The Student-Information Relationship

An excellent conference presentation from the perspective of a Warwick medical student, who implemented an entirely paperless resource workflow during his studies, and why he thinks the methods he used made very effective use of some of the tools and resources available via tablet devices.

Virtual Patients at Cardiff; Literature Review Abstract

Purpose
After developing a small number of experimental Virtual Patients as optional components in the undergraduate curriculum and having received very favourable feedback from students about them the School now needs to undertake a more comprehensive review of virtual patients. The review intends to uncover the pedagogic underpinnings for effective virtual patient delivery and help CU staff identify areas of the medical curriculum where they would be best suited.

Method
A literature review of how both national and international medical teaching institutions have reported the effectiveness of their VP implementation, with particular focus on elements of the educational theories which have best enhanced the intended transferable learning aspects. The results were then used with the intention of helping staff identify areas of the undergraduate curriculum where VP’s would be best suited, and to what degree they can be integrated into core teaching.

Results
Results indicated a wide variance of the ways in which VPs were integrated into core medical teaching but with common theme of pedagogic design prinicpals which were key to the effectiveness of preparing the student for ‘real’ patient encounters; authenticity was seen as a key enabling factor for this.

Conclusion
It was found that the development of competence in clinical reasoning was a key target for any VP; authenticity of clinical events and patient dialogue facilitated by appropriate media being a dominant factor in preparing the student for real patient interaction, particularly in exercising social and communication skills. VP’s can be integrated as a focal subject for use within lectures or seminars, or used as a self-directed study aid, accessed externally to core teaching; the degree of its integration should be left to the discretion of the curriculum leads.

Virtual Patients at Cardiff; A Review

Virtual Patients are computer-based simulations of fictitious patients presenting with a complaint. The complaint is analysed by the learner and encourages thinking processes surrounding history taking, examination, diagnosis, treatment and discharge, without the obvious risks associated with a student treating a real patient case. The cases can focus on important common condition but can also be used to cover important conditions that it may be difficult for students to gain experience of, such as domestic abuse.

Main Points...

• Allows self-directed learning opportunities
• Narrative/didactic style of delivery for earlier years students
• Branched/exploratory style of learning for later years where knowledge can be applied
• Focus is on applying clinical knowledge to diagnostic thinking and management
• Cognitive realism - that is that the challenge posed to the learner seems real - is more important than visual realism - that is that real photos or video clips are used
• Communication/social skills for patient dialogue can be exercised Opportunity to familiarise with patient dialogue
• Continual focus on learning objectives is key for maintaining relevance
• Regular self-assessment opportunities allows the learner to evaluate their own progress
• Promotion of clinical reasoning is arguably the most important distinguishing feature of VP delivery and purpose

Read more about the comprehensive literature review conducted at Cardiff University School of Medicine...

Access the full literature review here.

Wikis

A wiki is an editable web page which enables many-to-many communication – it is essentially a database created by a group rather than an individual (e.g. Wikipedia). Wikis are similar to blogs but allow the text on the website to be edited by others, with the creation of a common document that can be shared between individuals. One of the big advantages of collaborating with wikis is that it should reduce email traffic.

Wikis can be used to share dialogue and information among participants in group projects, or to allow learners to engage in learning with each other, using wikis as a collaborative environment to construct their knowledge or to be part of a virtual community of practice. Wikis show the evolution of thought processes as students interact with the site and its contents.

As users can modify the content of a wiki, allowing such manipulation carries some risks. Thus wikis are often monitored to ensure that inappropriate language or content are not allowed; however, this can be time-consuming.

How to do it
There are many different wiki creating and hosting services available. Wikimatrix provides a comparison of the key features offered by a variety of services. There are also plenty of other non-wiki collaborative editing tools such as googledocs. Most wiki-hosting services have a built-in search system for you to find wikis of interest, and there are some general wiki-search engines such as wikiindex.


Incorporating wikis

• To create multimedia presentations and simple digital stories as they are able to incorporate sounds, movies and pictures
• As e-portfolios illustrating their utility as a tool for collection and reflection of current thoughts
• To form groups around specific topics and might also prove to be an ideal vehicle for soliciting ongoing input for research or projects where community input can help inform and direct subsequent investigation
• As repositories for meeting notes. Agenda items are contributed prior to a meeting; notes added during the meeting are saved in a public archive

Considerations
In an open and collaborative web environment, anyone can very easily post copyrighted material without the permission of copyright holders (e.g. patient anonymity when clinical data and images are posted), post otherwise unsuitable or misleading content

A lack of clear and complete authorship/editorship information attached to each wiki entry, including authors’/editors’ affiliations and credentials, is a serious quality issue. Wiki author anonymity also poses questions for higher education institutions where assessment and grading are still typically based on individual efforts

Wikis are sometimes prone to vandalism and, as a result, to serious quality issues, because of their free form nature and the (relative/potential) lack of control over their content (e.g. edit in a way that reduces its accuracy, or even delete a good wiki entry)

Wikis do not have the functionality expected on more traditional web sites, such as the use of highly visual dynamic backgrounds that are integrated with various multimedia. However, they are highly useful pedagogically as a low technology approach to providing an online presence with the ability to have links to other online resources or to store a variety of files


