Reflecting on a Career in Education

I have thoroughly enjoyed writing this series of ‘Metrics That Matter’ articles to share my experience, hoping it might help other educators in similar positions or early in their careers. However, reflecting on the difficult times I have faced throughout my nursing education career has also been daunting. As I was writing the first article in this series, I went back to my formative years as an educator and that sickening, empty feeling of cognitive dissonance when I first realised that providing my bosses survey data showing how many staff enjoyed their study day was not the kind of metrics that mattered (Sharples, 2024). The metrics identifying the relationship between lifelong learning and quality care failed to land. These also did not seem to matter. While learning this lesson was not fun, I cannot deny that without it, I would never have come to understand the fundamental metrics that matter to health, aged and disability care organisations.

Metrics Do Matter

The reality is that no matter how passionate an educator you are, getting executive leadership support for the professional development of your workforce will invariably only succeed if you find a way to identify, measure and present the metrics that really matter. When I say matter, I mean to them, not to you. As an educator, your ongoing challenge will always be to stop looking at professional development through a personal lens and instead ask three key questions. Firstly, what would my organisation consider success to look like? Secondly, what evidence is available for me to measure this success? Thirdly, what are the most accessible and compelling options for presenting these measures of success (Sharples, 2024)?

Calculating Workforce Costs

In the second article in this series, I found myself reflecting on that painful, penny-drop moment when I finally understood that relentless rhetoric on the links between professional development and quality care would not exactly enamour an organisation that is struggling to recruit and retain a sustainable care workforce (Sharples, 2024). It is unlikely that these will be the metrics that matter when executives are battling daily to deliver sustainable health, aged and disability care services. To my surprise (and embarrassment), I found that when I did start genuinely asking organisations what success looked like (through their lens, not mine), reducing the financial burden of trying to maintain a consistent workforce, to stop the flow of workers quitting (Barry, 2024) (World Health Organisation, 2022) was the consistent answer. In the context of ‘no margin, no mission, this metric of engagement and sustainability really did matter (Marks-Maran, 2015).

Demonstrating Our Value

As educators, we have an unprecedented opportunity to demonstrate to our organisations that professional development could assist in solving the wicked and costly burden of employee recruitment and retention. Being able to project cost-saving metrics about open days, advertising, shortlisting, interviewing, contract development, onboarding, and orientation are the meaningful measures of engagement that we, as educators, can genuinely influence (Drake International, 2024). Metrics of sustainability such as reductions in overtime or contingency labour costs or improvements in staff job satisfaction, work-life balance or commitment to grow within the organisation are robust sustainability metrics, and they will matter very much to organisations with high attrition. Once again, these elements are at the core of the educator’s role; at least, that will be alluded to in most position descriptions.

Beyond Compliance Training

So, this begs the question: If engagement and sustainability of our workforces are at the core of our education essence, why have we not been measuring these metrics all along? The answer is that as educators, we can only influence recruitment and retention if we are also empowered to provide the type of education that is genuinely valuable (to everyone, staff included) and positively impacts care quality (and efficiency). The sad and painfully raw truth is that most education work in health, disability and aged care organisations has been reduced to delivery of mandatory training with the entire focus on compliance metrics (Australian Commission on Safety and Quality in Health Care, 2021) (Australian Government Department of Health and Aged Care, 2023) (NDIS Quality and Safeguards Commission, 2022).

Now, of course, mandatory training is mandatory for a reason and in our compliance-driven organisations, it will be around for a while (Sharples, 2024). However, we also need to be willing to accept that mandatory training will not draw employees into your organisation, nor will it encourage them to stay. ‘I just love your mandatory training program’, said no one ever. Arguing the case for education about engagement and sustainability will only gain traction if you can articulate the elements of professional development that will provide meaningful (and by meaningful, I mean cost-saving) metrics of value and impact (Marks-Maran, 2015).

What Do Learners Love?

Let us start with value. If employees do not value mandatory training, what do they value? What professional development opportunities would encourage employees to come to your organisation? What would encourage your current team members to stay? What about your managers? These metrics are usually not difficult to find as most organisations have undertaken some type of ‘employee satisfaction survey’, and you may even find the results already presented in various brand-approved pie and column charts. These metrics matter. Have your employees documented their aspirations and what they view as valuable? Would employees like an opportunity to rotate across the organisation's residential and community care functions to provide variety and flexibility in their work? If so, what would a professional development program that supported this internal rotation look like?

Upskilling the Workforce

Managers in your organisation would value a pick-and-mix learning pathway that allows them to act up in senior positions they are interested in to cover extended service leave. What professional development opportunities would you provide within a staged succession plan? How much money would it save organisations in recruitment and retention if education were used to manage foreseeable workforce fluctuations and support managers to gain valuable ‘next step’ career experience?

