Design and implementation of an online graduate program in health administration: an academic director's lessons from the field

The rapid growth of technology-mediated distance learning has prompted a number of health management programs to consider an online degree program as part of their portfolio. As online distance learning degree components figure more prominently into the strategic future of some programs, it becomes increasingly important for those who are guiding this process to understand certain common design and implementation issues. From inception to design to implementation, the program's academic leadership faces a sequence of decisions and issues that can have profound effects on the quality and marketability of the program. Technology-mediated learning has enormous potential in providing students who ordinarily might not be able to earn a graduate degree the opportunity to pursue a graduate education. However, the unique nature of technology-mediated learning presents a number of different strategic academic design and implementation issues. This article describes one program's experience in steering through the uncharted design and implementation waters of a new Internet-based graduate health management degree program and provides insights that could be helpful to colleagues considering similar initiatives.     

Physician communities of practice: where learning and practice are inseparable

Physicians interact with peers and mentors to frame issues, brainstorm, validate and share information, make decisions, and create management protocols, all of which contribute to learning in practice. It is likely that working together in this way creates the best environment for learning that enhances professional practice and professional judgment. So convincing are the arguments for this view that management practices already are changing to foster the integration of learning and practice. This article describes a program of research that is planned to assess the effectiveness of information and communication technologies that purport to support and enhance learning in practice.     

Experiential learning in health administration: a new approach for new times

A balance of experiential and didactic learning is essential to develop managers and leaders for early and mid-career positions in the healthcare administration profession. This article suggests pedagogical methods that enhance experiential learning. It also recognizes the need for a renewed focus on diverse experiential learning opportunities, management and preceptor development programs, and graduate program partnerships.     

Competency-based healthcare management education: the Saint Louis University experience

As a follow up to a school-wide initiative to create a common set of competencies for all degree programs in the Saint Louis University School of Public Health, in January 2000 the Department of Health Management and Policy (HMP, renamed from the Department of Health Administration in 2002) began a process to develop a competency-based curriculum for its Master of Health Administration (MHA) degree program with the goal of establishing a foundation for systematically measuring the learning outcomes of its students as they progressed through the program. This article describes how the department developed a set of competencies most appropriate for graduate training in healthcare management, how it incorporated these into its overall MHA program curriculum and content, and how effective this approach has been in measuring student progress in mastering these competencies over the first two years of this initiative. The problems and challenges encountered during this process are discussed, as are the next steps for effectively using competencies to assess healthcare management program learning outcomes. Our experience provides a model for other healthcare management programs considering using an outcomes approach for curriculum development and assessment.     

Neonatal health program management in a resource‐constrained setting in rural Uttar Pradesh,India

This analysis identifies salient features of team management that were critical to the efficiency of program implementation and the effectiveness of behavior change management to promote essential newborn care practices in Uttar Pradesh, India. In May 2003, the Johns Hopkins Bloomberg School of Public Health and King George Medical University initiated a cluster‐randomized, controlled neonatal health research program. In less than 2 years, the trial demonstrated rapid adoption of several evidence‐based newborn care practices and a substantial reduction in neonatal mortality in intervention clusters. Existing literature involving research program management in resource‐constrained areas of developing countries is limited and fails to provide models for team organization and empowerment. The neonatal research project examined in this paper developed a unique management strategy that provides an effective blueprint for future projects. Transferable learning points from the project include emphasizing a common vision, utilizing a live‐in field site office, prioritizing character and potential in the hiring process, implementing a learning‐by‐doing training program, creating tiers of staff recognition, encouraging staff autonomy, ensuring a broad staff knowledge base to seamlessly handle absences, and maintaining the flexibility to change partnerships or strategies. Copyright © 2009 John Wiley & Sons, Ltd.     

