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Saturday, August 01, 2009

Coming Full Circle

As noted previously in my blog, this winter I had an opportunity to work as an EMR trainer for a new hospital in our county. Before that I worked for two years at a local not-for-profit agency as their Grants and Compliance Specialist during which time I designed a grant reports tickler system to keep the agency compliant and our grantors happy. I enjoyed my job at the agency. The impetus to change occurred solely because of healthcare. In January insurance rates doubled - and I knew I would either have to find a second job, or find another job with more affordable benefits. I felt incredibly fortunate when the EMR trainer opportunity came along.

Unexpectedly, the position lasted only 8 weeks and I found myself in the unemployment line after several years of gainful employment. Even so working with the EMR was a great learning experience and opportunity to round out an area of my professional development - namely training and presentation skills (and learning an EMR). I ended up writing a four part series on Training the EMR. Another really cool thing is that recently I had an opportunity to bring what I learned back to the agency when they had me return to train my replacement.

I find it interesting to compare the two different training situations. In one I was learning how to teach clinicians the EMR. In the other, I was training the new Grants and Compliance Specialist how to use SharePoint in the context of the tickler system I had designed. The differences? Well for one thing, even though I'd been away from SharePoint, the tickler system, and the Grant report work flow for a while, I designed that system. I cleared the first path through the forest - so I know it from the inside out. Whereas with the EMR, I had to learn it in the reverse - from the outside in.

The similarities? Well, Adult Learning Theory still applies. And both scenarios are pioneering situations. People have to observe and analyze and pay attention to detail - and fortunately for the agency, their new Grants and Compliance Specialist is exceptionally good at it. People also have to be somewhat willing to wing it and to be experimental. Which is a little different from the mastery, expert, instructor-lead approach expected at the hospital. So let's go back to to the differences between the two training situations. Technology adoption - in the agency's case, empowering someone else with SharePoint in a way that they can take that ball and run with it - are able to maintain and improve applications they did not create, train others, and transfer knowledge to other applications not yet thought of - is not something you can teach someone in an expert way - for instance, the way we were expected to teach the EMR at the hospital. It's more like putting your heads together, engaging in give and take and having both people coming up with pieces of the puzzle when a real incentive exists to do that. Equals and partners as Adult Learning Theory says. For instance today, I had my replacement's brain to help me with SharePoint quirks, whereas when I was designing it, I had to bang my head against the wall all by myself because I had no one to talk to.

So what did I bring back to the agency from my training experience at the hospital? Well, thinking back, those traveling consultants at the hospital were darn good trainers. And I have always been a darn good student. I'm going to veer off course for a little rant here - probably not a good idea, but it is my blog, and it is therapeutic. :)

Begin rant.

I honestly believe the trainers could have gotten me up and training if our boss had approached his role as a true educator rather than as a reality tv-show judge . What do I mean by that? Entrusting me to expensive and talented resources to train me for six weeks, but then derailing the whole process by demanding a training demo before we were ready, and on top of that instituting full disciplinary action (of all things) against me because he felt I lacked polish in the demo - when I had been working really hard to learn it all and my trainers appeared quite satisfied with our progress to date. So if he was going to abandon traditional educational practice in favor of "newer," experimental approaches, he should have at least provided full disclosure during the interview process - like they are supposed to do in the reality tv shows - in which case I might not have taken the job and would still have a job. Ironically one of things I mentioned in the interview when he asked what I was looking for in a job was "stability." (Remember, I was leaving a job I liked because I could no longer afford health care.) And then to be denied unemployment compensation for going on four months is pretty unconscionable for an organization whose mission is to improve community life, improve community health, and be considered a premiere employer in the area. My physician of twenty years is employed by that organization and this spring wanted me to come back in for a blood pressure check because it's been running a little high. It's now approaching fall and I'm still trying to work up the enthusiasm to go back there because I'm not looking forward to having to explain to her why I'm no longer working for her organization. One thing about being part of the aging workforce in a technological society - if you lose your job, it's hard to find a comparable opportunity these days, let alone advancement. Even if you are willing to travel. Our work experience and education instead of being valued is considered outdated. In a sense it is both (valuable and outdated). It is outdated in the sense that technology changes rapidly. It is valuable in that it provides a scaffold which accelerates the process of building new knowledge and skills - rather than having to start from scratch. But even though we are a technologically advanced society, life's quirks and injustices still come into play along the traditional lines. The problem with technology degrees is that (despite the claims of the professors and the universities who make huge amounts of money off providing them) they go out of date as fast as that new computer you just pulled out of the box. They are considered obsolete before most people can even pay off the loans for their college education - and while the underlying skills they provide should equip an individual for life-long learning and service in their field, the opportunities to keep oneself updated still fall out among traditional categories of discrimination - race, gender, age ...etc. I've now been knocked back on my a__ twice and had to work my way back. It takes time. And huge amounts of money. And I'm no longer in my thirties or even my forties. I feel like I'm running out of time.

