Table 1 CONNECT protocol activities, rationale, who is involved and time required

Learning Protocols

CONNECT & Learn Protocols

CONNECT Basics (Session 1). Introduces local interaction strategies using storytelling and practice using role-play in context of falls prevention.

CONNECT Advanced (Session 2). Brief review followed by focus on the more advanced strategies of cognitive diversity, using storytelling, role-playing, and discussion of participants' experiences in applying concepts.

Interdisciplinary learning facilitates skill acquisition, creation of new horizontal and vertical connections among staff, and learning through cognitive diversity.

RNs, LPNs, NAs, social work, activities, rehab, MD, NP; dietary, administration

2, 30 min sessions occurring 2 weeks apart

(1.0 hrs total)

In-House Facilitator Training Protocols

In-House Facilitator Class Training. In-house facilitators learn to facilitate interdisciplinary in-class learning and/or practice mentoring and problem-solving at the point of care to improve local interactions.

Chance Encounter Mentoring Training. Researcher shadows the In-house facilitator trainee during the work day to identify mentoring opportunities and model 'chance encounter mentoring;' observe and advise trainee as s(he) practices the behaviors; and jointly problem solve (1 session of 1 hr).

Support by research facilitators. The researcher contacts the in-house facilitators weekly for support and advising; in-house facilitators also have a phone number to call to seek help from research staff as needed.

Prepares in-house care and supervisory staff to build trust and maintain consistency of CONNECT with the local culture. Facilitates information exchange between nursing home staff and research staff. In-house facilitators develop self-efficacy in using chance encounters to model local interactions and to mentor staff.

Care staff or managers in clinical departments (e.g., nursing, social work, activities). Individuals self-selected with encouragement of study staff.

1, 1 hr learning session;

Up to 1 hr of shadowing during regular work activities;

5, 10 min discussions

(up to 2 hrs, 50 min total)

Relationship Map Protocols

Group-to-group maps

Session 1. Researcher assists staff to describe actual interactions between work groups (e.g., NAs, LPNs, SW, Dietary, etc.).

Session 2. Researcher assists staff to depict new interaction patterns and develop guidelines for improved group-to-group interaction patterns.

Assists staff to make interaction patterns explicit (develop a group-to-group relationship map), and agree on guidelines for improved interactions.

Mid-level managers and selected LPNs, NAs.

1, 1-hr class; 1, 70 min class; 1 week apart (2 hrs, 10 min total)

Individual-to-individual maps

Researcher assists staff to draw an individual 'relationship map' that defines his/her ideal interactions with selected co-workers; reviews strategies for improving interactions. Participants learn to self-monitor and record interactions using relationship maps (available on a laminated card) and paper/pencil recording sheets.

Assists staff to evaluate relationships. Self-monitoring reinforces and sustains newly acquired behaviors and provides a measure of adherence and behavior change.

All CONNECT participants

1, 30 min session

(30 min total)

Unit Based Mentoring Protocols

Structured Mentoring (by Research Facilitator)

During the 2 weeks following each in-class session, the researcher engages each participant in a 10-min session to discuss and reflect on his/her experiences applying CONNECT concepts. The researcher uses a semi-structured guide to elicit concerns about using the strategies.

Facilitates authentic learning, which occurs only when learners can directly and independently apply concepts [75].

All CONNECT participants

2, 10 min sessions

(20 min total)

Chance Encounter Mentoring (by In-house Facilitator)

In-house facilitators engage in point-of-care discussions with staff to practice CONNECT behaviors and jointly problem solve, using the 'chance encounter' protocol. They record the number and descriptions of chance encounter mentoring sessions. At least 5 such encounters should occur daily during naturally occurring usual work activities.

Identifies staff concerns and barriers, facilitates ongoing learning about interaction, and strengthens sustainability of new behaviors. Facilitators learn to use existing time differently.

In-house Facilitators engage with floor staff in their department or work unit

1.25 hrs/day for in-house facilitator

(37 hrs total)