Designing Web-based telemedicine training for military health care providers

BACKGROUND: The purpose of the study was to ascertain those learning objectives that will initiate increased use of telemedicine by military health care providers. Telemedicine is increasingly moving to the center of the health care industry's service offerings. As this migration occurs, health professionals will require training for proper and effective change management. The United States Department of Defense (DoD) is embracing the use of telemedicine and wishes to use Web-based training as a tool for effective change management to increase use. This article summarizes the findings of an educational needs assessment of military health care providers for the creation of the DoD Web-based telemedicine training curriculum. METHODS: Forty-eight health care professionals were interviewed and surveyed to capture their opinions on what learning objectives a telemedicine training curriculum should include. RESULTS: Twenty learning objectives were found to be needed in a telemedicine training program. These 20 learning objectives were grouped into four learning clusters that formed the structure for the training program. In order of importance, the learning clusters were clinical, technical, organizational, and introduction to telemedicine. FINDINGS: From these clusters, five Web-based modules were created, with two addressing clinical learning needs and one for each of the other learning objective clusters.     

Constructing a conflict resolution program for health care

Resolving conflict throughout organizations requires a programmatic infrastructure and a committed management team. Leaders must recognize the need to approach conflict by building a format for learning, creating and managing an effective conflict management program. Careful attention to the elements of design and the stages of development can make all the difference in building a sustainable and useful conflict management approach.     

Problem-based learning versus lecture-based learning in postgraduate medical education

OBJECTIVES: The objective of this study was to investigate the effectiveness of problem-based learning in comparison with lecture-based learning in a postgraduate medical training program concerning the management of mental health problems for occupational health physicians. METHODS: A randomized controlled trial in 1999, with a mean follow-up of 14 months after the educational intervention, was used involving postgraduate medical education and training for occupational health physicians in The Netherlands, with 118 physicians in training as occupational health physicians. The experimental program was based on the principles of problem-based learning; the control program used the traditional lecture-based approach. Both programs were aimed at improving knowledge of and performance in the occupational management of work-related mental health problems. As the main outcome measures, knowledge tests consisting of true-or-false and open-answer questions and performance in practice based on self-reports and performance indicators were used. Satisfaction with the course was rated by the participants. RESULTS: In both groups, knowledge had increased equally directly after the programs and decreased equally after the follow-up. The gain in knowledge remained positive. The performance indicator scores also increased in both groups, but significantly more so in the problem-based group. The problem-based group was less satisfied with the course. CONCLUSIONS: Both forms of postgraduate medical training are effective. In spite of less favorable evaluations, the problem-based program appeared to be more effective than the lecture-based program in improving performance. Both programs, however, were equally effective in improving knowledge levels.     

Integrating school-based and therapeutic conflict management models at schools

Including children with emotional and behavioral needs in mainstream school systems leads to growing concern about the increasing number of violent and nonviolent conflicts. Schools must adapt to this evolution and adopt a more therapeutic dimension. This paper explores the possibility of integrating school-based and therapeutic conflict management models and compares two management models: a school-based conflict management program. Teaching Students To Be Peacemakers; and a therapeutic conflict management program, Life Space Crisis Intervention. The authors conclude that integration might be possible, but depends on establishing a positive school atmosphere, the central position of the teacher, and collaborative and social learning for pupils. Further implementation of integrated conflict management models can be considered but must be underpinned by appropriate scientific research.     

Reducing unmet needs: a prevocational medical training program in public health medicine and primary health care in remote Australia

OBJECTIVES: To describe the development and implementation of a prevocational medical training program in public health medicine and primary health care in remote Australia and to evaluate the program's adherence to adult learning principles. METHODS: Reports, funding applications and other relevant material relating to the program were reviewed to document learning objectives, and teaching and program implementation strategies. RESULTS: The 24-week program employs two prevocational medical practitioners each year and comprises four weeks at Fremantle Hospital's sexual health clinic followed by 20 weeks in the Kimberley. Curriculum objectives include clinical and public health aspects of sexually transmitted infection management, immunisation, clinical audit and quality improvement, primary health care in remote Aboriginal communities, oral and written presentation skills and working as part of an interdisciplinary team. Teaching strategies used were in accordance with adult learning principles. CONCLUSIONS: Prevocational medical training in public health medicine and primary health care in remote Australia is achievable and reduces current gaps in prevocational medical education.     

