title: Connecting the learners: improving uptake of a nursing home educational program by focusing on staff interactions.
abstract: OBJECTIVE
  The CONNECT intervention is designed to improve staff connections, communication, and use of multiple perspectives for problem solving. This analysis compared staff descriptions of the learning climate, use of social constructivist learning processes, and outcomes in nursing facilities receiving CONNECT with facilities receiving a falls education program alone.
  
  
  METHODS
  Qualitative evaluation of a randomized controlled trial was done using a focus group design. Facilities (n = 8) were randomized to a falls education program alone (control) or CONNECT followed by FALLS (intervention). A total of 77 staff participated in 16 focus groups using a structured interview protocol. Transcripts were analyzed using framework analysis, and summaries for each domain were compared between intervention and control facilities.
  
  
  RESULTS
  Notable differences in descriptions of the learning climate included greater learner empowerment, appreciation of the role of all disciplines, and seeking diverse viewpoints in the intervention group. Greater use of social constructivist learning processes was evidenced by the intervention group as they described greater identification of communication weaknesses, improvement in communication frequency and quality, and use of sense-making by seeking out multiple perspectives to better understand and act on information. Intervention group participants reported outcomes including more creative fall prevention plans, a more respectful work environment, and improved relationships with coworkers. No substantial difference between groups was identified in safety culture, shared responsibility, and self-reported knowledge about falls.
  
  
  CONCLUSIONS
  CONNECT appears to enhance the use of social constructivist learning processes among nursing home staff. The impact of CONNECT on clinical outcomes requires further study.
authors.affiliation: *Address correspondence to Cathleen Colón-Emeric, MHS, Durham VA Geriatric Research Education and Clinical Center, MD 508 Fulton St., GRECC 182, Durham, NC 27705. E-mail: colon001@mc.duke.edu.
authors.forename: Cathleen S
authors.initials: CS
authors.lastname: Colón-Emeric
authors.forename: Sandro O
authors.initials: SO
authors.lastname: Pinheiro
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Anderson
authors.forename: Kristie
authors.initials: K
authors.lastname: Porter
authors.forename: Eleanor
authors.initials: E
authors.lastname: McConnell
authors.forename: Kirsten
authors.initials: K
authors.lastname: Corazzini
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hancock
authors.forename: Jeffery
authors.initials: J
authors.lastname: Lipscomb
authors.forename: Julie
authors.initials: J
authors.lastname: Beales
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Simpson
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D016032:Randomized Controlled Trials as Topic
keywords: Falls; Nursing homes; Provider education