learning in healthcare

Implementing Low-Dose/High Frequency (LDHF) Learning in Healthcare

This blog post excerpts an article, “Low-Dose, High-Frequency Training is Transforming Learning in Healthcare” by Randy L. Carden, Ed.D., Senior Research Consultant, HealthStream, from our recent eBook, Trends in Healthcare Learning.

Changing the Approach

The first step of transitioning to a LDHF learning method is for leaders to not only acknowledge the changing workforce but also the changing approach to training methods. Leaders must be willing to adapt and spread enthusiasm among their staff about such transitions. The Resuscitation Quality Improvement (RQI) Program provides an excellent example of a successful LDHF learning model, and HealthStream’s VP of Resuscitation Solutions Marnie Kelly adds, “The same concept developed for RQI could be applied to any educational initiative. It’s simply a matter of examining educational content that is traditionally delivered over a several hour time period (i.e. high dose) and determining whether the content could be delivered in lower doses over the course of weeks or months, and in each ‘low-dose’, key concepts are continually reinforced.”

Bringing Change into an Existing Work Culture

Transitioning from existing trainings methods to LDHF models of training is a major shift for hospitals, staff, and instructors. This change in learning models is one of the biggest changes that has occurred in the industry in years, and because students and instructors are accustomed to a certain teaching format, some pushback can be anticipated. In order to help staff understand the rationale for such transition, a major paradigm shift must occur.

In discussing the challenges that arise when new training systems are introduced, Kelly states, “In general, we have seen very positive learner feedback and reports of high confidence in the more frequent training modules, which are also less time consuming.” She discusses the challenges of bringing something unfamiliar into an existing work culture and that its success depends upon the priorities for that particular organization. Kelly adds, “Some customers are more focused on cost effectiveness and are not able to invest in high quality training programs, like RQI. The LDHF training model may be preferred but it may have higher administrative costs associated with increased staff oversight.”

Transition Challenges

As mentioned, any time that unfamiliar or new training systems are introduced, there will be challenges to overcome and pushback from some employees to address. One major challenge that organizations face is the logistics of making the transition. They must have the technology available that can deliver smaller training components at a more frequent interval without overwhelming the training teams with administration. New training materials may need to be developed to include deliverable content that can be effectively broken down into segments that are short but still provide the same value. However, developing and deploying shorter training sessions will take time.

It is very common to initially experience opposition from all levels of staff. Upon hearing that they are going to have to train more often, even though for less time, employees may show resistance to the change. Some employees may be less receptive if they are uncomfortable with e-learning and virtual simulation or if they have been doing training a certain way for years.

Administrators may be concerned that it is going to take more time to maintain. Leadership may be concerned about the time and cost to implement a new training program. When facing pushback during a transition, the important thing to emphasize to all staff is the reason for transitioning to a new training method—preventing skill and knowledge erosion could be the key to saving more lives.

Measuring the Impact of LDHF Learning

The Key Performance Indicators (KPI) that should be measured for LDHF learning will be similar to traditional training methods, but with a particular emphasis on confidence and competence over time. The important KPIs for each program will largely depend on the content that is being delivered. Organizations should be able to measure increased competence by showing a more significant level of retention at various points of the training cycle. In addition to measuring a higher level of competence, the organization should also expect to observe and record a noticeable increase in the employee’s level of confidence, with respect to the training material provided.

In looking at an example program such as RQI, the KPI that should be captured is the actual resuscitation rate before and after start of program. This can be difficult to capture if the organization doesn’t have existing data. However, student skill level can be measured and monitored from the start of a new program and surveys can be given to capture the learner’s confidence levels over time.

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