When Margo McCaffery, RN, MS returns to teach "Non-Invasive Pain Relief Measures" to the nurses in Texas in the fall, she does not travel by airplane or car from her home in California. She arrives by telephone. Teleconferencing, the term used for such telephone conferences, is gaining increasing popularity in this age of energy and staffing shortages.
Margo McCaffery taught her first onehour session on the Teleconference Network of Texas in September 1978. As this was a new experience for her, she asked Lynn Graham, Coordinator of Teleconference Programs, for some guidelines. Lynn suggested that in addition to furnishing printed handouts and/or slides, it is important to speak a little more slowly than normal and modulate the voice. To avoid "listener fatigue," Lynn recommended taking natural breaks approximately every 10 minutes to ask for questions and comments.
Listening from her office in Santa Monica, California, Margo was amazed at the clarity of the participants' voices as she heard them checking in prior to the first broadcast. "Site coordinators talked to the teleconference staff as if they were old friends," Margo remarked. "They called one another by first names and when they gave the name of their cities, I had a better idea of the diversity of the audience." In the past it has been difficult to deliver a high quality of continuing education to the staffs of many small hospitals that are scattered over hundreds of miles, as is the situation in Texas. But teleconferencing can bring up-to-date education immediately to the smallest and remotest of hospitals.
At 12:30 p.m., Lynn welcomed Margo to the teleconference network, introducing her to the 300-400 nurses listening. Margo greeted the participants, reviewed the purpose of the program, referred to the printed handout material and began discussing her topic. "I must admit I was a little apprehensive at first since I couldn't 'see' my audience," Margo related, "but when I paused for the first question, and someone asked, 'Is whiplash painful?' I was so pleased to know that people really were listening and wanting to ask questions." Other questions followed through the remainder of the hour. In fact, the participants were so interested that many elected to stay on the network an additional 20 minutes to pursue the topic further.
What is it like, one wonders, for the instructor of a teleconference course? Several months before the first broadcast, an instructor puts together printed handout materials which include objectives, a course outline, charts, diagrams, self-tests and references for the registrants. These study guide materials are duplicated for each of the registrants and mailed to site coordinators.
For a one-hour program, instructors limit straight "lecture" material to 40-45 minutes. Participants always comment that they appreciate ample time for questions and answers. When possible, registrants call each other by name, so sessions often become quite lively. Two people are seldom talking at the same time, but if they do, enough is heard of each comment to ask one to repeat and then to call for the other question.
This network, the Teleconference Network of Texas (T-N-T), came into being in September 1976. It is a 24-hour "hotline" which connects the 75 sites all over the state to each other and to the Health Science Center in San Antonio. Programs are transmitted on dedicated four-wire telephone lines (regular telephone lines are two-wire). Participants listen through a small public address speaker which amplifies the sound of the program. Push-to-talk microphones at each site enable people to ask questions and to consult with the instructor and with one another.
Each of the participant sites selects a conference coordinator who acts as a liaison with the Office of Continuing Education Services. Prior to each program, the coordinator talks to the Health Science Center to be sure everything is working properly. The coordinator also distributes study materials, sets up slides, and sees that attendance sheets are signed. At the end of the sessions, coordinators return attendance records and participants' written evaluations to the staff at the Health Science Center. (Attendance records are recorded permanently on a computer at the Office of Continuing Education Services.) Sites coordinators might also be responsible for taping programs as they occur. So, the study materials, tapes and slides which are sent to sites for programs can be added to the permanent reference materials of the agency's library.
Since the first nursing program on the network in October 1976, 17 short courses have been offered for a total of 107 course hours of continuing nursing education. In addition to the short courses, there is a biweekly program titled "Current Theories and Concepts in Nursing" which looks at the latest material on a variety of topics. Each of the topics for "Current Theories and Concepts in Nursing" is suggested by a member institution and objectives for the sessions are identified by the nursing advisory committee. This nursing advisory committee is comprised of directors of inservice and directors of nursing service from the member institutions who meet via teleconference once a month to plan programs. Additionally, Barbara Hauf, RN, EdD, Coordinator of Continuing Nursing Education at the University of Texas Health Science Center at San Antonio, guides in development and needs assessment for courses. In three years, then, 159 hours of continuing nursing education have been offered, for a total of 31,800 student contact hours.
One of the benefits of teleconferencing for member institutions includes the ability to learn from and consult with well-known and highly respected instructors like Margo McCaf fery, who is nationally known for her publications and programs on pain. Neither the instructor nor the participants spend time or money on travel, and anyone in the world who can be reached by telephone may be joined to network programs. Participants in teleconference courses are often still on duty and can be called out of class in an emergency. Often they are able to return to the program after missing only a short segment, or if unable to return, they can listen to the taped broadcast of the session.
Large groups can participate in entire courses for the cost of sending one person to an out-of-town seminar. For example, the six-hour "Non-Invasive Pain Relief Measures" program is available to the individual participants at $15 per person. Can you imagine sending five people to an out-of-town, one-day course for $75.00? Travel and registration alone would be a grea t deal more than tha t, to say nothing of the staffing problems. Participant sites do pay a monthly line and equipment fee which is shared equally by all member institutions.
Does information received from teleconference courses affect patient care in Texas? Course participants say YES. Each session is evaluated by registrants, and their comments range from general praise like "What did we do before the network?" and "Keep them coming," to specific evaluation of the four-hour Analgesics course that Margo taught in January 1979. When asked how they would use the information in their work, they replied, "This information will help me toanticipate the patient's need for pain relief," "I feel more confident and knowledgable in giving analgesics in the ER setting," "This information has already helped me to explain to my patients certain questions they have about analgesics," and "I feel enlightened about analgesics' and narcotics' effects on patients." No wonder Margo looks forward to returning to Texas each fall. How else could she share with nurses in so many settings in so few "trips?"