Photo of a scientist looking into a microscope
eLearning Learning
July 11, 2021

Taking a Health System's Workforce to the Next Level

Providence is a large, West Coast, health system with more than 120,000 employees that need training. In this Powered by Learning podcast, Darci Hall, chief learning officer, and Johnny Hamilton, senior design and innovation consultant, talk to us about innovative ways to upskill current employees to stay relevant in current positions while building competencies for future opportunities.


Show Notes:

Darci Hall and Johnny Hamilton from Providence shared many practical tips for upskilling your workforce including the following:

  • Think big and start small when trying new learning approaches and technologies.
  • Use microlearning to fill identified, individual learning gaps.
  • Providing engaging learning experiences is critical to re-skilling and upskilling a workforce.
  • Targeted training helps retain employees and provides them with career growth in your organization.
  • Combine ongoing performance measurement and goal setting with adaptive learning technology to get the best results.
  • Rapidly build skills using the Push-Anchor-Pull approach. Content is pushed so workers build core knowledge, are anchored so they can practice their new skills, and pulled to apply their skills in the flow of work.

Learn more about the products mentioned in this podcast.

Fulcram Labs – Adaptive Learning Technology

Degreed – Learning Experience Platform

Qstream – Microlearning Platform

Additional valuable links:

About Providence:

The 120,000 caregivers (all employees) serve in 52 hospitals, 1,085 clinics and a comprehensive range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Delivering services across seven states, Providence is committed to touching millions of more lives and enhancing the health of the American West to transform care for the next generation and beyond. Learn more at


Announcer 1: This is Powered by Learning, a podcast designed for learning leaders to hear the latest approaches to creating learning experiences that engage learners and achieve improved performance for individuals and organizations.

Announcer 2: Powered by Learning is brought to you by d'Vinci Interactive. For more than 25 years, d'Vinci has provided custom learning solutions to government agencies, corporations, medical education and certification organizations, and educational content providers. We collaborate with our clients to bring order and clarity to content and technology. Learn more at

Susan: Hello, and welcome to Powered by Learning. I'm your host, Susan Cort, along with d'Vinci Learning Solutions director, Jenny Fedullo. We're joined by our guests, Johnny Hamilton, Senior Design and Innovation Consultant, Talent Management and Learning, and Darci Hall, Chief Learning Officer at Providence, to talk about workforce up-skilling through precision analytics, microlearning, and engagement. Providence is a comprehensive healthcare organization serving underserved populations in seven Western states. Welcome, Johnny and Darci.

Johnny: Thank you very much. Pleasure to be here.

Darci: Hello. Thank you for having us today.

Jenny: Hi. Welcome, Darci. Welcome, Johnny. It's great to see you.

Susan: Johnny and Darci, you recently spoke at the Training Industry Conference and Expo and are getting ready to speak at ATD, so you have some important information to share with our listeners today. Before we get to the topic, tell us a little bit about your roles at Providence so we can understand the perspective that you're coming from.

Darci: My role at Providence, I am our chief learning officer. I'm responsible for the care and feeding and learning of our 120,000 caregivers across our seven states. We're really focused on providing just-in-time learning to that workforce. So that’s my main focus, is learning.

Johnny: And my main focus is to put that vision into action. As a design and innovation consultant, to figure out what are the new methodologies, new tools, new designs, new ways of developing those experiences in order to meet that vision that Darci has set for the team and the organization.

Jenny: Wonderful, thank you. I know Providence has identified the need to up-skill its workforce capabilities, precision analytics, micro-learning, and engagement. How does this initiative align with your organizational goals and your vision that you're just discussing? What does this need to accomplish?

Darci: I'll start and then Johnny chime in. For us, one of our big goals is the mission at Providence. We are a Catholic-faith-based non-profit, and the mission is really what brings most of our workforce to come serve those poor and vulnerable populations. As we start to look at getting more and more serious about how do we move the mission forward, we know that the talent we have today, we need to grow and evolve. We also need to attract new talent into our organization as we grow ourselves.

One of our business goals is to continue to grow our organization year over year so that we can spread the mission further across more populations. So  skilling and re-skilling is really important to us because we know we have a workforce right now that embraces the mission that is focused on our values. Our goal and commitment is to take those internal employees and find ways to re-skill them and skill them into jobs of the future.

