#31003: Technology and Innovative Teaching Strategies in Healthcare Education

A clear, all-inclusive definition of e-learning has yet to be established, though research and international collaboration has focused on creating one [10]. Generally, e-learning refers to the use of computers and electronic media and resources in education. It is broadly inclusive of all forms of educational technology, including the Internet, web-based instructional modules, distance education, and reusable learning objects. Distance e-learning is used to describe the integration of available technologic methods for distance education. These methods continue to evolve based on the currently available web resources, information, and communication technologies. The growth and promotion of distance and e-learning education has been attributed to the need to reduce costs, introduce learners to information and communication technologies, and meet the increased demand for this type of learning from consumers [11]. Some also refer to any learning that uses a computer as the main delivery device of education as computer-based learning [12].

Implementing e-learning technology can help meet the needs of learners and create a dynamic and engaging learning environment. The benefit of e-learning is that it is often essentially "on demand" for users, being available anytime, anywhere, and to anyone, especially if the lessons are asynchronous (i.e., can be used without an instructor or immediate communication with others) [13]. One instructor can manage or reach more learners with this type of delivery than traditional classroom instruction, and the resources can often be used repeatedly, making it a cost-effective delivery option [12]. With the rapid growth of this mode of learning, there are a number of premade e-learning tools available for free or purchased use. Using premade materials, educators can supplement pre-existing courses with e-learning tools. The question then becomes how to choose the material appropriately and when to use it in lessons.

The e-learning environment is more solitary, and there are challenges to consider when choosing this route for instruction. For example, motivation and achievement of learning may be difficult to maintain because there is no instructor regulation or group collaboration [13]. Also, creation of e-learning resources can be cost-, labor-, and resource-intensive; benefit versus cost should be considered. Potential costs may be direct (e.g., software and hardware needs) or indirect (e.g., time spent by faculty and staff to create and maintain lessons) [14]. If a broad audience can use the tool, it can be used repeatedly, making the cost/benefit ratio more attractive. In addition, if the resource enhances and positively impacts learning, the costs may be warranted. The trend toward the use of online collaborative tools (e.g., video conferencing) helps to overcome the challenges of solitary e-learning by providing platforms (e.g., webinars) that facilitate group projects and group discussions, enhance teamwork, and improve communication skills [15,16]. Mobile apps that connect students to their e-learning platform of choice allows them to access course materials, quizzes, and resources on the go [17].

Courses may be fully e-learning based or e-learning tools may be incorporated into existing traditional courses. For example, the American Heart Association (AHA) offers the option for learners to do a portion of their courses online. The AHA's Basic Life Support course has an online option accessible 24 hours a day, giving a flexible alternative to the traditional classroom-based training for busy healthcare professionals [18]. The learner can complete the didactic portion of the course online, and then come to a classroom for the skills demonstration and validation to receive their certification. This transitions an all-day face-to-face course to a combination of brief face-to-face instruction and e-learning, allowing the content to be mastered by the participant at his or her own pace.

Web 2.0 is a term used to describe a group of Internet-based tools that all share a user-focused approach and have an affinity toward user content creation, syndication, and open collaboration between users [19]. Some of the most common Web 2.0 tools include blogs, wikis, rich site summary (RSS) feeds, and social media sites such as Twitter, Instagram, and Facebook. These tools allow users to access information but also to contribute, create, and share. Instead of passively reading or receiving information, learners can collaborate and learn with and from each other, making learning engaging for participants [20]. The use of these tools offers a chance for educators to allow participants to seek out information and learn from each other, helping to construct and grow their knowledge base in an active learning fashion. These tools are particularly helpful when aligned with teaching and assessment exercises that are meant to increase student engagement and/or require students to summarize information or verbalize insight into their conceptual understanding through means other than traditional writing exercises [21].

The benefit of using Web 2.0 tools is that it changes the passive participation of e-learning into an interactive experience [22]. Learners and instructors can collaborate without the limitations of the immediate classroom and group. These tools can also be used for learners to connect with others, depending on how the educator builds the activity. Often, learners are already using Internet applications in their daily lives for personal use, which can eliminate the need for instruction on how to operate or access these resources. Web 2.0 tools allow instructors to evaluate and assess learning and material comprehension and allow learners to report back or discuss course material and individual progress.

