Carol A. Jahn, BSDH, RDH
As both a student and a teacher of continuing education, I find nothing more desirable than to attend a course whose participants are enthusiastic and excited about learning. I believe that a ready learner (in both presenter and participant) is fundamental for learning to take place. However, attempting to link learning to work performance is difficult and fraught with complexities and complications.
Reflect for a few minutes on how you, as an accountable practitioner, try to incorporate new knowledge into your practice setting. Depending on the culture of your organization, doing this may be rewarding or it could be a frustrating situation. More than likely, your job satisfaction is directly influenced by the ability or inability to introduce new information into your work environment.
In a 1987 study by Warmuth, nurses identified their work environment as being three times more likely to discourage using continuing education than encouraging it. This perception is often described by dental hygienists who attend continuing education courses. Almost everyone has rushed back to the office full of enthusiasm for something new, only to have their hopes dashed by employers or other staff members. The staff who didn`t go to the course often denigrate the concept or refuse to purchase needed equipment.
Or, just as demoralizing, you are told to do whatever you want but can`t get support for your efforts.
What then is the relationship to competency? If you have just learned new information about the link between cardiovascular disease and periodontal disease and want to share it - but are discouraged from doing so because it might alarm patients - how then to evaluate the learning/competency link? Clearly, measurement of knowledge gained, as well as workplace changes, must be evaluated.
Just as those of us in health care struggle with this issue, so does business and industry. In 1996, for example, industry experts grappled with assessing the effects of training on workplace performance. The three-part series in Training and Development magazine also studied how and if the "bottom line" is increased after training, as well as determining the total return on investment that training provides.
The answers are still murky. Was it really the time/practice management seminar that increased productivity in the department or was it the temporary help that was hired during the busy season?
Despite these difficulties in outcome assessment, Laurie Bassi, vice president of research for the American Society of Training and Development, states that "most organizations believe that workplace training and development are becoming increasingly critical to their success." In fact, in a paradigm shift, money spent towards education and training is being redefined from an expenditure to an investment in human capital.
Can we generalize these benefits to oral health care professionals? Given our present structure, I do not think we can. In my opinion, business and industry have a greater commitment to education. With rapidly changing technology, continual improvement is a recognized way of life - valued by the organization`s culture. Being able to respond quickly to environmental changes is a necessity. How do they accomplish this? By ensuring everyone is on board. Would a company send its manager to a seminar and then rely on that person to disseminate the knowledge to the entire division? Not likely. Everyone goes, or, better yet, the presenter comes to the division for on-site training, making it easier on employees, as well as saving on costs.
This is contrary to what often happens in dentistry. During the more than 20 courses which I gave last year, it was a rarity to find an entire office in attendance. The single participant who wants to take new and valued information back to the office and try to incorporate it faces a difficult situation. Does the employer and other staff members hear the research? The case studies? The supporting evidence and information supplied by other learners? Since the answer is obviously no, how can we expect them to have the same reaction as the person who actually attended the course? And how, then, can we expect to see a consistent linkage between what we learn and what we do?
What does this mean for continuing education and its role in competency? While determining causality between the two would be difficult at best, I believe there is at least an association between continuing education and competency.
Attending courses are social as well as learning events. Viewing the presenter as a facilitator of knowledge, instead of the expert, opens up many avenues for learning which can occur at or after a continuing education course. For example, perhaps it was the comments of a fellow participant which had the most impact. Maybe it was something someone discussed during the break. Or, perhaps you were uncomfortable with the information presented. But when the latest dental hygiene journal arrives two days later and an article inside supports the course material, it makes you search for more information. Or maybe as you listen to the presentation, you realize your philosophies of practice do not match up with where you work. So you seek employment where you do have the opportunity to become a more competent practitioner.
Not every course will be meaningful to every individual. But that reflects more on our capitalistic society than indicating a real defect in continuing education. As professionals, we make choices for continuing education based on our own value system. Some will go for the best price, some for the best location, some are drawn by the speaker`s reputation, and others for the course content.
The tendency of human nature is to choose a course we think we will like as opposed to one which may fill a real need. In other words, if we are interested in periodontology, we search for perio courses. We search for perio even though we are acutely aware that our X-rays need improvement, and a radiology course may be more appropriate.
Providers also need to assume some responsibility for course outcome. The setting or room can have a definite impact on our aptitude for learning. Ask anyone who has ever sat next to the slide projector in a room where the lights could only be off or on (not dimmed) and where the temperature was way too cold. At minimum, most organizations require a vitae, course description, and objectives before approving courses. Nationally recognized provider programs, such as ADA CERP or AGD NSAP have more stringent guidelines in place that recognized sponsors such as universities, professional associations, and corporations must follow. One component of selecting a quality course is to choose from providers who adhere to the guidelines.
Learning is very personal. Just ask any presenter who is reviewing his or her course evaluations. The varying responses will make the speaker wonder if the audience attended the same course. That is one reason it makes the outcome very difficult to measure; not just in terms of competency but for providers in terms of quality as well. It is an impossible task to have the same impact on every member of the audience. Yet, quality encompasses more than just the speaker. Both the provider and the learner must bear an equal share of the burden.
Learning is about change and growth. For most, this change is not linear, but a constant loop of learning and evaluation. I believe continuing education plays an important role in our professional lives. Perhaps viewed over the 16 years I have been practicing, the sum of this knowledge is probably greater than any of the parts. Take away continuing education and you remove a very important component in our learning.
Carol A. Jahn, BSDH, RDH, is an educational representative for Teledyne Water Pik. She is based in Warrenville, Ill., and can be contacted at [email protected].
