COMMON QUESTION for ALL TEAMS, by Allison Rossett

Will was surprised when he got an email requesting his presence in Marcia's office. When he gave her the document, Marcia had thumbed through it, read the exec summary and turned right to the recommendations. She'd nodded with satisfaction.

So Will figured he was finito with that project. No problem if she wants to chat, he thought to himself, noting that he and Marcia were real tight.

Marcia wasn't alone when he was eventually shown into her office. Sitting at her large conference table was a woman who looked vaguely familiar, but he couldn't place her. She had a copy of his assessment in front of her.

Marcia said, "This is Dr. Gwen von Hinghis. Gwen heads up Education, Training, Technology and Performance Systems for headquarters in Chicago. You've probably heard about their brilliant work on EPSS for customer service. Gwen made all that happen and the CEO has come to depend upon her. Maybe you've seen her articles in professional journals? I asked her take a peek at your needs assessment. I knew you wouldn't mind."

Gwen got right to the point: "Well, Will, I can see what you were driving at here and I appreciate the array of sources you tapped, but I think you kind of let the people at Cadaceus run the needs assessment and dump what they wanted on you. They expressed joy and sorrow about Roberta, but I don't think you got all the information you need. And if you're going to do much training, did you get at what it is that different employees need to know and be concerned about? To create all that training, bet you'd have to do still another needs assessment.

Marcia tells me you're a recent PhD so I'm surprised that your inquiry doesn't reflect more cognitive and constructivist perspectives. Surely that makes a difference in needs assessment, don't you think? Could you take another whack at it with some of this in mind? I know that Marcia will appreciate it, and I will too.

This thing has to be right, you know. We're eager to see where you get to. Right, Marcia?"

Will was stunned. He'd enjoyed nothing but kudos in his career, and now this. Well, he was going to think about it and tackle it. Where could he turn for help? He had a little money for consultation...

Help Will. Strengthen his study in ways that reflect your opinions of what he did and didn't do PLUS Gwen's concerns.

SPECIFIC QUESTION for PSU TEAM, by Peg Ertmer

"Good afternoon, Will. Welcome to Chicago and to our corporate offices. Let me get right to the point. Although Marcia has tentatively approved your plan, I have some real concerns. You have suggested some very expensive and time-consuming solutions. I am not really convinced that so much training and re-training is needed. I looked at those directions for using the RBA and they seemed fairly simple to me. Which of these training solutions can you truly justify? Even your non-instructional solutions seem expensive--come on--do you really expect the hospital to sponsor social functions?? I hope you can suggest ways that we can keep our costs down and still achieve the results we desire. Judging from the quality of your original report, I am convinced you can come up with a more cost-effective solution. Please reconsider which of your training recommendations are essential and which can be handled in other ways. I expect a revised list of recommendations by the 18th. I'm sure you will not disappoint me."

There was a concern that I (Will-lead instructional designer for Cadaceus) let Cadaceus run the needs assessment, that different employees needs were not adequately uncovered and that there was a need to incorporate cognitive and constructivist perspectives as part of our instructional goals.

Summary of Specific Question

My solutions were considered to be too expensive and time-consuming. There was a question if training and re-training was really necessary due to the simple nature of the RBA instructions. A revised list of solutions was requested.

The common question asks me to address the broad question regarding the effectiveness of my knowledge acquisition strategy and methodology. The specific question asks me to provide a scaled-down set of solutions. These questions pose opposite concerns. Reframing the original needs assessment by utilizing the suggestions in the common question will yield solutions aligned with the concerns of the specific question. The needs assessment also revealed additional issues such as teamwork and communication which are essential to quality patient care. My response addresses the dual concerns of both questions in terms of specific training, as well as attention to these fundamental issues.

My original proposal included a formative evaluation of initial training within a service team. One of the purposes of this evaluation was to identify causes of RBA failure which were not identified in the original needs assessment. I now propose streamlining this initial training session and expanding the knowledge acquisition process. I will observe master performers as they conduct training. They will be using current instruction with minor modifications to meet the needs of the team environment. I plan to assess this process in conjunction with a cognitive task analysis. The analysis will identify the set of RBA tasks which result in performance deficiencies. Identification and analysis will include documentation of the RBA work flow and clarification of RBA related job responsibilities within the team framework. This user-centered assessment methodology provides instruction consistent with the constructivist perspective.