We also recognize there's a nursing shortage right now amongst other healthcare positions. We will not be able to hire our way out of that. We're going to have to figure out ways to take our internal populations, re-skill them, support them and grow them, as well as making community partnerships where we can, again, re-skill and up-skill new caregivers into our workforce.

Johnny: In order to affect that vision, we need to shift our focus in terms of learning because learning, up until recently from many organizations including Providence, has been a compliance-driven, a course-driven, a course-centric approach. Which is we have a library of content and we're going to push that out. What we get out of that is, basically, "Did you finish? How many people did this?" But that's not going to drive us where we need to go. In order to make Darci's vision actually happen, we need some analytics. We need real-time data on where people are, and then allow them to get the learning that they need.

We need to allow managers to be able to get that detailed information on who on their team is at what stage, and what are they focused on, so that the managers can also support their team, because right now that's kind of a black hole. They know who is completed possibly, and that's about it. So when we're looking at what it needs to accomplish, there's a massive shift in terms of how we're going to actually be doing that.

Jenny: Johnny, that's really interesting. There's a lot of research out there right now on learning experience design. Historically, it's always been, you heard content is king, but with this shift and what you just said is that people are king. The learner is king. What do they need rather than content first, it's people first. I'm curious when you mentioned workforce employees. Who really are you targeting with this initiative workforce? Can you describe the makeup of your employees?

Johnny: Our workforce is predominantly all of our caregivers. Those are the frontline workers, those are the nurses, the medical assistants, the EVS workers. It's also the leadership as well. We're also moving into clinical education in terms of what are the best practices in up-skilling not only the basic compliance pieces but also how to do better learning for some of the medical realm as well.

Jenny: You've identified the need to upscale your employees. You've been very specific on how you're going to do that, precision analytics micro-learning engagement. Can you unpack each one of those and tell me how you've selected each area to focus on?

Johnny: Absolutely. Think about it this way. If your focus is on compliance and this is one of the key shifts. We're doing a shift from compliance to building capabilities. Compliance is, "Did you do it?" That's a very easy thing, very high level. You don't need to get into any individual differences, you just need to know, “Did you finish?" And that's all you get. But when you take a look at capabilities, there's an individual approach to that. I will have different capabilities, different skill sets than another person, and mine will also change over time.

And in order to move me to my next level, the first thing you need to do is understand, "Where I am currently at in a variety of my skills."

Once you have identified this is the required skill-set and capabilities that the workforce needs to have to be successful in this role, then it's no longer just a compliance, did you do this big body of work that you need to do? You can actually say, "We need to find the analytics to find out what levels you're at and then fill the gaps between there." That makes it a much better experience for the learners because they're only doing what else they need to do to get to each particular skill level.

It's fantastic for the organization because instead of requiring everybody to do the same amount of work, you can actually use some adaptive technology, you can use some micro-learning design to just get the pieces that you need in order to reach that new level that you need to be at. That saves a massive amount of time and implementation cost to work at this new design and this new approach by shifting to an adaptive micro-learning, skill-based approach.

Darci: Yes, and to add on to that, I would just say that one of our goals is to create a better experience. I think Jenny talked about leading people first. That's really what we're focused on is, any of the enabling technologies that Johnny's talking about, really are focused around people first. Meeting our caregivers, our workforce where they're at, when they need the education, and also powering our core leaders. A lot of the tools we're using now have analytics behind them, so we have the ability to really push that data to our core leaders for more focused coaching. And that has helped us.

It also gives us the ability to go back from a return on investment standpoint, and let our executive know that when they're investing in learning, here's the performance implications to the organization. It's really a win-win for both the learner as well as the core leader, as well as our organization.

Johnny: One thing I want to add to what Darci just said is that it is really key that it is a design approach that has shifted in addition to some of the tools. It is not saying, "Oh, there's a new tool out there, let's use that." We set our vision first, we set our new design first in terms of how to implement that. Then we find tools, and services, and platforms that best match how we can go in the vision that we have set out.

