Helping Trainees Overcome Learning Challenges

It was Friday at 4:30. I was working with a practice training new hires and today was my last day. One of the technicians who had been trained to refract that week was bright and able to learn all the work up components quickly. She demonstrated proficiency more quickly than her colleagues had. When it came to refracting, though, she had a stumbling block. It was the dreaded (queue music) dah-dah-dummmmm.... Jackson Cross Cylinder.

She just couldn't understand the JCC. I'd encountered this before with many technicians, and usually I would use an analogy and they would understand it. I had worked with her all week on it and used every technique and analogy in my tool box but it just wouldn't click. It was the end of the last day of the training and I thought, "I can't leave here without her knowing the JCC."

If you're not a clinical person, you should know that the JCC is a very important part of refracting patients with astigmatism and is usually the most challenging part of the refraction for technicians to learn.

So, that day I put my thinking cap on. "How can I help her to understand this?" I had an idea. I said "Come with me." and I took her into an exam lane. Both of us were in front of the phoropter so I could see what she was doing. I drilled down on that one part of the refraction she didn't understand. I asked her flip to the JCC to offer me two choices "Sharper one... or two... or about the same?" I answered her. She turned the JCC in the wrong direction. I said nothing, but reached up and turned it the right way and said 'Do it again". This scenario repeated itself about 10-12 times until the last time when she turned it correctly. She looked at me, eyes wide open with a huge smile and said "I'VE GOT IT!". I was happy for her but now we needed to develop muscle memory, so I said "Ok, do it again." she did and did so correctly. We repeated this over and over until I was satisfied she had the muscle memory. It had really clicked for her. I hugged her and told her how happy I was for her and I never forgot her.

Fast forward 2 years. I went back to this same practice to train more technicians and went in to say hello to the Practice Administrator. I also asked about this tech. The administrator said "Sharon, you're not going to believe it! She is our clinical trainer now!" I was astounded at how far this tech had come in just 2 years!

I share this story because it teaches us two things:

1. Never give up on someone. if they're really trying. If they have the intelligence, it's not them - it's you. Change your approach to the training. Find another strategy.
2. Try doing 'drills'. A drill is a training strategy you can use when your trainee doesn't understand one aspect of a skill or process. You can help them by isolating just that one thing they don't get and having them do it over and over and over again until it clicks. Then, have them keep doing it until the muscle memory and proficiency is there.
3. Don't underestimate someone who has learning challenges, like this technician, they may surpass your expectations.