After more than 25 years working in healthcare, Yvonne Hanraets (50) wanted to take a new direction in her career. So, in 2017 she started as a part-time student of Organizational Learning & Development at the HAN in Nijmegen. Yvonne Hanraets: "My heart is in care and well-being; it is a world that I understand and the language I speak. Last year, when I knew I had to take my Aptitude Test in September, I decided to look for a large, complex healthcare organization where I could do my research. When I spoke with the VieCuri Learning Department, and it turned out the time was right for them to focus more on learning in the flow of work, all the pieces of the puzzle fell into place. The Learning Department asked me to map the possibilities for this - in line with the transition to a development culture - within VieCuri."

Promoting and enabling learning in the flow of work

In line with their positive experiences learning about workflow learning and with a vision towards it, VieCuri's L&D team wants to promote and enable (digital) learning created for the work context more and more.  

Marlies van den Munckhof, L&D Advisor at VieCuri: "When I attended a conference with my colleague in 2017 where both Bob Mosher and  Charles  Jennings were speaking, it became clear to me how you can apply workflow learning. The 70-20-10 provides a model of how and where you learn. Within that, the 5 Moments of Need®  is a great method to shape that. That got us very excited in the Learning & Development team of VieCuri; we immediately saw opportunities for how we could apply in our education programs.

With this in mind, in 2018, I participated in The 5 Moments of Need® Certificate Program of the 5 Moments of  Need® Academy Europe. Unfortunately, due to internal circumstances, we didn't work with it for a while afterward. But Yvonne's proposal came at the right time.  Not only because we discovered during the Corona period how important it is that our nurses can consult (new) information quickly and 'in the moment.'  But we also wanted to get a clear idea of whether what we had in mind - regarding supporting our nurses in their workplace with Performance Support - was what our nurses needed. So, that's how Yvonne was sent out. And, with success!".

Quality care for the patient first

Caring for patients in a hospital demands a range of knowledge and skills from nurses. Varied patients, illnesses, treatments, protocols, nursing plans, technical operations, and medications. Yvonne: "All that knowledge and science doesn't fit in someone's head, right?! It's not possible for nurses to always have the precise protocol knowledge and (recent) practical experience for all the activities they carry out when the work situation (often unplanned) calls for it. Therefore, nurses should have an 'external memory' in these situations. Which, in addition to their internal knowledge and skills, if in any doubt they can ask, then quickly get on with their fine and most important work: quality care for the patient."  

Yvonne's research question is:  'What 'moments of need' do nurses have when they execute their (risky) tasks, and how do we develop a suitable solution to help them perform their jobs effectively and safely?

So, Yvonne set about studying the research; she sent out surveys and held one-to-one interviews with nurses and other experts. Yvonne: "Interesting weeks where I received answers to questions like: 'What, and when, are the moments of need'? What are the needs of nurses at that time?  And: what is appropriate support for a nurse in these moments?"

Three key recommendations

Yvonne's research outlined three key recommendations on how to support nurses in the flow of their work. As follows:

1. Support nurses with Performance Support so that they can (continuously) perform their jobs well

Nurses sometimes may be unsure about a task and ask a colleague for help, or if time allows, search for the specific protocol in the quality management system, iProva. Performance Support would be an appropriate workflow support solution as a complement to peer support.

2. Design and develop performance support with the 5 Moments of Need® approach

The 5 Moments of Need® puts the work context at the center, helping to quickly locate and map performance-helpful content in 2 clicks or 10 seconds. New and existing material can be available here.

3. Make sure the pre-conditions are met for Performance Support to succeed

To properly develop Performance Support -and appropriately support nursing operations - six pre-conditions must be met, namely:

  • Involve stakeholders in the design and development of the Performance Support; make sure that the solution is appropriate to the nurses' workflow. For example, start a workgroup involving both L&D and nurses.
  • A Performance Mindset is needed. Keep focusing on the workflow. Let nurses get used to this way of looking at learning. Explain with practical examples. Start small, e.g., with one task, experiment, and grow it step by step.
  • The content must be readily and easily available in the workflow. Choose the right system for this.
  • The Performance Support content must be maintained and kept up to date. Make the topic 'content maintenance' a fixed agenda item of the workgroup.
  • Provide technical support for the Electronic Performance Support System. An EPSS needs to make the information available quickly and easily.
  • Evaluate it! As with all learning activities, workplace support also needs monitoring and evaluation to regularly review and improve the process.

Start after the summer

Marlies: "With the help of Yvonne's research, we are now even more focused on shaping workplace learning within our organization and offering Performance Support in the workflow for our nurses. What we thought before is true! Yvonne's research and her presentation to our team is the boost we need to move forward. Finally, we have insight into what we do and how we can support our nurses as best as possible. With this solid foundation and with tips for expanding our organization's support, we will continue with fresh energy after the summer. Together with our professionals at work, we will learn in the workflow and shape an effective Performance Support solution. I'm looking forward to it!"


Do you have questions about the possibilities of workplace learning and Performance Support for your organization? Please contact Alfred Remmits via

Do you have questions about the 'Aptitude Test' and Yvonne Hanraets' research? Please contact

Source photo: VieCuri Medical Center