Solutions
Monitoring and moderation: Wiki software packages have built-in ‘Administrator’s functionalities’ to support monitoring and moderation. However, these tasks can be very time-consuming and may prove to be too great a challenge to ask of educators who already lack time and resources

The ‘closed environment’ scenario: e.g. Learning Central – The wiki owner(s) /Administrator(s), enforce, check, and limit wiki and blog registration and editing privileges to selected, well-defined, and verifiable special interest groups or communities of users. Everyone else will still be able to access/read the wiki and, if desirable to also post limited (moderated) comments (to build a community)

Obtaining Patient Permission: Permission must be sought when posting clinical photos/videos, and all efforts should be made to preserve individuals’ privacy. Clinical wikis may also be password protected if necessary to further preserve patient confidentiality. The software also makes it a simple matter for an editor to delete/revert or modify material that violates patient privacy. Refer to patient consent and copyright policies

Blogs

A blog (short for ‘web log’) typically describes an online personal diary kept on the Web, usually maintained by one person – even one with few Web publication skills. The blog is a includes regular entries of commentary, links, or other material such as graphics or video about a particular topic. The activity of updating a blog is known as ‘blogging’ and someone who keeps a blog is a ‘blogger.’ Blogging is a straightforward and interesting way for students to generate, share and keep up-to-date with timely and topical information.

Research currently suggests that blogs engage students in knowledge sharing, reflection and debate, and so often attract a large and dedicated readership. This has the advantage of creating small virtual groupings of individuals interested in co-constructing knowledge around a common topic. Through linking, commenting and feedback, good or popular ideas spread quickly, while unpopular ideas are simply ignored.

The RSS feeds generated by blogs mean users can subscribe to the blog and automatically receive updates as and when new content is added to the blog. Blog subscription and syndication services include general ones such as Blogbridge, or specialised services such as Scienceblogs. Increasingly, blogs incorporate multimedia, and you can also upload and read them via mobile devices. Due to the vast number of blogs available comprehensive blog search facilities are available at Technorati and Google.

How to do it
There are a variety of blogging services available, many of which are free. When choosing a service, you must consider the configuration and moderation options available – for example, do you want your blog to be open to all, or just invited guests? Some of the major blogging services include Edublogs, WordPress and of course the University’s Learning Central. JISC also provides a useful summary comparison chart.

Incorporating Blogs
Despite the early state of implementation, there are several studies that list advantages for using blogs in educational settings including:

• As e-Portfolios for personal reflection on clinical experience or as portfolios to store personal thoughts and information sources
• To capture and disseminate faculty-generated content as well as peer-to-peer knowledge sharing and acquisition
• As a forum for discussion that goes beyond coursework to include other areas of personal exploration
• To informally follow the progress of a topic more quickly than is possible within the rigorous expert review model of evidence gathering required by academic journals

Considerations

• In an open and collaborative web environment, anyone can very easily post copyrighted material without the permission of copyright holders (e.g. patient anonymity when clinical data and images are posted), post otherwise unsuitable or misleading content
• Blogs are sometimes prone to vandalism and, as a result, to serious quality issues, because of their free form nature and the (relative/potential) lack of control over their content
• Blogs do not have the functionality expected on more traditional web sites, such as the use of highly visual dynamic backgrounds that are integrated with various multimedia. However, they are highly useful pedagogically as a low technology approach to providing an online presence with the ability to have links to other online resources or to store a variety of files]

Solutions

• Monitoring and moderation: Blog software packages have built-in ‘Administrator’s functionalities’ to support monitoring and moderation. However, these tasks can be very time-consuming and may prove to be too great a challenge to ask of educators who already lack time and resources
• The ‘closed environment’ scenario: e.g. Learning Central - The blog owner(s) /Administrator(s), enforce, check, and limit wiki and blog registration and editing privileges to selected, well-defined, and verifiable special interest groups or communities of users. Everyone else will still be able to access/read the blog and, if desirable to also post limited (moderated) comments (to build a community)
• Obtaining Patient Permission: Permission must be sought when posting clinical photos/videos, and all efforts should be made to preserve individuals’ privacy. Clinical blogs may also be password protected if necessary to further preserve patient confidentiality. The software also makes it a simple matter for an editor to delete/revert or modify material that violates patient privacy. Refer to patient consent and copyright policies]
• Importantly, educators need to set guidelines and expectations to maximize the benefits of blogs

Blogging can be seen as a behaviour of social knowledge construction, and the use of blogs in online educational settings has the potential to help enhance students’ knowledge sharing and learning effectiveness. However, some students may not blog in spite of the availability of blog platforms.

Technology & Pedagogy

Exemplary teaching combines skilful use of pedagogy with content expertise and innovative uses of technology, embedding key elements into course design. Wilson (2003)

As educational technologies continue their rapid evolution and the effectiveness of traditional educational techniques are brought into question (Bligh, 2000), it would be easy to become overly enamoured and forget that the technology is fundamentally dependent on the underlying pedagogy and learning principles employed to deliver the educational programs themselves; indeed “pedagogies before technologies” is a commonly touted phrase (Watson, 2001; Ascough, 2002; Mayes and De Freitas, 2004).

Beetham and Sharpe (2007) suggest that far from trying to create pedagogy anew, we should be in the business of locating new technologies within proven practices and models of teaching, where the focus is on educational issues or problems that might possibly be solved, at least partially, by the provision of learning arrangements that make a deliberate and effective use of technology. Unfortunately, there is no one simple approach to using technology to support learning that will succeed. Instead the starting point is not the technology per se, but the educational process itself.

