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.
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.
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).
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.
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:
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:
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.
General definitions.The following are definitions of important terms related to developing 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:
Knowledge | Application | Comprehension | Analysis |
---|---|---|---|
Cite | Apply | Associate | Analyze |
Count | Calculate | Classify | Appraise |
Define | Complete | Compare | Contract |
Draw | Demonstrate | Compute | Criticize |
Identify | Employ | Contrast | Debate |
Indicate | Examine | Describe | Detect |
List | Illustrate | Differentiate | Diagram |
Name | Interpolate | Discuss | Differentiate |
Point | Interpret | Distinguish | Distinguish |
Quote | Locate | Estimate | Experiment |
Read | Operate | Explain | Infer |
Recite | Order | Express | Inspect |
Recognize | Practice | Extrapolate | Inventory |
Record | Predict | Interpolate | Question |
Relate | Relate | Interpret | Separate |
Repeat | Report | Locate | Summarize |
Select | Restate | Predict | |
State | Review | Report | |
Tabulate | Schedule | Restate | |
Tell | Sketch | Review | |
Trace | Solve | Translate | |
Write | Translate | ||
Use | |||
Utilize |
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.
Learner Objectives | Content (Topics) | Teaching Method | Time | Evaluation Method |
---|---|---|---|---|
Part I.A. Participant will state 5 reasons why ostomy surgery may be performed. | I.A. Overview of ostomy. •Prevalence and incidence •Common factors leading to ostomy surgery. •Cancer •Trauma •Inflammatory diseases •Infectious disease; other |
Lecture Slides Discussion |
10 min | Posttest: List 5 reasons why patients have ostomy surgery |
Part I.B. Participant will name 3 types of ostomies and the effluent expected from each. | I.B. Anatomy and physiology of ostomy •Types of common ostomies and the type of effluent expected: structure/function •Colostomy •Urostomy •Ileostomy |
Lecture Slides Discussion |
20 min | Posttest: List 3 types of ostomies and the type of effluent expected from each |
Part I.C. Participate will list 3 characteristics of healthy stomas. | I.C. characteristics of healthy stomas •Red, round, and budded •Signs of stomal complications to report |
Lecture Slides Discussion |
10 min | Posttest: List 3 criteria of a good, healthy stoma |
Part I.D. Participants will demonstrate proper application of a 2-piece, drainable ostomy pouching system. | I.D. Postoperative care and management: Care of the pouching system. •Types of pouches: 1-piece, 2-piece; drainable, nondrainable •Criteria for selecting a pouching system for the patient •Technique to apply a 2-piece, drainable pouching system: Measuring/sizing; peristomal skin care; application of skin barrier flange; attachment of the pouch and pouch clamp; use of support tape/belts, if needed. •Recommended frequency for changing skin barrier flange and pouch |
Lecture Slides Discussion Video |
20 minutes | Skills Demonstration: Demonstration of the application of a 2-piece drainable, pouching system in a simulated experience |
Part II.A. Demonstrate proper emptying, rinsing, and deodorizing of the pouching system. | II.A. Routine Care. •Technique for emptying, rinsing, and deodorizing the pouch •Frequency to empty pouch •Procedure to rinse pouch •Types of pouch deodorants and how to use |
Lecture Slides Review handouts Video |
10 min | Skills Demonstration: Demonstration of how to empty, rinse, and deodorize the pouching system in a simulated experience |
Part II.B. Participant will identify indications for a colostomy irrigation. | II.B. Colostomy irrigation •Purpose/indications •Contraindications •Patient assessment •Type of ostomy suitable for management with irrigation |
Lecture Slides Review handouts |
10 min | Posttest: Name the type of ostomy that can be regulated with irrigation |
Part II.C. Participant will demonstrate the proper colostomy irrigation technique, using a cone-tip irrigator. | II.C. Colostomy irrigation guideline •Supplies/equipment •Irrigation procedure with cone-tip irrigator/advantage of using a cone-tip •Complications |
Lecture Slides Discussion Video |
20 min | Skills Demonstration: Demonstration of a colostomy irrigation using a cone-tip irrigator in a simulated experience |
II.D. Participant will discuss effective methods of dealing with possible emotional responses related to ostomy surgery. | II.D. Possible psychological implications of ostomy surgery •Body image •Social isolation •Sexual issues •Work/recreation concerns |
Lecture Slides Discussion |
10 min | Posttest: Describe 3 possible emotional responses related to ostomy surgery and how you would meet them |
II.E. Participant will discuss discharge information needed by ostomy patients including the United Ostomy Associations of America information, supplies, diet, resumption of activities, and return appointment. | II.E. Discharge planning, resources and instructions: •Resources: United Ostomy Associations of America •Supplies needed •Source of supplies •Diet •Resumption of activities •Return appointment |
Lecture Slides Discussion Review handouts |
10 min | Posttest: Describe needed resources and discharge instructions for the ostomy patient |
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.
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:
Some examples of collaborative projects addressed by resource teams include the following:
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.
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.