Cerner Corp. develops health care information technology solutions for more than 1,500 clients around the world. Its Cerner Millennium person-centric platform reduced medication errors and medication delivery time by 50 percent at the Children’s Hospital of Pittsburgh and decreased the average length of stay by six hours per case at the New York Methodist Hospital. The company’s learning mission – to dramatically improve the performance of Cerner’s associates, clients and business partners – is carried out by Cerner Virtual University (CVU), which provides customized end-user training for clients, as well as learning and development opportunities for the company’s roughly 6,000 associates.
Cerner Virtual University has developed a learning operation that is as structured and orderly as the Chose and Book scheduling application it created for the National Health Service (NHS) in the United Kingdom. Cerner also put together a mix of performance-based simulation and Web-based end-user training embedded in a performance support system, as well as in the software itself. Results have been so positive that the NHS asked Cerner to assist with other parts of its training program.
Vice President of Learning Rob Campbell isn’t surprised by Cerner’s success with the NHS. All of Cerner’s development activities are carefully crafted based on five key learning principles, the order of which is as important as the message each contains. “Number one, we believe that learning has to be relevant,” Campbell said. “It has to be relevant to the individual, and it has to be relevant to the organization. If not, at best it’s a waste of time. At worst, it can actually be dangerous if it’s not aligned with the needs of the business and diverts critical resources toward activities that are counterproductive to corporate goals.”
Second, Cerner believes strongly that people learn by doing. “If you wanted to teach a group of kids how to ride a bike, one way to do that may be to put them in a classroom and show them PowerPoint slides of bike riding. You could talk about steering and balance, and to really make sure they could ride the bike, you could give them a multiple-choice test, right? It’s ridiculous,” Campbell said. “Yet how often do we do exactly that in a professional setting? If you want to learn to ride a bike, get on the bike. Then you get someone to coach you, mentor you and guide you along. So it is with the work that we do. If you want to learn how to use a new software solution, watching a bunch of PowerPoint slides that show the workflow isn’t going to get it done. You need to get your hands on it and actually use it in the context of the work that you’re going to be doing on the job.”
Third, learning needs to be performance-based. The only way to find out if learners can accurately complete a task is to have them do it. Cerner puts the people who go through its training programs through performance-based assessments to gauge their level of competency either through activities that are built into the course or via formal assessments that measure proficiency upon course completion. “If they can do it, great. If they can’t, we’re not done, and they’re not done,” Campbell said.
Fourth, learning is most effective when it happens just in time or right before it’s needed. Campbell said that too much learning, particularly event-based learning interventions, occurs using a just-in-case model. “If you train too early, one of two things typically happens. Either people will forget it because they’re not applying it, and by the time they need to use it they will have lost that knowledge and those skills, or two, with time passing between when you take the training and when you’re actually going to apply it, things change. Quite often the very things you’re being trained on, particularly in a technology-related area, are going to change, and the training will be obsolete.”
Finally, learning must occur in real time because that’s how people learn. “We’re trying to blur the line between work and learning and recognize the reality that most learning happens in real time on the job. Consequently, we spend a fair amount of time thinking through things like knowledge portals, performance support tools, performance support systems, job aides, coaching programs, apprenticeship programs and work practicums where you have work activities where you need to demonstrate competency and get signed off on those competencies by a more senior practitioner who provides coaching and guidance along the way. We try to focus more of our efforts in this space than we have in the past,” Campbell said.
Courseware development for Cerner associates is not only based on the company’s five learning principles, but also applies a multi-step Learning Solutions Development Process. Of the approximately 150 people who work in Cerner Virtual University, nearly half work directly or indirectly on the Learning Solutions Development Process to mesh a combination of field expertise with education and learning theory. “We’ve defined the process based on learning theories, but it is more of a practical approach for developing courseware, and that process is maintained by the learning architects on my team,” said Mark Eaton, director of learning solutions, Cerner. “That helps us eliminate some of the variance we would otherwise see in courseware development.”
The Learning Solutions Development Process has three phases: design, development and delivery. The process requires a corporate sponsor and undergoes various project kickoffs and controls that are put in place to aid project management. “For example, we expect that a project team develops a conceptual design and later a detailed design, and that design goes through a peer review,” Eaton said. “The instructional designer takes (the project) to the community of instructional designers on other teams and sort of defends the design of the course or what they intend to build out with their peers. We expect the peers to look at the design, and those specific learning principles, and see how the design is supporting it. If it’s not supporting it, what are some other ideas they can come up with?”
The peer review is only the first checkpoint. Another checkpoint involves an early prototype where sponsors give feedback to ensure course development is aligned with business needs. “Then we do a pilot, and we try to always include the actual representation of the audience that we’re trying to work with,” Eaton said. “That might include Cerner clients, but would certainly include any of the Cerner associates that we’re targeting for that program. As part of that checkpoint, we do a formal executive summary or debrief of that pilot with the executives in Cerner Virtual University. We have the instructional designer and the project manager report those results, which gives us an opportunity to decide whether we’re ready to go forward and roll that course out, or are there deficiencies that we need to take care of before we roll it out? Then there is a formal handoff to the delivery function to make sure we have the equipment, infrastructure, whatever, in place to pull off a good show.”
With that kind of detail and care put forth for every course, it’s no wonder that Cerner has created a healthy learning consulting business practice. Campbell initiated this change not long after he joined the company nine years ago, moving the company from a cost center to a profit center and self-funded organization managed as a P&L (profit and loss). The company has found significant value rebundling and repackaging successful internal solutions for client use. “Often, because of the uniqueness of the audience, you’re going to need to tweak or adjust or modify, but that is much better, even if you only have 20 to 30 percent of reuse, than to start from scratch,” Campbell said. “Not only is there great leverage in some of the work that we do internally for our associates, we’ve got a seat at the table with the rest of the organization in terms of reporting on our quarterly earnings results and on the P&L. That gives you a great deal of credibility when you’re having conversations on the internal-facing side, because you’re viewed as a business peer, someone who has similar accountabilities as other leaders of the business.”
Next, Cerner plans to take a much broader view of its intellectual capital, moving away from the classroom or an event-based approach to learning and development. This approach won’t disappear entirely. Instead, Cerner’s training methods will actively support learning and knowledge needs that occur in real time on the job. “When I say ‘intellectual capital,’ I’m referring to moving more into the content management and knowledge management space, creating an integrated approach to knowledge creation or intellectual capital creation so that you capture knowledge or content around our solutions in one place, and you’re not defining the same content 10 different times for 10 different purposes,” Campbell said. “You drive out inefficiencies by getting a better handle on the intellectual capital for the organization and truly managing it as an asset. In the future, we are likely to see not just the CVU or learning organization, but an intellectual capital organization that includes documentation developers who are writing help files and support manuals and doing content development, as well as technology and process people who are able to create the systems and processes for managing content. We will merge content experts into this same team. At the end of the day, it will become more than a learning and development team – it will be an intellectual capital organization.”
Kellye Whitney, kellyew@clomedia.com
