The author provides the opportunity to redesign and improve the learning environment for Neonatal Resuscitation Program courses in a large health authority in B.C.. A chance to improve the learning for practitioners caring for our tiniest of patients. (photo from Pixabay)

Our final assignment for the RRU MALAT course LRNT 524 presented the opportunity to design a challenge for my peers and develop a pitch for my leadership to tell them why I felt the redesign of our training course was necessary.

I chose to use the context of redesigning the way we teach Neonatal Resuscitation Program courses within our health authority, with the goal of improving the learning environment for our students. In LRNT 524, I learned the importance of using soft skills of empathy to maximize design for users. The framework from Stanford University Institute of Design’s d.school Virtual Crash Course in Design Thinking will be an incredible resource as I move forward in my career, helping to lead innovation in the Virtual Health portfolio.

The following is my design challenge and the YouTube video for my pitch to leadership:

A Design Challenge for Improving Simulation Training in Healthcare

Overview

Healthcare simulation research is evolving to direct new areas for focus and improvement in training environments. Research evidence to demonstrate improved learner outcomes when using costly high-fidelity equipment instead of basic simulator training equipment does not yet exist (Norman, Dore & Grierson, 2012). Research by Zigmont, Kappus and Sudikoff (2011) called for increased learner-centered design of simulation training to improve learner self-efficacy and “promote life-long learning” (p. 51). Rudolph, Raemer and Simon’s (2014) research supported the necessity of creating psychologically safe environments for learning in simulation classes. These three areas of research should be driving our redesign of NRP simulation training environments. The author proposes that a research-informed examination of NRP course learning design should drive the exploration of innovative, low-cost training activities. Thomas (2010) supported the design of learning as “developing a model to guide the design of a learning environment that can provide learners with the conditions that maximize their opportunity to learn” (p.188). Our examination framework should support the creation of new models for learning in simulation that consider learner needs and improve learning conditions.

Design-thinking frameworks like Stanford’s d.school (Stanford University Institute of Design, 2016) employ deep empathy as a component of exploring innovative solutions to problems. Crichton and Carter (2017) stated that this empathy can help us understand “the concerns, insights, lived experiences, and/or needs of others” (p. 47). By challenging our simulation instructors and learners to use empathetic design to explore the experiences of learners, we may find innovative training design solutions despite our multifaceted context.

Design Rationale

NRP simulation environments can be intense and create anxiety in our learners. Breen (2013) supports the need for a psychologically safe learning environment in order to develop higher-order thinking skills while Slagter van Tryon and Bishop (2009) inform that cognitive load is increased for learners who must establish a social structure with strangers. Current NRP simulation training environments may prevent learners from engaging fully in learning conversations, reflection, and analysis during face to face training days. Pasquale’s (2013) work informed that this limited time for reflection and discourse can reduce learner opportunities to develop metacognition. Campbell and Schwier (2014) stated that “learning consists both of constructing meaning and constructing systems of meaning that are tested against past and current social experience” (p. 359). The current simulation learning environment would benefit from new methods of engaging learners in active conversation about their resuscitation experiences. An improved focus on learners in the course learning design can be achieved by examining the situation with an empathetic lens. Diamond and Vredenburg (2016) offered that the answer to achieving innovation lies within design and consideration of human needs. Given the intricacies and constraints of the intense NRP training environment, as situated within publicly funded healthcare, creative ideas will be required to offer potential solutions to this complex problem.

Problem Scenario

As NRP instructors and learners you are invited to take part in this design challenge. NRP instructors have a unique vantage point to redesign simulation instruction as you have witnessed your learners’ behavior in the training environment and heard their voiced concerns about course structure. NRP learners will be positioned to reflect on successes and frustrations as you moved through your previous blended learning NRP course as well as any emotions felt during training. In this design challenge (see Figure 1), both groups work together to design a prototype for a simulation learning activity that will improve the learning environment for NRP learners on their face-to-face training day. The learning activity will have success determinants and must meet specific parameters, including a minimal increase in cost to the employer for training the learners. The learning activity will incorporate empathetic design using the d.school’s framework (Stanford University Institute of Design, 2016). It should also incorporate technology that falls on the continuum of innovation (see Figure 2).

Figure 1.

Design Challenge graphic demonstrating the design rationale, empathetic design, and success determinants. (Boyce, 2019)

Success Determinants

Success will be determined by:

• The degree to which your design empowers learners to reflect on and discuss infant resuscitation with other learners.
• The degree of empathy or learner-centricity in your design.
• The ability of your design to support the psychological safety of learners .
• The ability of your design to reduce the cognitive load of learners by reducing split-attention scenarios.
• The degree to which your design is accessible to learners of all technical abilities. 

Parameters

Your ideas must:

• Have a minimal cost impact (< $5000/yr).
• Not increase the current face to face training time of 8 hours.
• Utilize affordable technology (within given cost constraints).
• Recognize the diversity in digital literacy of simulation learners.
• Employ evidence-based strategies to improve learning.
• Use technology found on the continuum of innovation (Figure 2, below).

Figure 2.

Graphic depicting the author’s view of how current educational simulation technology falls on the continuum of innovation. (Boyce, 2019)

YouTube Video

My YouTube video to pitch the idea of holding a design challenge for NRP Instructors and NRP learners to my leadership:

Thank you for reading and watching. I welcome your feedback and comments below.

CB

References

Breen, H. (2013). Virtual collaboration in the online educational setting: A concept analysis. Nursing Forum, 48(4), 262-270.

Campbell, K., & Schwier, R. A. (2014). Major movements in instructional design. In Zawacki-Richter, O. & T. Anderson (Eds.), Online distance education: Towards a research agenda. AU Press.

Crichton, S., & Carter, D. (2017). Taking Making into Classrooms Toolkit. Open School/ITA. Retrieved from: https://mytrainingbc.ca/maker/downloads/Taking_Making_into_Classrooms.pdf

Diamond, S., & Vredenburg, K. (2018, May). There’s no innovation agenda without design thinking. The Globe and Mail. Retrieved from: https://www.theglobeandmail.com/report-on-business/rob-commentary/theres-no-innovation-agenda-without-design-thinking/article31292340/

Norman, G., Dore, K., & Grierson, L., (2012) The minimal relationship between simulation fidelity and transfer of learning. Medical Education, 46(7), 636-647.

Pasquale, S. (2013). Education and Learning Theory. In Levine, A., DeMaria Jr., S., Schartz, A. & Sim, A. (Eds.), The comprehensive textbook of healthcare simulation. (pp.51-54). New York: Springer Science and Business Media.

Rudolph. J. W., Raemer, D. B., & Simon, R. (2014). Establishing a safe container for learning in simulation: The role of presimulation briefing. Simulation in Healthcare, 9(6), 339-349.

Slagter van Tryon, P. J., & Bishop, M. J. (2009). Theoretical foundations for enhancing social connectedness in online learning environments. Distance Education, 30(3), 291–315.

Stanford University Institute of Design. (2016). A virtual crash course in design thinking. Retrieved from: https://dschool.stanford.edu/resources-collections/a-virtual-crash-course-in-design-thinking

Thomas, P. Y. (2010). Learning and instructional systems design. In Towards developing a web-based blended learning environment at the University of Botswana. (Doctoral dissertation). Retrieved from : http://uir.unisa.ac.za/handle/10500/4245

Zigmont, J. J., Kappus, L. J., & Sudikoff, S. N. (2011). Theoretical foundations of learning through simulation. Seminars in Perinatology, 35, 47-51.