CHAPTER 21
Training Essentials for Implementing Healthcare IT
Cheryl A. Fisher
In this chapter, you will learn how to
• Plan, design, develop, deliver, and evaluate technology-based instruction
• Plan and implement an instructional needs assessment
• Construct a lesson plan using appropriate instructional methods
• Incorporate adult learning principles into program design
• Create a custom presentation using principles of effective multimedia presentation and current Internet technologies
• Plan and conduct an effective student assessment and program evaluation
• Discuss new trends and future directions for teaching with technology
Implementing new technology into the healthcare setting can be a costly and resource-intensive undertaking. Training requirements for new technologies include an enormous amount of time, effort, commitment, and change management on the part of the organization. Training is required for those who will be involved in the initial implementation of the healthcare organization’s new systems so that they will be familiar with the new capabilities and functionality now available. Because of this investment, it is imperative that best practices and sound educational design principles are applied to ensure success. Traditional face-to-face computer lab training presents many challenges and is time-consuming and resource-intensive. Because of a diverse workforce and varying schedules of healthcare providers, technology-supported design models can potentially address these limitations. This chapter will address training considerations when faced with the implementation of new technologies in healthcare settings and conclude with a look at future directions for training in new technologies as the field continues to evolve.
Models and Principles
The first step in developing a training program is to put together a team that understands the healthcare organization’s mission, the content to be delivered, the educational design considerations, and the end user’s perspective. This team must then develop a training plan that is flexible, dynamic, personalized, and reflective of post-implementation training requirements in order to reinforce the concepts and to drive the successful utilization of technology adoption. Vendor-provided training sometimes falls short because of generic content delivery that does not align with the organization or is not customized enough to meet the end-user requirements.
Several models should be considered when implementing training for new technologies in healthcare settings. These models guide the training developer through the appropriate steps and facilitate the incorporation of all considerations necessary for success. Instructional design is the analysis of learning needs followed by the systematic development of instruction to meet those needs. If such models are followed, they will facilitate the transfer of knowledge, skills, and attitude to the learner.1 The ADDIE model, for example, is a generic instructional design model that is used by instructional designers and training developers. The model consists of five phases: analysis, design, development, implementation, and evaluation. Table 21-1 describes what occurs in each step of the model.
Table 21-1 ADDIE Steps and Actions
One commonly accepted improvement to this model is the use of rapid prototyping. This is the idea of receiving continual or formative feedback while instructional materials are being created. This model attempts to save time and money by catching problems early while they are easy to fix.1 For example, if an institution was implementing a new technology for a new device, the course developer would incorporate evaluation and concept refinement after each step of development to provide corrective action along the way.
In the ADDIE model, each step has an outcome incorporated in the subsequent step. Instructional design (ID) is a general term for a family of systematic methods for planning, developing, evaluating, and managing the instructional process effectively in order to promote successful learning by students.2 Instructional systems design (ISD) is a problem-solving process that has been applied to the development of training since the 1940s. Since then, more than 100 instructional design models have emerged based on the fundamentals of the ADDIE model.
Assessing Basic Skill Level
One of the most challenging aspects of training is determining baseline skill level and the learning needs of the end users. Assessment is the process of determining these needs in order to write learning objectives directed toward these needs, and one method is through a learning or training needs assessment. A training needs assessment is a study done in order to design and develop appropriate instructional and informational programs and material in order to fill in the gaps.3 However, a learning needs assessment allows you to consider both formal and informal learning needs. That is, what do they need to be trained on, and how can you best support their informal learning needs? In other words, how are the end users supported outside of the classroom?
TIP Oftentimes the end users don’t know what they need to know. Setting up general overview sessions of a new system in an auditorium prior to training and go-live can help users to start developing questions.
The next step is to determine the student’s baseline knowledge and experience related to the technology to be learned. People do not learn from point zero, rather from the standpoint of their own knowledge and experience. The model seeks to motivate the student via prior experience and context to come closer to the idea of the topic. During this step, defining or describing the problem under study and sharing the objectives of the training process between trainer and participant are key.4 Questionnaires and structured interviews are the most commonly reported methods of needs assessments. Other ways to gather information related to learning needs include observations, surveys, or group discussions. Some questions to consider when gathering information for the needs assessment include the following:
• Who is the audience, and what are their characteristics?
