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Making Staff In-Services Impactful
By Sara Freiberg

There is an old Chinese proverb that states, “What I hear, I forget. What I see, I remember. What I do, I understand.” Hearing is not as good as seeing, seeing is not as good as experience, and true learning is only evident when experience produces an action.In the ever-changing and complex world of healthcare, one thing is certain; some occupations require us to not only continue our education, but create an action plan following our education.

Continuing education
Continuing education is important for healthcare professionals to remain current with their CBSPD and IAHCSMM certifications, and to maintain their CBRN licenses. Continuing education is also important to ensure staff is receiving the most current information on the professional guidelines in the industry. While continuing education is a requirement for healthcare staff to remain certified, the benefits are many for the facility, the individual, and more importantly, the patients we serve.

One of the best ways to engage our healthcare teams is to implement monthly in-services. In-services provide a dedicated time where staff come together to collaborate and discuss ways to learn new devices, new and current guidelines, processes, and scientific data regarding best practices to incorporate into their workflow processes. We can keep staff motivated with our in-services by offering education in a variety of ways from various reputable sources, and training may be presented in person through a presentation, product videos, chapter conferences, hands-on training, online learning, textbooks and professional journals, or via a live or recorded webinar. The numerous educational resources available for healthcare workers allows staff members to learn either in a group setting or individually, at their own pace, and through a wide variety of methods.

Making an impact
The Greek philosopher Socrates said,“Education is the kindling of a flame, not the filling of a vessel,”and in healthcare, this rings particularly true. IAHCSMM states, “Continuing Education is important because it keeps certified individuals abreast of changes in the industry, new and emerging technologies, and informed on policies that directly impact the Central Service/Sterile Processing department.”3

Staff members depend on knowledgeable educators to share current, relevant, and valuable information during their in-services. As educators, our in-services should mirror the regulatory and manufacturer guidelines, scientific data, and best practices in the industry. Staff members should receive the most out of their education investment; therefore, educators should keep their audience, objectives, and the desired outcome in mind prior to preparing a continuing education program.

As educators, we must consider what we want our in-service to accomplish? Is it to improve device knowledge, cleaning protocols, care and handling practices, communications? Having an education action plan is a great way to involve managers and staff in the process of turning an educational in-service into a measurable result.

The importance of follow-up
The benefits of ongoing education are vast. Staff can receive one or more continuing education credits (CEs) and, more importantly, continuing education allows an opportunity for various improvements to become incorporated in our department processes and daily workflow. But what happens when the in-service is over and staff returns to their department? Do they incorporate the new information they learned into their daily structure? Follow-up is key with education to ensure changes based on the new information are implemented. Follow-up also allows an opportunity for managers to hear feedback from staff about their newly acquired skills or knowledge.

Let’s use the example of insulated surgical instruments. Most facilities understand the importance of testing their insulated instruments (laparoscopic and bipolar) for intact insulation; however, some facilities are not currently or consistently performing this important task. Checking the integrity of insulated instruments is important for patient safety and could potentially result in an adverse event.  Per the manufacturer’s IFUs, all insulated instruments must remain properly insulated, and the insulation integrity must be inspected prior to, during, and following patient use to prevent unintentional burns. We should also document that testing occurred.

For departments to receive a return on their education investment, it is important to have a plan and an end goal. Following each in-service, department managers should consider how staff will implement this new information and how to measure it. If what is shared during an in-service is never mentioned again, is it any wonder changes do not occur? Follow-up allows us to provide both the resources and support that staff needs to transfer their training into their day-to-day activities and comply with patient safety. In following up, we also convey a message of seriousness and importance to our team members; otherwise, employees may wonder if or why they should bother implementing what was taught during an in-service.

Incorporating a plan
We would like to ensure education remains fresh in our attendees’ minds following an in-service; therefore, it is important that we don’t allow too much time to pass after an in-service. Follow-up can be incorporated in a variety of ways:

  • Involve staff. Following an in-service, email a short questionnaire to staff to gain their feedback. Ask each attendee to provide a brief summary of the key takeaways they gained from the in-service.
  • Gather their feedback and post within the department. Have a brief team huddle to discuss.
  • Allow a few weeks to go by and send out a short quiz to staff to ensure staff retained the information. Post the team member that received the highest score and award a small prize.
  • Develop action plans. Incorporate new processes and best practices into the daily routine.
  • Observe staff in action as they put their new skills into effect. Lead by example and offer praise for a job well done.
  • Gather and post statistics related to the training within the department (i.e., insulated instruments were inspected, tested, and documented before and after patient use, confirming insulation integrity, patient safety, and Joint Commission compliance).
  • Meet with staff periodically to hear what (if any) roadblocks they have encountered. This type of feedback is helpful for developing more effective training and knowing how to adjust processes and protocols.4

Looking ahead
Those who continue with ongoing education and follow-up will make better informed decisions on best practices, techniques, and processes that can be adopted to improve efficiency, reduce cost risk, and improve quality to the organization.5 We should look for metrics that can be tracked and measured. If we can measure it, we can coach to it. This allows staff to participate in establishing department goals, creating accountability for follow-up and learning. Document results. Training that is viewed as part of a bigger picture is as important to a staff person’s development and progress in the organization. If a work process is incorporated, we should commit to it and put measurements in place to determine if the work process is following best practices. This will determine if a work process is sustainable to establish consistency on project execution and contribute toward patient safety.


  1. http://www.episcopalcollegiate.org/uploaded/Wildcat_Weekly/lstechtalk_020413.pdf
  2. http://www.hlede.net/section-blog/27-e-learning/49-education-is-the-kindling-of-a-flame
  3. https://www.iahcsmm.org/education/education-faqs.html
  4. http://trainingtoday.blr.com/article/ensure-your-training-is-effective/
  5. https://www.linkedin.com/pulse/why-changing-business-work-process-so-difficult-matthew-craig/


Sara Freiberg, CST, CBSPDT, CER, has more than 15 years experience working as a certified surgical technologist, with five of those years spent traveling to various operating rooms across the U.S. Following Sara’s time in the clinical arena, she worked as a surgical technology didactic and lab instructor at Rasmussen College. Sara holds bachelor degrees in science and business and marketing, which led to her work with various medical device companies as a clinical specialist, product manager, and clinical training manager. She has experience working on quality and regulatory teams, monitoring patient-adverse events, and postmarket surveillance activities.


Sara currently works for Northfield Medical as a clinical education manager where she provides education which is based on current manufacturer and regulatory guidelines regarding various healthcare topics for SPD, OR, and GI staff. Training entails the care and handling of medical devices to ensure patient safety, as well as targeted education addressing departmental cost concerns. Her passion is working with SPD, OR, and GI departments; providing assessments; and sharing best practices with respect to patient and staff safety, surgical instruments, and medical devices. Sara is a voting member of the AAMI ST/WG84, ST91 flexible endoscope committee, and she has developed several CEU presentations approved through CBSPD, CBRN, NCCT, and IAHCSMM. Sara also authors a healthcare article for Ultra Clean Systems.

Sara is currently studying for the Certification Infection Control (CIC) exam through APIC.


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