Teaching the Process Where People Work

In practice

A hospital wants its nurses practising from evidence rather than from what they learned at school. The starting problem is that school recedes: clinicians practise from three sources, and formal education is the one that ages fastest. Teaching does not stop at graduation, which means the setting has to teach. Structure, process and outcomes apply to teaching exactly as they apply to care. Structure is what exists to teach with — protected time, a librarian, somewhere to meet. Process is what actually happens in those sessions, and it is where journal clubs either work or become a reading group with sandwiches. Outcomes are what changed in practice afterwards, which is the measure almost nobody takes: attendance is not an outcome, and a programme that reports attendance is reporting its own activity. Educators and leaders have to act together, because an educator without leadership gets a session and no protected time to hold it in. Dissemination is taught alongside the process rather than after it, so that clinicians who find something have somewhere to put it. And the whole thing is written into policy, because that is what survives the departure of the person who started it.