Proper Way to Train

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I'm old school in my understanding of training.
There is no right or wrong way to train and to be honest, I should ask my lab director this question but I wanted to hear from this group.

I'm training our anesthesiologists how to use the GEM 7000 which is usually in a group setting.
I created a powerpoint slide and then I have the anesthesiologist run samples and trouble shoot the device and then I sign them off.

I have limited time since the anesthesiologists usually have to run off to the OR.
One of the director suggested that I give the anesthesiologists the slides ahead of time, have them review it and just jump into the hands-on training.
I don't know why, but this doesn't sit right with me.

My standard approach has always been to deliver a lecture or presentation followed by hands-on training. If the lecture component is omitted, there is no assurance that participants have reviewed or fully understood the material. While the GEM analyzers are straightforward - I can demonstrate operation in approximately 2 minutes and basic troubleshooting in 5 - the presentation covers all SOP-required elements, including the test’s purpose, proper operation, collection, troubleshooting, limitations, and pre-analytical errors etc.

If I skip the lecture and assume they read through it, they will just drop in, run a test or two, do the quiz and leave. This would take maybe 10 minutes.
Would you call this training?
Is that appropriate? Is my thinking wrong? 

7 Replies

Hi Jo,
  I, too, train anesthesiologists to perform blood gas and while I structure their training to "meet them where they are" (i.e., having very limited time and anxious to return to patient duties), I do not skip the explanatory material/lecture but I dedicate fully to keeping it as brief as possible and sticking to points that matter most to them, like the relationship of good testing to better patient outcomes.  I take a bit more time to do initial training with new hires, but for annual renewal/competency, it is probably a 5-10 minute run down (probably closer to 5), having them run a sample/QC and do the written exam, which adds another 5" maybe.  I would not permit omitting even the brief lecture.  Your hunch is absolutely right; the option to review the material/slides ahead of time translates to they would very likely not review them at all and just do the minimum of meeting with you to perform the tasks.  I would not opt for them to review slides in your presence however, I don't think many would do that.  I would simply deliver the material verbally, albeit succinctly.

We have a robust user population that is very diverse in professional roles. You would, at minimum, be required to follow your institutions policy on training. If you are accredited, you would be required to have a policy on that. For instance, our policy outlines:  1. Collection, transportation and disposal of specimens 2. Quality control requirements 3. Step by step procedures, to be read in full. 4. Recording results 5. Interpretation of results 6. Troubleshooting 7. Maintenance of equipment. But...if the person I was training would not ever be responsible for maintenance or troubleshooting; I would not train to that specifically and document that it was not trained to them and why on their retained training document. 

If they would be responsible for et al...then they get trained on et al. How you relay it to them may differ. In the end you need to ensure that you gave them the information and that it was appropriate for them to test patients. It would also be prudent to think about what comes next. Would what you give them today be enough for them to pass competency with the 6 elements? Cutting corners now could be risky to both patient care and compliance.

My thoughts on this are that title does not exclude an individual from the type of training that other testing personnel will receive in order to be deemed properly trained and able to demonstrate competency. Having a standardized training "script" allows POC assurance that all pertinent information is being conveyed to the individual that will soon be performing testing on patients. You may try adjusting your training sessions to accommodate the title, but I won't recommend adjusting the training material. 

HI Jo and James,
I agree with James. Do not omit the PP slides. Maybe allow them opportunity to review the slides before the training but still go through the lecture. I am sure they did not rush through med school.

You all make great points. I really should not make exceptions to proper training. Thank you all!

I had Anes MD group wanted to start doing iSTAT due to shortage of CRNA's. You need to set your requirements up front, if you need to perform this testing, then this is what will need to happen--period. Transparency works well for them, tell them time of class (45 min for our initial class), must stay the entire time, and will need to come back for recert at 6 months and then again at 1 year to close the loop. Once they understood what needed to be accomplished, they turned out to be a great group to work with.  I made then all bring them their diploma to class, they were all very excited to bring in a photocopy or email :) They actually enjoyed the class, asked a lot of great questions and I got to learn from them as well. Everyone likes to talk about the exciting things they do when giving an opportunity to do so. I scheduled their classes at 7am on Wednesdays when we have cases that start late.  We are fortunate that we found two CRNA's that qualified as a TC and they help with recertification.

I was hesitant at first, they had a cranky reputation but turned out they had similar issues we have in the lab and were grateful for someone to listen to their needs and help them deliver great quality patient care and improve their workflow.  Point of Care has been very rewarding-- bringing the village together for the common good.









I've had to train people across all levels of education (even some MDs!) for POCT. The rule is this: everyone gets the same training, regardless of their credentials or education. Same for rehires (after a year) and agency hires. Everyone gets the same training, to maintain uniformity. No shortcuts.

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