CPD: methods for engaging occupational health learning

Learning is a key part of the occupational health professional’s role, and some experienced OH practitioners may find themselves mentoring or training more junior colleagues. Dr Simon Walker and Professor Anne Harriss suggest a possible method to keep learners engaged.

For many occupational health nurses (OHNs) supervising or assessing OH nursing students, mentoring or delivering ‘toolbox talks’ are important elements of their role. However, some of these practitioners have had little educational preparation and may struggle to ensure learning is delivered in the most engaging way.

Traditional forms of didactic educator-led narration have been replaced by more learner-centric methods of engagement, which typically encourage learners to take control of their learning. Studies of behaviour and knowledge acquisition range from Maslow (1943), Chomsky (2000) and Piaget (1958) to Downes (2005), Mezirow (1991), and Bandura (1977), with a host of alternative suggestions put forward by many other specialists.

This CPD article will present creative and techniques within teaching and training to help OHNs to support learners to develop and learn more effectively. Although using examples from Simon’s higher education teaching experience, the principles can be adapted and applied to the delivery of training in other settings, such as study days for occupational health professionals

Connecting facts, knowledge and experience

One favoured approach is Connectivism Learning Theory (CLT)(Siemens, 2005 & Downes, 2005). CLT is primarily built on the idea of strengthening learner understanding through aiding the connection of facts, knowledge, and experience. It encourages the learner to recognise that their views may change according to future knowledge and experience.

As an example, Simon has been using an ‘investigation board’ in his classes focused on women’s emancipation in the early twentieth century, which can be applied to other teaching initiatives, including study days for OH professionals. This teaching method uses sources of evidence collected into an investigation board, perhaps on a timeline, helping learners to visualise the case before them. This methods offers an engaging premise to ‘hook’ learners in and suppors self-directed study.

OH practice teachers, or OHNs with mentoring responsibilties, may be invited to contribute to students’ learning, particularly in relation to evidence-based clinical decision-making. The activity described below is designed to develop clinical decision-making skills when undertaking management referrals. Each student must familiarise themselves with the entire case and focus in more depth on at least two elements in preparation for a discussion. All topics should be covered and incorporated into the students’ own investigation boards to be shared with others,

Case Study – Carly

‘Carly’ (not her real name) has worked as an administrator in a travel agency for 10 years. She is held in high regard by her colleagues and her previous head of department who left the company about a year ago. Her current manager is now concerned that the quality of Carly’s work is deteriorating and her attendance is a concern. She has referred Carly for an OH opinion.

The company has recently been through significant change, in part as a result of Covid-19 related redundancies. There have also been changes to the senior leadership team. Previously it had been a pleasant place to work but now the organisational culture is changing from being friendly and supportive to being “cut-throat”, profit-driven and a less comfortable place to work. A senior manager was heard saying: “If you can’t stand the heat leave the kitchen.”

Information in the management referral to OH

Carly’s work used to be of a high standard but the number of errors she is now making is a concern for her manager, as is her level of absence. She had a three-month absence a year ago attributed to work-related stress, followed by a further 20 days absence over four occasions within the previous six months.

Information obtained from Carly at her OH appointment

Carly reveals she has dyslexia and experiences depression and anxiety, which has exacerbated her Crohn’s disease.  Until recently she had been able to manage the symptoms associated with these conditions, but her health has deteriorated significantly over the past 12 months, which she attributes to workplace stress. She says her previous manager had been understanding of the difficulties her conditions presented and allowed her to work both flexibly and remotely, enabling her to manage her workload. Her new manager, however, discounts her health problems, has increased her responsibilities, and has been much less accommodating. The manager uses a micro-management style and is adamant that all staff must work in the office and stick to their contracted hours.

Carly has a poor relationship with her manager, describing her as a bully. During a team meeting she was allocated a complex project to be completed by 9am the following day. She told her manager that the complexity of the task could not be completed in that time scale, to which the manager responded: “Stay late then, everyone else does.” Carly told her she must leave the office promptly at 5pm to attend her son’s parents’ evening.  Her manager stressed the project’s urgency and her disappointment in Carly’s attitude, adding: “You could use your mobile phone to work on the project whilst waiting for your appointment with the teacher.” Carly considered this to be an unreasonable request and felt  belittled in front of colleagues.

