Chapter 5: Educator Role

Educating others is an integral part of a professional practice. Orientation and ongoing education and development of staff are critical components in an effective WOC care program. This chapter presents guidelines for staff orientation and developing continuing educational programs and describes how to develop measurable learning objectives and educational plans (ie, objectives, content outline, teaching methods, and evaluation methods). Also, utilization of resource teams to enhance the WOC nurse's role is discussed.

Guidelines for Staff Orientation

Orientation of staff to the role of the WOC specialty nurse and the responsibilities of staff nurses for WOC care is a key responsibility of the WOC nurse. Orienting staff and new employees to the WOC nurse's role and consultative procedures should be included in the orientation program for all new employees. To ensure that the orientation achieves the intended leaning outcomes, the WOC nurse establishes minimal learning and skills objectives to be met during the orientation and these can be fashioned into a skills checklist. The learning objectives may be met by providing new employees with structured learning opportunities, such as making rounds with the WOC nurse, or by using skills-based lab activities. Other simulated experiences are also beneficial to the learner. For example, if the minimal objectives for ostomy care include sizing a stoma and applying a pouch, using a simulated stoma that is available commercially or can be fashioned from modeling clay and cardboard is effective. Similarly, if the minimal objectives for wound care include accurate documentation of wound characteristics and selection of an appropriate dressing, pictures, slides, or simulated wounds made of clay and paint can be used. Appendix O provides a sample structured orientation plan that can be adapted for a skills checklist.

Guidelines for Developing Educational Programs

Often WOC nurses are asked to help plan an educational program or be a speaker. Educational programs include short in-services (≤1 hour), seminars (6–8 hours), or conferences (several days). Some programs that are provided can be eligible for continuing education (CE) contact hours. Awarding CE credit for a program requires applying to an accredited CE approver who will review the program according to certain criteria.

According to the South Carolina Nurses Association (SCNA), which is an accredited CE approver by the American Nurses Credentialing Center's Commission on Accreditation, continuing nursing education, for which contact hours can be awarded, is defined as planned, organized learning experiences that are designed to improve the knowledge, skills, and attitudes of nurses (SCNA Continuing Education Approver Committee, 2009). Continuing nursing education enhances practice, promotes professional development, and improves overall health care (SCNA Continuing Education Approver Committee, 2009). In-service education is defined as planned instruction or training to help nurses perform in a specific work setting (SCNA Continuing Education Approver Committee, 2009). In-service is designed to orient to duties, maintain or increase competency, promote compliance with an employer's policies/procedures, demonstrate the use of facility-specific equipment, or provide practice for previously learned skills. Such in-service activities are not eligible for CE contact hours (SCNA Continuing Education Approver Committee, 2009).

Planning for Educational Programs

The key to success in presenting an educational program is advanced preparation and developing an educational plan. The components of the plan include measurable learning objectives, a content outline, identification of speakers (eg, the planner and speakers can be different), teaching methods, and the plans for evaluating the learning.

Writing educational objectives

When planning a nursing educational program, specific learning objectives are required for the overall educational activity as well as for any individual sessions. Writing objectives can seem intimidating and threatening, but they are integral to a well-designed educational program. Well-written objectives help to:

• Organize what will be taught.
• Determine which instructional methods will be most effective.
• Formulate the evaluative materials.
• Make measuring the outcomes easier.
• Help learners understand what they can expect to achieve upon completion of the course.

When writing instructional objectives, using a frame of reference that clarifies the type of learning outcome that is desired is advantageous to guide the selection and writing of objectives (Gronlund & Brookhart, 2009). A classification system known as the Taxonomy of Educational Objectives was developed by Bloom and others, who identified 3 domains of educational outcomes: cognitive, affective, and psychomotor (Bloom, Englehard, Furst, Hill, & Kratwohl, 1956; Gronlund & Brookhart, 2009; Krathwohl, Bloom, & Masia, 1964; Simpson, 1972). These domains as described by Gronlund and Brookhard (2009) are commonly recognized and utilized by educators when preparing objectives:

1. Cognitive domain. Intellectual learning outcomes; includes the categories of knowledge, comprehension, application, analysis, synthesis, and evaluation.
2. Affective domain. Outcomes related to interests, attitudes, appreciation, values; includes categories of receiving, responding, valuing, organization, and characterization by values.
3. Psychomotor domain. Motor skills; includes categories ranging from simple to complex motor skills (ie, performance skills).

In this structured approach to developing objectives, the learning objectives are hierarchically organized from simple to complex. Gronlund and Brookhard (2009) point out that the level of complexity does not necessarily mean the level of difficulty and that higher-level learning outcomes can be achieved by learners at different age levels and with varying educational backgrounds.

The following are definitions of important terms related to developing objectives:

• Course description. A brief overview of the content in the educational program.
• Goal. A general statement of purpose or intent.
• Objective. A specific statement of the desired outcome by the learner that is descriptive and measurable.
• Behavioral verb. Denotes a measurable action by the learner.