Jenny: As a learning professional, I was really raised on the 70-20-10 model. When I was preparing for this and research in Providence, and I attended the TIES conference, I found that you're using push-anchor-pool framework, which is really an evolution of 70-20-10, and authored by you Johnny, which I was pretty intrigued about. So for those not familiar with the traditional 70-20-10, it really is that learning essentially happens through formal, informal, and on-the-job learning. Maybe 10% is formal, 20% is social, 70% is really on-the-job. Johnny, can you talk about the push-anchor-pull framework? Why you developed it? What was the catalyst to bring you here? And then  why is Providence adopting it?

Johnny: The 70-20-10 model, by its name, is talking about how much time you should spend on each modality, whether it's formal learning at 10%, as you had mentioned, social learning the 20%, or on-the-job, or experiential learning at 70%. It's focused on time. The training industry actually did some research with over 1,000 people and learning professionals and said, "Do you actually spend that amount of time?" They developed a system that was called OSF for on-the-job, social, and formal learning. They actually found that the percentages that people were actually using, was actually 20, 25, and 55, which I found really fascinating. And that was actually more aligned to how I was viewing it.

Taking that the next step, calling it by the on-the-job, social, and formal, that's the modality. But it really doesn't feel back into the intent of what it is all for. Push is pushing to learn content. That's the intent of it, of that first step. You are pushing, so everybody understands, this is the body of knowledge that you need to now know. The next is apply, and that’s apply to practice the skill. Oftentimes, that is a critical component that's missing is that you have learned it and compliance says that you're done, and then that's it. But if you are building a skill or a capacity, you have to learn it, that's great, that's the first part.

But the second part is, you now need to practice it in a safe environment. There's a variety of ways to do that as well. And then the third is, well once you've applied it, it has not had the impact to the business yet, because you have yet to actually perform it in your workflows. So  that's where the last step of pull comes from, is that you get to pull to apply this in your regular workflows. Two weeks, or two months, or two years after you did that learning, you may forget exactly what you needed to do. You may just need a quick refresher. You may need to tap into a deeper, again. You may need to practice it again before you need to do and apply that particular skill in your workforce.

How do you readily pull that information of a two-minute thing, or a 20-minute thing, or a one-hour thing? Depends on what you need, so that you can be successful in your workflow. That's where the push-anchor-pull comes from.

Darci: Thank you. It's so interesting. I think throughout my career and even as a trainer when I used to train in a call center, it's so true where it's—it wasn’t necessarily time-box and I'm going to say right now you're informal learning, then you're going to move to social, and you only get 20%. And then once you move out into the job, it's time first not learning first, where then it’s that shift that you're talking about. So it's definitely practice that makes sense and it's certainly relevant for today.

Johnny: It also helps us with our design, and that's the whole intent of this. The intent is that these approaches help us inform a better learning experience, not only for the learners but also for their managers and for the organization. There's benefits that go all around and seen from a variety of perspectives. That's where the value really comes in. And that's what we can talk about as well in terms of the value to different stakeholders within the organization.

Jenny: From an enablement standpoint, looking at the technology that you've been researching, and I know a few minutes ago, you said it's not technology first, it's really strategy first, then design, and then it's selecting a tool that is going to enable what we need. Can you elaborate on that a little bit in your approach with selecting the technology?

Johnny: When we have a design that we need, the first major shift that we're looking for is, for example, with instructor-led training, that was a predominant way that most of our training was being delivered. With instructional-led training, as great as that is, it does not give us any analytics on the back end. We could tell who attended, but that's it. We don't know where the capabilities are and we don't have any insight into that. Learning that just does learning is very last year, it's last decade. As we are moving forward, learning needs to be learning plus workforce design, learning plus analytics that drive the business value forward.

It's a learning-plus approach that we're looking at. If we are looking for a solution that does not give us the analytics that helps us drive value to the business, then we are not going to pursue tools and designs and build programs that don't have that learning-plus to it. We look for tools that give us rich analytics. The other part is, it's not just data that we're looking for. We don't need rows and columns of numbers. We want something that's actionable. Not only actionable at the organizational level, but actionable at the managerial level, because that's where real change happens.

If we find tools that allow managers to help in real-time with specific things that their team is struggling with, and we make that a seamless process, then those conversations, those micro conversations that precision coaching, "I'm a leader, and I know that these two people on my team are struggling with this particular content in this last week. Then I can give them some resources, I can have a conversation with them, then I can follow up with them. And I know that I have that analytics dashboard. I know that the organization is also tracking that as well."

