There are many instructional design (ID) models that can be used in designing a digital learning environment. This paper will discuss the 4C-ID model and the Morrison, Ross, Kalman and Kemp (or Kemp) model by comparing the two models based on three components: their ease of implementation in the learning environment at the instructor level, consideration of media as part of the design, and potential application in medical education. By way of introduction to each model, a brief description of the 4C-ID and Kemp models will be discussed.
The 4C-ID model is used to design curriculum for programs requiring complex thinking (Sweller et al., 2019, van Merriënboer et al. 1992, van Merriënboer, 1997) such as medical education (Daniel et al., 2018). It is considered “an important extension to cognitive load theory” (Sweller et al., 2019 p.274) because while cognitive load theory provides principles for the design of short instructional experiences, the 4C-ID model focuses on designing instruction for education programs that are of long duration (Sweller et al., 2019).
4C-ID model from Sweller et al., 2019, Figure 1, van Merriënboer et al., 2002, Figure 2
The Morrison, Ross, Kalman and Kemp model, also called the Kemp model (Akbulut, 2007), focuses on curriculum design and takes into account the learner’s perspective when making decisions on ID by considering the learner’s objectives, needs, priorities and constraints (Branch and Dousay, 2015, Morrison et al., 2019). This model is considered a flexible design as the process is described as circular (see below) as opposed to linear like most models, including 4C-ID. (Akbulut, 2007, Branch & Dousay, 2015).
Circular design of the Morrison, Ross, Kalman and Kemp Model (from p. 26 Morrison et al., 2019),
Both 4C-ID and Kemp models are defined a class-oriented models, which means they can be used by instructors as a guideline to design their instruction, (Branch & Dousay, 2015). It has been suggested that the 4C-ID model is complex, (Sweller et al., 2019, Figure 1, van Merriënboer et al., 2002, Figure 2) and educators may find it difficult to incorporate such a complex instructional design at the classroom level (Daniel, 2018). A systematic approach has been created to assist instructors on how to use this model on a practical level. (van Merriënboer & Kirschner, 2017). The Kemp model has similarly been suggested to be difficult to implement on an instructor level as constant revision and formative assessments are steps incorporated into this model (Morrison, et al. p. 26). This complexity may require the involvement of experienced instructional designers (Branch & Dousay, 2015). While both these models are classified as class-orientated, additional guidelines or assistance from a team may be required for instructors to use these models for course specific purposes.
Online delivery means that use of media is an important consideration in the design of a digital online environment. The 4C-ID model does not provide guidelines on development or implementation of the design into practice (Branch & Dousay, 2015, van Merriënboer et al. 2002). According to van Merriënboer et al. (2002), this is because development is media specific and the selection of media is influenced by factors not included in the model. The Kemp model, in contrast, is a circular design that allows designers to begin at any step of the process (Branch & Dousay, 2015). Because of the fluid design of the Kemp model, it is ideal for use in designing online instruction as media requirements are part of the design process. (Branch & Dousay, 2015, Dousay, 2017). The Kemp model appears to have an advantage over the 4C-ID regarding the use of media as part of the design.
How can these models be used in designing medical education? Levinson (2010) argued that the use of ID is important in medical education and advocated for use of the 4C-ID model. More research is required, (Göksu et al., 2015), but the 4C-ID model has been used in designing case presentation curriculum for medical education (Daniel et al., 2018). A case presentation is a process that communicates important clinical information between health professionals. Being able to deliver a clear and concise case presentation is a complex communication skill that students must develop as a member of a healthcare team (Daniel et al., 2018). In addition to case presentations, health professionals must learn to be problem solvers as unexpected events occur in a hospital setting. A literature review by Göksu et al., (2015), found that ID based on the 4C-ID model has been shown to possibly improve problem solving skills. As problem solving is a complex thinking activity, the use of the 4C-ID model in medical education is promising. However, there are steps missing from the 4C-ID model that exist in other models such as Kemp that would affect its use in medical instructional design.
Healthcare education programs in Canada must demonstrate to a national accreditation body that they are providing instruction and assessing students based on standardized national competencies. This is to show that graduates from healthcare programs are competently meeting a national standard. An accreditation body asks for evidence for adherence to the national competencies that includes data from evaluation (such as course surveys) and documentation of revisions made if needed. The 4C-ID model does not include evaluation or revision as part of the design and therefore would not be an appropriate model at the program design level. In contrast, the Kemp model incorporates evaluation and revision as part of the design. (Branch & Dousay, 2015). Because of the evaluation and revision considerations, the Kemp model better suits the design of the overall healthcare education programs.
In comparing the 4C-ID model and the Kemp model, both are intended for use at the classroom level but have the potential to be too complex for a sole instructor to use. In a digital learning environment, the choice of media is very important. The 4C-ID model does not include media decisions as part of the design, while the Kemp model is flexible and factors in media selection. Evaluation and revision are lacking in the 4C-ID model but are heavily incorporated into the Kemp model. Both models have strengths that allow for their use in medical education. The 4C-ID model purposefully designs for complex skill development and the Kemp model has extensive evaluation and revision built into the design which is useful for providing data to accreditation bodies. The 4-ID model appears to be beneficial for curriculum specific design such as case presentation while the Kemp model would possibly be a design model to use in the overall planning of a healthcare education program. The Kemp model shows an advantage overall for designing an online learning environment, but the 4C-ID model has promise for use in complex thinking and problem solving.
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