ICCN 17

The Oncologic Emergencies course

Charissa Cordon – Princess Margaret Hospital, Toronto, Canada



Can you tell us about the Oncologic Emergencies course?

The Oncologic Emergencies course is a course that we used to offer as a two-day workshop for nurses. It builds on their foundational knowledge and that’s important because, as new nurses, sometimes there are certain risk factors for oncology that you don’t necessarily know. So we teach the course so that they can identify patients at risk, what signs and symptoms to look for, nursing management and intervention. As I said before, it used to be a two-day workshop in which newly hired nurses were required to attend the course and sometimes experienced nurses also wanted to attend the course to refresh their memories. Now, with that course we touched upon eleven different oncologic emergencies. Because oncology is such a specialised skill, a nurse may not necessarily see all eleven oncologic emergencies. So, for example, if a nurse in leukaemia works only in the leukaemia clinic she might only see emergencies such as sepsis, disseminated intravascular coagulation and tumour lysis and not necessarily other stuff like malignant bowel obstruction and other stuff. The reason why we had to make the innovation was because of limited financial resources and human resources. We didn’t have the financial budget to offer the course regularly as often as we had wanted to do. A lot of nurses who have been on the units and working for a long time wanted to attend it but because they couldn’t get replacement and the manager couldn’t support them then they were missing out on these learning opportunities so we thought, how can we meet the demands, get them to attend the course without using up all of our resources. We thought having the course online, easily available 24/7, they can review the content any time and they pick and choose which content they want to learn about.

Have you had any evaluations from participants?

Yes, absolutely. We evaluated it last year and we had newly hired nurses evaluate it and also nursing students evaluate the course. We used the Donald Kirkpatrick model, so we did a level 1 and level 2 evaluation. Level 1 is their reaction to the course, whether they liked it and whether it facilitated their learning, if the objectives were met. And we did level 2, which is the pre-test and post-test, if there was knowledge gained from gaining the course. So overall I believe we had over 80% of the participants liked the course and it was conducive to their learning. Some of the feedback we got was sometimes there were technological glitches, that it was difficult for them to log on to the e-learning platform, it froze sometimes but overall we had positive results from the evaluation. On the level 2 evaluation with knowledge transfer, for them to pass the course they would have had to receive 100% on the quizzes, so there’s definitely knowledge gained from taking the course.

Will you use the format in other educational areas?

Not everything because I don’t want to use all e-learning. What e-learning did for the Oncologic Emergencies course is it gave them the theory but the face-to-face social learning didn’t happen, there was no forum for discussion for them and that’s the part that’s missing in this course. So where the subject needs to be an introductory course we’ll probably do it as an e-learning format, where it needs further synthesis and integration of knowledge then we might need to have a different forum for that, such as a face-to-face group discussion, case studies and stuff.

Can you tell us about your presentation?

My presentation today, it’s just describing the adult learning principles that we used to design the course, how we evaluated it and there’s going to be a phase 2 of our course which should meet the various learning styles of people. Again, it should integrate, it’ll integrate simulation and also the face-to-face discussion and case studies.

What else can you tell us about the programme?

When we developed the programme we had to take several things into consideration: adult learning principles and the different learning styles of the learners. So we know that some learners learn best by reading, by pictures, others like to read, others like to hear, so those things were incorporated in the programme and the programme consisted of several phases. So there’s an e-learning course in which it replaced the didactic style of lecture; there were presenters on the screen with their PowerPoint slides and animation. We also incorporated case studies in the e-learning courses and so it walked the learner through how patients present and how they would be managed medically and nursing interventions. At the end of each Oncologic Emergency module is a quiz in which they have to get 100% in order to pass the module. Once the learner has completed all eleven modules then they have to write a final exam which synthesized everything they had learned and they need to get 80% of that. For the Oncologic Emergencies course we also developed a workbook and so that’s a print-out of the slides that they see online which would allow the learner to write down their thoughts or any new ideas they have received. They also get a pocket guide that summarises everything that they had just learned from the e-learning course and then the last thing they get is a worksheet and this worksheet works for reflective types of learners and experiential learners in which for every oncologic emergency they’ve observed or witnessed or experienced, they get to write what the situation entailed, how it was managed, the risk factors involved, how the patient presents and the outcome of the medical situation.