Those are the things that we are designing first. We know that there are tools out there that do some of that, if not all of that. That's what informs our decision in terms of, we are pursuing a platform that has these requirements, what's out there? And  when we find organizations that do have that, especially ones that are willing to partner with us and help us grow and design and develop our vision, that's what we are really targeting toward and we move after those kinds of organizations.

Darci: I would say to add a little color commentary to what Johnny's talking about, to give it a real-life example for us, as we were focused on our strategy, and with a vision of learning was going to be for us as we move forward. We really wanted to create what we call a progressive learning environment that was self-directed, seamless, in the rhythm of business, and so on. We had one area that our executives, our caregivers, everybody could agree on that wasn't great. I didn't want to use the word stuck, but that's what they used. I'm only saying what they used. And that was our compliance training.

I know many of you out there who are learning professionals or in business, annual compliance training is a thorn in everybody's side. What we did as far as living into the vision that we wanted is, how can we make it easy? How can we make it seamless? How can we create a better experience for our caregivers when it comes to something very specific like compliance training? What we did is we went out, and we talked to folks, we wanted to understand where the pain points were. That's when the beauty of having a Johnny in your organization, and you say, "Hey, this is kind of what I think I want to do."

Johnny so beautifully orchestrates and takes these harebrained ideas that I have sometimes, and makes them a reality for us. And so what we did is we implemented a new technology called Cue Stream, which is a micro-learning platform with, as Johnny pointed out, analytics on the back end. What it did for us is, one, it cut our time. E-learning was our regular modality for compliance training and everybody had to go through it. It was about an hour and a half long. At the end, you take the little test to say what you learned and everybody goes on living their life. But there's not a lot of follow-up. We end it and we go.

What we recognize is compliance is very important when it comes to mitigating risk in the organization. By making it more user-friendly, what we did is said, one people have been in the organization for a long time, most of them already know this content. I used to hear over and over again, "I know how to secure my laptop, if I go into the grocery store, why do you guys always have me walk through this whole thing?" So that's why Cue Stream was great because it leads with questions at the front end, those micro-learnings are no more than 30 seconds to a minute long.

If you know the information already, it's like testing out, you don't have to go back in and have a little learning. If you don't know or you get the question wrong, then a little micro-learning pops up for you. It also recycles the question so that you'll get prompted again. So not only are you getting reinforcement, but it also is creating that spatial learning and we know that people, if you get hit again, and again, with the same type of information, you're going to retain it. Those are some really great benefits that what we did is we reduced the time that people were in compliance training. They love it because they can use their smarts to test out of anything that they already know.

Then we also provide all that data and analytics that our E-learnings didn't have on the back end in regards to competency, proficiency, and then those micro-coachings that Johnny's talking about, we could provide to our core leaders. So it really was a win-win and that just puts that into action when we start to talk about when we make decisions about enabling technologies or partnerships, it's really going always back up to what is our vision? What do we want to do for the organization, and how do we want to ease the way of our caregivers?

Johnny: Let me add on to that, that when you say that it reduced the implementation time to actually do this, that has a business impact. We wound up saving millions of dollars in implementation costs because we reduced the time. We wound up getting just a crazy amount of people who were saying, "I love this, this is fantastic," because it only took just a little bit of time people got done with it and it was not this, "I have to stop working in order to do this learning that I really don't enjoy," it was actually a very fun way to do it. There were a lot of people using their phone on their app to do this learning and they didn't have to sit at a desk and do this.

That whole change was a new experience for them and they found it enjoyable. From a learning perspective when you are in a relaxed and in a state of, "Oh, this is the kind of fun, this is new, this is interesting," you're actually more receptive to the learning that's happening instead of being bored and halfway tuned out. From a variety of perspectives, it's a win from a financial perspective, from a user perspective, and also from the manager perspective, because they get every week, "Here's a snapshot of your team and if you want to email the three people that missed question 14 last week, tap here."

They get an email with what that question is, and anything that you as a manager want to address within that. That is actionable analytics, that is the right information to the right people at the right time and make that easy for me.  And that's what Cue Stream enabled us to do.

