Policymakers and electronic health records (EHR) experts agree that healthcare professionals lack proficiency in meaningful use of EHRs. This competency gap can result in increased medical errors. It is essential for health professions graduates to acquire skill sets that are adaptable to any electronic health information technologies including the EHRs to facilitate work process and information access. Simulation as an instructional method to create transformative learning experiences has shown promise in the medical profession. In simulations, learners are able to engage in real-life scenarios and practice their cognitive, affective, and psychomotor skills in a safe environment. The goal was to design and develop a simulation-based instructional module on meaningful use of EHR and interprofessional collaborative practice core competencies and evaluate students’ performance and satisfaction under an inter professional teambased setting. Using a design and development research approach, a simulation-based instructional module on meaningful use of EHR and interprofessional core competencies was designed. An internal validation of the module was conducted with an expert panel of medical professionals and instructional designers. Following validation, the instructional module was developed and pilot tested with a group of 21 second- and third year health professions students in medicine, pharmacy, and nursing in an interprofessional team-based learning environment. Students’ performance on meaningful use and interprofessionalism core competencies and their satisfaction during the simulation-based training were evaluated. The results confirmed that the students properly implemented the core competencies based on their performances during the immersive virtual patient encounter in the 3D virtual world. The analysis also showed how the students’ satisfaction was met as a reaction to the guided experiential learning’s (GEL) simulation-based instructional intervention, and in some instances were not sufficiently met. The analysis of the students’ testimonials further confirmed their overall satisfaction with the immersive simulation experience.The findings, based on the feedback from the students and faculty in this pilot implementation, highlighted simulation-based interactive gaming instruction and the hands-on experience in a 3D virtual world guided by GEL as an effective and engaging way to train healthcare professionals in the preparation to deliver care in a safe and effective manner under interprofessional team-based settings for better patient safety and outcome.

Indiana University-Purdue University Indianapolis (IUPUI) / Health care reform emphasizes prevention of chronic disease through the reduction of modifiable risk factors as a way to reduce health care costs, morbidity, and mortality. Motivational interviewing (MI) is an effective method of health behavior counseling. It has been used successfully applied in health related behavior change and self- management of chronic disease. The knowledge, skills, and attitude of MI are acquired through learning as other techniques used in the health professions. Nurse practitioner faculty need guidance on how to design instruction in MI that incorporates competencies and utilizes innovative strategies. Prescriptive instructional design theory utilizes knowledge from educational research to establish the steps in the design process. The purpose of this research was to apply prescriptive instructional theory to the design of effective, efficient, and engaging instruction in MI resulting in beginning proficiency in the NP students. A formative design was used for this study. The First Principles of Instruction served as the prescriptive design theory used in the design of instruction in MI. Data sources included the researcher’s design journal, observation during interaction with the instance, demographics of authentic users, authentic user reaction, and knowledge testing. Four cycles of design-redesign were completed. Results of the study point to improvements in the First Principles of Instruction. The instruction was effective, based on the improved scores from pretest to posttest on the Helpful Response Questionnaire. The improved scores also indicated an increase in knowledge of MI. Efficiency was not improved from pretest to posttest. The definition of efficiency as less time to completion of the task did not apply to MI communication skills. The First Principles of Instruction were useful in the design of the techniques of MI. However, there is little guidance for the affective component of MI such as empathy. The prescriptions of the First Principles of Instruction were useful in designing the instruction in MI. NP students indicated in post instruction interviews that engagement in the instruction was related to the relevance of the subject matter to practice and interactive exercises.