• What is the new behavioral outcome?
• What types of learning constraints exist?
• What are the delivery options?
• What are the online design considerations?
• What is the timeline for project completion?
Here is an example of the steps to follow when conducting a needs assessment:
1. Write objectives of what you hope to gain from the needs assessment.
2. Select an audience to sample. Consider the sample across multiple age groups, and consider those with English as a second language.
3. Collect data from participants.
4. Analyze data.
Once this information is gathered, the trainer will have a much better understanding of the baseline knowledge of the learners and any issues that seem to be prevalent among the learners. This will allow the training developer to ensure that potential problem areas receive additional attention.
Next-generation learners are now posing additional challenges and have been the focus of educators and national initiatives in order to keep pace with evolving needs. One approach to keep up with these changing needs focuses on personalized, relevant, flexible, and engaging experiences that offer effective learning.5 With video being one of the most popular means for delivering educational and training offerings, developers must keep in mind that cell phones, laptops, digital readers, and tablets are all popular devices for accessing content. The focus now for the digital-savvy generations is on the right tool for the task.
Design Elements
Once the learning needs are assessed, the learning objectives for the training program should be established. The general purpose for the training should be clearly defined, followed by the specific learning outcomes. The learning outcomes or objectives should be measureable and criterion-based. For example, “at the end of this module (given a set of conditions), you will be able (action verb and behavior) to (criterion with level of accuracy).” Here’s a sample objective: at the end of this module, the learner will be able to document medications with 100 percent accuracy. When evaluating the objectives, you should look to determine completeness, practicality, feasibility, and consistency. The goal of training should be more than just knowing how and where to enter the data. The overall goal should support users to think logically and critically about how to best use the system to maximize the benefits that the system has to offer the healthcare organization and the patients. The training team and healthcare organization management have the challenge at this point of obtaining user buy-in by developing program objectives tailored to the workflow of each person’s role utilizing the system. Emphasis should be placed on attitudes and benefits of the system to enhance patient outcomes. With a major focus now on measuring impact and outcomes, it should be clear within the objectives of the training what the intended outcomes hope to achieve. To achieve the full potential of what health information technology has to offer, including increased patient safety, improved healthcare quality, and reduced costs, healthcare providers must be both willing and able to use the technology effectively.5
Additional design considerations should include the order of the instructional program. According to Gagne’s nine events for learning, the instructor should do the following, in this order:
1. Gain the learner’s attention
2. Inform the learner of the objectives
3. Stimulate recall of prior learning
4. Present information
5. Provide guidance
6. Elicit performance
7. Provide feedback
8. Assess performance
9. Enhance retention and transfer
Gagne’s process steps for learning were developed based on an information processing model of the mental events that occur when adults are presented with various stimuli.6 To put this model into action, the instructor could tailor learning modules toward particular surgeon groups. These modules would use pre-op and post-op orders already familiar to the surgeons and provide them with the opportunity to translate new knowledge to their already familiar work.
A major consideration for designing and developing training pertains to the delivery method of the instruction. Whether the training will be conducted face-to-face, completely online, or using a hybrid format that includes a mix of online and face-to-face training will depend on the preference of the organization and the available resources. Training can be done by internal resources, third-party providers, or the EHR vendor, and a determination needs to be made about which groups offer the best chance for success. There are pros and cons to all approaches, and often the cost or resource impact will ultimately determine a healthcare organization’s decision. The goal is to develop comprehensive training in the shortest amount of time.
