By Michael A. Hall, senior director of professional education, Memic
Significant strides have been made in recent years in the development of innovative medical technologies and devices, especially in digital health and the field of surgical robotics. There are a range of challenges that manufacturers of new devices must overcome in development stages and on the path toward market approval. But ultimately, approval does not guarantee broad adoption among customers – it is essential that a product addresses an unmet need and that end users can rapidly and effectively implement it into their practices and in the operating room. Robust training and education programs play an important role in ensuring seamless adoption and implementation for any new product. There are several key takeaways that manufacturers must consider when developing, assessing, or redesigning a commercial training program.
1. Treat Training As An Education Continuum
Medical technology training programs should be designed around the core principle that, after training begins, it does not end. Programs should be viewed as an education continuum where end users have opportunities to progress their training based on their competency and confidence level. The goal is to prepare the end user as much as possible to ensure that they have a comprehensive understanding of how a product works, how to use it, and can articulate their knowledge to others.
2. Ensure The Operating Room Isn’t Treated As A Classroom
Another core principle is that the operating room (OR) should not be treated as a classroom. Training programs should be designed to include tutorials, materials, and other resources for continued education for end users in case, for example, they have not performed a procedure with a new device or technology in several weeks or months and have lost their competency or confidence. Opportunities for continued education might include webinars, symposia, lectures, workshops, procedure observation and consult, proctoring, and peer-to-peer instruction on best practices and guidance for complex cases.
3. Maintain Communication With End Users
Technology and device manufacturers must also position themselves to maintain open and frequent communications with target end users and encourage a long-lasting partnership in terms of education and training. While manufacturers should encourage end users to reach out to them directly or through their practice for more information and/or training about a product, manufacturers should consider proactively engaging end users for feedback and leverage any insights to refine a program to best meet everyone’s needs.
4. Make Customized Pathways Available
Training programs and resources should also be available not only to the primary end user – for example, surgeons using robotics – but also to the entire patient care team, which might include nurses, first assistants, and OR staff. Each end user has a different background and experience, and their training must be tailored to their role. The information one person needs to learn how to effectively use a product is likely different from another. In our training program at Memic, we offer platforms designed specifically for nurses and first assistants, including off-site wet lab experience with a surgeon, dry runs, post-case review, and technology troubleshooting.
5. Be Holistic And Comprehensive
At Memic, our training program is positioned as a holistic and comprehensive experience, covering all aspects of natural orifice laparoscopic-assisted transvaginal benign gynecological procedures using the Hominis robot from beginning to end. The program is divided into four phases.
First, we introduce end users to our technology and help them learn about the value of our product with product demonstrations and test drives, procedure video clip reviews, case observations, and peer-to-peer workshops.
The next phase is hands-on training and preparation for use of our product in real-world settings, which involves online training and assessments, on-site in-service system training, simulation and skills drills, and off-site training in a wet lab. Together, all of these steps add up to more than 13 hours of training before a surgeon can be granted a certificate of completion.
After receiving their training certificate, surgeons and their staff are prepared for their first real-world case, which involves dry runs of the procedure, including collaboration among all OR staff and proctoring. Once the first case is completed, our team monitors the results to gauge the patient outcomes and success of the procedure and offers the surgical team feedback, including skills drills and additional training, if needed, at this stage.
The last phase of the program is positioned as a training continuum, with the viewpoint that there will be a learning curve moving forward and that training and learning will never end. Device and technology manufacturers may consider offering advanced and master training programs to end users who already have a significant level of experience with a product but who might benefit from skills and technique reviews.
6. Follow The Kirkpatrick Model of Training
It is also essential that device and technology manufacturers optimize their investment in time and resources to provide the most productive training pathways possible. The Kirkpatrick Model of Training is a globally recognized method of quantifying the results of training and learning programs to keep them efficient, effective, and engaging. It assesses both formal and informal training methods and rates them against four levels of criteria: reaction, learning, behavior, and results.
Level 1: Reaction: The first level determines whether participants find the training favorable, engaging, and relevant to their jobs. In many cases, manufacturers conduct a post-training survey asking participants to rate their experience and use the feedback to improve the training program.
Level 2: Learning: Level 2 assesses the learning experience of participants to quantify the increase in knowledge, skills, and confidence through a training program. This level is generally used by instructors and training executives to determine if training goals are being met. Manufacturers might consider conducting both pre- and post-training assessments to accurately measure participants’ learning curves.
Level 3: Behavior: Potentially the most important phase of the Kirkpatrick Model is evaluating whether participants were truly impacted by a training program, meaning they changed their behaviors in the real-world setting based on the knowledge and skills they acquired. This step allows manufacturers to determine whether the trained skills were understood and applied appropriately in the workplace. It can also help manufacturers uncover whether there are any logistical or cultural challenges in a workplace preventing or limiting the implementation of the acquired skills, not necessarily reflective of the effectiveness of a training program.
Level 4: Results: The final level is used to determine whether a training program was effective and measures direct results, such as decreased costs, improved quality and efficiency, increased productivity, employee retention, increased sales, and higher employee morale. While these benchmarks can be challenging and expensive to quantify in some cases, they are the best methods for determining the return on investment of a training program.
7. Position Hospitals For Success
While effective training programs are positioned as a continuum and offered to end users on a continued basis, manufacturers might also consider offering a ready-to-implement training program to all customers that can be executed internally. Our team offers hospitals and ambulatory surgical centers a turnkey training pathway that combines key training activities, programs, and processes associated with the safe use of our product. We position them for success while monitoring their performance to ensure that the quality of the program is maintained.
The purpose of a training program is not simply to conduct a series of assessments and provide participants a certificate of completion. Programs must be designed as a comprehensive and continual experience so that all end users are competent and confident and know how to safely use a new medical device or technology. Not all training programs are created equal; they must be tailored to the product and the various end users and be continually refined to align with participant feedback and direct results. And if a device or technology’s indication expands, a training program must expand with it. Ultimately, a training program is critical to the safe and effective use of any complex medical device or technology and can help lead to efficient and optimal patient care.
About The Author:
Michael A. Hall is the senior director of professional education at Memic, where he leads the development of the company’s commercial training program for the Hominis robot-assisted surgical platform. Previously, he was the director of training at OsteoMed and held various roles at Intuitive Surgical, his most recent role there being director of sales and customer training, global distribution. Before that, he was Western region manager at Hitachi Medical Systems America. Hall served as a naval officer from 1985 to 2007. He received his MA in national security affairs and was an executive fellow at the Hoover Institute on War and Peace at Stanford University.