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This qualitative study investigated the extent to which a diverse sub-set of e-learning designers were aware of UX principles and practices, where their e-learning design practices overlapped with established UX practices, and where UX principles might benefit e-learning designers. E-learning has grown dramatically as an area of focus in instructional design within the last decade and a half. This growth suggests a need for a better understanding of design tools, concepts and principles that can guide an e-learning designer to design better and more effective instruction. One field of design that has potentially had an impact on e-learning design recently is user experience (UX) design. Both fields of UX and e-learning are concerned with designing interactions with technology, but while there are some shared ideas and terms between the two, there has been no research into the perceptions and understanding of UX tools by practicing instructional designers. Nine professional e-learning designers were interviewed to understand their perspective and experience.The findings of this study resulted in four themes and several subthemes. In general the participants of the study were not familiar with the formal practices of UX design. Many were also not familiar with several of the seminal works of the UX design field. The emergent themes suggest there are similar concerns between UX design and e-learning design. There were varying perceptions of the role of an e-learning designer as well as a broad spectrum of perception of what qualifies as good e-learning design. Participants reported the e-learning design field has numerous practitioners who lack formal training in instructional design principles in addition to limited training in other design disciplines. Participants also discussed constraints that could impact their ability to embrace UX practices. Findings suggest e-learning design practitioners and students of the field would likely benefit from a greater awareness of, or even formal training in UX practices. Additional research into the shared practices of UX and e-learning design could also likely open new opportunities to advance the practice of e-learning design.

A widely employed instructional design approach, the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model, has been one of the most popular and well documented instructional design models (Wilson, Jonassen, and Cole, 1993) for decades. Despite its widespread use, Thiagarajan, a leading instructional technologist, asserts that ADDIE, as an instructional design approach, is comparable to an outdated 1950's manufacturing model (Zemke, 2002). Since the 1950's, manufacturing has evolved, focusing initially on reducing inspection or evaluation costs and later on shifting these cost improvements throughout the organization. Just as manufacturing models and their application have evolved, service operations models such as instructional design models and especially their application are evolving. This dissertation reviews these changes in manufacturing models and associated service operations models in order to examine how these changes have informed instructional design models such as ADDIE and their usage in practice by those attempting to design conditions for learning and to create associated learning objects. In order to better understand how this shift may be applied to both theory and practice in instructional design, this dissertation uses an exploratory case study methodology to examine best practices in the inspection/evaluation process employed during the development of courses. This methodology reflects procedures used in a major study (Institute for Higher Education Policy, 2000). They followed a three-step process, which included a comprehensive literature review, the identification of subjects that "have substantial experience and are providing leadership in distance education." (p.9), and surveying leaders. In similar fashion, during the first phase of the study reported in this research, quality management and instructional design literature is reviewed. In the second phase, the case study subject, the Center for Instructional Design at a major university is selected. In the third phase, instructional design practices used at the Center were studied and areas for reducing inspection/evaluation costs were identified. Principles and methods surmised from the literature reviews and the case study research are presented along with application examples from the case study. These principles and methods illustrate how ADDIE has evolved and continues to be a viable model for the creation of instruction.

A year-long longitudinal study was conducted to quantify different types of teaching in the beginning of the year, and the effect of those choices on end of year instructional practices and student outcomes. Teacher practices were organized around the fidelity of implementation to the Responsive Classroom (RC) program (Northeast Foundation for Children, 2009). Most notably, a central RC tenant entitled “the first six weeks” was examined. RC is a universal prevention program that previously has been categorized as a Tier I social-behavioral program for students when considered within an RTI model (Elliott, 1999). Twenty-seven teachers from the New England region and 179 students participated. The Academic Competence Evaluation Scales (ACES), teacher-form (DiPerna & Elliott, 2000) was used to measure student outcomes. The Classroom Practice Measure (CPM; Rimm-Kaufman et al., 2007) was used to measure level of RC implementation. Finally, to quantify teaching behavior, a momentary time-sampling observation, called the Teaching Observation Tool (TOT; Marcotte, Klein, & Solomon, 2010), was implemented. Results from a series of multilevel models utilizing students nested within teachers indicated that both a constant, high level of instructional time and investment in environmental management time in the fall results in higher levels of student reading (significant) and math achievement (non-significant) in the spring, and lower levels of time spent correcting behavior. Teachers with large discrepancies in instructional time from fall to spring and teachers who failed to release environmental control to students over time had students with lower levels of reading and math growth. Relationships between the CPM, ACES, and the TOT indicate that RC is significantly correlated with increases in student reading achievement and motivation beyond what would be expected of a teacher that does not implement RC. However, in contrast to past research, RC in this study was not correlated with teacher reported improvements in social skills. Implications for practice and directions for future research are discussed.

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