How to Make Learning Stick: Designing Learning Ecosystems for Public Health

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How to Make Learning Stick: Designing Learning Ecosystems for Public Health

Transforming Public Health for the 21st Century: Bridging Theory to Practice is a blog series that will explore the challenges and opportunities faced by the public health sector and will introduce innovative ideas and unique voices to support transformation. Sign up here to receive these summaries and more, and also follow KHI on Facebook, X, LinkedIn, and Instagram. Learn more about the series on our blog page. Please feel free to share your feedback or suggestions with us by emailing [email protected].

When was the last time you truly learned something? Not just heard about it in a webinar or tried it once, but actually changed how you approach your work or solve a problem?

Learning is more than taking in information. It is a change in what we know, what we can do or how we see things, and that change shows up in how we act. That kind of change rarely comes from a single experience.

So, when does learning stick?

Learning sticks when it meets us where and when we need it and is designed around how we actually learn.

I experienced this firsthand through pottery. This past summer, I wrapped up my third year selling my handmade work at a local art fair and it got me thinking about how I got there. It all started with a one-time pottery class with friends. A dynamic teacher, a well-equipped studio and a surprising love for working with clay led me to sign up for recurring classes to learn the basics. From there, I started experimenting on my own during open studio hours. When I wanted a specific skill, like seamlessly attaching two pieces of clay or shaping a flower, I would find a short reel, watch it and test it out in the studio. I read books to understand the clay itself. When my glazes weren't coming out as vibrant as I hoped, I tapped into one-on-one consultations offered by a local ceramics shop. I picked up tips chatting with fellow potters. And I learned a hard lesson in patience when my third frog figurine exploded in the kiln - clay needs time to fully dry out.

My development as a potter wasn't the result of a single course or video. It was a mix of experiences, some structured and some informal, that were within reach when I needed them and met me exactly where I was. That is a learning ecosystem.

Why a learning ecosystem?

When we think about workforce development, it can be easy to focus on training. But training is an event. Learning is the change, and it rarely comes from a single event.

That distinction matters in public health. Our work is busy and can be unpredictable. We juggle competing priorities, an evolving landscape and a constant stream of information. A need to learn can show up in the moment: a new outbreak, a change in registries or electronic health record systems, an important conversation with a community member.

A well-designed learning ecosystem adapts to those realities. It offers a mix of formal, structured opportunities and informal, everyday ones, so people can find what they need when they need it. That might look like:

• a formal onboarding course for a new disease investigator (structured training),
• a checklist that walks staff through setting up a community health event (just-in-time support),
• a community health worker shadowing a colleague on a home visit and watching how they build trust (learning by observation),
• or a quick call to a colleague in another county who has handled a similar challenge (peer learning).

Sometimes these learning experiences come together organically, as mine did with pottery. But when we design an ecosystem intentionally, we can connect experiences so each one builds on the last, and that is where real, lasting change happens.

The idea of a learning ecosystem extends beyond workforce development, too. If you are designing health education for your community, you can intentionally provide a variety of experiences that meet people where they are. That might include a flyer, an interactive booth at a health fair, a conversation with a trusted messenger, a short social media video or clear talking points shared by a school nurse. Each piece reinforces the others, making it more likely the learning will stick.

Design with intent

So, how do we design a learning ecosystem intentionally? There are many principles, frameworks and strategies to guide this work. To get started, here are four elements, all grounded in how we actually learn, that can strengthen any learning ecosystem.

1. Identify the gap

Not every performance problem is a learning problem. Before designing a solution, it helps to name the actual gap between where learners are and where they need to be. In her book Design for How People Learn, Julie Dirksen describes six types:¹

• Knowledge gap: People are missing information they need. Once they have it, they can act.
• Skill gap: People need practice, not just information, to develop a skill and do it well.
• Motivation gap: People can do it but don't, perhaps because they don't see the value or they are navigating competing priorities.
• Habit gap: People know what to do and want to do it, but it isn't routine yet.
• Environment gap: The workplace or system doesn't support the behavior. Tools, time, access or structures are missing.
• Communication gap: Directions, guidance or expectations are unclear. This can look like a learning problem when it isn't, so diagnose carefully!

Take my exploding frogs. No course, workshop or video was going to fix that problem, because it wasn't a knowledge gap. It was a motivation gap. I was impatient and sent pieces to the kiln before they were ready. Once I saw the cost (shattered pieces, hours of work lost), patience suddenly felt worth it, and my behavior changed. What closed that gap wasn't more instruction. It was seeing why it mattered.

A performance problem often involves more than one gap. Consider, for example, data from a new reporting system that isn't coming in on time. When you look closer, you may find multiple gaps among staff: some may not be sure of the steps (knowledge), some find the system hard to navigate (skill), some may still be working with the old process (habit) and some may not have dedicated time to do it (environment). A single training may only address part of the problem. An ecosystem approach gives you the opportunity to address each gap with the most effective support, such as a quick guide, hands-on practice, reminders and protected time on the schedule. Remember, not every performance problem is a learning problem.

