Practitioner Profile – Holly HestonInterviewed by Ellen Reeder – September 21, 2009

INTRODUCTIONHolly Heston is a co-worker of mine and has been employed at the Association of periOperative Nurses (AORN) in Denver, Colorado for six years. She started out in the AORN Center for Perioperative Education as a program manager for face-to-face education events. She has seven years of experience working as an instructional designer and creating online education programs for nurses. Through her creative ideas, AORN has implemented several new learning programs. Holly also inspired me to investigate instructional design, and suggested to our director that I start helping her to write and develop courses when her work load became too big.

I conducted the interview will Holly over lunch at Caldonia’s (great BBQ) on Parker Road. And through email, water fountain gossip, and spontaneous questions that may have arisen. Holly is a very straight-forward person and very open about her job.

It’s not what you don’t know that will hurt you. It’s what you think you know that just ain’t so.

--Satchel Paige

INTERVIEW

Tell me how you prepared for what you do?

I was trained on the job at a company that built online courses for nurses. As a production house, they had a training program that I went through. It’s still the best training I’ve seen for nuts and bolts online learning. The production house had standardized the whole ID process in storyboarding system developed in Microsoft Word, which included an automatic testing tool, excellent graphic content, and an outstanding editorial process. It was easy to add fun things to the learning modules. Then end product was always clean and easy to use.

Describe what you do at AORN.

I manage the “Confidence Based Learning” (CBL) program. CBL reinforces learner retention by asking the user to repeatedly answer questions and indicate their level of confidence in their answer. AORN partners with Knowledge Factor (KF), the company who owns the LMS/software that delivers the training. (The quote at the top of this page was taken directly from a Knowledge Factor poster that hangs in our cubicles).

As far as content development goes, sometimes I work with subject matter experts and write questions myself, sometimes the SMEs write the questions and I review/edit them. Sometimes the SMEs are in-house; sometimes they are outside.

Managing the program includes working with KF on web portal content, training for AORN staff, and writing processes for AORN education department. Processes include items outside the main content development, such as schedules, lines of communication to KF and to AORN staff outside of the department, certificates, evaluations, beta test, ANCC credentialing, etc.

Because this is a relatively new initiative, I also work with Customer Service and IT to write the processes for user registration and account upkeep. An upcoming initiative for our departments is to automate this process. This may seem like a project that should lie outside the scope of the education department; however, the education department has historically had a greater understanding of the products than other departments; therefore we take an active role in operations.

Outside of the CBL program, I work peripherally on content upkeep and processes of the Periop101 courses, AORN’s flagship online education program sold to health-care facilities around the country. I also make content updates in Lectora to the Ambulatory Surgery Certificate program, Preparing for the CNOR exam and other courses as needed. I also troubleshoot issues that arise on the Geo LMS, help staff with webinars, and serve as a department liaison to IT for database updates.

What do you like best about your job?Definite rewards come from AORN members and other users who like the programs we develop and say that they helped them in their practice. Sometimes, I have to troubleshoot for those users who may be having difficulty with some aspect of our program, or connect them with IT if some kind if interface problems occur. My specialty, I feel, is writing good questions. I love that aspect of ID.

What do you like least?

Well, sometimes working with SMEs can be difficult. Because we provide medical content, we must be able back up all of our content with proper sources. Thus, the need to nurture relationships with experts who can write questions and/or content for little pay – AORN is a non-profit company – is very great. Many SME’s I’ve worked do not provide adequate content, do not understand copyright law, and do not correctly site and footnote their content. Even when we send them a detailed outline of what is required, sometimes they don’t provide proper content. What happens in most of these cases is that I call them, leave a message about the problem, they respond, and it’s still not what we need. Often, there’s a lot of back and forth with the SME, and it can take a lot of time to get information correct.

In addition, I find myself doing more process work than ID, sometimes. AORN doesn’t have a standardized ID process. We use Knowledge Factor for some and our own LMS for others. Because of this lack of standardization, I have to write out the registration process for customer service and marketing, and currently we’re working with IT to automate the payment process and most of the evaluation and needs assessment processes. It’s very time consuming.

What do you do to keep up with the ID industry?

I’ve attended a few conferences, and receive lots of newsletters about elearning. I’m also a member of the eLearning Guild (www.elearningguild.com) for resources, community, and best practices information. I’m also a member of the American Society of Training and Development (ASTD).

What’s hot right now in ID – what do you wish we were doing more of here at AORN?

Definitely social networking and how to incorporate more of it into elearning. Those in charge of our association don’t see the benefit of social networking, and have complete contempt for Twitter especially. The nursing field is just now arriving into the 21st

Century, and hopefully we’ll spend more time incorporating social networking into our courses.

I know what you mean about the members of our association. Only a year ago, even though the application I manage is all online, I received a typewritten (!) application from a member. That member since has learned how to use the web application, so things are definitely changing!

In that vein, what do you think should be hot in ID, but isn’t catching on?

Confidence based learning! It’s unique in that it makes people approach learning in a different manner because it reverses the traditional order of content and testing. Learners must answer questions first, give their degree of confidence in their answer, and then use the resources given to get the wrong answers correct. It works well in our industry since those nurses with a high degree of confidence and a low knowledge base can be dangerous.

Some users are put off at first because they feel like they’re being “tested” without having been given the content first. It’s the “testing” nerves that some learners have. They receive the content as they proceed through the course and must answer the questions until they’ve mastered them. Once they get used to it, most of our users really like it.

What advice do you have for people interested in ID?

In a lecture, the instructor fills in the gaps in the visual material. In an online course, there can’t be any gaps. To be a successful ID, you must be able to connect the dots and then fill in the space between them. You have to anticipate what those gaps could be when developing courses and during beta testing when potential learners test the new course before implementation.

CONCLUSION

Holly brought me into the CBL process with Knowledge Factor eighteen months ago, and experience led me to enroll in the ID master’s program. As noted in her interview, she’s a big fan of CBL and thinks that there could be a bright future in its application to online medical training and development. At AORN, we’re finally catching up to the technical requirements for web-based training, and Holly’s been at the forefront in the struggle to get us there. The perception at AORN about developing web-based education is that it’s like writing a novel – everyone thinks that they know how, but when it comes time to put actual thoughts on the page, the time and effort it will take, not to mention the talent, becomes evident. Those who make the final decisions at AORN love online learning because it’s popular, but they also flinch at the cost and insist that development should not take so long. That’s part of Holly’s job too – to clarify how elearning and ID work and why it’s so important to the education process at AORN.