A major issue facing medical education training programs across the USA is the recent advent of universal mandatory duty hour limitations and the time pressure it places on formal face-to-face educational sessions. In response to these mandates and associated issues many medical education programs are exploring the use of online instruction to address issues of accessibility. This chapter describes the instructional development process followed to transform a classroom-based pediatrics residency lecture series into an on-demand, video-enhanced, online instructional environment. An overview of the learning principles and instructional sciences that guided the design process is provided. The phases of the designed solution are then described in the context of enhancing the lecture series as it was transformed into online instruction. Implementation logistics are described followed by an overview of the benefits, barriers, and initial project outcomes. Plans for future enhancements and research projects are also discussed.
Designing good instruction is predicated on understanding learning. Effective learning is predicated on accurately defining learning outcomes and providing instructional environments that support the achievement of learning outcomes. Both are essential to successful online instruction (Koszalka, 2007, p. 2).
Principles of learning and the instructional sciences were used to enhance the overall strength of the pediatrics residency curriculum at SUNY Upstate Medical University in Syracuse, New York. In response to the recent advent of universal mandatory duty hour limitations and the time pressure it places on formal face-to-face educational sessions, the entire residency curriculum, consisting of a year-long classroom-based lecture series, was transformed into a blended video-based online format supported by application-based classroom experiences. The online lectures component was not a straight conversion where lectures were simply videotaped and offered to the residents through a distance education program, rather the demand for change was used as an opportunity to re-evaluate the design of the lecture series and apply sound learning and instructional design principles to enhance the overall residency instructional process.
Application of learning principles. Learning at its foundation is about change, change in human condition based on experiences. Principles of social learning theories posit that learning is a construction of knowledge based on an individual’s observations of, and interactions with, information and people around them. Learning can occur both at surface and deep levels depending on how individuals interact with new information.
Surface learning suggests storage and remembrance of information, facts, concepts, principles, and procedures. It often results in recalling basic information and demonstrating new procedures and behaviors, for example. Deep learning, or critical thinking, suggests activation of higher order thinking. Outcomes of this type of learning include constructing knowledge to evaluate, apply, diagnose, problem solve, debate, critique, and other activities that require successfully addressing complex and ill-structured problems, such as those encountered by medical professionals.
The construction or learning of knowledge at these different levels is supported through different types of interactions (instruction) with content and people that accommodate individual preferences and learning styles of the learner (Akdemir & Koszalka, In-press; Akdemir & Koszalka, 2005; Kidney, G., & Puckett, 2003). Thus, instruction is thought to be richest and most effective in facilitating deep learning when:
Learners are engaged in solving real-life problems;
Existing knowledge is activated as a foundation to new knowledge;
New knowledge is demonstrated to the learner;
When new knowledge is applied by the learner;
When new knowledge is integrated into the learner’s world (Merrill, 2000).
Application of instructional sciences and design processes. The instructional sciences inform how activities can be designed to prompt and facilitate required levels of learning that meet expected outcomes. To design instruction and learning experiences that apply learning principles successfully an instructional system design (ISD) process can be undertaken. The process includes: (A) analyzing the gap in knowledge (what does the learner know and what should they learn), (D) designing an instructional and learning solution, (D) developing the solution based on the design, (I) implementing and testing the solution, and (E) evaluating the results (Dick, Carey, & Carey, 2005; Smith & Ragan, 2005). An ADDIE approach, guided by principles of learning and instruction, is especially important when designing instruction for online applications, as the perceived separation of learner and facilitator can be distracting to the learner or fail to provide information and social learning interactions required by the learner.
Key Terms in this Chapter
Interface Complexity: A term that describes the degree of complexity that a user encounters when engaged with a digital medium like a website. With increasing complexity of the interface of a webpage, for example, the user required to dedicate cognitive energy to learning the intricacies of the interface as opposed to the content that is contained within the website.
American Board of Pediatrics Blueprint Document: This is a 212-page document that outlines the core content of the American Board of Pediatrics certification exam that is taken upon completion of pediatric residency training.
Instructional Systems Design: Systematic process for designing and developing instruction. Generally includes analysis, design, development, implementation, and evaluation phases.
Instructional Design: Phase with the instructional systems design process where instruction in planned that is designed to close and instructional gap based on learning theory and instructional design theory.
Course Management System (CMS): A packaged program that is used for creating, delivering, and managing online instruction. Often course management systems include menu and template based tools to help developers easily build content, communication, testing, and other types of screens that support teaching and learning. These systems often also include management functions that support assignment grading, monitoring learner access, and completing course evaluations. Examples of popular CMS include BlackBoard, WebCT, and ANGEL.
American Board of Pediatrics (ABP): The governing agency that certifies pediatric practitioners within the United States of America. The certification process involves passing a norm-referenced examination upon completion of pediatric residency training.
E-Learning: Also referred to as online learning, it is the use of internet technologies to deliver a broad array of educational materials.
Instructional Development: Phase with the instructional systems design process where instructional materials and processes are built based on a blue print developed during a design phase.
Core Curriculum: The core curriculum is the agreed upon scope of material that defines the significant knowledge that is contained within a domain like pediatrics. It encompasses what would be reasonably expected for a practicing pediatrician to know.