The Journal of Continuing Education in Nursing

Teaching Tips 

Game Changer: Integrating Technology to Bring Competency and Policy to Life

Kathleen Bradley, DNP, RN, NEA-BC; Margie Godin, MS, BSN, RN-BC; Froiland Agana Ascano, MS, MSN/Ed, RN, NPD-BC, CPNP-AC, CCRN


Using technology can transform methodologies for staff education and clinical practice while addressing different learning styles and competency needs. Video can enhance competency standardization and policy use. Videos increase staff engagement and level of confidence when supplementing clinical education and policy management. [J Contin Educ Nurs. 2020;51(12):544–546.]


Using technology can transform methodologies for staff education and clinical practice while addressing different learning styles and competency needs. Video can enhance competency standardization and policy use. Videos increase staff engagement and level of confidence when supplementing clinical education and policy management. [J Contin Educ Nurs. 2020;51(12):544–546.]

Today, technology is a driving force in society and in the ever-changing health care industry. We must transform the way we prepare, practice, and manage our workforce to meet these demands. Nursing professional development specialists (NPDS) and nursing leaders need new strategies to ensure staff can practice with the best evidence and current policies. Providing best practice is key for education and clinical practice professionals. Today's workforce relies heavily on the use of mobile technology and the ability to quickly access current information. Electronic resources, when systematically updated, can provide the most current information to frontline staff. Methods of teaching must facilitate the knowledge and skill development needed to support these changes.

Establishing Essential Skills for the Professional Development Team

To support facilitation of knowledge and skill development related to technology integration, our journey began with a “think different” philosophy to embrace and embed technology in the work of the professional development team. The key foundational vision was to transform health care education through mobile digital technology. First, the skill set of our professional development team needed to be expanded. This was accomplished through collaboration with the higher education team of a technology innovation leader. To facilitate NPDS learning about how to teach using mobile technology, a curriculum was codeveloped with the higher education team. Next, expectations were established for the NPDS to use technology and mobile technology as their essential teaching tool.

Providing the education to the team and having the resources to do this new work required little effort. The team attended courses at the technology innovator's locations and established both central and unit-based equipment in our facility. Early adopters of teaching with technology were the first to receive iPads and access to the training. Due to the speed at which technology changes, we decided to procure equipment through a lease to guarantee that we had the latest technology to create the material.

Embedding “Think Different” into Essential Professional Development Programs

The Think Different campaign and the expectation to use the technology was enculturated throughout our educational programs and used to monitor staff clinical practice. Nurses are expected to have the knowledge, skills, and right attitudes to provide the appropriate standards of practice and patient care. Standards of practice are defined in the policies and procedures of the organization. Typically, policies and procedures are in a two-dimensional electronic paper format. When considering how people learn and follow directions, words alone are not the best method in complying with standardization. The premise was that we need to consider other visual methods to support standardization. Literature such as the systematic review done by Green et al. (2019) demonstrated video learning as a supplemental educational tool which improved retention of the information, improved performance, and demonstrated greater satisfaction for learners. Similarly, Ahmet et al. (2018) identified the most effective education tool that improves learning, using visual signs and cues.

A natural starting point for introducing visual learning and practice standardization was the nurse residency program. The younger generation of nurses are fluent with mobile technology and expect information to be current, at their fingertips, and just-in-time (Bradley & Godin, 2020). The evidence-based practice project, which is part of the nurse residency program, proved to be the perfect spot to provide technologically supported education.

In the September 2019 cohort of the nurse residency program, four cardiovascular intensive care unit (CVICU) nurses recognized a lack of standardization in a complex procedure that was only performed intermittently in the unit. Because the process was so complex, the CVICU nurse residents and other nurses in the unit had difficulty following the competencies of how to change transducer tubing based on the written policy. The complexity of the policy posed an issue because policy and procedures are the backbone for nursing competency and are an essential onboarding and just-in-time education tool for new and experienced staff.

