5 Learning Playlists that help nurses DO effectively under pressure -durable learning

naomi620
Sep 24, 2025
6 min read

Updated: Oct 19, 2025

Naomi's Experience

Even with my love of learning, I struggled to learn effectively during high school and university. Despite putting in the time, re-reading my notes, making colorful mind maps, and condensing my notes, I would pass exams but not excel. I often found it difficult to recall content later.

In year 12, I had a great social life but was sad and distracted following a teenage breakup. I dedicated a solid amount of time to studying, and my parents even supported me with tutors. However, when I failed year 12, most people assumed I hadn't been diligent with my time. I felt that my heartbreak clouded my ability to focus.

Long after completing year 13, my undergraduate degree, and earning a Master's in Nursing, I recognised the limitations of my learning strategies. My knowledge and skills flourished when I began teaching—not due to any inherent brilliance, but because teaching compelled me to repeat, explain, and clarify content without relying on cue cards. This process involved constant review and the ability to recall information while tackling new challenges.

handwritten highschool notes and highlighters — *Student notes with Highlighters*

I still love a good stationery set or electronic notebook, but I now understand that these tools do little to support my acquisition or retention of knowledge. As a facilitator of learning, I have known for a while that engagement requires an emotional element. However, even the most engaging sessions often fail to ensure long-term retention. Disgruntled colleagues frequently report that my students cannot recall content a week later, convinced that my sessions lacked key information because the nurses "have done it all wrong" back in the unit.

Since then, I have discovered "Make it Stick" and "Talk to the Elephant," which excellently describe the science behind how we learn. When coaching nurse educators, I find they are eager to do a good job and believe their purpose is to teach the best evidence so that nurses know the right thing. I believe the role of the nurse educator is to inspire nurses to seek more learning. A one-time session, on a good day, will lead to the retention of about 30% of the content. Therefore, no matter how awesome your session is, you need participants to engage in at least three sessions to ensure better retention.

Introduction

In healthcare, the ultimate goal of learning and development is not just for professionals to "know" information, but for them to "do" the right things consistently and effectively. This blog outlines evidence-based strategies for nurse managers and educators to support their teams in developing clinical knowledge and skills that are relevant, well-retained, and translate into improved patient care and professional practice and individuals to understand how to set themselves up for success.

We hope this supports you and your teams to move beyond traditional, often ineffective, learning methods to embrace approaches rooted in cognitive psychology and behavioral science, prioritising performance support over mere knowledge dumping.

A significant hurdle in skill development is when individuals "know what to do but they still aren't doing it."

To address this, it's crucial to understand the underlying drivers of behavior.

The "Rider and Elephant" in Nursing

Our brains have two main decision-making systems:

the "rider" (logical, rational, conscious thought)

and the "elephant" (visceral, emotional, habitual, unconscious responses). Traditional training often speaks only to the "rider," making logical arguments and explanations, but it often fails to engage the "elephant," which largely drives our actions. For instance, a nurse might intellectually know the importance of a procedure (rider), but their comfort level or ingrained habits (elephant) might prevent consistent application. Effective learning must find ways to "talk to the elephant" by making concepts tangible, emotional, and personally relevant.

Defining Target Behaviors

Vague goals, such as "improving patient communication," are insufficient. Instead, focus on observable, specific behaviors. Ask: "If you took a photo or a video of somebody performing this skill correctly, what would you be seeing?" For example, instead of "improving patient communication," define it as "making empathetic statements when discussing sensitive diagnoses."

Is it a Training Problem?

Not all performance gaps are solved by training alone. The COM-B (Capability, Opportunity, Motivation, Behavior) model offers a framework to diagnose why a desired behavior isn't happening:

Capability

Do nurses have the physical and psychological ability (knowledge, skills, attention) to perform the task? This is where traditional training is most relevant.

Opportunity

Is the social environment (e.g., colleagues modeling behavior, social norms) and physical environment (e.g., equipment, time, easy systems) conducive to the behavior?

Motivation

What are the reflective motivations (stated goals, values, professional pride) and automatic motivations (habits, biases, feelings, unconscious responses) driving or hindering the behavior?

Iceberg of performance gaps — Many Performance Gaps are not related to training.