Whilst recounting her experiences Carly broke down in tears, stating staff shortages led to her poor work-life balance and feelings of  constant stress, which was exacerbating her Crohn’s symptoms

The activity

Students are given the case study with additional suggested resources, such as websites and employment tribunal decisions, to be completed before the learning session. The training session involves discussing the case as a group, considering the health conditions and what should be included an OH report in response to the management referral. The role of the teacher is to provide guidance to learners around what they need to consider, including:

• Carly’s current health status, particularly the impact of work on her health.
• Factors associated with effective management, including managing people and change.
• Organisational culture.
• Employment legislation, particularly the Equality Act 2010.
• The written response to Carly’s manager following the consultation.

Learners must present their case for what they would include in their response to Carly’s manager and discuss the evidence they have used in making their clinical decision.

This method of teaching requires learners to critically analyse and utilise key sources of information, which should help them demonstrate the questioning and evaluation skills required within OH nursing practice. There will be many similarities in the evidence presented, but perhaps with differences in focus. This teaching method encourages collaborative working which essential in an OH role.

The investigation board method keeps the lesson light, on track, sets clear goals, and provides enough closure to satisfy learners while leaving the door open for future study. This method is designed to excite learners and  allow them to assert agency over their knowledge acquisition and conclusion.

Setting the right tone

Another method to engage learners is the use of humour. For example, when delivering a teaching session about risk management, examples of how risk management does not quite hit the mark will bring the topic to life. Often photographs circulate on social media of inappropriate workplace set-ups – a prime example of which is a group of workers who are building a skyscraper in the 1930s, sitting on girders suspended several storeys up without any safety measures. These types of images can be useful within toolbox talks.

Tauber & Mester (1994) explained that humour that facilitates teaching without being hostile or derisive is ‘constructive humour’. Humour within a learning environment can help to lower nervousness for examination or contribution, humanise the educator, and significantly aid knowledge retention (Bobek (2002); Friedman, Halpern, & Salb (1999), McLaughlin (2001)). Powers (2005) makes the key point that teaching and humour work well together, but the classroom is not a stand-up routine: there are often topics where humour is not appropriate.

Some teachers lean into their comedic nature in order to bring students onside and give them the confidence to challenge them. However, this is not without potential pitfalls, as there is always the possibility of losing the respect of the learner.

Teaching and training is a complex practice that varies between individuals. Much of the research suggests that those delivering training are at their best when they lean into their strengths and embrace methods of and teaching that encourage learners to take ownership of their learning. There is no perfect way to reach a student, but they will take more from the session when effort is made to keep them central to the learning process.

References

Bandura, A. J. (1977). Social Learning Theory. Englewood Cliffs, NJ: Prentice Hal

Chomsky N., & Macedo DP. (2000). Chomsky on Miseducation. Lanham Md: Rowman & Littlefield.

Downes, S. (2005, December 22). An introduction to connective knowledge. Stephen’s Web.  http://www.downes.ca/cgi-bin/page.cgi?post=33034

Friedman, H.H., Halpern, N., & Salb, D. (1999). ‘Teaching statistics using humorous anecdotes’. Mathematics Teacher, 92: 305-308.

Maslow, Abraham Harold. (1943) “A Theory of Human Motivation.” Psychological Review 50.4: 370-396.

McLaughlin, K. (2001). ‘The lighter side of learning’. Training, 38: 48-52.

Mezirow, Jack. (1991). Transformative Dimensions of Adult Learning. San Francisco: Jossey-Bass.

Powers, T. (2005). ‘Observer: Engaging Students with Humour’. Association for Psychological Science, 18, (12), https://www.psychologicalscience.org/observer/engaging-students-with-humor

Siemens, G. (2005). ‘Connectivism: A learning theory for the digital age.’ International Journal of Instructional Technology & Distance Learning, (2): 3-10