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Continuing education work group: a useful strategy.

Continuing education work group: A useful strategy

Continuing education deserves a vital role in every clinical lab. A comprehensive CE program is essential to keep employees updated about new developments. CE is also a critical element of an effective quality assurance program.

Becan-McBride recommends allotting two hours per week for continuing education. (1) Even that level of scheduling, however, will not allow many employees to attend outside programming.

How can a lab insure each employee access to appropriate CE activities, whether on basic safety principles or on the latest technological wrinkle? As Yapit points out, (2) someone must take charge. An approach that worked well for the University of Iowa department of pathology was to establish a CE work group.

The department includes approximately 450 staff members working in clinical and research laboratories, various education programs, and administration. Each group of employees has special needs for continuing education. For example, staff members in the clinical lab need technical information; those in research need programs geared to their assorted specialties.

In 1987 the department administrator asked me to draft a proposal establishing a departmental CE program to be guided by a work group. The administrator also asked three other persons (co-authors of this article) who had interest and expertise in continuing education to join the group.

This was to be the first several ad hoc work groups convened to include personnel from all areas and levels in solving departmental problems.

The concept of work groups is a variation of quality circles, used in the business world. A work group focuses on a specific task, such as CE, or discusses related problems, such as employee morale. Work groups have been used in various areas of health care, including the clinical laboratory (3). * Framework. In the CE proposal, group members listed six goals:

(*)Document CE programs and attendance.

(*)Encourage and facilitate participation in CE programs.

(*)Provide consultation services to sections within the department.

(*)Decrease duplication of CE programming.

(*)Inform the staff more thoroughly about CE opportunities.

(*)Evaluate departmental CE.

After examining the goals in relation to our needs, we accepted them as objectives for the first year. We quickly found, however, that we needed more information before we could answer three basic questions that arose as we began to organize our plan: * What CE is currently available? * What CE would be ideal for us? * How do we progress from the current situation to the ideal? * Taking stock. To identify gaps between existing and desired CE programming and to validate and prioritize the work group objectives, we performed a needs assessment (4). We also wished to obtain information that would guide us in implementing and evaluating the departmentwide plan we had in mind (5).

We hoped that involving as many staff members as possible would help us identify more needs while building commitment by future participants and generating the support of management. We also wanted the information from the assessment to serve as baseline data so that years from now we would be able to judge whether our program made a difference.

To survey the status of our resources, needs, and constraints, we held open discussions, reviewed records and reports of current CE and available instructional media, and interviewed a CE contact person chosen to represent each of the 23 clinical labs and support areas. The interviews included a standardized set of 10 questions that we developed concerning current and desired levels of departmental and area CE programming (6). Our assessment, including collating the data, took about three months. * Progress report. The results of these diverse strategies provided the work group with a comprehensive description of existing programs, prospective participants, possible constraints, conceptions of an ideal CE program, and many good suggestions for achieving one (Figure I). The data we collated enabled us to substantiate the original six objectives and add a new one: to present department-sponsored CE programs. With many avenues available concerning CE - outside, individual, and self-instructional - we were delighted that the assessment showed a thorough interest in department CE.

Table : Figure I

Conditions and restraints identified during planning phase


Diverse ages, education, work experience Support, administrative, technical, professional staff Experience ranging from entry level to supervisor Maximum number: 450 Coverage: 24 hours (three shifts)


Two teaching hospitals - a 900-bed university hospital and a 350-bed VA hospital - in four buildings Clinical labs: 23 Research labs: approximately 10 Support offices: approximately 6

Existing CE programs

Seven marginal to thriving programs in different lab and support areas Some areas have no programs

CE documentation, reporting, and accreditation requirements

Multiple professional societies Multiple accrediting agencies University of Iowa College of Medicine office of continuing medical education

Supervisory/peer support



No line identified (one has since been established)

General work environment

Many continuing organizational changes Increased workload Job redefinition due to personnel shortage Personnel shortages in many areas

Program resources

In-house speakers (faculty, staff) UI Counseling Service UI Hospitals and Clinics Staff Relations Department (within hospital) UI staff development (within university)

We learned that many areas in the lab had their own programs but did not advertise them or invite personnel from other departments to attend. As a result, some speakers were often asked to repeat presentations as many as three or four times in different lab sections within the department. With coordination, such programs could easily be offered to the whole department and given only once or twice.

Many of the smaller staffs, comprised of one to five persons, told us they felt left out of CE offerings. They agreed that departmentwide CE programs would be a good way to channel information to everyone. * Priorities. The information that we obtained in this way helped us to identify our top two priorities:

(*)To establish a convenient, efficient, and comprehensive mechanism for documenting participation in CE (our original first objective).

(*)To improve the dissemination of CE throughout the department (our original fifth objective). * Record keeping. With the diverse CE activities available to staff members, such as outside and departmental CE, a simple yet comprehensive documentation system was crucial for the purposes of licensure and certification. The documentation system had to be able to record the established requirements of the participants' professional societies, the university's college of medicine, and hospital accrediting bodies.