Crucially, many behavioral challenges are linked to delayed or absent feedback. For instance, with handwashing, the immediate visual feedback of clean hands often contradicts the intellectual knowledge of germ theory, and the consequences of poor handwashing (infection) are rarely immediately visible to the individual nurse.

What Doesn't Work

Many popular study habits create an "illusion of mastery" but lead to rapid forgetting. Nurse educators should actively discourage these:

Rereading and Highlighting

These are widely used but have low utility for long-term retention and mastery. They may make material feel familiar, but this does not equate to deep understanding or recall.

Summarising (Passively)

While active summarisation (in one's own words) can be helpful, passively summarising or making notes without effortful retrieval is often ineffective, especially if the learner isn't already skilled at it.

Cramming (Massed Practice)

Concentrated, repetitive study of one topic provides fast initial gains but fades quickly. Spacing out practice is far more effective.

leaking bucket demonstrating ineffective study habits

Evidence-Based Strategies for Durable Learning

To develop robust, well-retained clinical knowledge and skills, integrate these scientifically supported learning strategies:

Active Recall and Quizzing: Make Retrieval Effortful

This is the most powerful learning technique. Regularly testing oneself, or your team, by retrieving information from memory without looking it up strengthens neural pathways and interrupts forgetting.

Application for Nurses:

Quizzing: Use low-stakes quizzes on recent material during in-services
Games: Incorporate competitive or collaborative quiz games that require active recall.
Online tools like Mentimeter: Facilitate quick, anonymous self-quizzing or group recall exercises, encouraging all participants to engage.
Flashcards: Encourage nurses to create digital flashcards for key facts, drug dosages, or procedure steps, using the app's spaced repetition algorithm.
"Explain it to a peer": After a procedure or learning a new protocol, have nurses explain it in their own words to a colleague, as if teaching them.

Long form answers are more beneficial in improving learning compared to multiple choice.

Spaced Repetition

Distribute learning and practice over time, allowing for a little forgetting between sessions. This effortful retrieval strengthens memory more deeply.

Application for Nurses:

Schedule regular, short refreshers: Instead of one long annual training, integrate brief, focused refreshers on core skills or knowledge throughout the year.
Vary topics in daily sessions: Mix topics in daily training sessions to encourage spaced practice.
Leitner system for flashcards: If using physical flashcards, implement a system where well-known cards are reviewed less frequently.

Interleaving and Varied Practice

Mix different types of problems or skills during practice. This enhances the ability to discriminate between problems and apply the correct solution in unfamiliar, real-world situations, rather than just in a predictable training context.

Application for Nurses:

Bedside support: During clinical rounds or patient care, interleave practice of different skills (e.g., patient assessment, medication administration, difficult communication scenarios) rather than focusing on one in isolation.
Simulation scenarios: Design simulations that require nurses to switch between different problem types or patient cases, mimicking the unpredictable nature of clinical work.
Mix topics in daily training: Instead of a 75-minute lecture on one subject, switch up topics and activities to engage long-term memory.

"The Harder, The Stronger"

Learning is deeper and more durable when it is effortful. Encourage nurses to grapple with problems before being given solutions, and to give new material meaning by connecting it to what they already know in their own words.

Application for Nurses:

Problem-based learning: Present clinical case studies or ethical dilemmas without immediate solutions, allowing nurses to discuss and generate their own approaches first.
Post-simulation debriefs: Facilitate discussions where nurses articulate their reasoning and connect their actions to theoretical knowledge.
Contextualise new information: When introducing new equipment or protocols, link them to existing knowledge or real-world experiences, rather than presenting them in isolation.

Making it Real through Simulation and Context: Engaging the Elephant

Abstract concepts are harder to grasp and retain; making learning concrete and personal engages the "elephant".

Application for Nurses:

Simulation sessions: Use high-fidelity simulations for complex cognitive behaviors and high-stakes scenarios (e.g., emergency responses, difficult family conversations). Simulations provide retrieval practice, are spaced, interleaved, and varied, and make the abstract concrete and personal.
Storytelling and Scenarios: Share real-world patient stories or case studies during training to evoke empathy and connect skills to their impact. Visceral experiences: For skills like hand hygiene, use tools like blacklights to make invisible threats tangible, providing a direct, emotional experience of consequences.