My reflection on the whole process of creating e-learning intervention

 

My reflection on e-learning module

As I perceive myself as a technically challenged person, I always asked someone to assist me when it comes to technological things most of the time. I am grateful that I am now working in the environment where my colleagues are up-to-date with new trends of education and technology, and they usually support me if I struggle with any of them. When I chose the e-learning module at the beginning of MPhil second year, I had no idea of what I was getting into. The reason I chose this was simply because of peer pressure and I had a feeling that the other module would be quite difficult to pass.

After reading the module assessment, I found that the assignment of the module was tough. However, the use of the ADDIE model guided the writing of the assignment in the correct direction. In applying the first phase of the ADDIE model, I had to do a mini-survey of students on need analysis of the chosen topic. Though it was difficult to organize towards the end period of the academic year, the data collected from the mini-survey supported my assumption of the problem and possible solutions. It took me a lot of time and effort to finish the analysis phase.

When I started designing the new intervention, I received feedback from peers which made me realize that there were some gaps in my design. Additionally, I could analyze the feasibility part of implementing this new intervention. This process saved me from doing uneventful things. I agree with Lianne that the design phase and development phase could be seen as one activity. After I put down the solution of the learning problems and teaching tools in the development phase, the prototype was produced. I am now so excited to show the prototype to my colleagues and welcome their feedback, as students are busy with writing their exams at this time of the year.

Hopefully at the beginning of next year I can test this prototype to some volunteer students and get feedback of how they felt about their learning, as well as, whether this prototype increases their knowledge about jaundice. I found this evaluation model of Kirkpatrick (ADDIE model, 2004) very useful and applicable not only in e-learning evaluation but also for other non e-learning courses as well.   

The rewarding part for me is after I uploaded the learning content on the Blackboard system with YouTube web links, it offered students the opportunity to learn everything about ‘Jaundice’ students needed to know in their second year. Additionally, the information is easily accessible to them anytime and anywhere.  Actually I felt like half of the responsibilities of teaching this module was already done even before the module started. Now I can’t wait to see the students’ performance outcomes in their case reports and in their final examination. As an educator and a medical doctor, my role is to assist medical students to enhance their learning to achieve the final goal of improving in patient’s outcome. Though I am involved only in the junior years of medical training, my duty is to plant the seeds of knowledge in the correct type of soil, which facilitates adult learning. This aims to achieve the best possible results which translate to improved patients’ outcomes of our graduates.

My concern is whether lecturers from other departments will be willing to participate and roll out the e-learning programmes. As my context is Sefako Makgatho Health Sciences University (SMU) which is the University for the previously disadvantaged students, even lecturers might feel e-learning is impossible in our context. This can be both due to the lecturers’ attitudes towards e-learning and their levels of technical competency. When I attended one of this year’s Academic Planning and Curriculum Development Committee (APCDC) meetings, the SMU information technology (IT) unit leader wanted to present about the full launch of the Blackboard system.  APCDC members seemed uninterested with regards to the Blackboard system. As I am one of the module leaders in the second year and one of the few lecturers who initiate e-learning in SMU, it is also important for me to encourage participation of educators from different departments by informing them of the evidence of improved learning outcomes and showing them how to use it. I think as we are in the 21^st century which is the digital age, we all have to be up-to-date with technology even though I am one of the slower educators when it comes to learning about technology.

Now that I am exposed to the e-learning, I had an opportunity to learn about the benefits and possible ways of implementing it in my context. If other lecturers are given enough information and opportunities to learn about it like me, I am confident that their attitudes to e-learning will become more positive.   

I am glad that I walked through this pathway of exploration of e-learning and its role in medical education with all of you and a big thank to Lianne who supported us in every step of the pathway. So, this is the end of our 2^nd year MPhil. Let’s shine ourselves in the world of medical education with what we have learnt through this degree.

 

Reflection on first three phases of ADDIE

E-learning assignment by Yamin

 

My assignment is creation of “Jaundice module” as an e-learning in 2^nd year medical students’ curriculum. Jaundice is one out of the two integrated themes in the curriculum. Application of ADDIE model for Jaundice module are as follows:

Analysis 

The need to implement e-learning arose after I (one of the facilitators responsible for review of the integrated theme) marked Jaundice case reports of the students this year. I found that students failed to explain the pathophysiology of Jaundice, interpretation of laboratory results and application to their patient’s case studies. Therefore, I informally discussed about this problem with other facilitators and I proposed whether we could implement an e-learning for “Jaundice module”. Fortunately, most facilitators in our department are computer literate health educators, they are all positive about this implementation. I was very excited about this implementation and happy about my colleagues support.

