Nurses, Learn Informatics!

I am a teacher. For 20+ years, I ran a highly successful technology training company, I have thousands of classroom hours, have developed numerous technical courses, and have mentored dozens of acclaimed instructors. Thus, I have strong opinions about the informatics skills nurses need and how nurses should be nurtured in order to acquire them. Here are some thoughts on the processes and topics that would comprise an effective nursing informatics curriculum.

Why do nurses need to know informatics? One reason is effectiveness on the job. We use computers every day. If we understand what’s "under the hood", we are more effective in using technology, especially when things go wrong. The obvious metaphor is driving. You can be a fine driver without the faintest grasp of internal combustion engines... Until the one you’re using breaks down. If you understand its principles and components you are better able to diagnose and resolve problems when they arise, or at least to converse intelligently with your mechanic.

Another reason for nurses to be informatics-savvy is to be equipped to advocate for nursing in technology decision-making and in participating in the evaluation and selection of the tools with which nurses must work.

What does it mean to be informatics-savvy? First, there is basic literacy. So much of our routine activity and communication uses technology. To function in today’s world, the nurse (and everyone else) must know and be comfortable with:

  • What is a PC? A server? A network?
  • Email
  • The Web and its main sites
  • Virus protection
  • Backup
  • Using Word, Excel, and Powerpoint
Whatever deficits may be present should be remedied in an unthreatening and supportive learning environment.

Building upon these skills, the next level of literacy encompasses:

  • Social media
  • Doing online research, especially with (for nursing) Cinahl and Medline
  • Doing literature searches that go beyond Google and Yahoo
  • Finding EBP guidelines
  • Creating web sites and pages
  • Sharing files and data, e.g. via Dropbox

Beyond this, there are nursing- and healthcare-oriented concepts, skills and resources that today’s nurses need:

  • Accessing drug, lab, disease, and population health databases
  • How informatics reports data to regulatory agencies
  • How to read and write research: copyright, plagiarism, publication, APA
  • EHR concepts, issues, industry players
  • Healthcare-driving legislation and regulatory bodies: ARRA, AHI, EMTALA, ACA

Who else is working on this? These thoughts do not originate with me. There is a national initiative, Technology Informatics Guiding Education Reform (TIGER), that describes these objectives and more. Others of these ideas came from Judi Godsey and her SOLO (Successful Online Learning Orientation) online course. She says (and I agree) to start with a skills assessment and to tailor the materials from there, as appropriate for each individual learner.

What is the best way to achieve this? I have found, from my experience providing technical training, that the most effective way to enable skills acquisition is not lectures nor discourses on theory but by means of brief, focused activities. Learning objectives must be stated in terms of specific tasks, activities, and thinking processes that relate directly back to the job of nursing. Learner motivation requires a strong sense that the material being covered is relevant and useful.

These objectives are then best achieved by means of hands-on exercises. Examples:

  • An objective might be to use social media in health care. The corresponding exercise might be to choose a chronic disease and identify a social media resource for it such as a discussion group on the Web.
  • Another objective might be spreadsheet usage. The exercise could be to create a spreadsheet and use it to gather and tally "Is and Os" for a kidney patient on a shift.
  • A third might be using guidelines and pathways for EBP. The exercise might be to name a condition or diagnosis seen on the job, find a relevant guideline or pathway, and discuss (in a brief writeup) how well it’s being applied.

In sum, the most effective training -- for nurses and everyone else -- is delivered in discrete chunks and is evaluated in clear terms of success ("yes, I did the task"). The delivery process involves an iterative process sometimes called the three E’s: explain, exercise, evaluate. The entire cycle should be brief — under an hour — and, if the evaluation step reveals incompletion (the learner was unable to complete the task) the cycle can be repeated with a variation (e.g. look up a different diagnosis) until success is achieved. In my classrooms and also in distance learning, no one was ever left behind; everyone accomplished every exercise and was recognized. "Attaboys" and "go girls" are strong motivators.

The point is that nurses can and must have access to high-quality training in technology in order to remain relevant and competent in the world of today’s health care.

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