Often, the end users have little time and patience for training, yet it is critical that they develop the skills and competency required to safely use the new system. Additional challenges include small training budgets, often with no minimum standard or time requirements ensuring adequate training. On average, online instruction and face-to-face instruction require similar time commitments for end users. Instructional strategies to enhance feedback and interactivity typically prolong learning time but in many cases also enhance learning outcomes.7 Online learning has advantages such as overcoming time and distance barriers and the ability to use innovative multimedia and virtual instructional methods. It is the challenge of any instructional designer to incorporate meaningful instructional strategies that engage the learners and enhance the learning. It is also up to the organization to determine whether they have trained instructional designers on staff or whether they have the resources to outsource the required training and follow-up. Oftentimes, combinations of online and face-to-face instructional strategies are utilized to address the many facets of training required. Here are some examples:
• Web-based tutorials for general concepts and higher-level learning
• Instructor-led classroom training workshops facilitated by clinical subject-matter experts as well as training team members
• One-on-one short training sessions with end users for each phase of the project led by superusers, focused on clinical care and efficient interactions with the system applications
• On-request support for assistance or clarification just after go-live
• On-the-spot training via walking rounds using clinical experts to offer support
• Web-based or instructor-led training on advanced features and new enhancements after go-live and ongoing as appropriate
There are multiple ways of delivering training materials and content during educational sessions in addition to user guides, pocket reference guides, and quick-tip sheets. Posters can be developed and placed in staff workstations in order to reinforce visual displays and contact information for the user help desk. Regardless of the approach, the goal is ultimately to develop a user-friendly rapport with the staff in order to answer questions and help problem solve. If users find they cannot get the help they need in a timely fashion, they will develop shortcuts or “workarounds” that may be difficult to correct later and could compromise patient safety.
The Adult Learner
When designing educational training programs for adults, success can depend on the adherence to adult learning principles that need to be embedded throughout the program. Adult learners have unique learning needs and expectations that set them apart from their younger counterparts. Adult learning has received increasing attention among educators, and a significant body of literature has established clear areas of emphasis for adult educators. These areas are typically recognized in the principles of andragogy developed by Knowles, which stress the following as hallmarks of adult learners:8
• Need-to-know Adult learners in training situations, as opposed to general learning courses, are focused on content and instruction that they feel is directly relevant to their job and/or functions they are asked to perform. Another aspect of this need is wanting to know why they should invest the time in the new content or task.
• Immediacy of application Distant or theoretical applications of the knowledge are not as valued by adult learners as what they feel they need to know immediately for tasks at hand or upcoming in the near future.
• Sharing of life experiences as a source of knowledge This hallmark has an internal and external application. Internally, the adult learner often references the new concepts or tasks to similar concepts or tasks in content, importance, or other factors to what they have experienced or know and thereby readily tap into successful strategies from past experience. Externally, they bring valuable experience to group learning situations.
• Affinity for real-life learning Stemming from the three previous hallmarks, adult learners have a preference for real-life scenarios closely related to their job or job functions in the classroom or online, as opposed to abstract concepts that might be tied back to their job. They also tend to enjoy learning on the job.
• Independence and self-direction Adult learners are ready to learn when the need arises, often self-motivated, and frequently need less guidance and feedback during the learning process than non-adult learners.
• Ownership Adult learners frequently accept responsibility for the educational offering’s learning objectives, sometimes somewhat modified and personalized, and take personal control of how to achieve those objectives.
When developing training with adult learners in mind, the developer must ensure that relevant training scenarios are utilized and that learning is self-paced and possibly self-directed. This can be done by creating training scenarios for different healthcare roles (e.g., physician, nurse) and by allowing for test-out options so as not to waste the time of the professional adult learner. For example, online training modules could be developed for physicians that focus specifically on order entry. Given specific concepts and opportunities for transferring knowledge, the physicians could be tested at the end of the module to demonstrate competency through applying their new knowledge. Training environments could also be made available for specific disciplines to practice their new skills. This simulated training environment should resemble the production system as closely as possible, should be accessible from every desktop, should include a realistic amount of data (with fictitious patient names), and should enable staff to practice navigation.
Game-based learning is also popular with both teens and adults and produces a range of cognitive responses that includes high levels of engagement, concentration, enjoyment, and active participation by the adult learner. Interdisciplinary teamwork, problem solving, and interacting with role-playing virtual patients produce opportunities for medical learners to apply the content being learned to relevant case scenarios.9
Constructing a Lesson Plan
Once the needs assessment is completed and the objectives are developed, it is time to develop a lesson plan for the targeted population. When put into simple terms, “tell, show, do, and review” is a good way to remember the steps. A sample outline for this plan could include the following:
I. Principal goal of the training
A. Module I
i. Learning objectives
a. Tell: Didactic content (PowerPoint or video)
b. Show: Demonstration of new skills to be learned (PowerPoint, video, or screen capture)
c. Do: Learning activity to apply learned concepts (application of learned content using case scenarios)
d. Review: Evaluation of learning (knowledge test, return demonstration)
B. Module II (repeat previous steps)
C. Additional resources and supporting materials
Training content should be focused on job roles and associated workflow. The key being that the training content is reflective of the actual EHR content and not a previous or outdated version of the system. Vendors usually provide the initial training materials and a limited amount of training services—often bundled with other, broader implementation services—which should be used to train the project team and the initial set of users or superusers. These superusers will then become resources to train other staff and to problem solve, support end users, and reinforce concepts at the unit or department level. The training department should then develop customized supporting materials that are consistent with workflow and the healthcare organization’s policies and procedures.