Okay, end rant.
Back to the subject at hand. After I returned to the agency to train the new Grants and Compliance Specialist, I often thought about what my mentor at the hospital said about it being my classroom and taking charge of it - even though the student is very actively participating in their own training. I also thought a lot about my boss's "Guiding the Eye" principle - and how to adapt that to my teaching style using a constructivist approach. I reasoned I could turn locating and recognizing objects on the computer screen into a treasure hunt. By that I mean if I didn't have a pointer, or didn't choose to point with my pencil, I could guide my student's eye with descriptive language or even use hints, like the games my grandchildren play - "What I spy with my little eye" - and "Hot and Cold." Then after my student locates the object on the screen, she and I could discuss what it is. She could help me name it and we could agree on what to call it so that we develop a common language - with an eye to rolling that language out to others as they come on board.

I remembered how effective my mentor at the hospital was at jogging my memory with review questions after we had covered a lot of new material. Thinking back to the teaching and learning strategies course I took for my masters in Educational Technology, I realized that my mentor's questioning and reviewing approach truly did help me learn and retain the material better -so I adopted that approach when I returned to the agency to train my replacement.

I also remembered my mentor's suggestions and feedback - she would always exclaimed "Good(!)" or "Perfect(!)" when I did something right, providing positive reinforcement. So I incorporated that into my training approach. Actually my replacement came up with her own feedback today when she observed that she was really beginning to learn her way around SharePoint. For her that was a revelation. (The trainers at the hospital often talked about leading their students to the "aha moment.") So these are some of the things I was able to bring back to the agency from my training at the hospital.

For my part, working at the agency as a trainer - rather than in my previous role with them - helped me realize how much I enjoy the social aspect of "teaching at the elbow," as the hospital termed it. It makes me feel much more comfortable and included in the workplace than working alone and isolated, although I still really like to analyze and design. But it's hard to design and get buy-in in a vacuum. And it's so great to have two heads to work on a problem - so you don't just feel like you're shooting in the dark. Coming back to the agency to train my replacement also helped me realize that I did get good training at the hospital - and that helps me know what to say at future interviews.

Even tho the hospital job was cut short, I got some really good training - and I was trained by some really good people, and I took those techniques and that learning back to my previous employer and used it to train their employees in SharePoint, which like Cerner, can be very technical. And even if the boss at the hospital didn't like my training style or whatever, he was correct in his initial assessment of me. Which is that I have an established track record of helping people adopt, and use, and leverage technology successfully and happily. I have been recognized as being good with at the elbow support and small group training for many years. That is why I was comfortable going with the hospital - they made the job offer in a way that I felt that they "knew" me, and I "knew" them - because we had all been there before.

Yes, looking back, I think that the consultant trainers at the hospital and I could have gotten the job done. They were good trainers. I was a good student. I remember when my mentor and others were teaching, I was paying attention to content (learning the content) AND to the teaching techniques and strategies of the trainer. And I was trying to connect it all back to my education and previous work experience. I don't think I was doing anything wrong. And I was flexible - when I was asked to change my approach, I did. I really appreciated the opportunity and the skills of the people I was working with, and I changed and adapted to maximize benefits of being around those folks. So those are all things I can say about that experience if I ever get to discuss it in an interview again.

And it strikes me that by sitting around and confabbing with my coworkers at the agency and listening to them discuss work flow, I was doing a lot what the trainers were doing with their units at the hospital. And that was another cool insight for me.


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