Careful analysis of my instructional solutions reveal that they provide cost-effective benefits by utilizing existing teams, the services of RoboMedic and existing master performers. The use of the team-centered approach addresses both the issue of cost and the focus on individual needs. A qualitative cost-benefit analysis is provided below.

Cost-Benefit Analysis of Solutions-Immediate Solutions Specific to RBA Usage

Assure Quality Standardized Training

As stated in the first needs assessment, analysis of past RBA usage does not indicate if out of range readings are due to human error, technical problems, or unavoidable problems with blood samples. Moreover, current training is conducted on an adhoc basis and the initial needs assessment has revealed uncertainty among a range of users.

• Costs:
  • Results from the formative evaluation from these initial training sessions may point to streamlining and other cost-savings for future training
  • Costs will be minimized by using master performers from currently established teams

• Benefits:
  • Initial training will establish precise data on RBA usage
  • Establishing certification will guarantee quality control necessary for critical medical equipment such as the RBA

Implementation of training in teams rather than per position

• Costs:
  • Less costly than mass training outside of service area
  • Savings from using master performers from within service teams as trainers

• Benefits:
  • Service team members will understand each others' roles and responsibilities
  • Cross-training leads to efficient implementation --Policies regarding RBA usage can be adapted to specific team needs.

Require liaison between RoboMedic and hospital concerning future redesigns

• Costs:
  • No cost to Cadaceus

• Benefits:
  • Will prevent unnecessary software changes which confuse employees
  • Creates source for future improvement which Cadaceus will oversee

Develop tutorials so that all staff can practice on multimedia computers

• Costs:
  • Necessary authoring program, multimedia computers infrastructure exists
  • Mock up of RBA interface with common interactions can be easily designed in-house
• Benefits:
  • Reinforcement of team training sessions --Training for software updates and new employees

Rewrite instructions included with RBA (new job aid)

• Costs:
  • No cost, can be done within design department Benefits:
  • Reduce errors made by staff by providing feedback on key features of interface

Cost-Benefit Analysis of Solutions-Long-Term Solutions to Promote Quality Care:

Focus groups to establish teamwork and employee empowerment

• Costs:
  • Minimal costs, teams already established through hospital restructuring
  • Cost savings resulting from suggestions which may streamline hospital procedures

• Benefits:
  • Better patient care through more effective teamwork
  • Providing "customer satisfaction" meets the need for financial success and stability

Promote the value of RBAs among the staff

• Costs:
  • Minimal cost to Cadaceus, conducted in concert with RoboMedic

• Benefits:
  • Will clarify value of RBAs in terms of patient care rather than financial savings

Align compensation and other rewards with the new hospital organization
Financially compensate staff for training sessions

• Costs:
  • These proposals represent the most significant financial investment of all the proposals
  • These proposals are supportive of the main solutions, but are not required for immediate implementation

• Benefits:
  • Will increase the effectiveness of training and team service concept

Provide incentives such as certificates, lunches, preferred parking spaces, picture on wall
Offer hospital sponsored social functions for teams and have a suggestion/complaint box

• Costs:
  • This proposal aligns currently supported functions within the service-team organization rather than by the more traditional occupational hierarchy
  • Minimal costs

• Benefits:
  • Will increase the effectiveness of training and team service concept without the expenses of restructured compensation strategies

The following solutions would be implemented only if initial formative evaluation demonstrates that interface design is a critical problem:

• Include an error message that alerts users to a machine malfunction
• Provide a better back up system for the robots when power fails
• Have robot automatically print a hard copy
• Redesign the RBA screen display to cut the chances of human error in entering the most important information (temperature and oxygen)
• Provide embedded instruction with new design

• Costs:
  • No cost to Cadaceus, redesign performed by RoboMedic per requirements from design team

• Benefits:
  • Could provide long-term solution which addresses both the need for software updates and training as needed