Pedagogical Perspectives
Pedagogy is a term that generally refers to strategies of instruction or a style of instruction (Stephenson, 2002). A number are often quoted in e-Learning literature and can be mapped into broad theoretical educational perspectives that govern the good practice of teaching (JISC 2004). These perspectives are not mutually exclusive, but within each, it is possible to identify a key set of assumptions, that have in turn generated a large number of pedagogical approaches and models that can be used to encourage specific aspects of learning (Insert Table 1).

Table 1: Defining approaches to learning from the Effective Practice with e-learning Guide

e-Learning Pedagogy
Although a number of reviews of learning theories and their relevance to e-Learning have been carried out (Conole et al., 2003; Mayes and De Freitas, 2004; Beetham and Sharpe, 2007; Dyke et al., 2001) it would appear that there is currently little evidence of how these models or theories are applied consistently to effective pedagogically driven e-Learning. Research indicates that most implementations of e-learning include blended elements that emphasise all three pedagogical perspectives: learning as behaviour, learning as the construction of knowledge and meaning, and learning as social practice. However, the literature also suggests that the emerging pedagogical consensus centres around constructivism – collaborative learning, authentic tasks, reflection and dialogue and to do so in a way that addresses both identity and community (Bangert, 2004; Mayes, 2004; Windschitl, 2002). Weller (2003) also cites constructivism as the dominant teaching pedagogy applicable to the Internet, but while advocating that there are opportunities for new pedagogies he also admits that they should be used “in conjunction with more traditional approaches”.

e-Learning also places additional emphasis on several key features including the ‘individualisation’ of learning, with each student making their own learning pathways at a speed that is appropriate to them, and ‘just-in-time’ learning where students have timely access to relevant and useful knowledge. Moreover the steady growth in mobile device ownership enables mobile learning (m-learning) where students are able to learn at ‘any time and in any place’. These features demonstrate students increasing reliance on an eclectic mix of personal and institutionally-based technologies and illustrate that much of this e-learning is not developing as conventional pedagogy – but as ‘informal learning’. This is facilitating the bottom-up development of learning communities by combining one-to-one (email and instant messaging), one-to-many (discussion tools, blogs and podcasts), and many-to-many (wikis) communication modes.

Technologies Identified
The tools used to support and deliver learning cover a wide range of different applications including:

• Virtual Learning Environments (VLEs) – Many institutions have now adopted VLEs which incorporate collaboration and communication tools such as wikis, blogs, forums and chat. However, research suggests that while VLEs may have enhanced learner access to online resources, the associated communication tools have been little used JISC (2003).
• Reusable Learning Objects (RLOs)
• Self-paced Computer Aided Instruction (CAI)
• Web 2.0 Tools – Technology can provide a medium for conversing and collaborating within the learning environment (Jonassen et al. 1999; McConnell, 2006). The growing interest in social dimensions of learning and the availability of more open-source web-based social networking tools have been adopted in learning and teaching (Dron, 2007). Web 2.0 social technologies include: social network services, social bookmarking, folksonomies, social search engines, file sharing and tagging, mashups, instant messaging an online multi-player games. More popular in education appear to be wikis, blogs and podcasts (Boulos et al., 2007). Wikis – enact knowledge building, where the focus is on the community itself rather than on the individual learner (Holmes et al, 2004). Wikis are based upon a principle of non-exclusive authority, anyone and everyone gets to decide what will be said (content), how it will be said (organization), and whether it will be said (dissemination). Blogs – are useful teaching and learning tools because they provide a space for students to reflect and publish their thoughts and understandings. As blogs allow comments, they also provide opportunities for feedback and potential scaffolding of new ideas. Podcasts – can be released episodically to ‘push’ content to students that want to listen when they want, where they want and how they want.
• Multimedia – In its most straightforward role, multimedia can be used to present the subject matter. There are many different ways of integrating graphics into tutorials, ranging from simple stick figures to sophisticated simulations using virtual reality applications. However, at no time should a desire for sophistication and look outweigh the pedagogical value of the item itself, especially not when functionality might be compromised. Video – is by far one of the most powerful and expressive non-textual media that can capture and present information. A number of e-Learning systems present integrated and synchronized instructional materials in different media such as video, presentation slides, and lecture notes to users.
• e-Portfolios
• Formative Assessments

An instructor is therefore faced with choosing from a plethora of tools and learning theories in order to create specific learning activities which can be confusing. JISC (2004) suggest that these technologies reflect the pedagogical perspectives listed below (Table 2).

Table 2: Pedagogical Perspectives and Technology

Summary
The use and understanding of technology in teaching is often viewed as a separate issue to that of teaching in itself. If the primary focus of teaching is on pedagogy, and technology is merely viewed as another mode of delivery, then technology and pedagogy can be seen as existing separately, with one having minimal impact on the other. However, if elements of technology and pedagogy can be seen as mutually supportive and interdependent, then it should be possible to construct new meaning about teaching online that is integrative and serves to bring about a bridging of the gap between pedagogy and technology (Maor, 2004 and Wilson 2003).

