# Building Supportive Learning Environments: Implementation Research in VA Cardiac Cath Labs

> **NIH VA IK2** · VA EASTERN COLORADO HEALTH CARE SYSTEM · 2021 · —

## Abstract

Background: The Veterans Health Administration (VA) has set a goal to become a learning health system to
ensure the consistent delivery of high-quality, safe care to Veterans. A learning health system, per the Institute
of Medicine, harnesses data and analytics to learn from every patient and feed the knowledge to clinicians to
implement with high-reliability. Transforming the VA into a learning health system is vital to Veterans health,
given the wide variation in use of evidence-based practices and Veteran outcomes. The learning environments
in which clinical care is provided can impact these variations. Learning environments are the educational ap-
proaches (e.g., on-line v. unit-based trainings), cultural context, and settings in which teaching, and learning
happen. Supportive learning environments, which are the ideal learning environment, engage employees
through team-based trainings, such as Crew Resource Management, that include communication and team-
work skills and employ highly-reliable work practices (e.g., checklists). Healthcare teams need flexible training
tools that can be easily implemented using available resources to create supportive learning environments.
Until this need is met, one-size fits all approaches will be the dominant educational method in healthcare.
Significance/Impact: The proposed research is significant for its potential to provide teams tailored Crew Re-
source Management tools to create supportive learning environments, resulting in enhanced employee en-
gagement, learning, and Veteran care and its contribution to implementation and learning health science.
Innovation: The proposed research is innovative in that it attempts to shift the current paradigm for learning
from standardized procedurally-focused educational methods that lack communication and teamwork content
to one that provides teams Crew Resource Management tools to change their culture toward learning to en-
hance Veteran care. We will partner with VA cardiac cath labs as a model learning health system for this work.
Specific Aims: Aim 1: Assess how and why VA cath lab learning environments differ. Administer learn-
ing environment surveys to the 81 VA cath labs, assess for changes over time and if learning environments
that are highly supportive are associated with higher employee engagement and safety climate scores. Ob-
serve two consistently supportive and two non-supportive learning environments to understand the basis for
diverse contexts. Aim 2: Adapt Crew Resource Management to the culture, work flow, and learning envi-
ronments of cath labs. Engage advisory panel and stakeholders using nominal, small group technique to
achieve consensus on program design and toolkit components. Assess feasibility, appropriateness, acceptabil-
ity of toolkit. Aim 3: Pilot test the Crew Resource Management-based toolkit at four cath labs over 1
year. Test the feasibility of implementation and collection of evaluation (e.g., adoption, implementation, maint...

## Key facts

- **NIH application ID:** 10102134
- **Project number:** 5IK2HX002567-02
- **Recipient organization:** VA EASTERN COLORADO HEALTH CARE SYSTEM
- **Principal Investigator:** Heather M. Gilmartin
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-01-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10102134

## Citation

> US National Institutes of Health, RePORTER application 10102134, Building Supportive Learning Environments: Implementation Research in VA Cardiac Cath Labs (5IK2HX002567-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10102134. Licensed CC0.

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