In short, a successful training program must be tailored to an organization’s environment. The materials developed should address the user roles and clinical workflow scenarios that will be familiar to the end user’s daily practice. The training should focus on workflow and ultimately enhance safe patient care.
TIP The change in workflow for end users cannot be underestimated. This is often one of the primary reasons why staff will resist change and develop workarounds. When changing from one electronic record to another, users try to translate what they used to do into the new workflow. To circumvent this, good relationships are critical so that staff will utilize available resources to facilitate problem solving.
Multimedia as a Method of Delivery
As multimedia and social media become more commonly used as instructional tools, researchers are finding that more than one modality (i.e., visual and auditory) is better than a single modality (visual alone) in any instructional environment for engaging students in active learning.10 The implementation of multimedia can effectively enhance learning performance and retention. Incorporating multimedia tools at an appropriate time can enhance learning interests. The use of gaming technology to demonstrate complex concepts has been shown to have no gender difference in terms of preference. Also, the presentation of reciprocal representations can enable students to have an in-depth understanding of a course and extend the effect of learning retention.10
Instructional quality of online delivery is still a common concern. Quality assurance requires a comprehensive framework of several perspectives of learners’ and instructors’ needs including critical analysis of teaching and learning practices with the technology platform.11 The use of high-quality instructional and course design standards by instructors in online learning has numerous benefits as well as challenges. Moving from traditional methods of teaching to online delivery methods of instruction requires a shift in the perspectives of both the instructors and the learners.12 When constructing instructional tutorials using presentation software, you must consider basic principles for the adult learner that will ensure the message is communicated and conveyed clearly. Here are some examples:
• Combine images with verbal text (less is more when it comes to graphics).
• Present content in logically grouped sections that allow the learner to organize for recall.
• Use a text of font size 28 to 30 (and limit the font to one or two text styles).
• Don’t use more than five lines per slide, and avoid using all capital letters.
• Use a title font size of 40 or larger.
• Minimize background colors and textures so as not to distract from the content, and be sure text color contrasts with slide background.
• Use consistent transitions.
• Unify slides and align text using bullets.
• Avoid using animation unless it is value added.
These principles are important to apply because they make the content easier to understand and avoid distraction from the information to be learned. When developing training tutorials, one of the most effective approaches includes the use of software that guides the learner through the navigational pathways. A videotaped lecture can be used for an instructional demonstration prior to allowing the participants to practice on their own. Instructional modules longer than 20 minutes tend to lose teaching effectiveness. Information overload is a real possibility, and the instructor must decide on the important points to be learned.13
Current Internet Technologies
Current Internet media and technologies that are easily accessible, modifiable, and publishable by an online community were coined Web 2.0 in late 1999, but the term began to be widely used in 2004. Features and functionality that allow for user interaction and information sharing such as blogs and social networks enhance communication, productivity, and sharing and continue to be the focus of a dynamic Internet.14 Despite the increasing use of current Internet technologies and tools in education, there appears to be a lack of empirical evidence detailing the process educators have taken to implement them in the classroom. Identification of the vast and varied technologies available can help the course designer to choose an appropriate Internet technology to meet the teaching and learning requirement. Providing guidance to educators on key practical issues to consider when introducing new technical features into the classroom is important because it provides direction on how to overcome any unforeseen issues when undertaking this process.15 With little guidance on how to leverage new Internet technologies in the educational context of healthcare information technology, examples and practical recommendations cited in the literature regarding implementation in organizations referenced document sharing sites, Facebook for announcements and group discussion, YouTube for uploading recorded lectures, and Twitter and others for streaming video.16 Because current Internet technologies can be used for knowledge sharing, learning, and social interaction, these tools are now prominently used in the classroom. The tools are acknowledged in the literature to have the potential to support different educational design approaches that facilitate both self-directed and collaborative learning. The primary concerns regarding the adoption of new Internet technologies are usefulness, advantages, compatibility, technology availability, and now privacy and security. Secondary concerns are resource-facilitating conditions, healthcare organizations’ technical policies, and senior management attitudes.16
Training Delivery and Accommodation
For any training program to be successful, the first consideration is the audience. In other words, to whom are you speaking? It is critical to know the answers to the following:
• What do you want to communicate?
