June 9, 2014

How Do You Get Physicians to Complete Online Training…and Learn?


The short answer to the question posed in the headline is this: it isn’t always easy, but definitely doable.

The more important question is, how do you get physicians to learn once they show up? After all, attendance doesn’t always equal learning. This article will provide several tips to increase your likelihood of success!


It is possible to achieve 99 percent completion on your e-learning initiatives. To do so, training has to be mandatory and tied to some form of “penalty” if skipped. For electronic health record (EHR) purposes, some organizations have made completion of training a requirement to get access to the EHR; if you don’t complete training, you can’t use the EHR to work! This is an especially common practice for training of new hires, in which case typically the employees are so excited about the new job that they don’t mind sitting for 8-12 hours to complete anything. The greater challenge comes from having to continually educate already-employed physicians who have been with the organization for years, and anywhere that new training is competing with already busy schedules. As the chief medical officer, you can mandate training, but it will come at the risk of backlash if many learners have a bad experience. If the training isn’t of high quality, then things are even worse – no one learns and the very expensive and precious time of your physicians is wasted before implementation (and afterwards, productivity takes a major hit). If making training mandatory is the key to high completion rates, how do you minimize the risk of failure, and how do you maximize learning when physicians do attend? Here are a few tips:

Clear Requirements and Training Beyond Basics: Learners should be able to see clearly what training is required or mandatory. This can become more complex when an organization rolls out both mandatory training and elective training at the same time. There is a difference between the level of competency achieved at the end of pre-implementation training versus the level of competency achieved through actually applying what you learned in your work environment (this is called “on-the-job competency.” Among the many strategies that exist to decrease the time to achieve on-the-job competency, elective (or, better stated, intermediate to advanced) training helps. If training can be identified clearly as required/basic or elective/intermediate to advanced, then your learners are more likely to complete their requirements and accumulate more knowledge on their own when they are ready to venture beyond the basics.

Convenient and Bug Free: Quality e-learning is delivered in “bite-sized” increments, about four minutes in length, and is interactive. The interactive part is what separates this online media from videos delivered via YoutubeTM and NetflixTM, and it is also where challenges can arise. Unlike computers of the general population, most hospital computers run Internet Explorer 7 or 8. That said, when not at work, most physicians prefer to use newer devices like a tablet. There are generally two file formats used to deliver interactive training media online, FlashTM (SWF) or HTML5 Video. Flash works on IE7, but not on some tablets. HTML5 video works on some tablets, but not IE7. Physicians must be able to learn using whatever device they have available, whenever there is time to learn, even if it’s for just a few minutes. Ensuring this level of cross-device and cross-browser compatibility isn’t easy, but is absolutely possible and necessary. If training is mandated and most users are having trouble accessing the training, they will have reason to not complete training by the required date, and this can hurt your credibility. Furthermore, if they can’t access training, they won’t learn.

Relevance: Last but not least, relevance is the key to capturing a learner’s attention, and with attention, information is retained. Relevance also greatly weakens any argument against making training required. For instance, if the ICD-10 training you are being forced to learn is focused on the top conditions that emerge at your clinic each day, if the training only takes a few minutes at a time, and if the training potentially can reduce the number of queries for additional documentation in the future, who could argue with that? In contrast, imagine a four-hour ICD-10 training course that is the same for all orthopedic surgeons. Not only will you frustrate the spinal surgeon when two-thirds of the training is covering topics like distal radius fractures or hip replacements, you will lose their attention. Once the learner’s attention is lost, you significantly cut back on the capacity to learn, and ultimately, training becomes only marginally effective. Just as important, when the next training initiative comes around, you will gain less buy-in from those physicians. The same is true for training on performance metrics, such as meaningful use clinical quality metrics. It turns out that most physicians are passing more than half of their metrics for Phase 2, so why deliver training on 100 percent of the metrics to all physicians? Software is available today that can help you target training to the individual and his or her performance. When at all possible, all training a physician is required to complete should be targeted at the sub-specialty level at very least, right down to the individual diagnosis and procedures they encounter most frequently.

Making your online training initiative mandatory is only part of the challenge to attaining high levels of completion by physicians; remember that they have to learn, too. Unfortunately, physicians who have very little available time on their hands are not always inherently interested in learning about ICD-10, making your task even more difficult. However, if you make training mandatory, with clear requirements on what must be completed, in addition to making sure training is convenient to access and relevant, your likelihood of completion and effectiveness levels will both increase!

Andres Jimenez, MD

Andres Jemenez, MD, is the founder & CEO of ImplementHIT, a physician and PhD Candidate in adult education, and his company's training software is used by hundreds of hospitals to train physicians on ICD-10 and their EHR.