How to make an effective eLearning module

1. How to make an effective eLearning module I want to make a module that will be an effective learning resource. But … How can eLearning make the content more interesting? Where do I start? If you would like help with these questions, this module is for you! How will the learner track their progress – so that they will be confident that they have achieved something?

2. Background -1 eLearning modules aim to fill several gaps: Provide health-care students and front-line health workers in resource poor countries with learning resources that will be effective in improving health outcomes • Take advantage of digital technology and copyright-free content to: • develop short learning modules that actively engage the learner • include formative assessment so that the learner can track their progress • use simple, widely available software so that others can adapt the materials for teaching other target groups • Involve health staff in resource-poor countries in making “home-grown” learning resources so that • the resources are directly familiar to “real-life”, day-to-day health care in their own setting • they build their expertise in developing effective resources for adult learners The modules are usually designed to be studied mainly by a single learner sitting at a computer screen. However, they can be used to generate discussion topics or exercises that can be suitable for groups of learners.

3. Background -2 Remember that the overall aim is to build the confidence of your learner to deliver health care more effectively. The learner should enjoy your module and feel that they have achieved something valuable by completing it. Therefore, make sure that the learning outcomes are appropriate for your learner and that the module allows them to achieve new knowledge and skills with confidence. This module describes some basic principles and approaches that may help you to develop a learning resource that is effective for adult learners. It complements the module by Jess Griffiths that covers the technical “How to do it” issues using MS PowerPoint. But beware! This module is for guidance only. There are many different ways to teach – and you should feel free to develop your own style and innovative methods for eLearning!

4. Learning outcomes By the end of this module and the accompanying module by Jess Griffiths, you should be able to: • Write concise learning outcomes (LOs) that state clearly what the learner should be able to do after completing your module • Present content in an interesting way that will engage the learner • Design an assessment that will allow the learner to assess what new knowledge and skills they have acquired

5. Before you start • Have a clear idea of who your learner is. What knowledge and skills do they have already? How should your module be designed to be most appropriate for their learning needs? • Always keep in your mind’s eye a mental image of your learner sitting at the computer studying your module. • Of course, we all learn from multiple sources (textbooks, websites, conversations with experienced colleagues and, most importantly, from patients themselves). You should encourage your learner to seek-out other information to complement your module. However, the module must be self-contained and contain all that the learner needs to meet its specific learning objectives.

6. Title slide • The title should state clearly what your module is about. • This first slide is the advertisement for your module. It is your best chance to capture your learner’s attention and make them want to study the module. • So make it as attractive and informative as possible! How to build a module...

7. Learning outcomes (LOs): start here! This is the most difficult bit! Although you may have a clear idea of what your module aims to achieve, writing down clear LOs needs careful thought and is the essential first step in module development. Do not start to develop your module until you have identified a few (usually 3-4) clear LOs – and perhaps agreed them with your supervisor • The LOs are vital because they • determine precisely the content of the module • determine precisely the assessment Once you are happy with your LOs – stick to them and do not allow the module to wander into other areas

8. What are good LOs? • Good LOs should clearly state what the learner should be able to do by completing the module • They should be “active” - so that the learner will be able to assess for themselves whether or not they have achieved the LOs • But how do you write a good LO?

9. Are these LOs good or bad?A module aims to improve knowledge of the diagnosis of tuberculosis (TB). Decide whether each of the following LOs is good or bad. Then click on the square to see our assessment. At the end of this module, you should: • Know about the diagnosis of TB • Understand how TB is diagnosed • Be able to describe the methods used to diagnose TB • Be able to describe how CXR and sputum examination are used in the diagnosis of TB a b c d

10. LOs – a few tips Try rewording the LOs a few different ways to get the balance right between sufficient detail but not too long-winded Tempt the learner to continue with the module. Say enough to interest them, but keep the best bits for the content! It is often useful to include numbers in LOs; for example “describe the 3 major ways that…” Use “active” words such as “discuss” and “explain”

11. Content • The content is the information that you want the learner to acquire. • Clearly, this information has to be accurate and up-to-date. • The content should also be clearly referenced so that the learner is able to check the source of the information. • Start by identifying a small number of reliable and up-to-date sources of information. It is often useful to use a recent review as the main source of your content.

12. Copyright Always a controversial area! There is no problem with reproducing other people’s material as long as you reference its source Your own simple images that directly show what you are trying to teach are usually much better. You can make these by using the simple autoshapes and drawing tools available in MS PowerPoint or draw them on paper and scan the image. Simple scanned line diagrams can be coloured easily using MS PaintBox to get very professional results! The main problem comes with reproducing images (figures, photographs etc.) Although it is tempting to “cut and paste” highly polished images from books or the internet into your module, these are usually not quite right for the point you want to make or are too complicated. Although “a picture is worth a thousand words”, complex diagrams without adequate explanation are just confusing. If there are existing images that are exactly right for your purpose, then you must get permission from the author or publisher to use it in your module. Click here for an example request to use an image for your module

13. Clinical images Carefully-selected, high-quality images that demonstrate key clinical signs greatly improve the effectiveness of learning resources. Digital photography has made obtaining clinical images much easier. Wherever possible, avoid images that allow the person to be identified. For example, if you want to demonstrate pallor by showing the palm of the hand, then just show the palm rather than the whole person. We consider that it is only acceptable to show clinical images if the patient or their parents or carers have given you permission to use the image for teaching purposes. Taking clinical images that are effective for teaching is not easy - but we all improve with practice! Click herefor an example of a consent form for medical photography. Click herefor an example of a statement to use in your module regarding permission to use clinical images.

