparatory work – no pre-class readings or training videos. There was a PDF for the class, but what was in there looked mostly like exercises without any foundational content. I wasn’t sure if I was missing materials or whether it was intentional, but I decided to head to class with an open mind.

I have to say that it was one of the most frustrating classes I’ve ever taken. The entire thing was taught in a hands-on fashion, with no structured presentations or materials that summarized the functionality. Each module was a situational vignette, and after reading it, we were expected to go into the application and figure out how to take the necessary steps.

It was completely frustrating. I knew the general layout of the application and the main menus, but I didn’t know all the shortcuts that this class apparently expected us to not only know, but use. It was made worse by the fact that many of the desired tasks had more than one way for them to be accomplished, but you only deduced this after working through the scenario a couple of times. At no time did the instructor explain why one might want to embrace one workflow over another.

Not having any kind of initial summary or teaching also made it difficult to figure out what the various options were. I felt like I was more focused on writing things down in my notes so I could try to put it together in a cohesive manner rather than trying to understand how to manipulate the different scenarios. Because of that, I found myself missing key information because I was still trying to figure out something that happened a minute or two earlier in the simulation scenario.

Even if I would have been given a one-page summary that listed the different workflow possibilities and explained why a user would select one compared to another, it would have been a significant step up. A handout of the system’s keyboard shortcuts would have been helpful as well. After completing the class, I ended up spending several hours in the system’s demo environment running through common scenarios and seeing if I could figure out how to execute them on the platform.

At the end of the course, there was an evaluation that contained a couple of the question formats I hate the most. The first was what my medical school used to call “multiple-multiple choice” questions, which typically had four answer options (A, B, C, D) but then would have additional options like “A and B” or “A and B and C” and other combinations. Inevitable you’d find more than one thing on the list that was likely to be correct, but you spent excess time trying to psych yourself out about which items to exclude.

The other most hated question format (which unfortunately continues to also be present on my medical specialty board certification platform) is the “choose the best answer” type question. “Best” is really a subjective question, especially when you’re talking about patients and how they might take or not take a medicine. There have been campaigns for many years to get those kinds of questions off the recertification exams, so I’m used to seeing them more rarely. However, those questions were all over this software training, with the problem being that finding the “best” solution depends on many more factors other than just the test taker.

For patient care, the best solution might be one that balances clinical effectiveness with cost and makes it easier for patients to take their medications they way they intended. Best could also mean the treatment that will give a patient the most longevity, or the highest quality of life. But it can also represent treatments that might save your life, but that also might cause horrific side effects and deterioration in your quality of life at the same time.

This can also be true in the healthcare IT side of the house. The term “best” might represent the solution that has the most bang for the buyer’s buck. It could also be the solution that has the lowest risk of patient care errors. Or perhaps the one that takes the least amount of time for nurses to complete their workflows. When you put on your client hat while reading test items like that, one can’t help but overthink them or overanalyze similar decisions you’ve made in the past.

After feeling like I had been led astray but the hands-on training and then burned by the confusing test questions, I was ready to give up. Sure, I could follow the instructor to perform a bunch of different tasks, but I had no idea how the application would help my daily work or benefit my organization. I’m a pretty decent test-taker, so I ended up passing the evaluation step, but I still don’t feel like I know anything as far as being able to operationalize the functionality.

One of my co-presenters at Outdoor Classroom has dyslexia, and working with him made me think about how others would perceive the class. Similarly, people who learn best from reading rather than watching an instructor perform tasks and then try to emulate them might be out of luck. Organizations need to do more thought around different learning styles and need to spend time crafting strategies that will work for the diverse groups of users that their products will certainly encounter.

What are the best and worst types of software training you’ve experienced? Any advice that you’d give those who create the strategies? Leave a comment or email me.

Email Dr. Jayne.