Podcast Interview on eLearning in Healthcare

Lawrence Laganelli of the Inside Medical Assisting Podcast interviewed me about elearning, especially as it applies in healthcare. Although we focused on examples related to training medical assistants, much of our conversation applies to other organizations as well. Note that this is geared to people outside the field of elearning, including subject matter experts and instructors.

Topics covered:

  • What media I prefer for online learning
  • Key elements that make elearning effective
  • Methods to maintain student interest
  • Example of how to teach interpersonal communication
  • Presenting yourself and managing virtual classrooms
  • Trends in the future of online learning

The interview is about 35 minutes long.

Links and References

The branching scenario example we discuss in the interview is available in my portfolio for you to try yourself.

If you want to read more on how to use storytelling and scenarios for learning, check out my collection of posts.

I referenced Julie Dirksen’s work several times in the conversation. You can buy her book Design for How People Learn.

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How to Get Started Writing a Branching Scenario for Learning

In a recent conversation, a colleague asked, “Once you and your client have agreed on a branching scenario approach, how do you get started writing it? How do you get from the broad concept of training on X topic to actually creating the scenario?”

The short answer is to “begin with the end in mind.” Let me walk you through the process of analysis and preparation I do before writing a scenario.

Get Started Writing Branching Scenarios

Begin with the End in Mind

At the end of the training, what do you want people to do differently? It’s important to ask what you want learners to DO, not what you want them to KNOW. Cathy Moore has been beating this drum for years. If we’re aiming for behavior change, then we need to focus on what behaviors we want. It’s not enough to simply increase awareness.

Get Specific with Behaviors

Julie Dirksen describes this as the “photo test.” If you took a photo or video of the desired behavior, what would it look like? For example, a client might ask you for training on “quality customer service” or “better communication between nurses and patients.” As part of your analysis, ask what that really means. It’s not enough to just get a list of principles or broad best practices. You need specifics and examples.

“Quality customer service” might mean cashiers asking customers if they found everything they were looking for and calling for someone to get it if they missed something. That’s a specific behavior we can observe and assess.

“Better communication between nurses and patients” might mean asking open-ended questions to learn what concerns are most important to the patient. That’s another behavior we can observe.

Identify Common Mistakes

Ask your SMEs questions about mistakes. In a branching scenario, it’s not enough to know what the right behavior looks like. You need to know the wrong behavior you need to change too.

  • What are the common mistakes people make?
  • Where do people get stuck in this process?

If you have access to learners or people who have recently learned the skill, ask them too. They may have more insight than the SMEs.
The mistakes you identify become the distractors in the questions for your branching scenario. The mistakes and places people get stuck help you determine where to put decision points. If certain parts of the process are fairly clear and unproblematic, you can make those sections of the scenario passive review. That way, you can focus on what you really need to meet your objectives in the scenario.

Identify Consequences of Mistakes

For each mistake you identify, find out the consequences. Ask your SMEs and sources this question.

  • What are the consequences if people make this mistake?

The consequences of those mistakes become the feedback in your scenario. Asking a patient a closed question rather than an open-ended one results in a one-word answer. Forgetting to ask customers if they found everything results in lost sales and less satisfied customers.

Keep Probing for Specific Behaviors

Sometimes SMEs have a hard time switching from talking about abstract principles to describing behaviors. If they answer your questions about mistakes and consequences with broad answers, keep probing for specific examples and behaviors. You may have to ask these questions several different ways to get what you need.

  • Tell me more about that mistake. What do you think is going through people’s heads when they do that?
  • What does it look like when they make this mistake?
  • What does that consequence look like in practice?
  • Can you give me an example?
  • Tell me about a time when you saw this happen in a real situation.
  • What happened next?
  • Where do people get confused? What do they do when they’re confused?

Sequence Decision Points

Once you have a list of mistakes, you can list and sequence the decision points. Often, you’ll be following a specific process where it’s clear what needs to happen at each step. In those cases, you outline the process and note where you’ll insert decision points that give learners a chance to make the mistakes you identified.

If you aren’t following an established process, think about a logical flow of events. Sometimes a particular mistake obviously happens at the beginning or end of a process. Look for the set points of the process and flow the rest of the steps around that.

Rough Flowchart

At this stage, I only do a very rough flowchart or outline. I find the flow is sometimes easier to determine by simply sitting down and writing it rather than planning out every branch in advance. However, if you’re just getting started with branching scenarios, you might benefit from planning out in more detail. In the planning process, I often only do the sequence for the main correct path; I fill in the branches later as the scenario develops.