• How will the messages best be conveyed?
• When will the training be seen as most relevant?
• Where will the training take place?
• Why should the individual participate in the learning?17
While it might seem obvious, it is critical to keep the message clear and concise and to keep all information simple.
When formulating a training plan, consider the needs assessment findings, the diversity of your audience, and any special needs of the individuals. For example, if the didactic portion of your training has been videotaped with audio recordings and you have a participant who is hearing impaired, you will need to ensure that your training has transcripts available for this individual to read. Likewise, if you have a participant who is visually impaired, does your training meet the requirements for using screen readers or assistive devices? All training delivered online must meet the requirements of the Americans with Disabilities Act. It is required by law that all participants have equal access to educational training or that special accommodations be made if required.
Training schedules need to be flexible, and given the 24/7 nature of healthcare, it may be necessary to offer late evening or weekend training classes in order to accommodate all staff. Training content should be introduced over a period of time to avoid information overload and to progress from novice to expert concepts. This can be done using a series of modules that build on previously learned content. Readily available and easy-to-use reference material can help support the formal learned content and can reinforce learning.
TIP It has been the standard that the training for implementing a new EHR should occur about six weeks prior to go-live and should be delivered in no more than three-hour blocks of time. This approach will facilitate learning and retention of information. Within the three-hour blocks of time, breaks should be given, and the “tell, show, do, review” process steps should be followed.
Evaluating Learning
Effective training should focus on the user role and should be workflow-based. A common misconception of how to train is to focus on features and functions of the system. While basic knowledge of how to navigate and what icons/buttons do is important, the training ultimately should be competency-based. It is less important for users to know every button or system function than it is for users to be able to accomplish their day-to-day tasks and to ensure patient safety. While some level of basic education is needed, physicians in particular respond best when training is clinically focused on content encountered in daily practice. Case scenarios are particularly useful when focused on complex areas of healthcare such as handoff communication for transfers of patients between clinical areas. However, considerations must also be made for cross training (for example, when nurses or medical assistants are entering orders as agents for physicians) and training within specialty areas (for example, the operating room), which will help to facilitate seamless work among the varied roles within a specialized environment through better care coordination.
Student learning and program evaluation are critical in order for the trainer to know whether they accomplished their task in delivering training. Two current working methodologies of formative and summative assessment stress involving students in generating and using assessment information as a key assessment function. Utilizing Kirkpatrick’s method of evaluation,18 questions to ask include the following:
• Were the students satisfied with their learning?
• Did it meet their needs?
• Would they recommend it to others?
• Did their behavior (or performance) change as a result?
• Did the organization achieve its desired results from the training?
A successful training evaluation must be aligned with the organization’s mission and goals, it should be a systematic process, it should be data-driven, and it should be focused on continuing improvement. The best methods for assessing student learning can be obtained from participant feedback, tests, and performance. Examples include surveys, structured interviews, and formal or informal tests. The trainers, peers, or supervisors can also make behavioral observations. The purpose for assessing student learning is primarily to determine whether knowledge gains have occurred. If the users say the training was useful and relevant, it was targeted correctly to the learning needs.
It is important to note that training does not stop at the end of the formal training sessions. Successful user adoption requires ongoing follow-up and follow-through in order to ensure that users are not creating a workaround, which happens frequently when they are unable or do not understand how to perform a task in the correct way. Follow-up is also important in identifying any previous paper-based or outdated workflows that may have been missed as part of the initial review and that clinicians are still utilizing. Once these individuals are identified, superusers can focus their training time on those most in need. Walking rounds and focus groups can provide useful sources of information that require follow-up in addition to the opportunity for understanding particular areas of challenge for the users. Optimization of training has become more important in healthcare organizations as the adoption of new technology and improvements are leveraged with current tools. Chart audits and reviews are helping organizations to focus on specific users who may be requiring additional time on tasks, to target them for additional support or training as needed.