Developing measurable objectives

Measurable learning objectives are written by carefully selecting a verb that matches the domain of learning and the level of complexity desired in the outcome. When writing objectives, avoid using verbs such as understand, realize, know, appreciate, is aware of, and comprehend, that identify achievements that are difficult to measure. Instead, use verbs that can measure behavior or performance. Table 5.1 includes a sample of verbs that can be used to identify objectives for different levels of learning within the categories of knowledge, application, comprehension, and analysis (Wound, Ostomy and Continence Nurses [WOCN] Society, 2005). The following 3 questions developed by Mager (1962) will help test the objectives, and if the answer is yes to all 3 questions, the learners will know exactly what is expected of them:

1. Does the objective describe what the learner will do to demonstrate achievement of the objective?
2. Does the objective describe the conditions under which the learner will demonstrate achievement of the objective?
3. Does the objective indicate how the learner's achievement will be evaluated? Does it describe at least the minimum acceptable performance?

Guidelines: Seminar and Conference Planning and Development

Planning for educational offerings and programs involves several steps, which includes identifying the need for the education, determining the goal based on the need, developing a brief description of the course, and developing an educational plan that includes the learning objectives, content, teaching methods, and evaluation methods.

The following example demonstrates program planning and development of a sample educational plan for a basic ostomy care class.

1. Program planning and development:
   1. Identify the need: Several nursing supervisors have indicated that they have new nursing personnel who have not had experience in caring for patients with ostomies.
   2. Determine the goal: Assist new nursing personnel in providing quality care for the patients with ostomies on their units.
   3. Develop a course description: Two 1-hour classes (parts I and II) will be developed to provide the following instruction about basic ostomy care:
      • Review of causative factors that may necessitate ostomy surgery.
      • Review the different types of ostomies.
      • Discuss the criteria for a well-constructed stoma.
      • Discuss postoperative care of ostomies.
      • Demonstrate techniques for care of the skin and pouching system.
      • Discuss colostomy irrigation.
      • Explore the psychological needs of patients with ostomies.
      • Discuss discharge planning needs and resources.
2. Develop the educational plan:
   • Based on consideration of the need, goal, and course description, develop an educational plan to include the specific measurable learning objectives, content, teaching methods, and evaluation methods. The components of the plan should be congruent so that the content, objectives, and evaluations are clearly related.
   • Table 5.2 provides an overview of a sample educational plan for providing a basic ostomy care class.

Appendix P provides a suggested conference planning timeline for developing an annual seminar or conference. Appendix Q provides sample forms that may assist in conference planning: sample conference budget planning form, application for exhibit space, exhibitor evaluation form, and conference evaluation form.

Developing Resource Teams

Across the care continuum, the health care industry is focused on efficient delivery of quality care. Often this means that utilization of the WOC nurse is better accomplished when a WOC nurse is a member of a resource team rather than the primary (or sole) provider of expert WOC care. As a key contributor to a resource team, a WOC nurse may:

• Identify other resource team members.
• Assess educational needs of the team.
• Provide necessary, ongoing education for the team.

Some examples of collaborative projects addressed by resource teams include the following:

• Creation of a wound product formulary.
• Identification of systemwide multidisciplinary policies and procedures.
• Role clarification of members of the resource team.
• Consensus regarding treatment protocols based on principles of wound healing.
• Policy development regarding a basic vascular examination and subsequent treatment of lower-extremity ulcers.
• Establishment of a communication pathway between departments and the medical staff.

The document Role of the Wound, Ostomy Continence Nurse or Continence Care Nurse in Continence Care (WOCN Society, 2009) is provided in Appendix R as an example and guide for defining a role for the WOC nurse on a resource team.

References

Bloom, B. S. (Ed.), Englehart, M. D., Furst, E. J., Hill, W. H., & Krathwohl, D. R. (1956). Taxonomy of educational objectives: Handbook I: Cognitive domain. New York, NY: David McKay.

Gronlund, N. E., & Brookhart, S. M. (2009). Gronlund's writing instructional objectives (8th ed.). Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

Krathwohl, D. R., Bloom, B. S., & Masia, B. B. (1964). Taxonomy of educational objectives, book II. Affective domain. New York, NY: David McKay Company.

Mager, R. (1962). Preparing educational objectives. Palo Alto, CA: Fearon Publishers.

Simpson, E. (1972). The classification of educational objectives in the psychomotor domain: The psychomotor domain (Vol. 3). Washington, DC: Gryphon House.

South Carolina Nurses Association Continuing Education Approver Committee. (2009). Individual activity CE manual. Retrieved November 2012 from http://www.scnurses.org/associations/10047/files/April-2011SCNA-CEAC-Individual-Activity-Manual_2009.pdf

Wound, Ostomy and Continence Nurses Society. (2005). Wound, Ostomy and Continence Nurses Society professional practice manual. Mt. Laurel, NJ: Author.

Wound, Ostomy and Continence Nurses Society. (2009). Role of the wound, ostomy continence nurse or continence care nurse in continence care. Mt. Laurel, NJ: Author.