Teaching Methods



Learning Modules are delivered online for viewing at the Learner’s convenience. They are structured with PowerPoint presentations with and without voice-over; streaming videos; inquiry-based projects; and case studies. Each Module contains concept testing throughout the learning event.  Client hospitals are encouraged to contribute specific topics of interest, policies, protocols, and related education materials. These are incorporated into the COS-Hospital Modules.


Structured demonstration and simulation occur both onsite and online. Onsite demonstration and/or simulation occurs under the direction of the Preceptor, Onsite Coordinator, Clinical Expert, and/or Manager. Online simulation occurs in an interactive, virtual environment.  Real-world scenarios are replicated in state-of-the-art simulation laboratories that complement course content. Using case studies, practical skills and knowledge are tested remotely; key concepts are reinforced; and exploration of new concepts occur in a safe context. What was once too expensive and too expert intensive to create for most hospitals, we have made available for all hospitals despite local access to simulation laboratories and expert teaching resources. 

Like online simulations, online interactive clinical Games are used to help Learners gain practical experience.  Some Learners may find them more engaging and less stressful than simulations. Games support critical thinking in complex patient situations. Correct responses are acknowledged as the decision is made, thus reinforcing learning, while wrong responses result in an opportunity to complete correctly without shaming the Learner. 


Key competencies are associated with many COS Learning Modules. At the hospital’s discretion, they may include hospital-defined, unit-specific competencies. These skills and behaviors, essential to clinically competent practice, are explained in the Learning Modules and often demonstrated in online Simulations. The Preceptor or an onsite Clinical Expert, is responsible for observing, validating and documenting each of the Learner’s competencies. Checking off competencies may occur anywhere there is an internet including at the bedside and in a simulation lab  by using the COS Bedside Skill Sign-Off. 

The Learner’s progress in completing competencies can be viewed online at any time. With this information, onsite leaders, as well as COS Faculty, are able to support successful, timely progress along the novice to expert nurse continuum.


Coaching is an important part of every COS Educational Program. Every Learner has a COS Faculty member assigned to them who is committed to the Learner’s success and responsible for their online guidance and support. This structured guidance takes several forms including email communication and Virtual Office Hours, available throughout the 24 hour day, weekdays as well as weekends. 

This eliminates the problems often faced by night and weekend shift Learners who may find education resources unavailable or difficult to access. 

Onsite coaching is provided by the Onsite Coordinator and Manager. In the case of Transition-to-Practice Learners, key coaches are also the Preceptor and/or Mentor.


Several of the COS Education Programs, including all the Transition-to-Practice Programs, include live, online Cohort Meetings led by COS Faculty.  These two-way video, at-will interactions create a learning environment that supports presentation of course material as well as a debriefing and collaborating.  The meetings are structured to stimulate the exchange of ideas and  encourage Learners to connect with their peers either within the home hospital or across hospitals nation-wide. With COS Faculty coordination, they support and learn from one another using instant messaging and immediate feedback. Next steps are reviewed and content for future meetings is planned. 


In all COS Transition-to-Practice Programs, online journaling is part of the transition process. The Learner is expected to journal each week, noting goals of the week, what went well, what were points of stress, and what are ideas for improvement. This structured debriefing encourages self-awareness and tracks progress toward competence and confidence.  The Learner is able to look back and remember wins as well as documenting outstanding questions and concerns. The Journal serves as a discussion guide for Cohort Meetings and for choosing a Clinical Leadership / Quality Improvement Project. 


Several COS Education Programs include Cross-Departmental Experiences, as do all COS Transition-to-Practice Programs. Learning experiences in departments related to the Learner’s home department are planned to help the Learner understand the patient’s total experience as well as to understand overall system issues. An example of Cross-Departmental Experience might be a Learner who is a New Graduate Medical-Surgical Nurse who is assigned to visit surgery for 4 hours one day to observe the flow of patients through the surgical experience as well as possibly observing surgeries common to the nurse’s home unit.  


The innovative COS learning platform supports real-time Tracking, Trending, and Feedback. Test results are available immediately upon completion of the test; competency validation is available upon reviewer sign-off. Throughout COS Transition-to-Practice Programs, Learner’s confidence and satisfaction are measured. These measures are available upon completion of the Learner’s self-assessment. 

Learners and Preceptors can access the individual’s Learner Competency Dashboard while COS Faculty, Managers, and Onsite Coordinators can monitor individual and class progress on Class Competency and Learner Competency Dashboards. By using these Dashboards, the Hospital-COS teaching team can monitor and intervene to guide the Learner ensuring success at each step along the journey to successful course completion. Course completion data is maintained by COS and may be printed for addition to the hospital’s employee folder.

All Learner process and outcome measures are maintained and may be used to feed the hospital’s Clinical Ladder Program, Quality Dashboards, and Communication Boards at unit, department and hospital levels. The data allow COS to examine the impact of the programs on the Learner and, to some extent, the contribution of the programs to the hospital. Cross-hospital comparative reports allow the hospital to compare results of their Learners to other Learners in similar programs. COS uses the data and trends over time and across hospitals to guide the continual development and improvement of its course offerings.


The RN New Gradate Transitional Residency Program includes the completion of a  Clinical Leadership / Quality Improvement Project.  These projects are chosen by the Learner in collaboration with their Manager and COS Faculty. They are based on the Learner’s unique perspective and passion. These problem-based projects place the COS Faculty, Manager, and Onsite Coordinator in consultative rather than authoritative positions thus fostering the Learner’s leadership role. Each project is designed for the Learner to collaborate with their colleagues to improve patient care in their own department. The goal is to foster a Culture of Engagement with the nurse acting as a thoughtful strategist rather than a functional doer.

Guiding Principles