Struggling with Carryover? Try Something New to Unlock Your Full Potential

Written by Joann Sorg, MS, OTR/L and featured in the recent NANT newsletter.

Have you ever felt discouraged by lack of carryover from caregivers and colleagues? Do you sometimes scratch your head as you watch a caregiver or colleague attempt to execute what you taught them and wonder, is that really what they thought I meant? Wondering what might tip the scales towards follow through and better outcomes?

At ERI, we’re continually examining our instructional methods to ensure learners are taking away the crucial strategies and research they need to do their jobs well. As NICU clinicians educating both caregivers and your colleagues, we know that you also want to teach well so the adults learn and babies thrive. Here’s a look at Knowles’ adult learning principles, various teaching strategies, and ways to merge them to deliver the content your NICU patients and their caregivers need for their best outcomes.

Principles 1 and 2: Problem-Centered Instruction and Application to Real-World Problems

This rings loud and true in the NICU setting, where caregivers confront multiple challenges around their baby’s health and development. Clinicians can pair their teaching strategy to this principle by using props, simulations, and hands-on methods for edema mobilization, positioning for feeding, handling and more. When Holly Schifsky teaches Baby Beats and Breaths and Babies Bodies and Brains, she embraces hands-on learning. Schifsky uses dolls to model and demonstrate techniques for her learners. You can use these same instructional methods with caregivers by coaching them through practice on a doll, providing specific feedback to refine their skills and facilitating their comfort and competence.

Principles 3 and 4: Motivation and Relevance to Current Roles

Caregivers’ experiences around parenting in the NICU encompass emotional and practical challenges. This may cause a re-imagining of their caregiving role and further spark their intrinsic motivation. NICU clinicians can acknowledge and validate the emotional experiences of caregivers while delivering essential instruction that aligns with the caregiver’s drive to perform in their new role. While teaching on medical complexities and feeding challenges for small babies, both Anjanette Lee and Shanna Semmler relate strongly to their learners’ motivations and roles as NICU clinicians. You can apply these same principles as you use video demonstrations, small group discussions and real-world clinical scenarios in your caregiver education.

To dive deeper into adult learning principles, including Self-directed Learning and Utilization of Background Knowledge, check out the work of Malcolm Knowles and his contemporaries in the field of andragogy.

infant simulator teachingTeaching the Teachers – Sharing Knowledge Amongst Colleagues

For those practitioners recently immersed in the 2024 NANT conference, you’re likely bursting with new and revived ideas and research to share with your teams. Perhaps you’re planning a professional development presentation and thinking of how best to hold your audience’s attention. You want to enhance the likelihood they’ll retain and apply the information you’re eager to share. How about pairing the familiar lecture and slideshow format with some additional strategies to connect more deeply with your leaners, inspire their clinical reasoning and lead to a cascade of favorable outcomes for providers, caregivers and babies?

Bringing your educational content to life:

  • Role simulations – pair up with a colleague to practice caregiver education; In both roles, ask questions, get it wrong, address gaps in knowledge and refine hands-on techniques.
  • Use videos and photos for meaningful analysis and to otherwise illustrate your learning objectives.
  • Facilitate small group discussions as a vehicle for learning. Steer your participants toward improved reasoning and technical skills by connecting to those adult learning principles above. Tap into their motivation as clinical leaders, advocates, developmental experts and compassionate providers as you work through case applications.
  • Ensure your learners are on the right track – real-time checks for understanding, along with pre and post-test assessments are made easy by digital polling apps that promote engagement.

NANT and ERI embrace common values around education and clinical excellence. We’re all devoted to lifelong learning that serves our patients, from their earliest days and through their most daunting challenges.


Gehl, M.B., Alter, C.C., Rider, N., Gunter, L.G., and Russell, R.B. (2020). Improving the efficiency and effectiveness of parent education in the neonatal intensive care unit. Advances in Neonatal Care, 20(1), 59-67.  

Kessler, M., Schuck, R., Rosenthal, C., Stobbe, D., Sinko, R. (2020). Caregiver education in the neonatal intensive care unit (NICU): A Review of the evidence. The American Journal of Occupational Therapy, 74(4_Supplement_1).  

Peterson, D. (2023, April). 5 Principles for the teacher of adults. 

Springer, C., Cooper, O., Elleman, B., (2023). The Effectiveness of parental education programs within neonatal intensive care units: A Systematic review. Research Directs in Therapeutic Sciences, 2(1), 2.