Alexander and Boud (2001) argue that much of the potential for online learning is being lost because too much of the pedagogy of online learning has been transferred unreflectively from didactic traditional teaching where the computer substitutes for the teacher and textbook as a conveyer of information. It has been argued that many of the digital learning objects created to-date simply translate existing lectures into a digital format, with no change in the pedagogy used (Donald Clarke – Don’t lecture me).

Recommendations in the literature point towards technologies specifically designed to provide interactivity that guide students towards online collaborations (Crook, 1994). This in turn promotes, among other things, skills such as articulation, justification and negotiation (Crook, 1994), shared responsibilities (Laurillard, 1997; Goodyear, 2001), scaffolding (Salmon, 2000), setting hypotheses (Valdez et al., 2000), reflection (Schon, 1992; Laurillard, 1997; Goodyear, 2002), knowledge activation and knowledge application (Gagne, 1965; Bruner, 1997; Goodyear, 2001) and individualized learning and motivation (Goodyear 2002). Advice and guidance is available to institutions as there is no blueprint for implementation of technologies, and each is currently deciding its own path (JISC, 2003)

References

Alexander, S. and Boud, D. (2001) Learners still learn from experience when online. In: Stephenson, J. (Ed.) Teaching and learning online: pedagogies for new technologies. London, Kogan Page.

Ascough, R.S. (2002) Designing for Online Distance Education: Putting Pedagogy before Technology. Teaching Theology and Religion: 1; p.p. 17-29.

Bangert, A. W. (2004) The Seven Principles of Good Practice: a framework for evaluating online teaching. The Internet and Higher Education. 7 (3), 217-232.

Beetham, H. and Sharpe, R. (2007) Rethinking Pedagogy for a Digital Age – Designing and Delivering e-Learning. Routledge, London.

Beetham, H. (2004) Initial Positioning Report. JISC programme on pedagogies for e-learning.

Bligh, D.A.  (2000) What’s the Use of Lectures? Exeter: Intellect.

Boulos, M.K. and Wheelert, S. (2007) The emerging Web 2.0 Social Software: an enabling suite of sociable technologies in health and healthcare education.

Bruner, J. (1997) The culture of education (Cambridge, MA, Harvard University Press).

Conole, G.  Dyke, M. Oliver, M. and Seale, J. (2004) Mapping pedagogy and tools for effective learning, Computers and Education, 43, 17–33.

Crook, C. (2009) Web 2.0 technologies for learning: the current landscape – opportunities, challenges and tensions. Becta, 2008

Dron, J. (2007). Designing the Undesignable: Social Software and Control. Educational Technology and Society, 10 (3), 60-71.

Dyke, M. (2001) Reflective learning and reflexive modernity as theory practice and research in post-compulsory education

Gagne, R. M. (1965) The conditions of learning (New York, Holt, Rinehart & Winston Inc.).

Goodyear, P. (2001). ‘Effective networked learning in higher education: notes and guidelines.’ Centre for Studies in Advanced Learning Technology, Lancaster University. Networked Learning in Higher Education Project, Deliverable 9, Volume 3 of final report to JCALT.

Goodyear, P. (2002) Psychological foundations for networked learning. In: Steeples, C. and Jones,C. (eds.), Networked Learning: Perspectives and Issues. London: Springer, 49–75.

Holmes, B. and Gardner, J. (2006) E-learning :concepts and practice. Sage : London.

Jarvis, P. (1987). Adult learning in a social context. London: Croom Helm.

JISC (2003)  Effective Practice with e-learning Guide (Managed Learning Environment Activity in Further and Higher Education in the UK.

Jonassen, D. H. (1999). Designing Constructivist Learning Environments. In Reigeluth, C.M. (ed.), Instructional-Design Theories and Models: A New Paradigm of Instructional Theory. Volume II (pp. 115-140). Lawrence Erlbaum.

Kolb, D. (1984). Experiential learning: Experience as the source of learning and development. Englewood Cliffs, NJ:

Prentice-Hall.

Laurillard, D. (2002). Rethinking University Teaching-a conversational framework for the effective use of educational technology. London, Routledge Farmer.

Laurillard, D. (1999) Learning formal representations through multimedia, in: N. Entwistle (Ed.)The experience of learning (London, Academic Press).

Maor, D. (2004). Pushing beyond the comfort zone: Bridging the gap between technology and pedagogy. In R. Atkinson, C. McBeath, D. Jonas-Dwyer & R. Phillips (Eds), Beyond the comfort zone: Proceedings of the 21st ASCILITE Conference (pp. 572-576). Perth, 5-8 December.

Mayes, T. and de Freitas, S. (2004) Review of e-Learning Theories, Frameworks and Models

Mayes, T. (2004) Learner-centred pedagogy: individual differences between learners, report for JISC Elearning

Models Desk Study,

McConnell, D. (2006) E-Learning Groups and Communities. Maidenhead, SRHE/OU Press.

Papert, S. (1980). Mindstorms. Sussex, The Harvester Press Limited.

Piaget, J. (1971) Biology and Knowledge: An essay on the relations between organic regulationsand cognitive processes. Edinburgh: Edinburgh University Press.

Salmon (2000) E-Moderating: the key to teaching and learning online (London, Kogan Page).

Schon, D. (1992) Educating the reflective practitioner: towards a new design for teaching and learning in the professions (London, Jossey-Bass).

Stephenson, J. (2002) Teaching and Learning Online: Pedagogies for New Technologies, Kogan Page Ltd. London.