The CVICU NPDS recognized that if policies and procedures were to be used as an education tool, they would need to integrate different learning styles of staff into their teaching. The CVICU residents struggled to follow polices in the written format because this was not their preferred learning style. The residents intuitively approached this problem with a technology-forward solution. They wanted a video versus words. The NPDS mentor then applied the knowledge and skills he had gained during the Think Different campaign to support their project; this from the ground-up scenario served to validate our Think Different philosophy and vision.

Next, the Game Changer

We instinctively know staff need more than written words in policy. The nurse residents highlighted the power of a video as both an educational tool and as a means of promoting standardized competency for all nurses in the unit. Standardization was particularly important for a high-risk, low-volume procedure that every nurse is expected to perform.

Making the video to use for education is important. However, the game changer to improve practice for this complex procedure was to embed the video within the policy and procedure. Staff can now choose between the written word versus a visual tool or both. Staff can watch the short 2- to 3-minute video on demand with their mobile device, allowing easy access and just-in-time education. This format aligns policy and video changes to occur simultaneously.

The impact of this new way of thinking was recognized when the data from the CVICU nurse residency project was analyzed. Typically, the postintervention sample size is lower due to less interest or participation in the project. In this case, there was an increase in staff participation postsurvey. More of the CVICU staff wanted to view the video and were appreciative of this new way of reviewing the procedure and volunteered to complete the post-survey. The participants who viewed the video had an increase of 37% in their confidence in performing the procedure. Additionally, 66% of participants considered the video to be the most valuable education resource, compared with 34% who stated the written policy and procedure was most valuable.


Integrating technology into professional development education can be done by anyone who has access to a smartphone or tablet. We have established some basic guidelines and processes to govern the use of video and clinical technology used in education and clinical practice. When creating videos, consider the length. We keep videos between 2 to 3 minutes in length for brevity, accuracy, and viewer attention span. The YouTube generation has shown us that shorter videos get more views. It is important to use the policy and procedure when making videos to ensure accuracy. The video becomes a visual version of the policy. Version control and sustaining accuracy need to be considered. Establishing technology solutions for maintaining the latest version is an essential step. We have embedded video review as part of the policy review, thus ensuring a minimal standard for review. It is better to embed a link than to add videos or other resources to educational material. This allows changes in the material without having to change educational content.

The nurses validated the need for technology and a new way of understanding how to perform skills in their nursing practice. A visual cue as found in a video made the policy come alive and made it more accessible to a broader number of nurses than a classroom presentation.


  • Ahmet, A., Gamze, K., Rustem, M. & Sezen, K. A. (2018). Is video-based education an effective method in surgical education? A systematic review. Journal of Surgical Education, 75(5), 1150–1158 doi:10.1016/j.jsurg.2018.01.014 [CrossRef] PMID:29449162
  • Bradley, K. & Godin, M. (2020). Think different: Reimagining clinical practice and professional development by collaborating with the Apple higher education team. Nurse Leader, 18(1), 73–77 doi:10.1016/j.mnl.2019.11.013 [CrossRef]
  • Green, J. L., Suresh, V., Bittar, P., Ledbetter, L., Mithani, S. K. & Allori, A. (2019). The utilization of video technology in surgical education: A systematic review. The Journal of Surgical Research, 235, 171–180 doi:10.1016/j.jss.2018.09.015 [CrossRef] PMID:30691792

Dr. Bradley is Associate Chief Nursing Officer and Executive Director, Center for Professional Excellence and Inquiry, Ms. Godin is Interim Director of Professional Development and Clinical Education, and Clinical Nurse Informaticist, and Mr. Ascano is Nursing Professional Development Specialist, Cardio Vascular Intensive Care Unit, Stanford Children's Health, Palo Alto, California.

The authors have disclosed no potential of interest, financial or otherwise.

Address correspondence to Kathleen Bradley, DNP, RN, NEA-BC, Associate Chief Nursing Officer and Executive Director, Center for Professional Excellence and Inquiry, Stanford Children's Health, 725 Welch Road, Palo Alto, CA 94020; email:


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