Accurate Reporting Also Matters

Now, let’s consider the impact of education on an organisation and, specifically, the measures of impact that will matter to the bottom line. Our health, aged and disability care sectors have not become so compliance-focused on a whim. Instead, the high risk associated with much of our care provision has understandably led to the need to regulate our practices through policy, standards and legislation, which is good (Sharples, 2024). So, mandatory training is not negotiable, and that is just fine if we all accept that the impact of these metrics is on reportable compliance. Assuming your organisation has chosen its learning management system wisely, these compliance metrics should be relatively straightforward to measure and report.

Using Quality Metrics Wisely

The difficulty is that the impact of mandatory training on risk mitigation and improved quality of care is a myth. If mandatory training were the answer to risk-free care, our workplaces would be institutions of perfection. We all know they are not, and the metrics of falls, pressure injuries, medication errors, and hand hygiene (the list goes on) continue to taunt us despite all the energy and faith placed in compliance training. The truth is that mistakes still happen in practice, not because staff members are malicious or lazy, but because we expect mandatory training to improve quality when its purpose is to improve compliance.

Quality Care Matters

In healthcare law, we all know about our duty of care and accept that proof of negligence requires the combination of both foreseeability and causation (Griffith & Tengnah, 2023). I have often thought ‘experience’ would be a far better term than ‘foreseeability’. The more our workforces churn through employees, the greater the risk that this dearth of consistency and experience will hinder the foreseeability of harm. I think we can all agree that no amount of mandatory training will compensate for an itinerant worker who has little experience in a workplace and little investment in the ongoing best interests of an organisation. Regarding the impact on quality, the costs associated with negligent practice will matter, and these metrics will also be readily available within your organisation.

Measurable Quality and Education Initiatives

So, if mandatory training is not the answer, what education programs will have the desired impact quality and more importantly, how can we demonstrate that these metrics matter? Story time. Many years ago, I was fortunate to be in a healthcare organisation with a brilliant nursing leadership team. The Director of Nursing had the vision to realise that more than mandatory training alone would be needed to recruit or retain a strong nursing workforce, and it would be seen as valuable by staff or have an identifiable impact on quality care.

Instead, we developed a quality improvement education program and wove this into a selection of professional development pathways across different organisational groups. Beginning with our new graduate nurse program, we advertised this opportunity in our recruitment campaign and were overwhelmed with applications. We successfully engaged new employees who could see the value of joining and sticking with an organisation that provided a demonstrable professional development pathway. As for impact, we were able to extend our quality improvement program to external organisations, creating not just a significant cost saving in recruitment and retention but also a new revenue stream for the organisation that could be funnelled back into extending professional development opportunities across the workforce (Sharples et al., 2022). Within just one year, we had quantifiable metrics that measured the impact of this initiative through twelve clinical improvement projects. Impacts like this can be made; it just takes exemplary leadership, vision, and a spirit of cooperation.

Investing in Education

Building a case for education and, specifically, continuing professional development can be challenging, but it can also provide educators with an opportunity to demonstrate that investing in the professional development of our health, aged, and disability workforce can save rather than cost money through measures of engagement, value, impact, and sustainability. These metrics, in addition to compliance, are what matters.

References

Australian Commission on Safety and Quality in Health Care, 2021. National Consensus Statement: Essential elements for recognising and responding to acute physiological deterioration (3rd ed.), Sydney: ACSQHC.

Australian Government Department of Health and Aged Care, 2023. The Strengthened Aged Care Quality Standards – Final draft. [Online] Available at: Link to Document [Accessed 28 May 2024].

Barry, R., 2024. A survey shows that almost half of the nurses in England plan to quit or are considering it. [Online] Available at: Link to Article [Accessed 16 May 2024].

Drake International, 2024. The cost of employee turnover calculator. [Online] Available at: Link to Tool [Accessed 23 May 2024].

Griffith, R. & Tengnah, C., 2023. Law and Professional Issues in Nursing. Exeter: Learning Matters.

Marks-Maran, D., 2015. Educational research methods for researching innovations in teaching, learning and assessment: The nursing lecturer as a researcher. Nurse Education in Practice, Volume 15, pp. 472–479.

NDIS Quality and Safeguards Commission, 2022. NDIS Practice Standards. [Online] Available at: Link to Standards [Accessed 28 February 2024].

Sharples, K., 2024. Metrics That Matter - Engagement and Sustainability. [Online] Available at: Link to Article [Accessed 20 June 2024].

Sharples, K., 2024. Metrics That Matter - What Data Should an L&D Team Track? [Online] Available at: Link to Article [Accessed 20 June 2024].

Sharples, K., 2024. The Challenge of Mandatory Training for Compliance Driven Organisations. [Online] Available at: Link to Article [Accessed 30 April 2024].

Sharples, K., Armstrong, T. & O'Neill, D., 2022. Innovation in Practice – Implementing Australia’s First Online Transition to Practice Program. Presented at the 8th International Nurse Education Conference, Sitges, Barcelona.

World Health Organisation, 2022. Ticking timebomb: Without immediate action, the European Region's health and care workforce gaps could spell disaster. [Online] Available at: Link to Article [Accessed 22 May 2024].

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