Valdez, G. McNabb, M. Foertsch, M. Anderson, M. Hawkes, M. Raack, L. (2000) Computer based technology and learning: evolving uses and expectations.

Vess, D. L. (2006). History to go: Why iTeach with iPods. History Teacher,39(4), 479-492.

Vygotsky, L. S. (1978) Mind in Society. Cambridge, MA: Harvard University Press.

Watson, D. (2001) Pedagogy before technology: Re-thinking the relationship between ICT and teaching. Education and Information Technologies, 6 (4), 251-266.

Weller, M. (2003) Delivering Learning on the Net, Routledge Falmer

Wenger, E. (1998) Communities of Practice: learning, meaning and identity. Cambridge. Cambridge University Press.

Wilson, W. (2003) Faculty Perceptions and Instructional Uses of Technology. Educause Quarterly (2003)

Windschitl, M. (2002) Framing constructivism in practice as the negotiation of dilemmas: an analysis of the conceptual, pedagogical, cultural, and political challenges facing teachers. Review of Educational Research 72 (2): 131–175.

Step 4: Install, Maintain & Develop Prototype (Rapid Prototyping - 4 Step Instructional Design Model)

Once you have implemented your amendments, the learning episode should be installed and appropriately maintained.

A logical directory structure is required to keep all of the graphics, text, audio clips organised into folders in such a way that you know where to find them when they need updating. Documentation should also be developed such as user guides and any further information.

Your evaluation should continue as part of an iterative process, in particular feedback from students. This will allow you to improve the effectiveness of your tutorial.

Click here to repeat Step 3 – Utilize Prototype.
Click here to repeat Step 2 – Construct Prototype.
Click here to repeat Step 1 – Analyze.

Step 3: Utilise Prototype (Rapid Prototyping - 4 Step Instructional Design Model)

A crucial part of the prototyping process is the utilization of the design with peers and potential learners. During utilization, the strengths and weaknesses of the prototype can be discovered. This needs to be done in a structured and timely way. There are three stages to the evaluation and ideally, each stage would occur in sequence, with a revision step between each stage where amendments to the prototype are made.

• Expert/Peer Review – Competent experts in the field check the content for validity, relevancy and currency
• Student Review – At this stage ideally a small number of learners work through the materials (four to eight selected from the student audience)
• e-Learning Review – The e-learning team proof, apply quality standards, evaluate instructional design, ease of navigation, screen design layout, technical performance

Ideally you should gain feedback on the following elements:

• Content
• Sequence and layout
• Media chosen
• Graphics/animations
• Navigation
• Assessments
• Objectives and Outcomes
• Overall comments

Click here for more information on Step 4 – Install, Maintain and Develop Prototype.
Click here to repeat Step 2 – Construct Prototype.
Click here to repeat Step 1 – Analyze.

Step 2: Construct Prototype (Rapid Prototyping - 4 Step Instructional Design Model)

The rapid prototyping process continues with the parallel processes of design and review, or construction and utilization. It involves:

• Incorporating your chosen pedagogical approach such as problem-based, collaboration, self instructional
• Deciding what content should be contained and how it should be structured and sequenced
• Preparing review and/or assessment questions, learner assignments
• Deciding what multimedia you require
• Deciding what is the proper ratio of text to audio, graphics, and interactivity

Structure and Sequence
The learning content should follow a simple, logical structure with clear sequence and instructions. The structure should include:

• Prerequisite knowledge requirements – this allows students to be able to put the learning episode into context
• Clearly stated learning objectives – both at the start and end of the learning episode. This allows the student to reflect on the knowledge that they have gained and provide closure by relating it to other learning episodes
• Sequenced content – ideally in increasing order of complexity, that matches specified learning objectives. Content should be relevant, meaningful practical and supportive, but unnecessary content should be made available in a downloadable document or perhaps into a wiki. If there is still a substantial amount of content then consider smaller learning episodes, rather than one big one.
• Formative assessment
• Summary of the key concepts
• Further reading resources
• Employ clear navigation which is consistent and accessible from anywhere within the session
• Employ real-world examples and scenarios where possible

Creating Assessments
A number of factors can determine how you assess or measure learners’ performance including your philosophy as an educator, the types of students you are dealing with and the delivery system you are using. However, the biggest consideration has to be the content you are teaching, particularly the levels of learning it represents and the performance objectives you have specified during the analysis phase of the process. Formative assessments enable the learner to test their knowledge, and to modify it or fill in gaps if necessary. A diversity of measures can be incorporated into your design either embedded or at the end of the module. These range from:

• Multiple choice, matching, or fill in the blanks (Bloom’s knowledge lower order content) to …
• Online discussions and simulations for performance objectives (Bloom’s higher levels of analysis, synthesis and evaluation)
• Performance measures that encourage critical reflection, are open-ended, practical, and provide opportunity to contextualize learning, are often more valuable and relevant than formal testing based on right or wrong answer

 If your assessment is robust enough, those who understand the content will pass, while those who don’t will fail. Ask a colleague to bluff their way through your assessment. If they pass, it’s obviously too weak. However, in every instance provide rich feedback.

Multimedia Options
All of us learn differently: some of us need to physically manipulate objects, others require auditory stimulus to reinforce key concepts, and still others require graphs, charts, diagrams, and photographs to create understanding. Few of us are either one way or the other. Rather, most of us learn best when a combination of learning styles are engaged to deliver concepts.

