Paul van Keeken, MSc N, Nicolai van der Woert, MSc E Nijmegen Expertise Center for Neuro Rehabilitation, Neuro-Sensory Department Radboud University Nijmegen Medical Center, The Netherlands Community Vocational Training Action Programme Second phase:

The project: Partners Radcliffe infermary, Oxford Heilig Hart Ziekenhuis, Roeselare-Menen University medical center St Radboud, Nijmegen Univerity Hospital, Helsinki Oulu Polytechnic, Oulu Lund University Hospital Landspitali University Hospital Reykjavik Örebro Universität, Jonkoping University St. Luke’s hospital, Malta Silent Partners (European Associations) EANN EFN (nurses EU) FINE (nurse educators) (National Associations) BE: BVNV/ABIN DK: DANN UK: BANN FI: FANN SE: SANN NL: NVNV IS: IANN IT: ANIN SW: SGNP Mikkelli University Hvodovre University Hospital, Copenhagen

EANN strategy plan Support continuing and post-basic education in neuroscience nursing care for nurses in all healthcare settings. Accommodate national requirements for accreditation for post-registration neuroscience nursing courses and develop standards for EANN educational activity Develop a common definition of “neuroscience nurse” to include educational and clinical preparation Develop an adequate infrastructure to support the activities of the EANN European Commision... and funding !!! Bologna Process – Ba,Ma,PhD – ECTS VET: professional competences, quality control framework, Teacher Training Life Long Learning Plan (LLP) and European Qualification Framework (EQF) Mobility and exchange Harmonisation of Education Situation in Europe EANN zero survey: only some NW European countries have curriculum 15,500,000+ patients, 125,000-1,500,000 nurses  Enormous training need Diversity: Different laws & regulations, different educational systems, culture Ranging from good educational systems to no specialized education at all Competence based training is a rising star, but nowhere really implemented Working together as solution to EU & time/money problems EU context

1. European Framework for life-long learning of neuroscience nurses: which structure, which tools? 2. European curriculum: what should be inside ? 3. Developing and sharing learning materials: how,what, by whom? 4. How to implement all of this in Europe? But first: a zero survey! Research questions

Workshop ELMAC NeuroBlend implementation and Change Management European versus Local implementation Cultural issues Curriculum level Connecting Learning materials to curriculum parameters – role of the repository opening up NeuroBlend for teachers – requirements for Train theTrainer course Instructional Design Webquests and competence based learning What is the right “blend”?

4 Factors, 4 Quadrants, 4 Questionnaires Zero survey preliminary results Quadrant IV: organisational factors j) Ambition and policy k) certificates, accreditation, quality care l) Organisational culture Quadrant I: educational factors a) Curriculum b) Educational and ICT process c) Pedagogy / didactics Quadrant III: human factors: people involved in educational process g) Nurses and nursing h) Teachers i) Leaders and support Quadrant II: resource factors: learning materials & ICT resources d) Resources e) design and development of materials f) blended learning / educational material 5 maturity levels (ordinal scale) 1. Awareness phase: In this phase the awareness arises, that a change is needed or will start 2. Preparation phase: the old paradigm is not working anymore, change is felt needed and is being prepared 3. Substitution phase: shifting to a new approach, using the same old things and ways in a new environment 4. Transition phase: starting to understand what the change is about and using the new possibilities in a basic way 5. Transformation phase: the innovation is there, people have adopted it, the organisation has been transformed a) Curriculum b) Process c) Pedagogy d) Resources e) ISDD f) Blendedg) nurses h) teachers i) lead/supp j) amb/pol k) quality l) culture Educational factors Organisational factors Human factors Resource factors

Organisational factors / change management Organisational culture cannot be expressed in a maturity level. A choice is made to use the color model of organisational change This is based on the change management literature and spans the field of the most important change models. Yellow: socio-political models of change Blue: rational design, and implementing change; project approach Red: Human Resource Management Green: Action Learning and the Learning Organisation White: chaos theory, complexity theory, self-organisation Questionaire adapted from: L. de Caluwé: Thinking about change in five colors Zero survey preliminary results

Example questionnaire “organisational culture” Zero survey preliminary results

Preliminary results  online view Zero survey preliminary results

Experts from all over EU Sharing, give and take From a curriculum as a basis Competence based Using internet and multimedia Blended learning strategy Open source software Community of practice Research questions 1: European Framework for life-long learning of neuroscience nurses: which structure, which tools?

e-Tools overview 3. Virtual Patient Case/ Virtual Ward Case 1.Learning Objects/ Digital Repository 2. Virtual Learning Environment 4. Community of Practice for teachers Open Source software

Virtual Learning Environment

Competence based learning A competence describes behaviour needed to be successful in a professional context. Levels criteria, reflection Competence development requires the use of knowledge, skills and attitudes in an integrated way within an authentic learning environment Different every time  situation Meta-action Result/product action Knowledge Skills Attitudes roles Anticipate Plan care or treatment Reflection Justify actions Explain why Criteria for action Product criteria  standards & routines

