Creating learning circles in public health: Practice-based, online, quality improvement training for rural local health departments

Background: Geographic distance and workforce capacity may create barriers to effective public health training that supports the learning needs for rural health departments. The University of Kansas School of Medicine-Wichita, in collaboration with the Kansas Workforce Development Group, designed, implemented and evaluated an online quality improvement training using “just-in-time”, experiential adult learning methods, and long-term technical assistance.

Methods: A five-module, 32-week program was developed using the Plan-Do-Study-Act cycle. Modules included (1) QI methods, (2) measures and data collection, (3) data management in Excel, (4) data analysis and (5) reporting and presentation of results. Materials included the Public Health Memory Jogger, headsets and recorded demonstrations and easy-to-use materials available online. Weekly sessions included lecture, discussion and application using their own data. Assignments were shared during the following session. Results: Training began in July 2012 (two sessions per week for 20 weeks, and then twice monthly). Additionally, one-on-one online meetings were conducted to meet individual learning. Within six months, a total of 64 sessions had been held with each session lasting 1.5 hours with 6-9 attendees per session. Participants represented LHDs in the 7 of 15 public health regions. To date, participants have compiled quality improvement plans including a logic model, data collection instruments, data collection plans, data entry into an excel spreadsheet, have begun analysis by performing perform calculations and creating graphs in excel and have initiated data analysis, interpretation, report writing and presentations. The results of pre-post surveys indicate increased confidence to perform new skills, particularly in the use of Excel.

Conclusions: The “Learning Circle” online training and technical assistance program appears to be an effective and efficient method to increase the capacities of LHD staff. This innovative multi-county, pilot project has the potential to serve as a national model for workforce development in rural states.