However, inter-peer collaboration can be a challenge with these tools. Educators should be sure to monitor posts and discussions to clarify misinformation, moderate conversation as needed, and remind learners that they are present and available by posting feedback on a regular basis [23]. If the tools are new to the learner, he or she may require instruction on how to use them appropriately, and if learners are accustomed to using the tools in daily life, they may need guidelines or standards of participation to guide their use for the purpose of scholarship [24].

The effects of Web 2.0 tools for learning generally seem to be positive, although the available research and quantitative data are weak [25]. As stated, implementation of these tools should be carefully designed with attention to the specific purpose for their use [26]. If not well planned, incorporation can become a barrier for users and teachers to moderate and participate. Educators should become familiar with Web 2.0 tools and understand their functionality, consider limiting the number of new tools used in one course, and be mindful not to overwhelm participants with having to learn and use too many tools at once [20]. Consider ways to use Web 2.0 to modify or replace existing assignments or material that learners have found difficult or tedious in traditional methods.

Because there are many Web 2.0 tools, they can be integrated in many ways. For instance, Flickr—a photo-sharing application that lets users upload photos and share comments or stories—could be used as a forum for discussion or an educator may send learners on a virtual scavenger hunt. For instance, learners may be instructed to find and post a photo example of a pressure ulcer with a caption describing treatment options or medical chart documentation.

A wiki is a web application that allows various users to contribute, edit, or remove material in collaboration with others. This type of application could be used for learners at various locations to participate in a case study. The educator could post the link to the wiki with the case study and moderate to make sure participants are on task. Additional case information or questions may be added to evolve the case.

When real cases are involved, it is important to keep confidentiality and the rules of the Health Insurance Portability and Accountability Act (HIPAA) in mind. Even if a patient's name and specific identifying information are excluded, the details provided could increase the risk to violating confidentiality. This risk is further increased with the advent of data mining software, which can analyze and search e-mails for certain content or key words. Therefore, steps should be taken to alter the details in such a way that the patient is not recognizable.

Simulation has become increasingly popular in medical and nursing schools and education programs across the country [27]. A 2016 study indicated that, among nursing programs across the United States, 91% were using simulation in their curriculum [28]. This approach is more interactive than traditional lecture methods and allows for immersive learning [29]. The National Council of State Boards of Nursing (NCSBN) defines simulation as "activities that mimic the reality of a clinical environment and are designed to demonstrate procedures, decision making, and critical thinking through techniques such as role playing and use of devices such as interactive videos or mannequins" [30]. Simulation in healthcare education is often associated with mannequin-based simulation or human patient simulation, with the use of mannequins to replicate real patient cases. The ability of the simulator to realistically replicate real patients depends on their fidelity. High-fidelity simulators are more capable of replicating patients than lower-fidelity simulators. A 2014 NCSBN study showed that replacing up to 50% of clinical hours with simulation in prelicensure nursing education achieved comparable student outcomes (e.g., clinical competency, pass rates) to traditional clinical experiences in nursing education (i.e., simulation used in less than 10% of clinical hours) [31].

Using simulation in healthcare education has a variety of applications, including teaching new skills, testing and validating competency, improving team dynamics, and testing of protocol or procedures. It is a valuable tool because it offers a unique, controlled, learner-focused environment that can mimic real-life situations and experiences without risking patient harm [32]. These devices can provide realistic situations and opportunities for hands-on experience of procedures and the practice of professional skills [12]. As such, simulation-based learning can build confidence and improve clinical judgment [33]. Students in the simulation setting are also permitted to practice in their full scope of practice, performing skills they are not permitted to do in their student functions in traditional clinical settings. Creating realistic, student-driven simulation cases can increase critical-thinking skills and promote knowledge retention when correlated with previously learned content [27]. Cases may be adapted to challenge learners and expose them to diverse clinical situations.

Simulation is a teaching method as well as a technology (e.g., virtual reality) [16,32]. Simulation technologies have revolutionized teaching and learning in health care [16]. For example, virtual reality technology immerses students in a 3-dimensional (3-D) environment in which they can interact with virtual patients or anatomical structures. Augmented reality overlays digital information onto the real world, enhancing students' understanding of anatomical structures and their spatial relationships without the need for physical models [15].

