Business Problem: A recent patient satisfaction survey at Good Medicine Healthcare (fictional name) in clinical settings indicates a relatively low satisfaction rate (50%) among non-white patients on key measures of interaction with staff. At the same time, demographic trends show increasing diversity in the communities served by the healthcare system. Specific complaints from the survey indicate that nursing staff may be unaware that common biases shape interactions with patients and they are not currently engaging in a self-reflective practice to identify such biases. Nor are they using strategies to mitigate bias in patient interactions.

Audience:  Nurses in Good Medicine Healthcare clinical settings are the target audience for this training. Nursing staff is primarily white, 85% female aged 25-65 years. They have a clear understanding of what good healthcare with positive health outcomes looks like and want to deliver good healthcare. There is a range of understanding regarding causes of health inequities and the role clinical settings play in fostering or helping to correct this problem.

Solution: Given that there can be serious negative health impacts when patients experience inequity, Good Medicine Healthcare has undertaken a series of steps to address diversity, equity, and inclusion and this course is one part of the multi-phase plan that involves all staff. Nurses play a key role in clinical visits, and their ability to identify biases and use mitigating strategies will contribute to overall efforts of increasing equity within Good Medicine Healthcare’s system. Specifically, this training will have a positive impact on nurse’s interactions with patients. This will contribute to Good Medicine’s goal to improve patient satisfaction amongst people of color as measured in survey scores on key measures of interaction with staff by 20% within an 18-month period. 

Highlights: The following highlights are grounded in Adult Learning Theory, making particular use of Transformative Learning, Motivational Factors, Contextual Learning, and Practical Application.

• Use of a nurse character guide to mirror concerns and questions previously voiced in the clinical setting

• Practical tools provided for achieving the learning outcomes

• Mini scenario involving the Black Maternal Health Crisis helps the learner connect use of the mitigating strategies with improved patient interactions that can lead to better outcomes

• Quiz questions are scenario based providing learners with additional real-life examples and solutions

• Well organized into two goal-oriented sections – identifying bias through self-reflection and tools to mitigate biases – with internal consistency of presentation to decrease cognitive load

Process: Although this project is a fictional scenario, it is based on a real problem in modern healthcare in many areas of the United States. To define the problem, I drew on personal observation, discussions with healthcare professionals and educators (medical anthropologists), and professional literature. Had it been a real-life project, my research would have also involved review of the patient satisfaction survey, discussion with a nurse and patient focus group (if possible), and SME (if available). Solutions presented in the course were gleaned from professional healthcare research literature.  Instructional strategy, content, and assessment methods presented in a design document resulted in feedback leading to an adjustment of the nurse character's reactions and nurse voices in the quiz to accommodate a more diverse learning group. Feedback at this stage also led to clarification around the importance of self-reflection. Following approval of the design document, a detailed storyboard was sent for feedback prior to development. Using Articulate Storyline and following the storyboard, the module was developed and two rounds of feedback with minor edits improved the final gold version.  Implementation of the course would take place within the context of the larger program with nurses provided time, space, and tablets to take the class at work. Kirkpatrick's Level 2 evaluation is a scenario-based multiple choice quiz at the end of the module. Kirkpatrick's Level 3 assessment is multi-level observational and discussion-based evaluation.

Tools Used:

Articulate Storyline

Canva

Related Portfolio Documents:

Design Document

Storyboard

Self-Reflection Job Aid

Business Problem: Natural Measures (fictional name) is an analytical testing lab where food and beverages, dietary supplements, and botanical products are tested for a variety of reasons, such as purity and strength. This sample is based on a real lab and a real business problem. Staff members of the intake and prep lab currently clock excessive amounts of overtime as they do not finish a normal sample quota within their regular 8-hour shift. The team must work together to assess the complexity of their daily sample load and work together to process the samples.  Currently, team members interact with one another as if they are in a standard lab where work is individualized and segmented; lack of teamwork is leading to interpersonal conflicts that exacerbate the overtime issue. The goal for this training is to decrease the amount of overtime for the lab by 20% over a 3 month period.

Audience: All team members of the intake and prep lab, including regular staff and the shift manager comprise the audience. The demographic is mid/late 20 to early 30 year olds, there is an equitable gender diversity in the group, and there is low racial diversity with the vast majority of staff being Caucasian. Members of the team generally have a science background and entry-level experience in an academic or standard science lab setting where they worked as individuals responsible for limited tasks. Learners have a relatively low understanding of how to interact with one another to effectively work as a team.

Solution: This learning module will help the lab staff engage in good teamwork practices and work more effectively as a team to process the expected sample load, thus reducing the need for overtime hours. Team members will use the four elements of teamwork best practices, they will consistently select teamwork-enhancing behaviors to improve overall team efficiency, and they will respond appropriately with encountering teamwork hindering behavior.

Highlights:  The following highlights are grounded in Adult Learning Theory, emphasizing relevance, practicality, and motivational factors.

• Four elements of teamwork best practices form the foundation for behavioral change

• Scenario based learning

• Greater work-life balance motivation

• Engaging knowledge checks with real-world examples

• Scenario based practice

Process: Analysis of the issue was achieved in collaboration with the lab supervisor serving as the SME. A design document was generated and reviewed with the SME. Content on teamwork was generated through literature review, with examples coming from the SME. Incorporating the feedback, an alpha prototype was designed and feedback from the SME was sought. As this was a training sample, the beta version was approved by AIDA instructors as was the gold.  Kirkpatrick's Level 2 evaluation is a scenario-based multiple-choice quiz. The recommended Level 3 assessment involves supervisors observing staff members' teamwork practices and objectively measuring overtime occurrence. 

Related Portfolio Documents:

Four Elements of Teamwork Job Aid

Business Problem: The Historic Marbold Farmstead Association hosts an annual Heritage Festival.  It is relatively well attended by returning and new visitors, but it is difficult to provide comprehensive information on all aspects of the event that motivates and allows for optimal visitor planning. This can negatively impact attendance numbers and even those who do visit are often unaware of all the various offerings at the event.  An increase of 10% in attendance and an increase in attendee participation across the different kinds of offerings at the event is desired.

Audience: Members of the general public with an interest in the agricultural history of west-central Illinois, including potential new visitors and return visitors. The demographic varies widely and includes young and old, families and individual visitors, tech savvy users and those that have limited online skills.

Solution: An easy-to-use Rise format accessible on the association's Facebook and website presents a complete summary and listing of the various kinds of activities offered along with general information so that learners are motivated and prepared for their visit and can make informed decisions about how they might spend their time at the festival.  The module includes information for return visitors regarding new renovations to the farmstead, summarizes the kinds of exhibits, vendors, and entertainment that will be on hand, and provides a detailed daily schedule. 

Highlights: The following highlights are grounded in Adult Learning Theory, emphasizing relevance, practicality, and motivational factors.

• Effective organization of types of information 

• Sneek peek interaction creating interest in newly renovated rooms  

• Complete schedule to aid in planning

• Visually informative for new attendees

Process: Needs analysis took place in conversations with the festival committee members and through observation.  In lieu of a formal design document, a mock-up of the module with sections in place and types of information to be included was submitted to the committee chair. With feedback and information provided from the committee, a beta version was completed and submitted for another round of feedback. The gold version was then submitted and approved. Recommended assessment includes polling of attendees as to whether they used the module, and if so, was it helpful and easy to use. Attendance numbers and engagement in various activities will also be monitored.