Tip: Mind the gap.

Before you build anything, ask yourself: Do they know what to do? Can they do it? Do they want to? Does their environment make it possible? The answers will help guide you to the most effective solutions.

2. Work with memory, not against it

We cannot talk about learning without talking about memory, because learning sticks when it makes it into long-term memory. In Learning Science for Instructional Designers, Clark Quinn describes a "stores and processes" model of how we take in, hold onto and act on information. Put simply, the model includes:²

• Sensory memory briefly takes in what is around us, but only what we pay attention to moves into the next store.
• Working memory is where we actively think about and make sense of new information. It is a powerful store, but limited.
• Long-term memory is where learning sits, ready to be pulled back out when we need it to act.

Working memory can only handle so much at once. You may have heard of George Miller's "7 ± 2" pieces of information as the limit of short-term memory. But for learning, Quinn suggests designing for about 3 ± 1 new pieces at a time.² If learners are given more than that, they experience cognitive overload, and information gets lost before it ever has a chance to stick.

This is why a single training event rarely leads to true change. Imagine a new staff member's first week: new policies, new systems and a long list of acronyms. Most of that won't make it past working memory. A learning ecosystem gives new staff multiple access points, increasing the chances that information sticks and skills develop. This might look like sharing a few key pieces of information up front, providing a quick guide so they don't have to memorize everything and checking in a few weeks later to reinforce what they've learned.

Tip: Protect learners from overload.

Break information into small, focused chunks, and space them out over time so learners get multiple chances to revisit and apply what they've learned. An email series that delivers one short lesson a week, each building on the last, is one simple way to do both.

3. Design for adults

Malcolm Knowles popularized andragogy, an approach to helping adults learn. He proposed a set of core assumptions about adult learners: they are self-directed, they bring rich life and work experience, they need to know why they are learning something, they are ready to learn what helps them handle real-life situations, they approach learning through problems and they are largely intrinsically motivated.³

Two of these are especially useful when designing a learning ecosystem: adults learn best when learning is relevant to their real-life situations and built around problems they're actually facing.³ Consider my experience with pottery: I didn't go looking for a lesson on joining clay until I had two pieces in front of me that needed to stay together.

Learning that connects to a real problem that busy public health professionals are facing is more likely to earn their attention. When learning is built around real problems, like a case study based on their actual work, learners are more likely to connect new information to what they already know, increasing the likelihood that learning will stick.

Tip: Be real.

Take time to know more about your learners' day-to-day, their barriers and what motivates them. Then, build scenarios and case studies around the challenges they actually face. Bonus: invite learners or key stakeholders into the design process and ask which scenarios would be most useful.

4. Make the learning easy to reach

Even the best-designed learning won't help if people can't get to it or truly access it once they do find it. When designing a learning ecosystem, consider accessibility in these two ways.

First, consider accessibility in terms of time and place. Learning should be easy to find and available when the need shows up: an on-demand module, a quick guide saved in a shared folder, a colleague to call. That is what made the reels and the one-on-one consult so valuable in my learning. Both were there the moment I encountered a problem.

Second, consider accessibility in terms of format. Use plain language, clear headings, strong color contrast, readable fonts, alternative text for images and captions or transcripts for audio and video. Offer materials in the languages your learners use, and when you can, deliver content in more than one way, like a short video and a written guide. This isn't an exhaustive list. The Web Content Accessibility Guidelines (WCAG) offer more detail.

Tip: Clear the path.

Before you share materials, run the built-in accessibility checker in Microsoft Word or PowerPoint, test your colors with a free tool like WebAIM's Contrast Checker and ask someone outside your program to view it for clarity.

What will your learning ecosystem look like?

Think about the last time you truly learned on the job. How many different experiences got you there? Each one was a part of your learning ecosystem, strengthening your ability to solve real problems in your work and in your community. When we design each of those parts with intent, learning no longer depends on a single event. It meets people where and when they need it, and that is how we start transforming public health.

So, as you plan your next learning opportunity for your staff, your partners or your community, start small. Choose one recurring challenge, identify the gap, look at what support already exists and consider what pieces could work together to help that learning stick.

At the Kansas Health Institute, we are working to build this kind of ecosystem, too. Facilitated learning events, workshops and self-paced KHI Learning courses offer structured learning. Case-based ECHO sessions bring peers together to work through real problems, and quick, no-login tools through Learning on the Go keep support within reach whenever the need shows up.

Explore educational opportunities

References

1. Dirksen J. Design for How People Learn. 2nd ed. New Riders; 2016.
2. Quinn CN. Learning Science for Instructional Designers: From Cognition to Application. ATD Press; 2021.
3. Knowles MS, Holton EF III, Swanson RA. The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development. 6th ed. Elsevier; 2005.