Design of training programs for a positive youth development program: Project P.A.T.H.S. in Hong Kong

To facilitate the implementation of the Secondary 1 to Secondary 3 program of the Project P.A.T.H.S. in Hong Kong, systematic training programs are designed for the potential program implementers. The rationales, objectives and design of the Secondary 1 to Secondary 3 training programs are outlined in this paper. The training programs cover theories of adolescent development, positive youth development, background and curricula of the Project P.A.T.H.S., factors affecting program implementation quality and evaluation of the project. Besides introducing the curriculum units, the training programs also focus on nature of learning and related theories (particularly experiential learning), teaching methods and instructional techniques, motivating students, and classroom management.     

A qualitative evaluation of a mentoring program for Aboriginal health workers and allied health professionals

Objective: Effective partnerships between Aboriginal Health Workers and non‐Aboriginal health professionals are essential to achieve Aboriginal health outcomes. This study aimed to evaluate a mentoring workforce development strategy for Aboriginal Health Workers and non‐Aboriginal allied health professionals. Methods: Thirty‐four Aboriginal Health Workers and non‐Aboriginal health professionals were recruited to the mentoring program where they were paired and established a learning relationship for approximately six months. A qualitative evaluation with thirty of the participants was undertaken involving in‐depth interviews at the completion of the program. Results: A total of 18 mentoring partnerships were formed across Victoria. The data revealed three key themes in relation to the evaluation of the program: (1) The mentoring program facilitated two‐way learning, (2) The Aboriginal Health Workers and non‐Aboriginal health professional participants reported being able to meet their identified learning needs through the partnership, (3) The capacity to improve practice was facilitated through readiness to learn and change practice and personal attributes of the participants, as well as organisation and management support. Conclusions: Peer mentoring between Aboriginal and non‐Aboriginal health workforce was found to be a powerful mechanism to promote two‐way learning that has the capacity to meet learning needs and promote practice improvement. Implications: Peer mentoring may be part of a multi‐strategy approach to the development of the Aboriginal health workforce.     

Organizational Learning and Continuous Quality Improvement: Examining the Impact on Nursing Home Performance

Interest is growing in learning more about the ability of total quality management and continuous quality improvement (TQM/CQI) initiatives to contribute to the performance of healthcare organizations. A major factor in the successful implementation of TQM/CQI is the seminal contribution of an organization's culture. Many implementation efforts have not succeeded because of a corporate culture that failed to stress broader organizational learning. This may help to explain why some TQM/CQI programs have been unsuccessful in improving healthcare organization performance. Organizational performance variables and organizational learning orientation were assessed in a sample of 181 Canadian long-term care organizations that had implemented a formal TQM/CQI program. Categorical regression analysis shows that, in the absence of a strong corporate culture that stresses organizational learning and employee development, few performance enhancements are reported. The results of the assessment suggest that a TQM/CQI program without the backing of a strong organizational learning culture may be insufficient to achieve augmented organizational performance.     

Training family day care providers using self-study written and video materials

This paper describes a self-instructional training program for family day care providers. The program includes training in health and safety, business management, child development, and nutrition. It combines the use of written material with VCR-compatible videotape material to be viewed at home. The program uses the resources of an existing agency to deliver services to a large and geographically dispersed population of family day care providers. The paper also includes an evaluation of the impact of this pilot program on learning. The evaluation includes measurement of pre- and posttest scores, reported changes in child care related practices, and the participants' evaluation of the program. Results indicate positive change in the percent of respondents who answered the questions in the pre- and post-tests correctly and in the number of child care practices reportedly adopted by the participants. Moreover, most of the participants evaluated the program highly.     

Using web‐based simulation learning to deal with shoulder dystocia

Simulation‐based learning can provide education and training to individuals in a variety of industries. The military, aviation and nuclear power industries have seen demonstrable improvement in critical event handling through the use of this type of learning when coupled with crew resource management techniques. Simulation training is also emerging in the healthcare field as an effective patient safety and risk management tool. In the area of obstetrics, healthcare risk managers can have an impact on injury and claim reduction rates related to shoulder dystocia by advocating for and implementing simulation training for obstetrical providers. This article will describe a shoulder dystocia simulation training program that uses a high‐fidelity mannequin, and illustrate the impact that the healthcare risk manager can have in reducing injuries due to shoulder dystocia.     

