This paper examines transfer of learning—the application of training knowledge and skills to the workplace—and its critical role in clinical education. Drawing on cognitive theory, identical elements theory, and stimulus generalization, the paper outlines evidence-based strategies across pre-training, training, and post-training phases. It then applies these frameworks specifically to SMART infusion pump training, emphasizing the importance of adhering to medication administration standards, preventing common programming errors, and establishing supportive learning environments that bridge simulation training with actual clinical practice.
Transfer of learning refers to the manifestation of knowledge and skills that have been learned in a training session or in a program of professional preparation applied to the job environment, the professional role, and the duties of a position. Follow-up evaluation and support with the actual transfer of learning have been shown to be crucial to the effective application of learning in the professional context. In order to be considered completely transferred, the learning that was accomplished through training must be effectively and continually applied on the job.
Thus, the criteria for successful transfer of learning include demonstration that the learner has generalized the skills to the work context and that the learner has maintained those skills in the work context. For these reasons, transfer of learning must be measured after a learner has completed a training program.
Many different theories have been developed about the transfer of learning. Three key theories are cognitive theory, identical elements theory, and stimulus generalization.
Cognitive theory proposes that learning material should be meaningful and that coding schemes should be designed to enhance storage and recall of training. Cognitive theory is said to engage both near and far transfer and is appropriate for all types of training and work environments.
Identical elements theory proposes that the training environment should be identical to the work environment. This theory is said to involve near transfer and functions best in work environments with features that are predictable and stable.
Stimulus generalization theory holds that general principles can be applicable to many different work situations. Stimulus generalization is considered to be far transfer and functions well in work environments that are unpredictable and highly variable.
When establishing training sessions for the use of SMART pumps, consider that the environment in which learning first takes place is only a simulation of the actual clinical setting to which the learning must effectively and completely transfer. As much as possible, trainers should strive to achieve identical elements and support near transfer.
Transfer of learning in the professional development of adult staff members or practitioners in training must focus on the three stages of pre-training, training, and post-training. Together, these three stages address the five key purposes that result in transfer of learning.
The purposes that support learning and the transfer of learning include:
Baldwin and Ford (1988) first proposed a three-factor model of transfer of learning, and Burke and Hutchins (2007) updated and extended the transfer of learning model. According to the model, many variables influence both learning and transfer of knowledge and skills from a training event. The model clearly shows that transfer is not the end goal; rather, effective transfer of learning leads to improved performance at the individual level and ultimately at the organizational level due to the collective impact of workers who have successfully transferred learning from trainings to the workplace.
The characteristics of learners influence the level and rate of learning and of the transfer of learning. Learner characteristics are many, but those attributes that have received the most attention from researchers include motivation, personality, intellectual ability, self-efficacy—which is the perceived ability of learners to appreciate, understand, and use their knowledge and skills—and the usefulness of learning to job and career enhancement.
It is important to recognize that the training design affects transfer only through the process of learning by the participants in the training. Trainers can facilitate transfer of learning by applying adult learning principles in their training design, by facilitating the training through the use of instructional media that supports the training goals, and by adhering to the specific learning goals articulated in the training design. For their part, learners can speed their goal attainment by using self-management strategies that assist with envisioning how newly learned skills and knowledge will be used in their work setting.
A pivotal support to transfer of learning is ensuring that training objectives are strategically linked to the goals of the organization and that learners can clearly see how their own transfer of learning has the potential to improve the overall performance of the organization. Environmental influences that are important for employers to focus on include the following:
Support for transfer of learning must come before evaluation, but support must also occur through the development of interventions that are available before the training experience, during the training experience, and after the training experience. In this way, the transfer of learning occurs at the learner level, the training design level, and the work environment level.
Smart infusion pumps are used to deliver fluids, medications, and nutrients to patients at precisely controlled rates. As smart infusion pump technology has advanced, features have been added, including pump software that serves a close error-reduction function in the form of a drug library. Smart pumps support the calculation of doses and delivery rates by enabling clinicians to appropriately program the pump software. Proper use of smart pump features has been shown to prevent errors in the administration of intravenous medication and to reduce the incidence rate of patient harm through medication infusion errors (Wilson & Sullivan, 2004).
Regardless of the innovation and continued development of smart pump technology, clinicians must adhere to established standards of care, use professional judgment, and diligently monitor patients. Standard operating procedures for the safe administration of medication must be followed regardless of the mode or channel used. The five rights of medication administration absolutely apply to the use of smart pumps; clinicians must ensure that these criteria are met: the right patient, the right drug, the right dose, the right route, and the right time (FDA, 2010).
Furthermore, in addition to ensuring the five rights are followed, the practice of having a second nurse perform an independent double check with high-risk infusions should be followed when employing a smart pump.
"Common programming errors and prevention strategies"
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