Jenny: That's so interesting and so powerful. You talk about a shift right, where you have compliance training, that traditional compliance training where it's one size fits all to check the box. You've really shifted to like you said, the right info for the right people at the right time, very specific for what they need. So that's pretty powerful stuff. Tell me how far along are you in the process of up-skilling your employees and for those out there who might be in the same boat or starting a journey, what might you share that could help them be successful?

Darci: We are beginning our journey and the reason why, is our industry. Healthcare traditionally isn't leading in learning innovation. They're leading in patient care innovation, which is what they should be doing. Our job as we've come into these healthcare organizations, is to start to really take a hard look at how do we modernize learning. And the skilling journey’s a little bit different. When we looked at learning in totality it's been really around robust catalogs, self-investment, people going in, taking those journeys, and understanding how they want to grow.

The difference now is that we're looking at focusing on populations. Where do we see skills decline, where are skills going to be replaced with, whether it's robotics or automation versus skills that are going to be on the incline. That's what we're working on right now. It's bigger than just learning. We are working with workforce strategy to understand our workforce, and where they're at now. We're having each one of our regions, our CHROs build out their workforce plan. Which includes, here's the type of work we're going to need, here are the skills we're going to need. And then what that's going to do for us is feed that into our workforce development team.

And we're going to be starting to do much more focused work on re-skilling than we've ever done before. We are getting smarter about job re-architecture instead of accountabilities, starting to look at what are the skills and capabilities not you're accountable to do this, but what are the skills and capabilities you need? And then how do we put that into our systems, so that it can dynamically produce for any of us, what's the delta to where I'm at today, in what careers I want in the future. So we're really doubling down on workforce development in different ways.

Then more of what I would call passive learning, which we've done in the past, which was, we have all this content available, and we want you to grow and learn to really focusing on populations and understanding strategically what we're going to need. And that's going to involve a lot more technology than we have today. It's also going to have to shift the perception of learning in our culture, which we're working on right now. We've begun this journey, I think what we did, strategically, like with Cue Streaming compliance, we also have a learning experience platform using Degreed, those technologies were our baby steps into the future of being 80% instructor-led training organization into moving into the digital age.

COVID also allowed us to springboard a lot of what we wanted to do, because we sent people home for those people that were not patient-facing. We're on the journey, we're going to be out 2025 before I think we feel like we can step back a little bit and take a breath. I think we're going to be pushing pretty hard for the next few years. One thing that we do as a practice, Providence, is we talk a lot about think big. I, my team, I love a team that thinks big. I always tell my team ,"Challenge me to think outside the box and challenge me to push our organization forward."

We embrace that think big mentality but it can be overwhelming when you think about all the things that you need to get done to make that happen. So we always say, "Think big, start small." Pick the one thing that you think you can get your arms around, you can get momentum on, and you can see a real win. And then that will take you to the next thing and the next thing. Just like any journey or pathway, those milestones are super-important but don't lose that North Star. That's really what we're talking about here is 2025 is our North Star. Each year, we're going to be doing some cool things that continue to shepherd our organization in the direction that we want them to go.

Johnny: One of those areas in terms of thinking big and starting small is going into adaptive learning that has been an area we have also been exploring. We've done a pilot several years ago. Just that pilot wound up winning three Learning Industry Innovation Awards. We know that adaptive technology and our partner with that was Fulcrum Labs to do the work of actually individualizing. If this is the skill set you need to have, where are you? And then, what are the particular things that you need to grow in those particular different skill sets?

When we have that in conjunction with Degreed, which is our learning experience platform, that people can then pull information at any given time on any given thing because they are tracking their specific skills over longer periods of time, and their one-up manager has direct view into what their team is doing. It's no longer an annual conversation about your performance review and development goals. It's an ongoing conversation. That dynamic is another shift that Darci has laid out in terms of this is what our vision is. And so we're looking for tools and have already identified the tools.

And it's more than just the tools, it's changing the culture. It's changing how we actually implement and get people to think differently because learning is not sitting down for 20 minutes or an hour in a computer. Learning happens all the time and it's all those pieces together. It's changing that mindset that is the challenge to design toward that, find the tools and make some fantastic experiences so people go, "No, that was really cool. I really enjoyed that."

Jenny: This journey is so inspirational. I know Darci you said you're really just at the beginning. Knowing that continuous improvement never stops, at some point when you step back at a certain stage in this process and say, "This was successful." What is going to make you say that?