One of the key characteristics of e-Learning is its capability to integrate different media to create effective multimedia instructional material. Each medium offers unique opportunities to deliver instructional methods that others cannot. To exploit each medium fully, the unique capabilities of the technology should be used in ways that effectively support learning. However, a note of caution, be selective as too much unnecessary multimedia may distract learners and actually decrease learning performance. It can also prove to be impracticable and very costly to re-edit content with a short life expectancy.

Instructional Design Guidelines
This is where the learner interacts with the content by listening, reading, manipulating, and viewing the instructional content. Your choice of words, images, sounds, content flow, variety, and novelty all affect the success of a lesson. A balance of each ensures you are meeting the learning styles of diverse learners while creating an engaging and entertaining user experience. The five elements of the instructional component to consider are:

Text – Reading from a computer screen is around 25% slower than from paper; therefore as a guide text should:

• Be set into narrow columns rather than allowed to stretch across the entire webpage
• Have 50% of the word count of its paper equivalent
• Be written in a way that is easy to read and digestible
• Be used in conjunction with graphics, photographs, animations, audio and video to add meaning where appropriate
• Have a minimum font 10pt/line height 12pt and stick to one font type where possible
• Have enough whitespace
• Be mindful of using coloured text and backgrounds
• Have limited bold text – generally key terms, headings and subheadings
• Be enclosed in a box to make it easier to digest when necessary

Graphics/Photographs
Graphics in the form of illustrations, photographs, charts, graphs etc… can be an effective way to describe concepts and add visual interest. However, avoid bright decorations that compete with the substantive content for the learner’s attention. In addition, the overuse of graphical elements can be distracting and reduce the speed at which pages will load, given that good quality images can be large and require additional wait time for the user as they download, their effectiveness must be carefully weighed against this reality. Where possible use real photos rather than cartoons or illustrations to highlight key concepts. Be mindful of the School’s copyright and consent policy.

Audio – By no means should you use audio to read the entirety of a lesson to a learner. Nevertheless, audio done the right way can greatly enhance your e-learning materials because you are directing information to both the auditory and visual channels, distributing the mental workload. Audio can assist with humanizing the content by having a voice either welcome the learner to the course or give an introduction to a lesson. Audio can also be effective for providing auditory interest to simulations and to add authenticity to your content via subject matter experts. Users, however, must have a soundcard and speakers installed in their computers to benefit from audio.

Interactivity/Simulation – Animations can provide much needed interaction where appropriate and include: flip books, rollovers, click-ons etc… Again, avoid bright decorations and looped animations that compete with the content for the learner’s attention. Formative Assessments are also vital and can include: drag and drop, True/False, single best answer, multiple correct answer or hotspot. Simulations are time consuming to build but provide a powerful means for bringing content to life.

Video – Has long been accepted as a valuable teaching resource. It can provide a clarity and explicitness not possible with words or still pictures alone and it is an easily reusable/ shareable resource. Video is great for simulations and demonstrations. However, using video doesn’t guarantee effective learning, and it can create a passive experience if used inappropriately. Although it is true that digital video can now be produced on desktop equipment, there are still some important issues to consider including: very large file-sizes, quality, cost and content re-editing factors.

Once you have completed the design step and are happy with your prototype, again, please talk through your session progress with one of the e-learning team. This way we can:

• Review your chosen multimedia
• Provide any requested assets
• Provide further instructional design advice
• Proof read and apply specific quality standards
• Answer any questions and offer advice and guidance on best practice

 Click here for more information on Step 3 – Utilize Prototype.
Click here for more information on Step 1 – Analyze.

Step 1: Analyse (Rapid Prototyping - 4 Step Instructional Design Model)

In essence, the first step of the Rapid Prototype process is to conduct a focused and structured analysis of the students and their needs and requirements. The following elements should be considered.

Learning Needs
An assessment of student needs and the identification of any potential problems at this stage will allow you to make some general goal statements. Any analysis should consider:

• The task and conditions
• Current performance levels
• Potential problems/s or potential causes
• Desired performance outcomes and the associated expectation of your learning episode as related to the outcomes

This analysis is vital in order to identify the best way to achieve those needs and check your interpretation.

Student Audience
Students will not buy in to you tutorial unless it suits their needs, interests and motivations. Without this information it would be possible to end up with a learning episode that is either too easy or difficult. Five categories of audience characteristics can be considered including:

• Instructional preference - The type of presentation, the need for practice, the type and amount of feedback, the time available and the likely location when reviewing content
• General characteristics – Student demographics, IT skills
• Affective characteristics – Motivation, self-concept, attitudes, interests
• Entry skills – Existing knowledge, skills and abilities
• Personal/Physical characteristics – Geographic location, sensory, motor or mental conditions

Resources
When choosing the right delivery system – or combination, you must consider your students resources such as financial, time, facilities, equipment, materials, institutional characteristics and existing instructional resources.

