Research and Evaluation Conversation Series: A Conversation with Heidi Keeler, Ph.D., RN

By Wendy Turell, DrPH, CHCP

Editor’s Note: This series explores the various types of evaluation and research endeavors that CEhp professionals undertake within their organizations.

In an interview with Heidi Keeler, Ph.D., RN, Wendy Turell, DrPH, CHCP, addresses Alliance National Learning Competency Area 3: Measuring the Effectiveness of CEhp Activities and the Impact of Overall CEhp Program.

Based in Omaha, Nebraska, Heidi Keeler, Ph.D., RN, is an assistant professor at the University of Nebraska Medical College (UNMC), College of Nursing, and interim director in the Office of Continuing Nursing Education (CNE). She has worked in the CNE office for over five years, although the office itself has been in existence since at least 1980 (the first year it received ANCC accreditation).

What is your background?
I started as a practicing nurse in acute care as an inpatient nurse. We used to take nursing students on our floor, and I really loved teaching and being a preceptor. I realized at that time that teaching nurses would be a good fit for me, so I decided to go back to school to learn more about nursing education. I pursued my Ph.D. in health promotion nursing research, with a focus on education.

What is the relationship between the CNE office and the CME office at your university?
At UNMC, we actually have separate offices as the focuses in medical and nursing education are unique to each pro­fession. We do, however, collaborate often. There has been a trend in recent years toward interprofessional education, and we have been striving toward multiple partnerships for many of our continuing education ventures.

What is the focus of the office?
Our office focuses on programs that are relevant to maintaining competencies for all levels of nurses — from LPNs to masters and doctoral level nurses. We provide professional development through over 150 activities annually, many of which are jointly provided. We provideeducation for nurses across our five campuses, programming for nurses across the entire state of Nebraska, as well some programs that have a national focus. Our unit is accredited with distinction by the ANCC.

What do you think is unique about your department?
Our role as evaluators of activities is unique; it’s been a large focus of what we do. Research and data are key factors and drive many of our undertakings.

Please tell us more about your evaluation and research work.
We have developed standardized evaluation tools and a system that incorporates best practices to collect and analyze imme­diate and long-term evaluation data online. By administering some standardized questioning across different disease educa­tion programs (irrespective of disease), we have more options for analysis across programs. Beyond immediate evaluation, we have been engaged in the development and administration of long-term evaluation processes. For example, for one of our national largest programs, students complete follow-up measures three months following participation. We often administer baseline evaluations as well, and repeat some stan­dardized questions at different points (pre/post follow-up) for fuller analysis. Our evaluation reaches Level 6 on the updated Moore’s scale using self-report measures, including clinical behavior change and changes in patient outcomes.

We are also looking at two to three years of data across formats, therapeutic areas and delivery systems to identify trends, which is made possible by the standardization of our process. For our programs that are ongoing, we are looking at longitudinal data; we are collecting data to analyze and see if there are any trends to see what the impact of delivery mechanisms are on clinical knowledge, practice behaviors and patient outcomes.

Do you conduct any quality improvement projects?
We are engaged in several practice improvement projects geared toward nurse practitioners and physician assistants. Currently, there are not established standards or criteria for performance improvement (PI) programs for nurses. We had to analyze and adapt CME standards to apply to nursing clinical situations. For these programs, [nursing] providers pull charts, self-assess their practice, create action plans, exe­cute on these plans, and then go back and review their charts again to assess whether or not there was change from base­line. Our PI educational programs are currently conducted entirely online, using a very attractive and easy-to-follow design. Moving forward, we hope to develop more robust programs and techniques using our previous experience.

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