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In the complex and ever-chang-ing world of ophthalmic prac-tice management, there’s muchto learn for administrators,doctors, and staff. Whether it’s

compliance with new federal regula-tions, conversion to electronichealth records, or the introductionof new equipment or lines of serv-ice, staff training is an integral part

of the administrator’s day-to-dayresponsibilities.

But are training efforts as effec-tive as they could be? Do we meas-ure the impact? Do we design train-ing modules in systematic ways thatensure standardized instruction thatsolves problems and/or changesbehavior? Do we encourage self-directed learning among the adults

who work in our organizations, thuscreating a broad-based “learning cul-ture”? Do we use multimedia andtechnology to capture the attentionof employee-learners, or are we stuckin the past using handouts,PowerPoint, and the “sage-on-the-stage”?

This article approaches theopportunity for staff training by pro-

AdultLearners in theOphthalmicPracticeSandy Boles, COE

Do we use multimedia and technology to capture theattention of employee-learners, or are we stuck in the pastusing handouts, PowerPoint, and the “sage-on-the-stage”?

AE Spring 2010 59

viding a brief overview of modern-day thinking about adult learners,citing some strategies and tacticsborrowed from the fields of profes-sional training and adult education.I hope you’ll find a pearl or two tohelp you tackle your next trainingopportunity.

Why Train?Training does more than just teachskills. It can engage the attention ofyour team, cultivate rapport, providelight for each person’s career jour-ney, spark the desire to grow, sparkthe desire to serve, teach individualsto delve deep into details, and createtrust — trust in you as a facilitator ofthe information, knowledge, andproficiency staff members need to dotheir jobs and to serve their employ-er and ultimately, the patients.

As a busy ophthalmic adminis-trator, I shudder to think of all themissed opportunities I have had tobenefit my staff through additionaltraining (see sidebar). I shudderbecause the reality is that there’smuch more going on every day thatclaims a more urgent portion of ourtime and energy. Training seems toalways take a back burner to the“urgent,” “important,” or “moreprofitable.” Yet, consider MarkTwain, who said, “If you think edu-cation is expensive, try ignorance.”And, John Pinto, who says weshould be offering one hour of con-tinuing education for every 79 hoursworked.

Making Training Relevant,Accessible, InterestingWhat do we need to do to make ourtraining and staff education as rele-vant, accessible, and interesting as itcan be?

First, we remember that trainingis problem-solving. We start by usingan academic model called ADDIE:• A=Analysis of the problem• D=Design the training solution• D=Develop the training modules

• I=Implement and deliver thetraining

• E=Evaluate the pre- and post-training outcomes quantitatively,identifying each problem we hopeto solve. Secondly, we realize that we are

not schoolteachers. Our students arenot children in teacher-directed set-tings, with parental support, learn-ing a standardized curriculum. Weare administrator/leader teacherswith adult learners who are com-pletely self-directed, who will engageor not in the subject matter beingtaught based on their own life expe-riences and their own immediate,need-to-know assessment of whetherthe training will be worthwhile or awaste of their time. The good newsis that most workers really do wantto learn and become as well-trainedand informed as possible. Adultlearners seek mutual respect, want tobe regarded as individuals (not as a

staff person, worker, or employee),respond positively to a balancebetween theory and practice, appre-ciate the freedom to choose learningtechniques that are compatible withtheir own learning style, and wantto be recognized for unique lifeexperiences or contributions.

Finally, the delivery of the train-ing module itself becomes “showtime.” (Consider the aptly namedtraining resource by Stolovitch andKeeps, Training Ain’t Telling [ASTD,2002]). During the training event,bypass lecture in favor of education-al technology options such asYouTube, podcasts, and recordedaudio and video interviews. Break upthe training schedule with old-fash-ioned, low-tech games such asPictionary, Bingo, or Jeopardy (usingmodule topic content for questionsand answers). Level the learningfield so that the “teacher” is simply

Ophthalmic Training OpportunitiesNew Employee OrientationCustomer Service Technician Proficiency Introducing New Implant OptionsIntroducing New Equipment Company Wellness ProgramsConversion to eRx, PQRI, and EHRWorkplace Safety Reimbursement Compliance State and Federal Compliance

Training ResourcesAmerican Society for Training & Development (www.ASTD.org)ASOA (www.asoa.org/meetings/overview.cfml)Management Help (www.managementhelp.org)New Horizons (www.newhorizons.org)Second Life (www.Secondlife.com)Wii (www.wii.com)

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a “guide” and not an authority fig-ure. Encourage idea generation, feed-back, and alternative solutions fromeach participant. Adult educatorsrecommend a mental break of fiveminutes’ “play” time for every 30–45minutes of on-topic course work. Forexample, take a break every 40 min-utes and begin the next session witha five-minute game related to yourlearning objective. Before long, the

participants will look forward toresuming the training, as the gamesbring their minds back on task.

Making Training Effective and“Sticky”The follow up to training is also crit-ical. Stay in touch with your team oflearners through email, Twitter, orold-fashioned red-rising thermome-ter graphics to monitor progresstoward the learning/performance

goals. As in any endeavor, the followup, feedback, and customization areas important as the initial training.All are elements of effective trainingsystems.

Effective staff training can be avital differentiator among oph-thalmic practices in implementationof change, efficacy in problem-solv-ing, and compliance. Effective stafftraining also creates high levels ofemployee satisfaction and retention.The advent of technology may bringamazing new modalities with web-based simulations that provide cus-tomized training content and usherin a new generation of trainingmethods and venues, like SecondLife and Wii. Second Life is worthan online visit to get a glimpse ofhow other industries are using virtu-al reality for training opportunities.If you’ve played a Wii game, youknow how amazingly sensitive theWiimote is and how “life-like” theMiis are. It’s not much of a stretchto imagine the training room of thefuture where adult learners aretaught to measure intraocular pres-sure, register a new patient, answerthe phones, or educate patientsusing virtual reality simulations.

In the meantime (as I learnedfrom the ASTD blog), go fromwatching and reading to doing andengaging, from telling and testing toconversation and reflection, fromcommand and control to guide andnurture, from top-down to harness-ing collective intelligence, from cau-tious and safe to wacky and rebel-lious, from people-going-to-trainingto training-going-to-people, andfrom boring to fun.

Best wishes and good luck! AE

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America has become a learning society.We no longer leave school when we goto work.

—Smith & Walter, Success Strategies for Adult Learners

Best-selling author John Pinto will make a personal appearance atthe ASOA Congress on Ophthalmic Practice Management to sign

copies of his many practice management books. Be sure to visit the ASCRS•ASOA Resource Center – Booth 1718, Sunday or Monday from noon – 2 pm.

The following books will be available for sale at the ResourceCenter:

Little Green Book of OphthalmologyThe Efficient Ophthalmologist

Cash FlowLegal Issues in Ophthalmology

Turnaround

Won’t be at the Annual Congress? Shop online at http://shop.asoa.org.

Book Signing – John Pinto

Sandy Boles (405-833-0338; sandybolesok@gmail.com) is business devel-opment manager for AbbottMedical Optics, Guthrie, Okla.