Simulation is an evolving best practice in healthcare education, with recommendations and new technology constantly emerging for implementation. A challenge with this is mastering the teaching strategies associated with the facilitation and debriefing of simulation lessons while also learning the technology and operation of the equipment. The high costs associated with starting simulation programs and procuring equipment can be a challenge to programs and educators wishing to gain access to this modality [12].

With the growing popularity and implementation of simulation in healthcare education, resources are increasing. There are a number of prewritten simulation scenarios available from reputable resources such as the National League for Nursing, the AHA, and the American Academy of Pediatrics. Some textbook publishers are also creating companion simulation scenarios. Most often, these are available only for purchase, but some networking groups also share cases. All cases not written by the educator should be reviewed closely for adherence to current best practices, pertinence of learning objectives, and content validity.

The decision to implement simulation should be based on program objectives and support of learning goals and outcomes. Educators may use course evaluations when assessing the need for simulation in educational courses or identify areas of the curriculum that are weak or that learners are having difficulty comprehending and choose simulation activities to supplement instruction.

One example of simulation integration is the use of cardiac arrest scenarios in hospital units to practice interdisciplinary code responses. Cases may be basic life support for non-intensive care or cardiac units for staff to practice recognizing the patient is in cardiac arrest, initiating a code team response, and correctly performing cardiopulmonary resuscitation. Alternatively, in undergraduate nursing programs, the faculty could review the standardized test scores, course evaluations, and learner feedback to identify trouble content areas. For instance, they may find that the learners repeatedly have trouble with oxygenation concepts and oxygen delivery systems. This could then be worked into a simulation session with patient cases around chronic obstructive pulmonary disease, asthma, or pulmonary embolism.

Artificial intelligence (AI) creates algorithms and software that imitate human thinking and decision-making. In recent years, AI has emerged as an integral part of healthcare education and has been adopted by several medical institutions worldwide [34,35]. AI can influence the student learning process through direct teaching, support teaching, and learner empowerment [36]. With direct teaching, AI imparts knowledge to the student while playing the role of educator. Support teaching involves AI playing a supportive role and collaborating with students as they learn. Learner empowerment means multiple students can collaborate to solve a complex problem with AI (educator) feedback [36]. AI systems used in healthcare education include chatbots, intelligent tutoring systems, and virtual patients [36].

Chatbots are AI systems that are programmed to understand, process, and generate human language in response to students' queries. Because most medical students own a smartphone or tablet, chatbot systems can be easily deployed as a web application to aid learning [36]. In the setting of healthcare education, chatbots can efficiently automate time-intensive tasks, such as summarizing and evaluating research and medical literature [37]. With the capability to summarize, simplify complex concepts, automate the creation of memory aids, and serve as an interactive tutor and point-of-care medical reference, chatbots have the potential to enhance students' comprehension, retention, and application of medical knowledge in real-time [38]. However, chatbots also can potentially create false references, a phenomenon described as "hallucination." Therefore, students should not rely on chatbots completely but use them as assistive tools only [38].

Intelligent tutoring systems (ITSs) are AI-based adaptive instructional systems that try to emulate the benefits of one-on-one human tutoring [39]. ITSs can analyze vast amounts of data regarding the student's past performance, preferences, and learning style to identify learning gaps and create a personalized learning experience that can be adapted to the student's needs and progress. The common themes of ITS use in medical education include teaching course content, diagnosing strengths or gaps in students' knowledge, providing automated feedback, curating learning materials based on student's needs, and facilitating collaboration between learners [40].

Virtual patients are programmed interactive computer simulations of real-life clinical scenarios. They exhibit realistic symptoms, respond to student's interventions, and generate dynamic clinical experiences. The student assumes the role of a healthcare provider by acquiring information, suggesting differential diagnoses, medical management, and patient follow-up. Virtual patient simulations can replicate various medical scenarios and present students with challenges they may face in real-life situations [41]. When interacting with virtual patients, medical students can practice their communication and clinical reasoning skills, thereby creating an immersive and interactive virtual environment that mimics real-world scenarios [41]. One systematic review and meta-analysis found that when compared with traditional education, virtual patients can more effectively improve student skills (i.e., clinical reasoning, procedural skills) and at least as effectively improve knowledge [41].

Audience response systems (ARS) are a technology that promotes interactive learning by allowing participants to anonymously answer questions in response to a live presentation. This allows the presenter to instantly gather and collect learner feedback to live questions via remote devices and display a graph of the collected data in real time [42]. Students tend to have a strong desire for interaction and engagement in their learning process, and ARS can allow an educator to make traditional presentations more interactive and increase learner engagement [43].