Storyboard or Draft

Once I have a rough flowchart and I know my primary decision points, I start storyboarding or drafting. I check my storyboard against my list of behaviors from the beginning of the analysis. Did I include all the critical decisions and behaviors? Did I include all the common mistakes?

Your Process?

What is your process for preparing before creating a branching scenario? Let me know in the comments.

Scaffolding in Microlearning

How do you incorporate scaffolding in microlearning? How is scaffolding different in microlearning than in longer formats?

First, let’s define scaffolding. Scaffolding is support for learners that gradually fades away until the learner can do the task without support. Think of construction: you use the scaffolding while a skyscraper is being built. When the building is complete, the scaffolding is taken down.

That raises an issue for microlearning. Scaffolding is removed over time, but microlearning doesn’t have the long time span for typical scaffolding. In a two-day course, it’s easy to create multiple opportunities for practice, each with decreasing amounts of scaffolding. In a 5 minute microlearning module, it’s harder to create multiple opportunities for practice.
We have several options for scaffolding with microlearning.

  • Microlearning as Scaffolding
  • Contextual Help
  • Repeated Practice in a Single Microlearning
  • Multiple Microlearning Modules

Microlearning as Scaffolding

Maybe you don’t need to scaffold within a microlearning module. Maybe the microlearning itself is the scaffolding. When we think about the five moments of need, this strategy works best if people are applying what they learned (and may have forgotten) or are solving problems. Microlearning is perfect for refreshers of previous training or to support troubleshooting.

For example, I recently needed to format Word handouts for a PowerPoint presentation. I used to know how to do this, but I’d forgotten where it moved in the current version of Office. I found a 90 second tutorial on YouTube and was able to finish the task. That tutorial was microlearning, and it worked as scaffolding to support my work.

How many times have you gone to YouTube to help you solve a problem? YouTube is full of microlearning. Maybe you need to watch the video the first time you troubleshoot a problem, but the next time you remember the steps without help. That’s scaffolding!

Contextual Help

Another option for scaffolding is offering contextual help within a microlearning module. For example, the Best in Show winner at the eLearning Guild’s DemoFest offered links to hints related to your current action. If you need the help, it’s one click away. If you don’t need it, you can ignore the help and continue with the practice on your own. The winning project is “Microlearning for Teaching Government Contract Basics” by Elizabeth Gusmati, Booz Allen Hamilton and Dan Keckan, Cinecraft Productions. (If you want to see this and the other DemoFest winners, the Guild is hosting a webinar on 4/19/17 sharing the winners.)

Screenshot of Duolingo app with a hint of "midnight" for the German word Mitternacht
Duolingo provides contextual help

Duolingo is an app and website for learning languages that also uses contextual help. It’s a great example of microlearning, using evidence-based practices like spaced learning, interleaved practice, and retrieval practice. You can complete a single interactive lesson in about 5 minutes.

One way Duolingo provides contextual help is by providing hints for specific words. Any underlined word can be clicked to view the translation. When I’m going through lessons, I often need the hint for new words and sometimes as a reminder. Over time, I don’t need that hint any more and I stop using the scaffolding.

Both of these examples of contextual help are pull learning, not push learning. You’re not forcing the support on everyone. You’re making it available to those who want it.

Repeated Practice in a Single Microlearning

You can create more traditional scaffolding with repeated practice within a single microlearning module, especially if your microlearning is mostly (or completely) practice rather than content delivery. Duolingo is almost entirely practice, so this is another strategy they use. For new lessons with new vocabulary, the exercises are heavily weighted toward forced choice options where you select words from a list rather than typing the whole word yourself. As you progress, you do more open-ended typing without the scaffolding of provided choices.

You could use this technique in other short practice modules by providing easier practice with forced choices at the beginning. Over the course of the module, gradually make the practice more complex and fade away the hints. This technique may be easier in a 15-20 minute module than a 3 minute module (although Duolingo proves it’s possible even with very short practice).

Multiple Microlearning Modules

A final option for scaffolding is to provide a series of microlearning modules. In the early modules, provide more scaffolding and support. In the later modules, remove the support. This is more like scaffolding in a longer training, just broken up into small modules over time instead of crammed into a single large course.

Your Ideas

How have you used scaffolding with microlearning? Do you have an idea I missed here? Let me know in the comments.

Scaffolding Image Credit: GraphicStock.com

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ID and E-Learning Links (4/9/17)

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