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A case study of a managers’ workshop


To apply for Magnet® recognition, a healthcare organization must describe and demonstrate how its nursing leaders promote and develop nursing cultures that support implementation of structures and processes to achieve excellence in patient care and nursing practice. Orlando Health in Orlando, Florida, used the five Magnet® Model components and standards to develop a workshop to prepare nursing operations managers at Arnold Palmer Medical Center (part of Orlando Health) to lead their staff in enculturating these standards.

The organization initiated a workshop for all nurses to help familiarize them with Magnet Recognition Program® goals and guiding principles. The premise was that as leaders, managers would be engaged because they’re knowledgeable about Magnet standards. However, it quickly became apparent this wasn’t the case. The need for manager education was clear, prompting the nursing projects department to develop a workshop for nurse managers and leaders.

Teaching strategies

Knowles’s adult learning principles and Bloom’s taxonomy were used as guiding frameworks. Knowles’s theory holds that adult learners are self-directed and need to know why they must learn something. Bloom’s taxonomy promotes a higher level of thinking by using such methods
as application and analysis during educational activities.

We designed the managers’ workshop around the Magnet Model components—transformational leadership; structural empowerment; exemplary professional practice; and new knowledge, in­-novations, and improvements. (The empirical outcomes components are embedded within the four components.)

Most workshop sessions used facilitated discussion, presentations, role-playing, surveying, home- ­work assignments, and group interactions to provide as active a learning environment as possible. Brief PowerPoint® presentations and videos were used to deliver specific information, such as motivational videos and information about the Magnet Model. To promote a group effort for assignments, the room was set up the same way for each session, with tables seating six to eight participants.

Workshop sessions

The workshop took place over 4 weeks, with one 4- to 5-hour session each week focusing on a different component. Before the first workshop, we asked managers to complete a brief self-appraisal related to their perceived knowledge of Magnet standards. We gave them a hard copy and an electronic book of the managers’ workshop, including articles and tools used in the course.

Each session ended with a homework assignment that participants were to present at the next session. Most homework questions related to the specific Magnet Model component covered at that session and required each manager to describe how he or she already was, or would be, contributing to it. This allowed managers to delve more deeply into the standards and get feedback, which reinforced their role in implementing the standards.

Transformational leadership session

This session started with a 25-item multiple-choice pretest administered through our learning management system. The same test was given at the end of the workshop to determine if learning had taken place. Also, each participant was asked to complete the Multifactor Leadership Questionnaire (MLQ). Results were kept confidential and given to participants, who had the option to receive additional coaching from a leadership consultant to strengthen their transformational leadership abilities. The consultant advised the group how questionnaire results related to the coaching sessions would be used.

After an introductory exercise, participants watched a motivational video and took part in a facilitated discussion on why people follow leaders. Then the chief nursing officer presented the transformational leadership lecture. Each table was assigned a component of Bass’s transformational leadership theory to role-play in front of the group, with everyone trying to guess which component was being portrayed.

Structural empowerment session

Activities for this session included identifying the structural empowerment standards from a presentation about a manager who was rounding on her unit. A poll was conducted that asked the managers if they had reached goals regarding degree and certification rates. Next came a review of the characteristics of Magnet-recognized organizations and a discussion on how to improve degree and certification rates.

For most of the remainder of the session, participants discussed the manager’s role in a shared leadership environment. Many said they didn’t know what their role was relative to unit practice councils and weren’t sure how they could provide support. The session ended with a review of the literature on leaders’ changing role in a shared governance environment.

Exemplary professional practice session

This session focused on four main topics—professional practice model, care-delivery systems,
peer review, and nursing outcomes. Managers at each table selected a patient that they or their team had cared for, and they discussed the elements of the hospital’s professional practice model that applied to that patient’s care. The care-delivery section included an activity that asked everyone to describe their care-delivery system, followed by a presentation on these systems.
Next, the results of a just-completed peer review pilot on falls and pressure ulcers were shared, followed by a presentation on the importance of peer review. Recognition that peer review can have a marked effect on nursing quality (such as decreased falls and pressure ulcers) prompted an organization-wide implementation effort at Arnold Palmer Medical Center.

The final part of this session included several exercises involving analysis of patient satisfaction graphs and nurse satisfaction and quality indicators. After the analysis, managers were asked to develop an improvement plan to help them identify contributing factors for improvement.

New knowledge, innovations, and improvements session

This session focused on appraising literature related to evidence-based leadership. Managers at each table were asked to read and appraise a leadership article using the American Journal of Critical Care guidelines for critiquing research. A spokes­person for each table presented the appraisal and received feedback from the facilitator.

During the last part of the session, participants discussed how to “connect the dots” of the Magnet Model. Then they played a “Jeopardy”-style game to reinforce the last 4 weeks of learning in a fun way.

Workshop results

Overall, participants’ 25-item multiple choice posttest scores showed a significant improvement over their pretest scores, with the average score increasing from 54.75 to 71.82. However, nine of the 20 managers didn’t complete the posttest.

The self-appraisal, which used a Likert scale, showed improvement as well, although 12 of the managers didn’t complete it. Of the 22 participating managers and four nursing leaders who completed it, 13 opted to attend the coaching sessions. Overall, coaching sessions were well-received and recommended by participants. Based on evaluations, the managers’ workshop was perceived as beneficial. (See How participants rated the coaching sessions.)

Translating Magnet standards into practice

The Magnet standards provide guidance to nursing organizations seeking to achieve excellence
in nursing practice and patient-care outcomes. Transformational leaders are essential for implementing standards that enable nurses to provide excellent patient care. Our workshop provided insight into the managers’ knowledge and understanding of Magnet Model components, as well as their ability to interpret and apply the standards.

Although the testing tools we used weren’t validated, the workshop helped participants “connect the dots” and translate the Magnet standards into practice. Translation of the Magnet Model into practice is supported by education and also requires continuous reinforcement by nursing leaders.

Organizations need to keep investing in development of nursing leaders to meet the high demands of our evolving healthcare culture. The Magnet Model remains a proven framework that drives nursing quality to address global healthcare issues.

Selected references
American Nurses Credentialing Center. The Magnet Model® Components and Sources of Evidence: Magnet Recognition Program®. Silver Spring, MD: Author; 2013.

Bass BM. Leadership and Performance Beyond Expectations. New York, NY: The Free Press; 1985.

Bastable SB. Nurse as Educator: Principles of Teaching and Learning for Nursing Practice. 4th ed. Sudbury, MA: Jones & Bartlett Learning; 2013.

Billings DM, Halstead JA, eds. Teaching in Nursing: A Guide for Faculty. 4th ed. Philadelphia: Saunders; 2011.

Bloom BS, ed. Taxonomy of Educational Objectives: The Classification of Educational Goals. Book I: Cognitive Domain. 2nd ed. Addison Wesley; 1984.

Knowles M. The Adult Learner: A Neglected Species. 3rd ed. Houston: Gulf Publishing; 1984.
Kress G, Selander S. Multimodal design, learning and cultures of recognition. Internet Higher Ed. 2012;15(4):265-8.

Eugene Waterval is the Magnet® program manager and manager of special projects at Orlando Health in Orlando, Florida.

Note: This article describes one method for conducting a workshop on the Magnet Model; this method is not endorsed by the ANCC or the Magnet Recognition program as the only method.

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