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Updated: Mar 20, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Better Care Teams: A Stepwise Skill Reinforcement Model.

Beth-Anne Christopher, Mary Grantner, Lola A Coke

    Journal of Continuing Education in Nursing
    |May 28, 2016
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    Summary

    This study shows that a stepwise skill reinforcement model using continuing education (CE) effectively improves patient outcomes. This adaptable and cost-effective approach enhances learning and resource efficiency for healthcare organizations.

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    Area of Science:

    • Healthcare Education
    • Community Health Initiatives
    • Patient Outcome Improvement

    Background:

    • The Building Healthy Urban Communities initiative emphasizes continuing education (CE) for improving patient outcomes.
    • Traditional CE formats were adapted with new methods and rigorous, longitudinal evaluation.

    Purpose of the Study:

    • To evaluate the effectiveness of a stepwise skill reinforcement model in continuing education.
    • To assess the efficiency of financial and human resources in CE delivery.
    • To determine the adaptability and cost-effectiveness of the CE model for organizational adoption.

    Main Methods:

    • Implemented a CE initiative with adaptable traditional and novel delivery formats.
    • Conducted rigorous evaluations at multiple time points: pre-course, immediate post-session, 6-8 weeks post-session, and monthly 'testlets'.
    • Utilized outcome measures for content adaptation, learning objective reinforcement, and innovative testing/retrieval practice.

    Main Results:

    • The stepwise skill reinforcement model demonstrated effectiveness in learning after one year of programming.
    • The model proved to be an efficient use of financial and human resources.
    • The design is suitable for low-cost adoption by partnering organizations.

    Conclusions:

    • The stepwise skill reinforcement model is an effective strategy for continuing education in healthcare.
    • This adaptable and resource-efficient CE model can be adopted by organizations seeking to improve patient outcomes.
    • Partnership and innovative evaluation methods contribute to successful implementation.