ARS systems can be purchased as bundles or as mobile applications. If a mobile application is used, the instructor is usually required to log on to a hosting website and learners must download the application to their mobile devices.

The anonymous factor of ARS use allows learners to feel free to respond honestly to the best of their ability without fear of being embarrassed by a wrong answer [44]. Most commonly, educators pose multiple-choice questions, which learners answer using a remote device. The educator can then see the number of responses collected and close the ability to answer when all learners have responded. The information is then analyzed and reported to the educator and/or presented to the group.

These systems work well with large groups in lecture courses or conference format because multiple devices can be used simultaneously, allowing every learner the option of interacting with the material and presenter. As financial support for healthcare education in all areas seems to be decreasing, educators may see larger class sizes, which can make it more difficult for educators to actively engage participants in the learning process. ARS may be one solution to such a problem [45].

If students perceive the use of ARS to be useful, they are more likely to use them effectively [45]. Educators may help increase positive perception by explaining how to use the devices and why they will be used at the beginning of the educational session.

There are a variety of ways to implement ARS into courses. The most common is the question-immediate answer format. ARS may also be used to facilitate discussion. In this instance, the educator divides the class into small groups, poses a question, and asks the group to select an answer after a brief discussion. These questions may be more challenging or complex (e.g., based on a case study). Well-constructed questions that target critical thinking and specific learning objectives stimulate active learning when using ARS, so educators should build them into courses wisely [46].

ARS may also be used to conduct surveys, assessments, and course evaluations. Questions may be entered into the ARS system, and participants may complete the survey while they are still present and captive in a course. The graphic output of the results may be made available only to the educator after completion. This can be valuable tool to collect information in real time and electronically.

Problem-based learning is a student-centered instructional approach whereby students are exposed to real-life problems or situations as opposed to subject-related courses. Students are then asked to generate learning issues related to what they need to know to solve or understand the problem. They seek out this information either independently or as a group and then reconvene to use their findings to solve the original problem through application [48]. It is a guided learning activity based in inquiry and built upon the foundation of cooperative learning [49]. The major goal of using this approach is to foster critical thinking that relates to professional practice situations. Other goals include helping students to develop flexible knowledge that can apply to various situations, fostering effective problem-solving skills, and increasing intrinsic motivation [50].

Problem-based learning has been used extensively in medical programs [48]. Yet, there is little available high-quality evidence supporting the promotion of critical-thinking outcomes related to this approach [51]. Still, there is an increased demand to prepare problem-solving professionals to be able to work in modern complex healthcare environments, and this educational approach seems to address this need [52]. It can be a challenge to implement problem-based learning in large classes or conferences due to the complexity of managing constructive learning in larger groups; additional faculty may be needed to help facilitate. With this approach to teaching, faculty adopt more of a facilitator role than that of a traditional educator or lecturer role, which some educators are not comfortable with [48].

There are issues to consider when implementing a problem-based approach. Orientation is very important, as many students are not familiar with this type of learning experience [53]. In addition, resources available for learners should be assessed. Learners require sufficient educator and resource support in order to successfully address and devise solutions for the problems. The scenarios should be carefully created by the educator from real-life situations, published cases, or educator experience [53].

Professionals and learners in the healthcare industry require specific clinical and technical skills to practice [54]. Blended learning combines traditional face-to-face instructional methods with online or e-learning techniques with the goals of supporting and enhancing student, educator, and resource interactions and making learning meaningful [55]. Many universities and colleges have turned to blended learning as a means to meet the needs of learners and their current or potential employers [56]. With this approach, educators post course lectures, resources, lecture slides, or other materials in online formats for participants to access as required or needed. It allows the learner more flexibility in using content, as participation in a traditional class setting is not necessary to receive class materials. This appeals to the principles of adult learning, giving learners more flexibility in their educational process [57].

It is important to ensure that blended learning is focused on course objectives and goals, not the technology itself [54]. Lessons should be geared toward the goal of achieving optimal learning by combining instructional modalities [58]. Choosing the appropriate technology or content is challenging and combining them in a way that does not overwhelm learners or distract from course material is a difficult balance.