An efficient recording system would enable us to track CE credits. The pathology department sponsors or cosponsors 16 conferences that have received Continuing Medical Education (CME) category I accreditation from the Accreditation Council for Continuing Medical Education. Yearly CME totals for each conference are submitted to a central coordinating office within the university run by the college of medicine. This office in turn converts the CME credits to CEUs, which are comparable units for non-physician personnel.

The approach we chose tracks attendance at accredited conferences as well as at other CE activities and staff meetings. Our system computes the amount of time each employee has spent away from the work area to attend CE programs and staff meetings. The resulting data are used in conjunction with our laboratory's productivity assurance system, which is based on the CAP Workload Recording Method.

One of the coauthors with a knowledge of computers developed our system using the dBase III+ program. The system features separate files on conference and personnel attendance, and keeps track of session topics. Programs connecting the databases were written to allow us to: * Enter information on attendance at conferences; * List dates of attendance; * Produce monthly tallies of employee time spent at CE or staff meetings by lab section; * Provide a report for each employee registering attendance at CE and staff meetings for the current calendar year (Figure II), with one copy sent to the employee and another placed in his or her personnel file; * Produce annual reports for the conferences, including the number and names of attendees; * Modify employee demographic data, such as home address if a staff member should move; and * Modify conference information. In one situation the sponsorship changed, and we needed to be able to change that information in the records.

PHOTO : Figure II

Personnel file report

Pathology Department continuing education - 1989
 Attendance for: Joe Elliot
 Address of lab: 202 Main St.
 Social Security No. 123-45-6789
 Lab section: Chemistry
Clinical laboratory sciences program Hours spent
 01/17 Ideal Job vs. Real Job 1.0
 03/10 Pediatric Bone Marrow 1.0
 Total 2.0

Microbiology CE program
 03/08 Meningococcal Virulence 0.8
 Total 0.8

Pathology grand rounds
 02/24 Mycology and Yours 1.0
 Total 1.0

Special or non-pathology continuing education
 01/05 Town Hall meeting 0.5
 01/13 Epidemiology conference 1.0
 01/20 Epidemiology of Candidemia 1.0
 01/25 Infection Control 1.0
 Total 3.5

Total attendance at CE and staff meetings, 1989: 7.3 hrs.

Implementing the computerized tracking system involved a relatively smooth transition period. Looking back, if we had had a better understanding of the type of reports needed, we might have designed the CE tracking system more effectively. The original goal was simply to produce an annual report for the CME conferences. As the design progressed, however, it became apparent that we could easily adapt the system to include other features.

The college of medicine, which coordinates CME records, has established a fixed format for all such reports. This requirement dictated the form our reports would take. The ability to record an employee's time away from the bench to attend staff meetings for workload recording purposes grew naturally from the individual reporting function. The system is flexible enough to be modified for future needs without starting from scratch. * Expanding. The work group began two other projects to improve communication of CE information: a newsletter and a communication network.

The newsletter's original function was to give all personnel a list of current and future in-service programs available within the department. It also listed CE programs open to personnel outside the sponsoring area and explained how to register for them.

The first newsletter was published three months after the work group was established. The first edition contained articles on the formation and goals of the committee and on the importance of CE. It also included a form for recording program attendance and a list of all CE coordinators in the pathology department.

The next newsletter again discussed the importance of continuing education and listed several non-traditional forms of CE - books, software packages, videotapes, and self-study materials - available within the department. * Smoothing the bumps. Although the newsletter filled our needs, it also presented some problems. At first, for example, it was distributed only to supervisors, with the expectation that they would pass the information along. Yet the work group learned that the information was not reaching the staff. This dilemma was easily resolved by delivering the newsletter to each staff member. While this involved additional cost and effort, we felt that it was worth the trouble.

Time and energy created the second problem. The newsletter was a resourceful tool in our endeavor to inform, but it entailed considerable work. Pathology solved this problem by forming a work group whose sole purpose was to publish a departmental newsletter. The CE work group simply incorporated its information into this publication.

A network of CE contacts from each area further improved the departmental communication efforts. These representatives are notified about programs in different areas that are open to other staff members. The communication network coordinator (a member of the work group) sends the messages via electronic mail.

The CE contacts, in turn, notify the coordinator of any upcoming CE meetings in their areas that might be of interest to those from other sections. CE contacts are also invited to participate in work group meetings. They receive a copy of the minutes and serve as liaisons to other staff members. * A step further. With the documentation and communication systems up and running, the group was ready to focus on the seventh objective: to provide pertinent, non-technical programming for all staff members throughout the department.

We accomplished this by holding quarterly continuing education weeks. Each CE Week features three or four different presentations, with some offered more than once so that more employees can attend. The first continuing education week was scheduled for January to break up the midwinter doldrums. We have presented such seasonal topics as infection control and stress management in January and travelers' diseases in July.