Prevalence and implementation of IAQ programs in U.S. schools

In this study, we determined the extent to which U.S. schools are implementing indoor air quality (IAQ) programs. We administered a questionnaire on IAQ programs and practices to a representative sample of schools. Participants were asked to provide information on the use, administration, implementation, challenges, and benefits of the IAQ program in their school. We developed an IAQ Practice Index to determine the level of activity directed toward IAQ in schools. The index was computed based on responses to specific survey questions and was normalized to a range of 0 to 100. Each question was weighted qualitatively according to its contribution to strong IAQ management practices. Forty-two percent of schools in the United States have an IAQ management program, and there has been sustained growth from 1998 through 2002 in the number of schools that have such programs. Nearly half of those schools use the U.S. Environmental Protection Agency's IAQ Tools for Schools program. The IAQ Practice Index scores varied widely for schools with an IAQ management program, suggesting that having a program is not equivalent to implementing effective IAQ policies and procedures. Respondents indicated that their IAQ programs led to improved workplace satisfaction, fewer asthma attacks, fewer visits to the school nurse, and lower absenteeism. When actively supported by the school administration, an IAQ program appears to be a valuable factor in improving the learning environment for U.S. schoolchildren.     

Improving knowledge on vaccine storage management in general practices: Learning effectiveness of an online-based program

BackgroundAdequate vaccine storage is a prerequisite for assuring effective vaccinations yet storage conditions in practices are frequently inadequate. The online learning program Keep Cool aims at improving knowledge on international best practices. This study evaluates the program’s learning effectiveness focusing on key indicators for knowledge on vaccine storage, such as temperature target range (2 to 8 °C) and documentation requirements.MethodsParticipants were recruited from within a university teaching practice network. Knowledge was measured with an online-based questionnaire (11 correct items = optimal vaccine storage knowledge) which was completed before and after the online program.Results60 physicians and practice assistants from 25 practices participated. The mean knowledge score was 5.6 correct answers (standard deviation [SD] 1.9), which increased to 9.8 (SD 1.2) after program participation (p < 0.001). The item with the highest net change addressed the need for twice-daily documentation of temperatures (+76.7%). Knowledge of the lower and upper temperature targets improved from 58% respectively 63% to 100% each. Optimal vaccine storage knowledge after participation (38% of participants) was associated neither with age, gender, occupational group nor practice type.ConclusionThe new online education program showed a high learning effectiveness regarding key indicators for the quality of vaccine storage management.Clinical Trial Registry Number: DRKS00006561.     

Continuing medical education, needs assessment, and program development: theoretical constructs

Continuing medical education (CME) program development and needs assessment have historically been practiced within the tradition of Ralph Tyler's education model. In light of transformational social, political, economic, and technical forces that demand greater account-ability and responsiveness from physicians, CME units are challenged to transform their cultures and structures from models that deliver education to models that support the facilitation of learning for enhanced competence and performance. This article describes key change forces for physicians and brings program development and needs assessment into focus for the discussion. The impact of change forces on program development and needs assessment are examined, and some techniques to move beyond the traditional approach of felt needs are presented as a way of enabling strategic administrative planning and change management.     

Learning through vulnerability: a mentor-mentee experience

The following essay, drawn from the journals and work notebook of a family medicine resident and a visiting clinical mentor, chronicles their work together in an Advanced Clinical Mentoring program. This program included afternoons of direct clinical observation immediately followed by feedback sessions. In addition to addressing specific professional issues, such as time management, limiting patient encounters, agenda matching, and the One-Minute Preceptor model, the authors developed personally as they opened themselves to learning and growing as a clinician and a teacher.     

Towards facilitating change in service delivery: An illustrative example

Background:  The management of change in organisations is a challenge facing many occupational therapists in practice today. This article presents an example of a program implemented to facilitate the process of change in paediatric service delivery. It presents the principles and design of the program, as well as the program's implementation and resultant findings.
Methods:  The principles and process of organisational change laid the foundation of the program and were utilised as measurement of changes occurring in the perceptions of participants. Interviews and online focus groups were utilised as data-gathering methods.
Results:  The findings of the study illustrate the process of change that participants were undergoing.
Conclusions:  The article provides an example of how managers can facilitate change in service delivery by using the principles of organisational change and adult learning. Recommendations are made for application of similar change management processes in other organisations and the future use of the online discussion medium as research tool and in practice.