This is also an opportunity to expose your students to new media and methodologies and to demystify technology; however, do not assume too much prior knowledge. At this point you should be able to:

Identify the delivery methods most conducive to learning and any associated learning constraints
Check accessibility elements
Use self-study materials and distance learning methodologies that allow learners to study independent of time and space (however, it is important that learners do not feel isolated)

Content
Essentially, what the learning episode should contain in order to achieve the instructional goal/s. Content analysis considers what learners need to do to perform and what learners need to know to perform. Your analysis should discover:

• What the lesson should contain in order to achieve the instructional goal
• How you will organise and sequence the content in easily completed chunks
• How you will balance self-direction carefully with more structured learning
• What level of learning each piece of content represents (e.g. does the content require the simple recall or recognition of facts, or more abstract mental processes and intellectual activity?) This is crucial because it determines how you will write your performance objectives, and how you will assess performance based on those objectives

Learning Outcomes
These will describe what students will be able to do upon completion of the instruction and should be stated in terms of precise, measurable, and observable actions. Conducting an analysis of learning outcomes allows you to formulate a general aim and establish the associated objectives. At this stage a statement of objectives is simply the definition of a plan for the design and as a plan, it serves two functions:

1. To communicate to everyone involved the purpose of instruction
2. To delineate tasks the learner will pursue

Establish Learning Objectives
Clearly defined learning objectives lead the learner into the learning episode. They drive the lesson and inform learners of what they will be able to do upon completion of the lesson. Improperly stated objectives are frustrating to the learner and will ultimately mislead. It is important to explain up-front why the learner should bother.Having already established through your content analysis the level of learning your lesson represents, Bloom’s Taxonomy and corresponding list of verbs may be helpful at this stage (Table 1).

Level of Learning	Associated Verbs
Knowledge	Arrange, define, duplicate, label, list, memorize, name, order, recognize, relate, recall, repeat, reproduce, state
Comprehension	Classify, describe, discuss, explain, express, identify, indicate, locate, recognize, report, restate, review, select, translate
Application	Apply, choose, demonstrate, dramatize, employ, illustrate, interpret, operate, practice, schedule, sketch, solve, use, write
Analysis	Analyze, appraise, calculate, categorize, compare, contrast, criticise, differentiate, discriminate, distinguish, examine, experiment, question, test
Synthesis	Arrange, assemble, collect, compose, construct, create, design, develop, formulate, manage, organize, plan, prepare, propose, set-up, write
Evaluation	Appraise, argue, assess, attach, choose, compare, defend, estimate, judge, predict, rate, core, select, support, value, evaluate

Table 1: Bloom’s level of learning taxonomy

Once you are happy with the analysis you have conducted and are ready to move forward and develop your prototype, please talk through your session requirements with one of the e-learning team. This way we can establish:

What multimedia you may need to use
What graphics, illustrations, animations etc… you require
Answer any questions and offer advice and guidance on best practice

Click here for more information on Step 2 – Construct Prototype.

Rapid Prototyping: 4 Step Instructional Design Model

The rapid prototyping instructional design model offers a systematic approach to aid you in the creation of learning materials for the web. It allows you to develop a prototype, which gives you and others the opportunity to visualise and evaluate your lesson design early in the process, ultimately saving you time and costly revisions.

The design model itself is a four step process. The overlapping boxes represent the fact that the various processes do not occur in a linear fashion. In other words, the analysis of students and their needs, content requirements and resources depends in part upon the knowledge that is gained by actually building and using your prototype.

Step 1 Analyse
In essence, the first step of the process is to conduct a focused and structured analysis of the students, their needs and requirements.

Learning Needs
Assessing student needs and any potential problems allows you to make general goal statements. Analysis is needed of the task and conditions as well as the current and desired performance outcome requirements.

Student Audience
Students will not buy in to you tutorial unless it suits their needs, interests and motivations. Without this information it would be possible to end up with a learning episode that is either too easy or difficult.

Resources
When choosing the right delivery system – or combination, you must consider your students resources, constraints, facilities, materials, equipment, institutional characteristics and time availability.

Content
What the learning episode should contain in order to achieve the instructional goal/s. Content analysis should consider what learners need to do to perform and what learners need to know to perform.

Learning Outcomes
These will describe what students will be able to do upon completion of the instruction and should be stated in terms of precise, measurable, and observable actions.

Establishing Learning Objectives
Clearly defined learning objectives lead the learner into the learning episode. They drive the lesson and inform learners of what they will be able to do upon completion of the lesson.

Click here for more information on Step 1 – Analysis.

Step 2 – Construct Prototype
The rapid prototyping process continues with the parallel processes of design and review, or construction and utilization. It involves:

Incorporating your chosen pedagogical approach such as problem-based, collaboration, self instruction
Deciding what content should be contained and how it should be structured and sequenced
Preparing review and/or assessment questions, learner assignments
Deciding what multimedia you require
Deciding what is the proper ratio of text to audio, graphics, and interactivity

Click here for more information on Constructing your prototype.

Step 3 – Utilise Prototype
A crucial part of the prototyping process is the utilization of the design with peers and potential learners. During utilization, the strengths and weaknesses of the prototype can be discovered. However, this needs to be done in a structured and timely way. Ideally you should gain feedback on the following elements:

• Content
• Sequence, layout and navigation
• Media chosen
• Graphics/animations
• Assessments
• Objectives and Outcomes
• Overall comments

Click here for more information of utilizing your prototype.

Step 4 – Install, Maintain and Develop
Once you have implemented your amendments, the learning episode should be installed and appropriately maintained.

Your evaluation should continue as part of an iterative process, in particular feedback from students. This will allow you to improve the effectiveness of your tutorial.

