Making It Easy: Team Member Microlearning With QR Codes

Nurse educators often receive education requests from managers and nursing team members related to low-volume, high-risk skills or infrequently used equipment. These requests pose challenges for nurse educators in determining the best method to deliver education. In-service presentations and learning labs can be conducted on the units; however, scheduling conflicts and unit demands often limit participation. Unit rounding is another avenue to provide support when immediate answers are needed for questions that arise, but educators cannot be on the units 100 percent of the time. So, what is the answer? Novant Health, Winston-Salem, N.C., uses recorded short instructional videos, accessible at the point of care using quick response (QR) codes.

At Novant Health, our professional practice model (PPM) focuses on the patient and family, placing them at the center of nursing practice. This reflects the ongoing commitment to provide remarkable nursing care and is emphasized to all team members. Nursing practice validates the PPM through alignment with Novant Health’s strategic elements and service standards. The clinical education (CE) department has further integrated these strategic elements and service standards to the team members delivering care to patients. Being knowledgeable and competent in practice is essential to care delivery, and nursing executes these strategic imperatives and service standards daily. However, two behaviors are emphasized from an education perspective—“easy for me” (strategic element) and “care about me” (service standard).

CE staff want what is easy for the customer, whether it is a patient or a team member, while also accentuating “caring about me.” As a result, emphasis is placed on the resources and tools that provide the ease in functionality and delivery of education to team members. Nurses, at the forefront of patient care, often do not have time to dig through multiple pages on organizational intranet sites to find resources or immediate answers to questions. Novant Health searched for solutions. How do we support our nurses and demonstrate our commitment to “care about” them? One method: microlearning sessions using QR codes.

Strategically designed to improve the competence and confidence of nursing team members, QR codes enable team members to receive education immediately. “Just in time” education is delivered conveniently and efficiently to the team member, on demand, in their own clinical setting in an “easy for me,” user-friendly format.

Adult learning principles 

When considering teaching and learning strategies for nursing team members, adult learning theories must come into play. The father of andragogy, Malcolm Knowles, theorizes that adult learners have distinct characteristics when compared to juvenile learners. According to Knowles, adult learners are self-guided, problem-centered and internally motivated. In addition, adult learners need to understand the reason why learning something is important for them, and learning needs are often influenced by social roles (Spies, Seale, & Botma, 2015). Adults prefer to learn when they actually have the need to know.

Generation Z, which is defined as those born between 1995 and 2010, are cleverly named “digital natives,” simply because the generation grew up with smart devices in hand, as their lives have been infused with technology from birth. Gen Z also has inceptively experienced the convenience of streaming services, which promotes and sustains the ability to watch what they want, when they want (Shatto & Erwin, 2016). Further, Gen Zers prefer to learn through observation and practice rather than attending presentations. With Generation Z entering the workforce, creative strategies must be incorporated to engage the learner and deliver need-to-know information in an effective manner. What better way to engage these learners than with technology allowing them to learn when they need to?

Microlearning and QR codes

Microlearning is described as brief educational sessions aimed at teaching one specific skill, ideally in less than five minutes. An example of microlearning is a Google search, “a quick answer to a specific question” (Epstein, 2017, p. 16). Microlearning sessions should be brief and to the point; therefore, microlearning sessions should consist of simple, concrete principles, not complex ideas. Oftentimes, microlearning sessions take place within the learner’s own environment, making this teaching tactic ideal for adult learners. 

QR codes are found on a multitude of items and are easy to generate. These small black and white boxes make it simple for the end user to access the resources digitally linked to the QR code. Many smartphones have a QR code reader built into the camera application and for those that do not, applications can be downloaded to support this function. Users only need to “hover” to capture the code, and are immediately directed to a specific web address. 

The use of QR codes for education is appealing because it allows “location independence, time independence” and the delivery of “meaningful content” (Durak, Ozkeskin, & Ataizi, 2016, p. 46). These concepts are similar to adult learning characteristics and are especially appreciated by members of Gen Z. It follows that the same logic can be used for nursing education in the hospital setting. 

Case study 

In the emergency department (ED), several pieces of equipment are used infrequently, but are imperative when needed. One such piece of equipment is the infant warmer. As a birth in the ED is not a frequent occurrence, the operational components of this piece of equipment are often forgotten until it is needed, which then initiates a frenzy of calls and emails for education.

Taking into consideration adult learning characteristics, as well as learning characteristics of generations within the workforce, the CE team devised a plan. Clinical educators recorded a microlearning video with the help of the organization’s media and communications department demonstrating basic use of the infant warmer. This five-minute video was posted on an external and secured video sharing site. The web address for the video was converted to a QR code, which can be created on any number of internet sites or smart phone applications. Once the QR code was generated, it was printed on a flyer, laminated, and attached to the infant warmer. Nurses can use their smart phones to scan the QR code on the warmer to access the video for a just-in-time refresher. 

This one QR code microlearning resource ignited a corporate initiative to help make learning easier! Within a few months, clinical educators produced many more microlearning videos accessed via QR codes for other infrequently used equipment as well as low-volume, high-risk skills.