I also distributed questionnaires to students enquiring about their feel of need, what intervention do they think could improve their learning and suggestions. So most of the students requested that they wanted to learn more student case studies as group discussions and extra lectures on clear explanation of pathophysiology. I am glad that I did manage to give out questionnaires just before they write their final exam. By doing this I found out how I could plan to fill the students’ knowledge gap.

Design & Develop

I am thinking of creating a flipped classroom in which I put up the lecture notes, power point presentations of lectures, link explanation videos on you tube on the blackboard system. Then in class tutorial of small group discussion will be done by facilitators in periods of some lecture times. One facilitator will have to facilitate 5 students in a small group each tutorial. As this is the integrated theme, lectures from different departments eg physiology, internal medicine, chemical pathology will also continue to give lectures in relation to their subjects throughout the first semester. The discussion forum will also be opened on the blackboard whenever students from each facilitator needed to ask any questions. Then assessment will be each student has to write the Jaundice patient case study and submit it online to facilitator directly at the end of the semester. So this is using the blended approach of e-learning on the existing module. I am not sure whether I am doing so many things at once, logistically & technologically whether my institution will be ready to implement this.

Any opinion is welcomed.

 

Summary of articles

A Global Model for Effective Use and Evaluation of e-Learning in Health

By

Kai Ruggeri, PhD, Conor Farrington, PhD, and Carol Brayne, MD

(Institute of Public Health, University of Cambridge, United Kingdom)

 

Healthcare systems worldwide face a range of challenges in the 21^st Century due to global health trends changes, healthcare delivery costs have risen steeply in recent years and in 2008 it was estimated that none of the health-related Millennium Development Goals would be met by 2015 in sub-Saharan Africa. In response to all these challenges, many healthcare systems across the world have initiated policy reforms aimed at reducing inefficiencies and health inequalities. The range and severity of global healthcare challenges combined with healthcare reforms generate considerable difficulties for medical education and continued professional development (CPD). A recent study outlines these difficulties which arise against a changing educational background. 

These challenges have been particularly severe in developing world contexts and consequently, renewed efforts to reform medical education and CPD to be necessary in a wide range of contexts and for a wide range of workforce sectors.

E-learning in health is defined as the delivery of training or CPD material via electronic media. The e-learning programs can be classified as eight dimensions with different advantages and disadvantages. They are:

Synchronicity

·         Asynchronous means content delivery occurs at different time than receipt by student;

·         Synchronous means content delivery occurs at the same time as receipt by student;

Location

·         Same place means students use an application at the same physical location as other  students and/or the instructor

·         Distributed means students use an application at various physical locations, separate from other students and the instructor

Independence

·         Individual means students work independently from one another to complete learning tasks

·         Collaborative means students work collaboratively with one another to complete learning tasks

Mode

·         Electronic-only means all content is delivered via technology. There is no face-to-face component

·         Blended means E-learning is used to supplement traditional classroom learning (and vice versa)

Out of all eight dimensions, the blended learning (ie learning used to supplement traditional classroom learning) is considered to have more positive and interactive learning experience.   

Numerous studies have done about e-learning and they concluded that most e-learning programs are far more effective than no training intervention and are as effective as traditional small. There is no report of cost effectiveness in any of the study. There are no security and no reliability against misuse due to the nature of the Internet. Many public information outlets are without review, therefore accuracy should never be assumed from unknown sources. 

According to the evidence, critical success factors (CSF) for e-learning include: institutional characteristics, instructor characteristics, learner characteristics, and e-learning program characteristics. Additional CSFs for a healthcare context are: constant updating of course content, monitoring of workforce learning to ensure the latest clinical guidance, adoption of new technologies to ensure alignment of training with delivery models.

Unfortunately, there is no standardized model (universally applied but locally adapted) to evaluate the effectiveness and safety of e-learning programs in healthcare.

This article discussed the importance facts about developing the evaluation model and described the proposed model in schematic form as in figure 1, as well as, illustrated form. The model provides a minimum standard but it can be a starting point for discussion and dialogue. The model also has limitations.

 

 

Fig. 1. A model for evaluation of e-learning programs in health and care. KPIs, key performance

indicators.

Limitations of the model include language barrier, no accreditation standard for online training, it does not describe how to structure the content or facilitation or presenting information within the program and it applies to a direct training program. Interested organizations should work toward establishing a standard model for evaluating programs in a wide range of contexts. Therefore, a standard model should aim to provide a practical and adaptable framework to support the systematic development of high-quality evaluations to elicit valuable and important information for decision makers.

