EDUCATION AND ADVANCEMENT THE VHA WAY

Programs support current and future VHA medical professionals.

By J.R. Wilson

THE VETERANS HEALTH ADMINISTRATION (VHA) has created a number of programs to assist its employees with further education and future advancement. The programs fall into two broad categories: educational programs most closely tied to employee professional development and highly relevant educational topics enabled by work on face-to-face conferences. In FY 2018, more than 95,848 people took one or more of the programs offered by the Department of Veterans Affairs (VA) Employee Education System (EES).

EES is dedicated to providing VA health professionals with new learning opportunities through the VA’s nationwide Employee Education Resource Centers (EERCs). These centers provide VA professionals with the most up-todate resources, a collaborative environment, and necessary training.

“VA health care professionals are constantly learning, from diagnostic methodology to advanced treatments and the latest in experimental technologies,” according to EES, “and we’re continually improving our ability to provide top-notch care for America’s veterans. Continuous learning is essential to the work we do. That’s why we also encourage VA employees to pursue higher education by offering one of the most comprehensive education support programs in the nation.

“One excellent support tool is the Education Debt Reduction Program [EDRP], which authorizes VA to provide student loan reimbursement to employees with qualifying loans who are in difficult-to-recruit positions in direct patient care. Participants may receive up to $120,000 toward a qualified loan over a fiveyear period, covering tuition and other reasonable educational and living expenses, including fees, books, supplies, equipment/materials, and laboratory costs.”

While EDRP addresses debt from existing degrees, the Employee Incentive Scholarship Program (EISP) authorizes the VA to award scholarships to permanent full- and part-time VHA employees still pursuing degrees or training in health care disciplines for which recruitment and retention of qualified personnel is difficult. EISP led to a second program – the VA National Education for Employees Program (VANEEP) – which also provides scholarships to employees pursuing degrees or training in health care disciplines for which recruitment and retention of qualified personnel is difficult.

VANEEP provides scholarship and replacement-salary funding to VA facilities to allow certain scholarship participants who are enrolled full time in an approved education program to accelerate their degree completion by attending school full time. VANEEP participants agree to work at their VA facility during academic breaks and, in return, receive full salary and payment for education costs, including tuition, books, and certain fees.

Another program stemming from the legislative authority of EISP is the National Nursing Education Initiative (NNEI), a scholarship awarded to permanent full- and part-time VA registered nurses seeking baccalaureate and advanced nursing degrees from an authorized, accredited education program. This helps nurses meet the VA requirement to have a bachelor’s in nursing (BSN) degree to advance beyond the Nurse Level 1 position. However, NNEI scholarships also may be used to pursue other advanced degrees in related fields.

According to Dr. Elizabeth James, EES acting chief learning officer, one of the VA’s professional development programs provides educational project managers and technicians with training for master instructional designer certification.

“This training provides VHA clinicians, as well as veterans, the skills expected of world-class trainers, enhances their job performance, and enhances their opportunities for advancement within the organization,” she said. “Twelve Events employees earned this certification over the last two years [and VHA has gained] confident employees with critical job skills and the potential for advancement.

“The program has been well received by employees, creating a continuous demand for provision of this training. EES will continue to offer this training to all employees desiring to take it.”

The second category of programs includes what EES calls Process Improvement Training (Yellow/Green/Black belts).

“Change from the top can be ponderous, at best, but employee understanding of process fundamentals creates an environment of change at the lowest levels, quick wins gained through continuous small changes enabled by employee knowledge and understanding. Thirty-five Events employees earned this certification in the last two years,” James continued.

“Events has provided opportunities for this training for at least five years, seeking to provide employees the basic tools to recognize process flaws, recommend solutions, and execute approved solutions. As a result, we have gained employees capable of influencing positive and rapid change in VA from the lowest levels.”

VHA-level training in the prevention and management of disruptive behavior (PMDB) has continually evolved and improved since the late 1970s.

“Health care employees are at risk from potentially harmful disruptive behaviors. Widespread availability of training focused on handling disruptive encounters, provides VA health care providers an increased level of situational awareness, proven techniques to manage encounters, and a greater level of confidence in their ability to enhance workplace safety,” she explained.

“Staff are trained to identify disruptive situations, recognize the signs that a disruptive situation could escalate to violence, and master their own personal responses, empowering them to intervene appropriately to reduce risk of injuries to self and others.”

The PMDB curriculum will be updated in FY 20 to be better aligned with the needs of clinical participants and veterans, she added.

EES also works with program offices throughout VHA to provide focused, relevant training to take care of specific needs of veterans through a mix of peer-to-peer and guided discussion forums.

Educational incentive programs the VA has offered its employees and trainees during the past five years include:

• Women’s Health – provides care specific to the needs of female veterans

• Whole Health 101 – provides training to veterans to directly counsel each other on mental health care and suicide prevention options

• VA Voices – provides training and information for veterans transitioning to civilian life

• Warrior to Soul Mate – training to repair spousal relationships after deployment

• Stepped care for opioid use disorder train-the-trainer conference – improves access to substance use disorder (SUD) specialty care

• Improve access to SUD specialty care by increasing knowledge of medication-assisted treatment for opioid use disorder – saves lives by reducing the risk of overdose, suicide, and all-cause mortality

• National Veterans Wheelchair Games educational sessions and National Blind Services Conference – serve veterans with spinal cord injury, multiple sclerosis, amputations, and other central neurological impairments, with the goal to increase their independence, healthy activity, and quality of life through wheelchair sports and recreation

• Clinical Team Training (CTT) Champions Course – participatory leadership, followership, and assertive communication, situational awareness, team decision-making, and just culture; content is delivered via simulation and use of adult learning principles

• VA/Department of Defense (DOD) Suicide Prevention Conference – a forum for sharing state-of-the-art practices and state-of-the-science findings related to suicide prevention efforts among service members and veterans

• Peer Support Specialist Blended Learning Certification Training – transforming VHA’s mental health programs to the recovery model “About 1,200 people participate in these programs each year and we’ve had requests for more offerings,” James said. “These programs – and emerging programs based on identified needs – will continue to be developed and executed as required.”

The VA also has scholarship programs that could be compared to DOD’s ROTC programs, awarding competitive scholarships to students receiving education or training in a direct or indirect health care services discipline in exchange for a commitment to work in a VA health care facility.

While NNEI scholarships are designed for nurses already employed at the VA, the VA Nursing Academic Program (VANAP) reaches out to those still in nursing school. VANAP scholarships are intended to expand the VA’s future cadre of BSN-prepared nurses to provide quality veteran-centric care designed to improve patient outcomes and reduce the overall cost of care.

A sister nursing program scholarship is offered to those pursuing bachelor’s, master’s, or doctoral degrees in nursing and requires a two-year minimum post-graduate commitment to the VA as a full-time clinical employee.

The Physical Therapy Program awards scholarships to students working on doctor of physical therapy degrees. The scholarship requires a minimum two-year commitment to full-time clinical employment with the VA as a physical therapist.

The Physician Assistant Program awards scholarships to students working toward a Master of Science in physician assistant studies. As with other VA scholarships for nonemployees, it requires a post-graduate commitment of at least two years as a full-time clinical VA employee.

“The VA’s goal in offering these incentives is to increase opportunities for care for the whole veteran to maintain positive and productive quality of life,” James said. “Through them, the VA has gained a cadre with enhanced skills to better understand the patient population of veterans and facilitate development of complete, effective care regimens.”