Keywords

COMPETENCIES, COMPUTER-BASED TRAINING, ORIENTATION

 

Authors

  1. Welton, Robert MSN, RN
  2. Nieves-Khouw, Fe MSN, RN
  3. Schreiber, Deborah A. PhD
  4. McElreath, Mark P. PhD

Abstract

Competency in adapting care to the developmental needs of patients is not only a clinical expectation but also a requirement of regulatory agencies. Training programs on age-specific care competencies vary widely in format, content, and method. This article describes the process used by the authors to develop computer-based training (CBT) programs on age-specific care competencies and the process used to develop traditional self-paced learning modules on age-specific care competencies. The conversion of these printed modules to CBT is described and reports are given on the pilot test experiences of using CBT with clinical staff. Also included are lessons learned since organization-wide CBT deployment for age-specific care competency and other mandatory training.

 

Competency in adapting care to the developmental needs of patients is not only a clinical expectation, it is also a requirement of regulatory agencies. Age-specific care competency training programs vary widely in format, content, and method. The following are examples of how developmental traits influence how care should be adapted:

 

* Infants are not able to use words, yet their behavior needs to be understood by their care-givers.

 

* Toddlers like to explore but cannot sense danger or risks.

 

* Preschool children can enjoy jokes with people they know and trust.

 

* Older children may have fantasies that cause them to fear medical equipment.

 

* Rapid growth among 8- to 12-year-olds causes them to re+4spond with jerky movements and experience "growing pains."

 

* Young teenagers experience hormonal changes that can affect their skin at a time when they seek peer acceptance.

 

* Teenagers do not usually think of the consequences of their behavior.

 

* Adults want accurate, understandable information about their illnesses and worry about the effect of their illnesses on family and career.

 

* Older adults experience the most stress when illness threatens their independence.

 

Effective clinical practice mandates healthcare professionals demonstrate age-specific care competencies to deal effectively with the different characteristics and expectations of patients at varying ages. Age-specific care competencies are also a requirement of regulatory agencies (e.g., the Joint Commission on Accreditation of Healthcare Organizations), which require healthcare agencies to consider the special needs and behaviors of specific patient age groups in defining the qualifications, duties, and responsibilities of staff and have competency assessments that clearly address the ages of the patients agencies serve (CAMH: HR.3, January, 2000). Most professionals acknowledge that they could improve their age-related competencies. While age-related topics are discussed in healthcare professionals' preparatory programs, the greatest need for the training is in clinical orientation for hospital and ambulatory care practice settings.

 

Over the past several years at a university-affiliated regional hospital in Maryland, we have been involved in developing computer-based training (CBT) for age-related competencies. The training program is now being used by hospitals throughout the nation. The purpose of this article is to discuss how the age-related instructional materials were developed and to explain how the CBT system is being administered and evaluated. This case study has implications not only for the use of CBT systems in hospital settings but also for the refinement of age-related competencies in the healthcare professions.