 

Application of this model in my context (Medical University training programs)

As the contexts are differ between medical training for undergraduate programs and healthcare program training, this model cannot apply in my context. I agree that training in healthcare program could benefit to use this model for evaluate their e-learning programs but due to its detailed structure, and extra components than simple medical training, it is not applicable to my context.

For medical training context, I would prefer using the Kirkpatrick model for outcome evaluation of e-learning which focuses more on the learner. It is quite simple model which evaluates four levels. They are: (level 1) Reaction, which measures both students and facilitators’ feelings to the course; (level 2) Learning, which measures what students learned; (level 3) Learned behavior, which measures behavior changes of students after the course; and (level 4) Results, which measures the outcomes of the course.   

Summary of article

What drives a successful e-Learning?

An empirical investigation of the critical factors influencing learner satisfaction

By

Pei-Chen Sun, Ray J. Tsai, Glenn Finger, Yueh-Yang Chen, Dowming Yeh

 

This research developed an integrated model from previous studies which identifies critical factors influencing e-learner satisfaction. It consist of thirteen factors in six dimensions as shown in figure 1. Results from this research indicated that seven out of thirteen factors cannot be neglected when implementing a successful e-learning environment. These are: learner computer anxiety, instructor attitude toward e-Learning, e-Learning course flexibility, e-Learning course quality, perceived usefulness, perceived ease of use, and diversity in assessments. These factors can serve as potential obstacles not to overlook when institutions want to develop and implement e-learning course.

Learner dimension
-Learner attitude toward computers
-Learner computer anxiety
-Learner Internet self-efficacy

Instructor dimension

-Instructor response timeliness
-Instructor attitude toward e-Learning

Course dimension
-E-Learning course flexibility
-E-Learning course quality

Technology dimension

-Technology quality
-Internet quality

 

Design dimension

-Perceived usefulness
-Perceived easy of use

Environmental dimension

-Diversity in assessment
-Learner perceived interaction with others  
Fig. 1. Dimensions and antecedents of perceived e-Learner satisfaction

 

If I apply these factors from the research in my context which is the medical institution of disadvantaged students of South Africa, I have many more critical factors to emphasis for students satisfaction. These are as follows: 

Learner dimension

·         Factors such as computer literacy and internet self-efficacy might be additional factors with computer anxiety, as majority of our students come from rural areas.

 Instructor dimension

·         Instructor’s attitude towards computer and network technology is very important as some of our lecturers prefer traditional teaching methods. 

Course dimension

·         Course flexibility of time, space, location, methods etc, as well as, course quality such as course design, teaching material, course schedule, discussion arrangements and multimedia presentation of course are strong factors of student satisfaction.

Technology dimension

·         Technology use in our institution faces many challenges such as frequent technical difficulties, poor internet quality and speed.

Design dimension

·         Usefulness of the e-learning program and easy use of it, definitely give higher learning satisfaction.

Environment dimension

·         Assessment in e-learning using diversity of assessments (which include formative assessment, self-assessment and/ or peer assessment) also give students’ satisfaction but the challenges in my institution is feasibility in terms of administrative tasks.

In conclusion, this research provides insights for institutions to strengthen their e-Learning implementation and further improve learner satisfaction.

 

 

Analysis phase of ADDIE model

Dear all,

I chose the peripheral signs block in second year medical students' curriculum for analysis. The reason was about 25% of students of the whole class failed the written component of this block. The written test is based on patient's case scenario where students have to interpret patient's blood results and answer the cause of the pathology. Therefore, I need to do needs analysis with students about it. I am thinking of asking students to complete the questionnaire about their challenges concerning written test (what are they finding difficulty?). In addition, I would also include questions about whether students have access to internet facilities and they are willing to participate in chat room discussion or not.

In this way I can know whether there is a need to integrate e-learning in the block. The e-learning is a good option in this regard as there is no other extra time available in the students' academic timetable.

Any suggestions are welcomed.

Expections for the module

My expectations of e-learning are:

• to be able to implement & use new technology in students' learning in addition to traditional way of teaching & learning
• to be able to enhance learning of medical students by technology assisted models
• to be able to learn and identify appropriate e-learning activities and strategies according to own's context

e learning module for peripheral signs

I am going to create video play lists of clinical examination of peripheral signs block.

I think it will save a lot of time for lecturers & students. Students will learn it in their own time, own pace and review as many times as they want.

It will help the lecturer not necessary to be with students all the time.

It will enhanced students learning and empower them with new technology skills.