Darci: For me, when I think about it in our organization and who we are and where we want to go, success for us is going to look like learning is part of the rhythm of the business. It's almost invisible and I think there's many CLOs out there who have said that, so I don't want to take their thunder. This isn't my new thinking. But it should be invisible. So, as people are working, as they are needing assets, needing support, it feels integrated, it feels like it's just how we do business. So I think that's one area where I think that we would say, "Yes, if we're at that point ,we're successful."

I think the other piece of it is, as we know people join the workforce now and stay much longer than they ever have in their past lives. Another element of success for us is that people commit to our organization and we have the ability to skill and re-skill them in all sorts of jobs. Like I said, we have 117,000 employees and thousands, I think like 30,00 different types of jobs out there encouraging our caregivers to say, "I love this organization so much and what it provides for me. The opportunities for me to be a nurse or maybe I want to go into human resources or maybe I want to go into learning and development, or finance," that we have the ability to make that happen for them within our four walls.

Johnny: From my point of view, success looks like we have, as Darci has always mentioned, a consumer great experience in learning. The Amazon of learning, the Netflix of learning that it is fun, it is enjoyable, it's something you look forward to. Success is that we have made a variety of shifts. One of those shifts is our business need that we've made a shift from compliance to capabilities. That we made a shift, and evolved our focus from degrees and experiences to skills and competencies. That we have an evolution of our tools, that everything within our ecosystem is analytics-rich, that we have shifted our approach.

A shift from pushing an instructor-led training as the predominant modalities of learning, to now having a push- anchor-pull approach to everything that we're offering. Finally, that we have evolved, and that we've shifted our value. We've shifted our value to the organization because learning is now a strategic driver to the business. We've shifted our value to managers because we've empowered them to provide precision support to their team members. We also provide value to our caregivers because now learning is engaging. This is the way that we are re-skilling and up-skilling our workforce to increase their engagement as we move forward. That's what success looks like.

Jenny: Wonderful. I know I said it before that this conversation has been inspirational for me and I'm sure many of our listeners. I think you gave all of us practical ideas and made this entire process more relevant and digestible, so thank you.

Susan: Absolutely. Such great, great thinking, as Jenny said, very inspirational. I think regardless of the organization or the industry that you're in, everyone's going to think a little bit differently after listening to your conversation today. Johnny Hamilton, Darci Hall, thank you so much for joining us. We really appreciate the time you took to be on Powered by Learning with us today.

Darci: Thank you for having us.

Johnny: Thank you so much. This has been a wonderful opportunity.

Susan: Jenny, so much energy and so many great ideas from Johnny and Darci. What are some of the key takeaways from your interview today?

Jenny: Oh, agreed. There's so much energy and they work so well together. I think the biggest is how they could describe the shift and the transformation and the evolution with very tangible things that just make sense. The shift from compliance, check the box once they switched all to, "Let's start with people first and what they need and the learner first." Also, the think big, start small is so relevant and so practical. I love their high-level vision, but then they break it down into specifics so that they can manage it. Like we said, I'm excited to see how they do and to touch base with them at a further step in their journey.

Susan: I agree. It will be interesting to check in with them and see how they're progressing on their journey. Thanks very much, Jenny for taking the time to talk with Darci and Johnny today, I really appreciate it.

Jenny: Oh, you're welcome, I really, really enjoyed it.

Susan: Special thanks to Johnny Hamilton and Darci Hall from Providence for joining us today. If you have any questions about what we talked about, you can reach out to us on d’Vinci social channels through our websites or by emailing us at

Announcer 2: Powered by Learning is brought to you by d’Vinci interactive. For more than 25 years, d’Vinci has provided custom learning solutions to government agencies, corporations, medical education and certification organizations, and educational content providers. We collaborate with our clients to bring order and clarity to content and technology. Learn more at

Jenny Fedullo

By Jenny Fedullo, Director, Learning Experience

About Us

d'Vinci Interactive is an award-winning comprehensive learning solutions provider for corporate, government, medical, non-profit, and K-12 target markets.

Ready to Connect?

Contact us today to start the conversation. We work with you to find innovative solutions that drive a sense of shared accomplishment and trust.