Click here for more information on installing, maintaining and developing your prototype.

Mobile Devices

Laptop/Tablets
Laptop/Tablets – The most complete and functional system of all the portable devices, laptop/tablet PCs come Bluetooth, Wi-Fi and Ethernet enabled. Tablet PCs offer additional features such as handwriting recognition and voice-to-text conversion as part of their operating systems.

Instructional Uses - Students can:

• Download audio and video lectures and podcasts
• Create and edit course-related assignments
• Surf the Web
• Send e-mails, instant messages (IMs), and text-messages
• Log on to the course Web site at home or while on the road
• Provide a high level of interactivity for global collaboration and research

Pro’s

• Great for students who need to take their work home with them
• Provide the most power and capabilities of all devices

Con’s

• Still relatively expensive
• Size makes them cumbersome while travelling
• Unlike some smaller devices they cannot be used while walking

i-Pods©
The iPod© portable media player from Apple© allows users to download music, audio books, podcasts, photos, and video. It has an address book and calendar that synchronize with Microsoft’s Outlook or Outlook Express. It can also serve as a mass-storage device.

Instructional Uses – Students can:

• Download podcasts of relevant instructional material along with audio and video lectures
• Exchange information files, collaborate on projects and share project results
• Review coursework and prepare for exams
• Provide visual, step-by-step directions that are difficult to convey with words only (applies to instructors too)
• Students or instructors can add a microphone to their iPods to capture material for educational use

Pro’s

• With a large market share, the iPod has already proven its popularity with students
• The iPod’s many apps increase its functionality, and it’s great for students on the go

Con’s

• An iPod may not be affordable for all students, and requires Apple’s iTunes program (free) for downloading files
• It provides one-way communication, not interactivity, although it can record material
• The screens are generally too small to use sophisticated applications or to read quantities of text (although this will probably change in future versions)

Smartphones
A smart phone combines telephone capability with a PDA, camera, video, mass storage, MP3 player, Internet access, and networking features in one compact system.

Instructional Uses – Students can:

• Download audio and video lectures and podcasts to their smart phones
• Play audio, video and Flash movies
• Display and edit text documents
• Access e-mail and Web content
• Send instant messages (IM) and text messages
• Use the phone for mass storage
• Collaborate and research as they can access information globally. Smart phones thus support interactive learning

Pro’s

• Very popular with students
• Combines a multitude of communication and computing features in one compact system

Con’s

• Small screen makes web browsing and reading difficult
• Small keys or a virtual keyboard make text entry inefficient for longer e-mails or texts

Personal Digital Assistants (PDAs)
The PDA combines computing capability, internet access, and networking features in one system with a calendar, notepad, address book, and productivity tools. It is a programmable, Bluetooth-enabled, Wi-Fi–equipped device with a pen/stylus input interface.

Instructional Uses - Students can:

• Play audio, video, and Flash movies
• Display and permit editing of text documents
• Let users access e-mail and Web content as well as support Instant Messaging (IM) and text messaging
• Be used for mass storage
• Support interactive, collaborative learning – students can use them to present projects, conduct research and take notes in class

Pro’s

• Large screen (for a portable device) that makes reading easier
• Combines several computing and communication tools in one device
• Text and data entry are possible through the screen keyboard, a stylus, or external peripherals

Con’s

• Bulky compared to other portable devices and won’t fit in a standard-sized pocket, although packs, purses, and other carriers will accommodate them
• They are not efficient for entering long e-mails or texts without using a peripheral input device

e-Book Readers
e-book readers are used to download text-based materials. They can store hundreds of e-books, newspapers, journals and magazines. Magnification and highlighting features facilitate easy reading and marking of texts, and full-text search makes it easy to find specific passages.

Instructional Uses – Students can:

• Download and store text-based instructional materials and electronic textbooks
• Read resources on demand
• Conduct research

Pro’s

• Large screens for easy reading, while backlighting facilitates reading in dark places
• Digital bookmarks and highlighters let users mark their texts, and full-text search capabilities make it easy to find specific passages
• Can store all the content and textbooks for several courses

Con’s

• Single-purpose device with limited computing capabilities
• It may require proprietary text formats
• A limited number of e-book titles are currently available

MP3 Players
This digital audio player plays music and audio files. Some models have an integrated voice recorder and line-in recording.

Instructional Uses - Students can:

• Use an MP3 player to download and listen to podcasts and audio lectures
• Review course material and study for exams
• Stay informed about course content
• Listen to audio books
• Record information such as a lecture on some devices

Pro’s

• Compact and lightweight
• Have no moving parts which increases their battery life
• Feature excellent audio quality and are upgradeable

Con’s

• Replaceable by other devices that also play audio files
• Encoding files and transferring data can be time-consuming
• These players provide one-way communication, not interactivity

USB Drives
The USB drive is a mass-storage device that attaches easily to many computers and other devices.

Instructional Uses - Students can:

• Store coursework, audio and video files
• Share files for collaborative projects
• Transfer work to and from computers at school
• Save their work
• Submit work to the instructor

Pro’s

• Small and portable
• USB interface is compatible with all newer computers

Con’s

• USB drive is a single-purpose device
• Loss of data -you need to comply with secure data storage guidelines, especially if patient data is being transported
• Other devices can also serve for mass storage

Click here for tips on constructing mobile learning.