LEARNING ON THE JOB: HOW BEST TO DELIVER TRAINING SESSIONS TO NURSING STAFF WITHIN THE WORKING ENVIRONMENT

Abstract
Nurses are expected to engage in professional development, but clinical pressures often limit training opportunities. This project assessed the effectiveness of ward-based teaching, delivery methods, and the ideal duration for bite-size sessions. Methodology: A clinical education fellow (CEF) was assigned to each ward to deliver 10-minute sessions on SBAR for at least 3 days in one week, followed by a practical session the next week. Confidence was measured through pre- and post-session surveys. In the second cycle, sessions were delivered during ‘quiet time’. The CEF taught a 10-minute session on fluid balance over 3 days, followed by a practical session, or combined both into one week. Confidence was reassessed, and feedback gathered from staff and CEFs. Results: Cycle one: Teaching penetration ranged from 22% to 84% across 13 wards. Teaching occurred on average 3 days/week. Before the sessions, confidence using SBAR was already high (80.5%). Post-session, confidence improved (84.7%) with those who disagreed dropping to 13.3%. Use of SBAR increased from 21.5% to 35.9% between teaching sessions. Staff found the sessions “concise,” a “useful refresher,” and appreciated the practical element. They felt it improved team cohesion between staff and doctors. Cycle two: Teaching penetration ranged from 17% to 75% across 8 wards. Four wards from Cycle 1 taught during handover where penetrance dropped significantly in Cycle 2. One ward declined quiet time teaching and two experienced a 45-53% decrease in attendance. However, one ward saw a 50% increase. Overall, attendance dropped by 34%. Confidence in using fluid balance charts was high before the sessions (94.4%). After the sessions, 89.5% felt more confident. Staff feedback described the sessions as “focused, informative, and engaging”. Overall: 89.2% of staff found being taught by doctors useful. 64.6% of staff and 87.5 % of CEFs preferred the topic to be taught in one session, with 83.1% of staff and 50% of CEFs preferring future sessions during quiet time. Discussion: The project demonstrated that ward-based teaching is effective, improving confidence and inter-professional relationships. The bite-sized, practical format was well-received. Feedback evidenced doctors as facilitators and one session per topic were appropriate. However, timing of the practical requires careful planning. Challenges included clinical pressures, varying participation, and time constraints. One ward showed strong engagement attributed to a supportive nurse-in-charge; another declined second cycle quiet time teaching. Initially, students and healthcare assistants weren't identified in surveys, possibly skewing confidence data – job roles were noted in cycle two. Collecting feedback via online forms was challenging. Future cycles may benefit from paper forms or dedicated computer access. Facilitators found multi-day delivery time-consuming. Involving ward-based colleagues could help alleviate this. This project involved multiple facilitators, wards, and learners, with challenges in time-management, organisation, and consistency, which we’ve addressed for future cycles. Conclusion: Teaching nursing staff within a ward environment is effective with high levels of engagement and satisfaction between facilitators and learners. We recommend one session per topic delivered as a theory session followed by the practical, at a time agreed by the nursing team. Keywords- Nurses Education/Training, Work Place Based Teaching, Bite Size Teaching, etc.