InPlace® Learning

Every person in health and community services needs suicide prevention training. But keeping staff trained and supported long-term can be a struggle.

• Expert-led workshops and large group trainings are costly and difficult to schedule in healthcare and community service environments.
• Train-the-trainer programs increase flexibility, but often lack fidelity and don’t provide direct access to an expert.
• Individual online learning alone can feel like you're checking a box, rather than inspiring change.

Training this foundational shouldn't be so hard to deliver.

With InPlace® we blend the convenience, fidelity, and repeatability of online training with access to experts and the opportunity to practice skills that small group learning provides.

The Story & Studies Behind InPlace Learning

Having a reliable, repeatable method for training staff is a challenge. Suicide prevention deserves consistency, quality control, and expert interaction, but the many models of education fall short. So how do we close the gap?

Here’s how.

In 2011, Dr. Pisani, along with colleagues Dr. Madelyn Gould and Dr. Wendi Cross, conducted a study on the state of suicide prevention workshop education (Pisani, Cross, & Gould, 2011). The paper included a call for greater focus on patient outcomes. Dr. Pisani's own response to this call began with Commitment to Living, an engaging and practical workshop that produced objectively-rated improvement in assessment documentation (Pisani, Cross, Watts, & Conner, 2012). He authored a major revision of another national workshop, Assessing and Managing Suicide Risk (Suicide Prevention Resource Center), and trained new leaders of this workshop across the country.

While Dr. Pisani enjoyed workshop training and leading new generations of trainers, his concerns about ’one and done’ workshops and train-the-trainer programs grew. The scales tipped when he worked on a major national study of a train-the-trainer rollout (Gould, Cross, Pisani, Munfakh, & Kleinman, 2013) in which investigators found wide variability in adherence and competence among second-generation trainers (Cross, Pisani, Schmeelk-Cone, Xia, Tu, McMahon, Munfakh, & Gould, 2014). He observed a similar pattern with workshops he led. Some trainers brought the material to life and became local champions, but others fell flat or never delivered training at all (see also Cross, Cerulli, Richards, He, & Herrmann, 2010). What’s more, participants who later attend usually don't have access to the experts who developed these excellent programs, or a mechanism for following up with questions that arise when actually putting learning into practice.

Individual online learning is a promising alternative for scale and convenience. And materials can be updated as new research and practice emerge. But you miss the richness of live Q&A with a trainer and the chance to discuss and practice with a group.

So, how can you have high fidelity teaching, group interaction, and follow-up support from an expert?

A study Dr. Pisani worked on with colleague Dr. Ken Conner sparked an idea (Conner, Wood, Pisani, & Kemp, 2013). In this study of facilitated video-based learning, groups of substance use counselors viewed video teaching and carefully constructed skills demonstrations, then took part in interactive discussion and exercises. A coordinator convened the group and helped the discussion along, but no special training to 'lead' the engaging sessions was needed.

Could this be the solution — high fidelity expert teaching, team-based learning and interaction…all delivered in a scalable, and sustainable way? All that was missing was ongoing learning and interaction with experts. A review of the literature on blended learning provided the missing piece of the puzzle: virtual office hours (Li & Pitts, 2009).

A federally-funded patient safety study led by colleague Dr. Wendi Cross gave an opportunity to experiment with online teaching. Drs. Pisani and Cross teamed up to bring Commitment to Living for Primary Care onscreen as part of a randomized trial focused on patient simulation and feedback (AHRQ 5R18HS024224). The online materials were well-received (manuscript under review), and provided the jump-start that was needed. With assistance from a University of Rochester program that helps faculty turn innovations into high-impact products, Dr. Pisani set out to create a blended learning program that would make meaningful and engaging suicide prevention education easy to deploy in healthcare and community services settings. SafeSide Prevention was founded to pursue this goal.

The result of this work is InPlace℠ Learning, which blends the convenience, fidelity, and repeatability of online training with access to experts and the opportunity to practice skills that small-group learning provides.

Dr. Pisani and his team are engaged in research collaborations and continuous quality improvement processes to further test and improve InPlace. They welcome your ideas and feedback to help write the next chapter in this story.