A blended format can be as simple as posting videos or other course resources online that learners are to access and use outside of traditional class time. Or, it can be more innovative or complicated. For instance, educators may use the flipped classroom model, whereby all instruction is presented outside of class in the form of videos, readings, and other formats. Then, class time is used for application of the pre-class work. For instance, a blended course on pharmacology might require learners to review the pharmacokinetics, uses, side effects, and patient teaching related to beta blockers outside of class. Then, class time would be spent on various cardiac patient case studies.

Gamification refers to the application of a wide variety of activities typically found in games into educational sessions. This can include anything from board and card games or quiz competitions to online virtual or digital games. Simulation and simulation games may also be used. Educational gamification is most often governed by a set of rules and is completion based, with elimination criteria removing players from the game until there is a winner [59].

Healthcare education benefits from tools that foster systems thinking and facilitate complex learning [60]. More complex forms of gaming, such as digital role-playing or simulation-based games, can provide immediate or just-in-time feedback, helping participants realize the consequences of their actions in a safe learning environment [49,60]. Educational games can address all levels of learning, including reinforcing content, helping participants with application of content, and employing analysis and decision-making skills [59].

Creating complex games for use in the classroom can be time consuming. If digital or simulation games are being created, the cost may also be high. Resources for creation of classroom learning games are available from textbook publishers and/or outsourced agencies. Some tools are free source, meaning educators can access, modify, and use them for no fee. When implementing games, educators should remember that poor planning, lack of attention, and lack of follow-up will result in failure. Also consider that "losing" a game may have a negative effect on learners' self-esteem [59]. Game development should be closely tied to curriculum content and appropriate for the audience and environment. The game should have a designated objective for its use.

The growing literature on gamification in medical education shows promising learning outcomes that strengthening learning behaviors and attitudes [61]. However, debate still exists as the essential elements of gamification remain uncertain [62,63].

Adult learners have a past and bring life experiences to the classroom with them; these histories can promote or inhibit learning [64]. Telling stories is part of human nature, a way of passing information through generations, helping members of society connect with one another, and archiving history [65]. In essence, it is one of the oldest methods of teaching. For these reasons, some individuals are more attuned to this type of learning; others may shy away from it [66].

Journaling is simply the process of writing down one's personal thoughts, feelings, beliefs, and/or values related to an experience or situation. It can be used as a tool for healthcare providers to reflect on and review how personal experiences and beliefs influence their professional practice [12]. Storytelling can be used as a way to relate taught material to professional situations and practices, particularly for learners with limited exposure to clinical practice. Educators may also use storytelling to illustrate how course content relates to various clinical situations, thereby enhancing understanding.

Every learner's past, positive and negative, is carried into the learning process, and linking lessons to a person's life experiences accesses the affective domain and can assist in making cognitive learning more memorable [64]. This connection is more likely if course materials are related to positive personal stories. If material is tied to stories that are painful or emotionally charged for participants, then the educator should consider this and help put the material and story into a frame that promotes learning and understanding. For instance, sharing a story of how a family member died due to a medical error is sad and can be upsetting. Sharing how the death could have been prevented through different medical decisions can give the story purpose by helping participants think critically about the story as a case in which alternatives could mean a positive outcome.

There are various ways storytelling can be implemented by teachers. Even case studies can be story based if the educator uses clinical stories to guide learners through reflective exercises in order to build critical-thinking and decision-making skills [12]. Educators may also instruct learners to tell a story to a peer or write a story that relates to the material presented. There is a growing amount of literature that indicates that while learners can learn from their own experiences in experiential learning, they can also learn from their peers' experiences [67]. Learners may also journal about clinical experiences to explore their personal knowledge, feelings, and ideas related to a clinical situation.

As noted, social networking sites are online applications that allow users to share, interact, and collaborate. The adoption of social networking in education has changed the way learning and teaching take place [68]. These sites are very often used for personal reasons among friends and acquaintances, but they are also popular in education, as they provide an opportunity for learners to interact in a familiar online environment while connecting with learners in other geographic or learning environments. The evolution of the Internet as a large-scale information resource has created these opportunities for collaboration regardless of spatial or temporal limitations [68].

Social networking can be a means to create virtual communities that do not limit participation to those who are able to attend a class. The increasing application of social networking sites as online communities of practice in education is not exclusive to personal, social, and cultural identities and relationships [69]. Most social network memberships are free, making these sites useful resources for any course in which participants have Internet access. Another benefit to social networking is that some learners are more comfortable expressing their opinions and questions in a virtual environment as opposed to in the traditional classroom. These sites can serve as a way for learners and educators to share resources and information with one another while also learning through active participation and contribution [12].

