Learning in one minute: survey of the One Minute Wonder Network

Continuous education of clinicians is an important aspect of professionalism in healthcare, especially in ICUs [21, 27]. One goal is the transfer of knowledge into practice [9]. There are different ways of learning and further training for healthcare workers like e‑learning [18], conferences [25], seminars, workshops or degree courses [2]. Furthermore, short offers from seconds to minutes like SMS [5, 24], videos, or podcasts are also possible [7]. It is not always necessary to be a part of a training course because work-based learning (WBL) also takes place day by day, e.g., during a discussion of a few minutes with colleagues [1] or on the regular work like handovers of nurses or other healthcare professionals [4].

One Minute Wonder (OMW) is a training method for the continuous education of clinicians in different healthcare settings, with a focus on critical care [23]. Usually, OMW summarize best practice knowledge such as ventilator settings, blood sugar management, new rules of bandages/dressing changes etc., on one page. OMW include text, tables or figures. OMW are hung up in places with regularly recurring waiting times in daily nursing practice ([23]; Fig. 1). In nursing departments, recurring short waiting times occur in different frequency and duration at certain locations, e.g., at a microwave oven or a laboratory device. OMW are changed in regular intervals of, for example, two weeks. The content of an OMW should be designed to be taken in within about one minute [23]. In addition, the method can be used in many other areas of healthcare, such as the ambulance service [8, 23], gastroenterology [20] or neonatal intensive care units [12]. So-called “OMW managers” can be appointed for coordination and implementation of this educational method [16]. In first pilot projects in anesthesia, OMW were perceived as helpful by caregivers [13]. In combination with continuous educational methods, OMW were able to lead to an improvement in patient care [6]. In addition, two pilot evaluations [15, 19] and one evaluation study [17] with nurses from ICU proved that the staff appreciated OMW as a learning method.

Following the inspiring example of England [23], an OMW network in German-speaking countries (Austria, Germany, Luxembourg, and the German-speaking part of Switzerland) was founded in March 2018. Participation and registration in the OMW network was via email request and without any charges. The aims are free exchange, discussion and dissemination of OMW. Members of the network have access to many OMW of other settings in healthcare, which gives them the opportunity to receive additional external impulses and ideas for their own nursing activities. A newsletter with updates and new OMW are distributed within the network quarterly. Currently, about 300 people from different healthcare settings are taking part [16]. However, the benefits of this network have not been scientifically evaluated yet.

The primary objective of this evaluation study was to examine whether and to what extent the members of the OMW network used OMW for training in different settings. Secondary objectives were subjective educational gain, OMW as a training method, and OMW-related structures and processes.

The study is an evaluation study using a closed online survey. The survey was designed in accordance with recommendations for reporting electronical surveys ([26]; Table E1 in the online supplementary material).

OMW network members were from different settings including ICUs, intermediate care, hospitals’ wards, long-term outpatient and inpatient care facilities and others. They are from Germany (n = 289), Austria (n = 7) and Switzerland (n = 5).

The primary outcome was the use of the OMW, operationalized by the questions of how many participants were using OMW, for how many years OMW have been used and how many have been created during that time.

The secondary outcome parameters are operationalized by:

Based on previous evaluations [15, 19], we developed a questionnaire for data collection. In addition to questions about the use of OMW, sociodemographic data (country, profession, work experience etc.) were added (Table 1). The development of the questionnaire was carried out within an expert panel of nurses and researchers. The current questionnaire was standardized pretested by 13 clinicians with experience of the implementation and development of OMW for comprehensibility, linguistic adjustments and the time to fill in the questionnaire, resulting in minimal modifications.

The survey was a closed online questionnaire consisting of 25 questions on 4 pages, including 151 items, with a mean of 6 items per question. The survey included closed questions with single and multiple items. In 12 questions a comment option was possible. Participants had the choice to go back and forth while answering the questions but had no access to overall results. Participants did not have to fill in every question and had an option of “not applicable” or the like. In the pretest, the mean required time to fill out the questionnaire was 8 min 30 s.

The survey assessed the following: implementation of OMW, country, profession, years of ICU experience, place of work (bedside, management, education etc.), pediatric, adult, or geriatric care, educational possibilities, number of units with OMW and discipline, number of OMW locations within one unit, OMW location, frequency of change, OMW archives, ideas for creating OMW, authorship, time since implementation, number of OMW produced, peer-review, topics, personal benefit, benefit for unit, conflicts, support, personal educational gain, overall ranking of OMW from 1 to 6 stars with 6 representing highest score.

All authors approved the final version of the survey. The survey’s items and answers in the survey were in a different order than in this publication.

The survey’s data were exported to SPSS 22.0 (IBM, Armonk, NY, USA), coded including missing data and calculated. Nominal and categorical data are reported as number and percent, ordinal data in its modus. Metrical data are reported as median and interquartile range (IQR), due to nonnormal distribution. Items were not weighted. Possible statistical relationship between the implementation of OMW and different countries, professions, years of work experience, place of work, specialty or institutions with more or less than 4 educational offers were calculated by Fisher’s exact test on the base of double-sided α = 0.05.

No personal data were requested. All participants were informed about the voluntary, anonymous approach and the time required to answer all questions. Participation was counted as consent. In advance, the local ethics committee of the Medical Faculty of the Christian Albrechts University in Kiel approved the survey (file number D 441/20). Afterwards the study has been registered in the German register of clinical trials (DRKS00021116) on 18 March 2020 (www.​drks.​de).

A strength of this survey is the high response rate of participants. Another strength is the widespread OMW network, covering a broad range implementation in different types of ICUs. Our study has some limitations. Since our results are limited to answers of participants from the OMW network, respondents possibly represent a recruitment and/or performance bias. However, the survey was anonymous and participants had no benefit for providing best answers. Second, we could not prevent participants from multiple entries, but due to the noneconomical or nonpolitical nature of this survey, this is unlikely to have happened. The report of this survey is limited to German-speaking population and culture; in countries with English as the first language, or different medical education, the perception of such an educational method may be different. Another limit is the self-constructed questionnaire without any data about its validity, reliability or objectivity. However, the questionnaire has been developed within an expert panel and was standardized pretested by 13 clinicians as an important step for practical use.