Program Evaluation
The overall program can be evaluated using satisfaction surveys, interviews, and knowledge outcomes.19 The purpose is to incorporate the data and findings into the program for the purposes of improvement. Feedback can also provide useful information for necessary revisions to the overall program design and delivery, which will then become the orientation program content for new employees. A Likert rating is a five-point (or some other number from 3–9) scale that allows an individual to indicate how much they agree or disagree with a statement. Questions specific to the overall program could include the following and should be answered using the commonly accepted Likert rating:
Please indicate your level of satisfaction with each of the following:
• Whether the program met your expectations
• Program content
• Ability of presenter to communicate
• Presenter’s knowledge
• Content and usefulness of handouts
• Location in which program was held
• Convenience of program day and time
• Overall program
Utilizing a Learning Management System
Once the training program is designed and developed, one of the most efficient ways to implement the electronic content is by using a learning management system (LMS). An LMS is a software application used for the administration, documentation, tracking, and reporting of training programs. A robust LMS should do the following:
• Centralize and automate administration
• Use self-service and self-guided services
• Assemble and deliver learning content rapidly
• Support portability and standards
• Personalize content and enable knowledge reuse
• Implement healthcare organization–wide initiatives seamlessly with the opportunity to run reports on completion status
These platforms are particularly used to make the course materials, such as lecture slides, exercise sheets and solutions, and assignments, accessible.20 During the past fifteen years or so, LMS deployments have been utilized in most traditional educational institutions, not only to replace face-to-face instruction (e-learning) but also to combine it with computer-based instruction or hybrid learning. In addition to the delivery of learning content to students, LMSs often support interaction and cooperation with discussion, news forums, wikis, blogs, and quizzes, thus creating collaborative learning. LMSs also enable instructors to evaluate students electronically and to generate student databases where grades and progress can be charted.20 E-learning course management systems provide educators with new tools and media to aid their teaching. For example, students can learn at their own pace at whatever time they want. These systems are not simple turnkey operations that can be implemented without some level of customization. They require an understanding of instructional design and demand a considerable amount of planning configuration, integration with user accounts, migration of course content, and testing.13 Human resources are a major consideration from the perspective of system administration and system maintenance.
Although most LMSs are commercially developed, some have an open source license, which allows for their source code to be shared. One popular set of open source software licenses includes those identified by the Open Source Initiative (OSI), an organization dedicated to promoting open source software.
In recent years, e-learning has changed the traditional teaching and learning styles from teacher-centered to learner-centered. It emphasizes that the learner actively participates in the process of knowledge construction. The Sharable Content Object Reference Model (SCORM) has become the standard for the tracking of records in LMSs, based on previously developed standards by the Aviation Industry CBT Committee (AICC). SCORM facilitates content acquisition from multiple providers with a single, real-time interface for recordkeeping and administration purposes. By definition, SCORM refers to a set of specifications that produce small, reusable e-learning objects when applied to course content. One advantage is these objects can be reused with other training materials.21 For example, video clips, graphics, or learning modules might fall into this category. SCORM is a set of rules specified by the Advanced Distributed Learning (ADL) initiative that specify the order in which a learner may experience the training materials, such as using bookmarks to track progress and the opportunity to take breaks from learning without having to start over. SCORM also tracks test scores and feedback to the users. The office of the U.S. Secretary of Defense originally developed these standards in 1997.22
New Directions
Currently, training is offered as a one-size-fits-all approach that is not always what is needed by the learner. Adaptive learning is now evolving and can provide next-generation learners with information they need on demand in a format that is best suited to each particular learner and situation. Although there is currently no widespread agreement of what is personalized or adaptive learning, the U.S. Department of Education Office of Educational Technology offers the following helpful way of understanding different kinds of adaptive learning:23
• Individualization Learning goals are the same for all students, but students can progress through the material at different speeds.
• Differentiation Learning goals are the same for all students, but the method of instruction varies according to the learning preferences.
• Personalization The learning objectives and content as well as the method and pace may vary.