Challenges implementing social networking methods are often related to professional boundaries. As noted, most learners are accustomed to social networking sites, but guidelines for professional learning participation should be provided if they are to be used as instructional mediums. The guidelines should include communication expectations and standards and how to represent oneself professionally online. Professional agencies, such as the American Nurses Association, remind healthcare professionals that their participation in social networking and online self-portrayal are reflective of the overall profession [12,70].

Privacy can also be a concern. If the learner or educator uses a personal account for participation in professional development or education, their personal content (e.g., follows or friends, pictures, previous postings and comments) may be available for students and other class participants to view [70]. It is wise to investigate privacy settings and the various options to limit the sharing of personal content when incorporating this method. As noted, information or photos acquired through the professional-patient relationship should not be shared online [70].

Social networking sites can move beyond communities of practice and information sharing. They can be used as way to reflect on topics, debrief events or difficult situations, and work through complex problems by promoting group thinking and collaboration. These applications can also bring students together for emotional and professional support. For instance, first-year nursing students at various colleges could be invited to the same social networking sites to discuss and share opinions or questions uniquely related to their common situation. Remember, any information published on social media should reflect professional standards and best practices, be well vetted for accuracy, and be closely monitored for abusive or misinformative comments or content. The desired outcomes as well as the consequences of a social media post should be considered before publishing [71].

When creating or revising a course, it can be difficult to determine where to start, and deciding which new strategies or technology to incorporate can be complex [75]. Learners and instructors have seen trends come and go in technology and innovation use in education [9]. Making strategic decisions regarding the incorporation of innovative techniques requires educators to take on the role of designer and analyzer, which they may or may not be familiar and comfortable with. However, this is necessary in order to create a balanced course delivery. Finding this balance is important to ensuring an efficient mix of conveying class material and providing a means for students to connect with it [76].

Although it is possible to incorporate innovative design and implementation strategies without assistance, finding support services to aid in the process increases the chances of success. There are a variety of ways an educator can find sources of support related to their personal projects or interest, including professional development courses, technology training classes, mentoring relationships, support or interest groups, and professional learning communities.

All educators will need help at some point, but they may not have the time, experience, or connections to access the support they need to be successful [79]. Gaining access to materials or people that could be helpful can be a challenge. If available, technical support staff can provide assistance with troubleshooting and questions. However, many educators do not belong to institutions with dedicated information technology staff or access to such staff may be limited. Alternative resources may include the startup guides, troubleshooting guides, and frequently asked questions related to usage of specific technology. Manufacturers or vendors may also have instant messaging services to contact remotely located support professionals. Discussion boards and chat rooms from professional organizations and networking sites can also provide knowledge and insight.

Attention should be paid to the impact of incorporating technology into teaching practices and workload, including the educator's time and learning curve [75]. If the estimates of time are high and/or significant, then it would be wise to consider speaking to a supervisor about accessing additional support to expand teaching practices.

Innovative teaching methods challenge long-held assumptions and standards regarding clinical-based education in nursing and other health sciences [84]. While the use of technology is growing in acceptance and popularity, educators implementing innovative teaching strategies may have more challenges to address. The natural instinct for curiosity and drive to learn seems to be dissipating, especially for students in higher education [76]. Today's learners prefer class information to be given passively through notes and lectures. New strategies require a substantial shift in students' roles and responsibilities [85]. This can translate to negative acceptance or pushback when educators try to employ engaging, innovative, active, and/or new teaching methods. Support for these approaches may be found in empirical research, other faculty members who have or are implementing such strategies, and supervisors (if learner complaints are made). Explaining why certain methods are used and the expectations for learners can improve participation and commitment. When an educator uses a teaching method that may make learners uncomfortable or anxious, time should be taken to explain why [86].

Professional organizations and learning groups, as previously mentioned, can also be a source of support. These organizations often connect educators to share materials, techniques, and advice on handling challenges and dealing with uncooperative learners or administration. There are a number of professional organizations related to healthcare education, nursing, honor societies, and professional development, and they may be accessed through peers, the library, Internet searches, or professional social networking sites such as LinkedIn.