14. How to make content interesting There are many ways of presenting information in an interesting way. The key is to actively involve the learner – rather than just “spoon feed” information. The following slides give 3 suggestions as to how to present information in a way that engages the learner. Remember that the information is probably already available in a book or on a website. Your module needs to go beyond just presenting information. It needs to be an active learning tool. An example about the fluid management of severe dehydration in severe acute malnutrition is used to illustrate each approach. Incorrect management is common and may result in the death of the child. This example aims to change practice by increasing understanding of the underlying principles. The LO for this example is: “Be able to discuss the pathophysiological principles that underlie the fluid management of severe dehydration in severe acute malnutrition”

15. “Show and test” Engaging the learner - 1 This approach is best when the learner has little or no existing knowledge of the topic. First, present the information just as it might appear in a book or on a website. Remember to include good images to make the information as engaging as possible! Click here for an example of this approach Then, re-enforce the learning by repetition by engage the learner in some interactive formative assessment Use the answers as an opportunity to further re-enforce and extend the learning

16. Engaging the learner - 2 This approach is appropriate if the learner already has some knowledge of the topic and you aim to build on this existing knowledge Ask them to provide some information “from scratch” and then compare their answers with the correct answers “Have a go” Set the level of difficulty so that the learner performs fairly well (gets about 60% right). He/she is then encouraged to learn more (up to 100% correct) and continue with the module. Click here to see the same severe dehydration in SAM example presented in this way

17. Engaging the learner - 3 This is a higher level of learning which requires the learner to apply their existing knowledge to solve a problem You present a “real life” scenario which mimics as closely as possible the learner’s day-to-day work “Making it real” You present a problem and then ask the learner to work through to a solution Click here to see the same severe dehydration in SAM example presented in this way This prompts the learner to think about the information carefully and work-out for themselves the important “take-home” messages This also provides an opportunity to promote good clinical practice (e.g. multidisciplinary team working, clinical audit)

18. Engaging the learner - summary These are only a few suggestions and there are many different approaches. Do invent your own methods for presenting information in an engaging way! A few general comments on presenting information: • Do not use too many different methods within a single module. To avoid confusing the learner, allow them to become familiar with just 2-3 different methods in your module. Think carefully about the likely learning style of your learners and also how best this particular information might be presented. • Although effective, “active” learning is quite tiring. Including some “spoonfeeding” of information as well as one or two more demanding methods is often best. • Remember that the aim of the module is for the learner to achieve the learning outcomes – not to demonstrate your skills as a teacher!

19. Assessment - 1 • In most cases, the assessment for the module should be “formative”. This is purely for the learner’s benefit – so that he or she can track their own progress.* • The assessment should be limited to the LOs. The purpose is to allow the learner to confirm that they have achieved the LOs. • The learner should perform well in your assessment. This confirms that your module has been effective! * “Summative” assessment is for formal examination purposes and will not be covered here

20. Assessment - 2 These simple formats can be used just to test recall of facts. At a more advanced level, your questions can test the learner’s understanding of the information. You have already met some examples of formative assessment in this module. The accompanying module by Jess Griffiths provides you with a simple template for writing “pick the best of 5 options” questions. This can easily be adapted to “true or false” or other simple formats. • Two simple techniques to make these simple formats more effective • provide the leaner with explanations when they select the wrong answer • take advantage of a correct selection by providing some additional information Now use Jess Griffiths’ module “International Health Template Module”

21. Beyond individual learning • Although eLearning modules are usually designed for study by an individual sitting at a computer, most topics demand the extension of the learning to group activities. • In our example regarding the management of severe dehydration in SAM, it is likely that many of the staff working in a health centre would benefit from the module – and not just the person who has managed to get time on the computer. • Try to think of ways that the key messages acquired by the individual learner might be passed-on to their peers. Provide the person who has completed your module with some help in spreading the word. • Examples might be • providing a case scenario for discussion at a team meeting • including a simple questionnaire that captures information about current knowledge and practice and identifies gaps • including a simple management protocol that could be adapted and then printed-out and posted in the ward or treatment room

22. Some final remarks • Please remember that there are no right answers to eLearning. You should look at as many other examples as you can, experiment and develop your own approaches. • The key to success is to have a clear idea of the needs of your target audience, carefully designed and clearly stated LOs and then an engaging module that allows the learner to achieve the LOs with confidence. • Finally, we hope that you have found this module useful and enjoy developing your own eLearning module. We would be very grateful for any comments, corrections or suggested additions to this module. Please send an email to s.j.allen@swansea.ac.uk • And, most important of all, good luck!