Core competencesLevelsRoleTask AreaDomain specific? To provide professional neuroscience nursing care, based on independent responsibility. Competent Proficient Expert Care providerContent of care (A,C) Acute, Rehab and Palliative are different To coordinate an integral and coherent package of neuroscience nursing care with one goal: continuity of care in the complete care chain. Competent Proficient Expert Case manager Content of care (B,D) Acute, Rehab and Palliative are different To set a good example (role model) for (new) neuroscience nurses and to teach and coach team members in functioning as care provider/ case manager and develop as individual in the organisation and the profession. Proficient Expert Coach/ teacher/ supervisor Organisation of care (F) Profession (E) Same for each domain To design and develop a policy concerning nursing, care programs and/or guidelines and protocols for neuro patients, aimed at care innovation and improvement of quality of care and to this, to play a renewing role in neuro-science- nursing. Proficient Expert Planner/ practice developer Profession (E) Same for each domain To advice on or to design and develop a policy concerning organisation of care, ward management and institution policy and to this, to become the neuro patients advocate in organisation and management. Proficient Expert Planner/ practice developer Organisation of care (F) Same for each domain Competence Profile

Research questions 2: European curriculum: what should be inside ? European function profileTask oriented, gives clues about how to do the job European competence profileCompetence oriented, gives clues about roles, contexts, outcomes & products and their criteria, reflection European Learning PlanGives info about the philosophy of learning and teaching Module DescriptionsDescribes the content areas in relation to competences Flexible Learning PathsAlternatives for an individual to acquire competences at a certain level Blended Learning PlanDescribes alternatives for using different modes of learning Educational OrganisationAlternatives for institutes at different levels of maturity to implement ECP in learning and teaching Plan for Professionalising TeachersTrain the trainer plan Implementation planStrategies, do’s and don’ts for different contexts

Competence - Competency A competence describes behaviour needed to be successful in a professional context. Levels Criteria, Reflection Competence based learning and teaching philosophy includes: ………  Learning is aimed at actively constructing knowledge in a meaningful context  A competence is connected to meaningful job/task-specific learning contexts  Integrative learning aimed at coherence rather than loose facts  Active reflection  Working together as on the workfloor where possible  Flexible learning paths  Adjusted to needs and Elsewhere Gained Competences of individual learner  Competences cannot be learned in one click, they grow in a process  Individual learner is responsible for own learning process  Teacher is facilitator or coach for learning process

Virtual Patient CasesFor developing competences in caring for patients. Real life situations, authentic learning context. Virtual Ward CasesFor developing competences in coaching, mentoring, managing the ward and vision on developing the profession. Knowledge Base Repository of reusable learning objects Webquest format: inquiry based learning, case based learning, problem based learning, competence based Blended learning strategy EU context Research questions 3: Developing and sharing learning materials: how, what, by whom?

Virtual Patient Case: WebQuest PDP  portfolio learning outcomes 1 Case intro Patient & care problem Digital Portfolio Store products, reflection, and assessment, Learning outcomes, adapt PDP 6. Evaluation, assessment Teacher, coach, peer 5. Reflection Learning outcomes, products, performance Assessment product, coach, peers, test, portfolio,products 2. Assignment Products, learning outcomes 3. Learning Process Steps to take for learning task 4. Learning Resources Common / patient Info & learning resources videocase, digital patiënt record, guidelines, handbooks, opinion of collegues or other disciplines websites Products  portfolio Diagnosis, Care plan, etc

Patient cases / Webquest

PDP & portfolio

Virtual Ward Case Setting up a mentoring and coaching system Introducing a new intervention method for rehabilitation at the ward Starting with evidence based practice Making a training plan for the ward Budget cut reorganisation: change management Developing a policy for the next three years Managing the ward: planning and scheduling Introducing the multidisciplinary approach

Repository of Reusable Learning Objects Store, search, retrieve Multimedia Peer reviewed Rating possible Informed Consent Metadata description Creative Commons

Range: from traditional to partly competence based Range: used to B-learning or not Range: with/without teachers / resources Scenarios as examples for different settings Educational organisations Cases Readyness / maturity model  next steps EU wide support Teacher training Quality Assurance,Accreditation and Certification Developing materials together Sharing, give and take, Creative Commons Role of EANN Working towards a new structure and new projects Research questions 4: How to implement all of this in Europe?

Community of Practice / website Community of practice for teachers and educators: a virtual workspace News Documents Knowledge base Working together Discussion Focus Groups Design & Development Surveys Sub-projects Calendar … Open source!

Project structure Work package 1: Curriculum Development Work package 2: Conferences & Publications Work package 3: Evaluation, Surveys, and Monitoring of Effects Work package 4: Educational Design and Development Work package 5: ICT Support and Production Project Advisory Group Silent Partners Project Board Full Partners Project Management Follow up projects: Train the trainer Quality assurance, accreditation and certification Adding more training materials

Follow up projects (2007+): National roll-outs in hospitals, nursing homes, home care Higher Education Cooperation with EANN and national nursing associations New EU member states Train the trainer Master Class, star trainers from many countries spread the word Summer school, certificate training-coaching-educational design & development, community of practice Quality assurance, accreditation and certification Adding more training materials Transition to other domains of nursing

A new structure EANN - Networked Communities of Practice RESEARCHRESEARCH RESEARCHRESEARCH EDUCATIONEDUCATION EDUCATIONEDUCATION Special Interest Groups (SIG) Focus Groups (FoG) Stroke Parkinson ….. Acute Neuro Care Neuro Rehab Neuro Palliative Care Strategic Partners and consortia

Contact Information Project Management Paul van Keeken Nicolai van der Woert Website (as of october 31 st, 2006) Project Presentation EANN Reykjavik conference May 30 th - June 2 nd

Workshop ELMAC NeuroBlend implementation and Change Management European versus Local implementation Cultural issues Curriculum level Connecting Learning materials to curriculum parameters – role of the repository opening up NeuroBlend for teachers – requirements for Train theTrainer course Instructional Design Webquests and competence based learning What is the right “blend”?