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Tips to Engage Nurses in Mandatory Training

By Jo-Ann Byrne, RN, for HealthLeaders Media  
   January 25, 2011

It’s that dreaded time of year again. All staff members must complete annual mandatory education, and once again, you’re struggling to figure out how to reach all of them in a prescribed period of time. You have to provide education regarding corporate responsibility, hazardous waste, infection control, The Joint Commission, the organization’s mission, risk management, and safety. This information must be reviewed annually and can become repetitive and tedious. The question to be addressed is: How can you make annual mandatory training meaningful and fun?

How many of you are still holding those 24-hour for three days open sessions hoping everyone will show up? Maybe you’ve switched to a unit/department-based method where managers, or their designees, are responsible for catching everyone over a period of days and making them do the “test.” How’s that working for you?

Up until three years ago, my organization was using a paper and pencil testing process to meet our mandated annual requirements. Not only was it cumbersome, it was hard to administer and even harder to track. There had to be a better, more efficient, and, hopefully, more creative way to instill in our staff a desire to complete their required mandatory education. My hope was that we could find a way to get them so excited about it that it wouldn’t feel like the burden many perceived it to be.

The first consideration of any mandatory training is always the validity of the content and the learning that needs to occur. In our organization, materials are always reviewed annually by content experts to ensure that we are presenting accurate and timely information. Once this is accomplished, we are comfortable pursuing innovative strategies to accomplish education goals.

1. Online Training

Two years ago, we made it into the 20th century, but just barely. We had just launched our learning management system (LMS), an online training and tracking system, where we hoped a significant amount of courses would be housed and offered in the future. One of the advantages of the LMS is that it’s available and accessible 24/7. To kick off the LMS, we used our annual education as the first program offered. It was essentially the paper and pencil test administered electronically, but we were up and running.

It was much easier to track, but not much fun to take. Our staff were given 30 days to complete it and it took every one of those 30 days to reach the entire organization. In fact, more than 50% of our staff waited until the last week to complete it, and truth be told, we needed a fifth week to catch everyone up. Required or not, it wasn’t much fun, so folks weren’t jumping in to get it done.

Lesson learned: Our goal was to have 100% of our staff complete the program. We did that, but not without a great deal of struggling. Test scores indicated that our staff read and retained (at least temporarily) the information, but the time it took us to reach 100% was unacceptable. We learned that just because something is electronic doesn’t mean it’s effective or interesting. It is, however, much more efficient from a tracking and trending perspective.

2. The Video Game Approach

Last year we knew that we wanted to once again offer the mandatory annual training online, but it had to be more fun while simultaneously reinforcing the valuable content. We defined better results as more learners completing the training with less arm twisting and in a more timely fashion (not waiting until 3-5 days before the deadline.) We thought that by adopting a video gaming approach, the learning process would become more of an enjoyable game rather than a tedious obligation. In other words, we wanted to give this training some punch.

During the program’s development, we decided to adopt a theme, hoping for a creative way to get folks excited. Football was the inaugural theme and appropriate graphics and sounds were used throughout. It was minimally interactive, providing appropriate cheers for correctly answered quiz questions that were interspersed throughout the content as a way of review, followed by graphics depicting the participants’ move down the field with each correct answer, and a touchdown as the signal that training was successfully completed.

Six modules made up the entire program. Word soon spread that the mandatory modules were “more fun,” and “you should do it” was heard more than once in the corridors. By the end of the first week, 40% of staff had completed the program and we didn’t have nearly as many people waiting until the bitter end to jump in and get it done. We added an additional incentive, a pizza party, to the mix for the first department/unit to have 100% participation.

Lesson learned: We concluded our new approach had a modicum of success: 40% completed the program by the end of the first week and post-test scores continued to be in the 90-100% range. It was definitely a less painful experience for those of us who were monitoring progress and making calls to encourage staff to complete the training. We felt that if this rudimentary stab at gaming as a way of online learning was mildly successful, we should step up our next theme and level of interactivity. Could we get to 50% or greater participation by the end of the first week?

3. Create an Engaging Theme

For the third year, we decided to pull out the big guns and our instructional designer outdid herself. This year’s theme centers on a Mexican fiesta. As participants work their way though the program, they will earn parts of Pedro’s party wardrobe, ultimately ending up at a fiesta, music, dancers, and all.

The program is introduced by a video clip of our instructional designer giving the directions for navigating the various modules that comprise the activity. She also introduces “Pedro” and tells participants they will help Pedro get to the fiesta by accurately answering quiz questions throughout each module and ultimately completing the post test at the end of the activity. Each quiz question is introduced by a graphic that represents a member of the education department. We believe this adds another layer of personalization and interaction to the module. We also made answering quiz questions more interactive. For example, some items can be dragged, such as by placing specific types of trash in the correct receptacle.

We learned that offering a prize worked well last year as an incentive to have all staff complete training. So in keeping with our theme, this year’s first department to have 100% participation (which also means successful completion of their post- tests) will win a piñata full of candy and trinkets.

The content experts who have tested this year’s program for us were handpicked to represent a cross section of staff throughout the organization. They are overwhelmed by the enhancements. Without exception, they have agreed that we have taken non-exciting content and made it fun to review and learn.

Lesson learned: Sometimes a good idea can become a great idea with a bit of tweaking. It often isn’t necessary to abandon a methodology, instead, just enhance it. We have found that as we learn more about gaming techniques and their application to education, each year we have been able to take an online program from boring to exciting. It’s now a program that our staff look forward to and wonder how we’ll step up our game for the next year.

We may still be novices at this, but we have come miles in terms of our ability to develop and deliver an exciting program.


Jo-Ann C. Byrne, RN, BS, MHSA, is director of education and organizational development at St. Vincent’s Healthcare in Jacksonville, FL, and the coauthor of the book Quick-E Pro Scripting: A Guide for Nurses.

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