Tools Used: Articulate Storyline, Photoshop, Snag-It, Audacity, EV-RE320 Dynamic Mic
Roles Played: Proposed the solutioning, drafted the storyboard and prototype, recorded and edited the SME demo scenarios, used Storyline to fully develop the course and all simulation hotpot triggers, QA tested the course, and validated passing results to Cornerstone LMS. My clinical trainer was responsible performing demos, navigating the clinical software interface, and providing the “why” for both demos and “try me” feedback item triggers. (Click on the bolded items to see more of how I did these and loaded to Cornerstone LMS)
Problem: Every Fall, to meet the Center for Medicare and Medicaid (CMS) standards, clinical nurses had to be certified in McKesson InterQual software for determining the medical necessity of proposed clinical procedures when working in a managed healthcare setting. To become certified, you had to pass an online 50 question, McKesson scenario-based test that was live proctored and taken on their web site. Each Spring, McKesson would release newly approved software procedures and governance standards to their clients that would be reflected in that year’s certification test. WellCare would use the McKesson PPT and a clinical nurse to teach the new standards in a large series of web-based training events. The problem was, not all nurses comprehension of the new procedures could be demonstrated in a live webinar that was passively experienced. It was costly to have to take our one clinical trainer away from other live teaching responsibilities, and the ROI on Fall testing scores was not where it could have been.
Action: I proposed to clinical nursing leadership that when the Spring updates came out, instead of scheduling months of passive webinars, we create a pre-learning eLearning curriculum using Articulate Storyline and case study examples that would reflect the case study test questions the associates would face in the Fall. We could record our clinical trainer presenting and demonstrating a clinical scenario, then screen record the trainer taking the actions in McKesson InterQual software while the audio provided the “why”. Using Storyline’s “try” screen recording feature, we’d have the learner walk through a new Practice Review scenario click through for a true hands on experience. This process was used for eight clinical and four behavioral health topics that each had their own course assigned to the specific clinical roles of the learners in Cornerstone LMS. The data for each learner’s performance and gaps could be identified. Gaps that were the most common across all learners had scheduled live summer webinar sessions to close them before Fall testing, and was a much better use of live trainer time.
Results: The results were very strong on several levels. The pre-learning gave everyone a chance to experience the new InterQual annual updates and rule changes in an on the job, experiential and meaningful way. Our clinical nurse saved hundreds of hours of live proctoring of the same content and was able to target other projects and use gap closing follow up live events far more strategically. In the Fall, testing scores went up to a 97% pass rate on the first exam take from just under 90% in years past. This saved the time of having to build and send successful intervention training data to CMS.
Perhaps the biggest win was presenting our courses to CMS, who after testing out their accuracy and validity, allowed us to use our courses’ LMS results data, with of course case study swap outs, as an equivalency to taking the Fall test in year two of our curriculum project. This saved dozens of hours of test proctoring time and clinical trainer productivity.
This was one of those projects that showed what could be accomplished when everyone’s skills, expertise and talents come together to do something no one could have done on their own.