Learning By Doing: A Model That Works in EHR Training-Breakaway Thinking

I didn’t learn to change the oil in my car until I changed it. My father instructed me a dozen times, and I watched him a dozen more, but it wouldn’t resonate until I got my hands dirty. I can count an endless number of other tasks that never stuck with me after reading about them in a textbook or hearing about them in a classroom. Some things I need to learn by doing; and I’m not alone.

Why is changing oil different from learning about the Roman Empire? Even years after taking history in college, I still know the story of Romulus and Remus. I can tell that story with the help of a knowledgeable friend, someone to nudge me along as I weave through a non-linear narrative. But when you’re changing oil, you can’t begin at the end, jump to the start, and then fill in the middle details. It’s a linear task with a clear beginning and end, and the workflow impacts the outcome. Changing the oil in a car isn’t life-or-death, but placing an order in an electronic health record (EHR) does impact the lives of patients.

For decades, healthcare has relied on Instructor-Led Training, or ILT, as its answer to education. More hours in the classroom equals a more informed and prepared workforce. It’s the same model supported by our nation’s education system. This would be fine, except that the learning outcomes are vastly different. Where a history class, for instance, aims to teach learners to know something, a hospital class aims to teach learners to know how to do something. Clinicians enrolled in a three-day training session must emerge with the ability to place a medication order using the EHR—a single task that may require upwards of 30 clicks on the computer.