Adaptive learning is a method for delivery as opposed to a technology, but it is easy to see how systems or design can support flexibility to meet a spectrum of learner needs.24
And finally, from the educational offering developer’s perspective, mobile technology can add important flexibility to learners, as was also mentioned earlier in the chapter. Mobile learning offers great opportunities for education; however, while more demand exists for mobile learning, technical issues and design challenges related to mobile learning content delivery platforms still need to be further developed.25
Chapter Review
The task for instructional designers to train large numbers of employees on electronic medical records is a large and complex undertaking. It is increasingly apparent that innovations in information technology can deliver instruction more effectively in a wider range of contexts.2 Anecdotal evidence suggests that projects for developing online instruction, particularly in educational settings, are often challenged by limited staff, funding constraints, and quick turnaround times. With increasingly limited resources, corporate and governmental departments responsible for designing online instruction have been reduced. Large projects requiring complex instructional design have been replaced by smaller, less complex, and less resource-intensive initiatives.26 Having transformed traditional learning styles and sparked the interest of business communities and schools, e-learning is now regarded as an effective way to save labor and money, while enhancing learning performance.10 Online learning using web-based computer programs and emerging mobile technology for teaching can facilitate learning with instructional efficacy similar to that of traditional teaching approaches. Key topics in this chapter include the following:
• Instructional systems design and the ADDIE model as a guide for developing training
• Principles of adult learning theory and the importance of incorporating these principles into training programs
• Lesson plans and the various methodologies for developing educational content along with suggestions for evaluating student learning and program evaluation
• The use of a learning management system, open source software, and the incorporation of Web 2.0 technology to enhance learning
• New trends in adaptive learning designs and mobile technology
Ultimately, it is not the amount of time spent training or the method of delivery that is important but the competency of the end users and their safe practices with system use that matter.
Questions
To test your comprehension of this chapter, answer the following questions and then check your answers against the list of correct answers at the end of the chapter.
1. Utilizing an instructional systems design model can facilitate the transfer of which of the following?
A. Knowledge
B. Attitude
C. Skills
D. All of the above
2. The best way to conduct a needs assessment is to do which of the following?
A. Conduct a survey
B. Conduct a focus group or structured interview
C. A and B
D. None of the above
3. During which step of the ADDIE model is it appropriate to write the learning objectives?
A. Analyze
B. Design
C. Develop
D. Implement
4. Characteristics of adult learners include which of the following?
A. Are responsible for their learning, are ready to learn when the need arises, and are task-oriented
B. Are autonomous, need direction, and do not feel responsible for their learning
C. A and B
D. None of the above
5. When developing content using presentation software, good design principles include which of the following?
A. An abundance of animation and a variety of background colors
B. Consistency and uniformity of text and font sizes
C. Excessive use of graphics and text to convey the message (“eye charts”)
D. Cartoons and humor to hold the learner’s attention
6. The benefits of using a learning management system (LMS) to implement a training program include all of the following except which one?
A. Automatic tracking of user grades and participation
B. Incorporation of SCORM standards
C. Administrative management
D. Turnkey technology
7. Why is Web 2.0 (or current Internet) technology becoming popular in education and training?
A. Younger generations are familiar with this technology.
B. Many frameworks exist for the use and incorporation of this technology into training.
C. Research is beginning to show the effectiveness of this technology in collaborative learning.
D. None of the above.
8. Which of the following is a true statement about mobile learning?
A. It is now a preferred method of learning.
B. It should be an option for all courses developed.
C. It is not yet fully developed.
D. None of the above.
Answers
1. D. Use of an instructional systems design model to develop a training program can facilitate the transfer of knowledge, attitude, and skills to the learner.
2. C. The best way to conduct a needs assessment is a survey or a structured focus group.
3. B. The design step of the ADDIE model includes writing the objectives.
4. A. Characteristics of adult learners include responsibility for their learning, are ready to learn when the need arises, and are task-oriented.
5. B. When developing content using presentation software, good design principles include consistency and uniformity of text and font sizes.
6. D. The benefits of using a learning management system (LMS) to implement a training program include all of the options given except that it is not turnkey technology.
7. C. Web 2.0 technology is increasingly popular in education and training because initial research is showing its effectiveness in collaborative learning.
8. C. Mobile learning is not yet fully developed.
References
1. InstructionalDesign.org. (2016). Home page. www.instructionaldesign.org/.
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