Figure III lists the steps and timetable for developing the department's CE Weeks. The CE contacts and supervisors in each area offered programming suggestions. A form in the second newsletter enabled staff members to make requests. CE contacts also helped us arrive at the best time and day of the week. Programs last about one hour and are usually offered at 8:15 a.m. and 3 p.m. or at noon and 3 p.m. to try to reach staff members on all three shifts.

PHOTO : Figure III

Developing a CE Week

Time needed before
presentation date Task
Eight weeks Define programs
Eight weeks Determine days and
 times for presentations
Eight weeks Invite speakers
Six weeks Locate and schedule
Six weeks Develop advertising
Four weeks Send advertising
 to all personnel
 (electronic bulletin
 board, flyers,
Four weeks Develop evaluation form
Four weeks Confirm speakers
One week Find moderators to keep
 attendance sheets,
 collect evaluations,
 introduce speakers

At the end of each presentation, evaluation forms were distributed to the participants so we could get their input on that lecture and ideas for future ones.

Attendance was encouraging. Even with a CAP inspection scheduled the same week, 110 of 450 (24 per cent) staff members attended presentations during the department's first CE Week. Sixteen came from areas that did not hold regular CE programs. The most popular programs turned out to be "Dealing with Difficult People" and "Infection Control."

Although programs were well accepted, there were initial problems. One suggestion was to allow more time for discussion and to practice new techniques. Now we ask speakers to lecture for 30 to 40 minutes and to let staff members participate during the rest of the hour.

Another problem evolved in the scheduling of the room. Some participants had trouble finding the right meeting room, especially when room assignments were changed on short notice. On one occasion, the room reserved for a lunch-hour presentation had an enforced no-eating-or-drinking policy - inconvenient for busy staff members who had to return to the lab immediately. To solve these dilemmas, we began holding all CE Week presentations in the same room - where eating is allowed - even though it is located farther from the major labs. * The ideas keep coming. Another project completed during the first 18 months involved coordinating a one-day off-site seminar on team building. This was presented by a college of business faculty member and was open to all departmental supervisory personnel. The work group also drafted a proposed budget for departmental CE and published a continuously updated list of local, regional, and national CE opportunities on a monthly basis. The supervisor of each lab chooses which staff members to send to these outside CE programs.

An offshoot of the CE recordkeeping database is a system that lists upcoming opportunities for continuing education. There was no shortage of information about conferences and workshops, but individual faculty and staff members didn't have the time or means to convey this news to the rest of the department. This information is now forwarded to one office, the pathology learning center, which uses the computer documentation system to produce a summary sheet of CE data that is distributed to the staff and published in the department newsletter.

This listing includes session or conference titles, meeting date(s), location, cost, registration deadlines, and a brief summary of the program. Programs are listed chronologically by registration deadline dates. The detailed information and registration forms for the conferences are kept in the learning center office, which provides a copy of the listing on request.

The system has done a good job of informing the department staff about upcoming formal continuing education opportunities. Surprisingly, no major problems have surfaced.

While our work group feels it has accomplished many of its objectives - and has learned much about departmental CE documentation analysis. Figure II showre is much more we hope to do. In particular, individual staff commitment to a regular, documented CE program ranges from nonchalance to enthusiasm and must be continually nurtured. A departmental policy statement supporting individual and group CE activities was suggested and approved. A request from staff members that participation in CE be made a part of the performance evaluation system was included in the CE policy statement sent to the department administration by the work group and is under consideration.

Meanwhile, the work group will continue to evaluate the CE needs of our department. Our dual goal is to seek innovative new programs while maintaining the high level of CE activities we have already established.

(1.) Becan-McBride, K. "Textbook of Clinical Laboratory Supervision," pp. 261-271. New York, Appleton-Century-Crofts, 1982.

(2.) Yapit, M.K. Resources and strategies for a successful continuing education program. MLO 21(4): 47-56, April 1989.

(3.) Schaupp, D.L., and Parsons, B.L. Employee-involvement work group. In: Snyder, J.R., and Senhauser, D.A., eds. "Administration and Supervision in Laboratory Medicine," 2nd ed., pp. 123-136. Philadelphia, J.B. Lippincott, 1989.

(4.) Cummings, O. Comparison of three algorithms for analyzing questionnaire type needs assessment data to establish need priorities. J. Instr. Dev. 8(2): 11-16, March 1985.

(5.) Goldstein, I. "Training in Organizations: Needs Assessment, Development, and Evaluations." Monterey, Calif., Brooks/Cole, 1986. (6.) Steadham, S. Learning to select a needs assessment strategy. Training Dev. J. 34(1): 56-81, 1980.
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Article Details
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Author:Schwabbauer, Marian
Publication:Medical Laboratory Observer
Date:Apr 1, 1990
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