Tag Archive: e-learning

Questioning strategies in Healthcare Training develop critical thinking, decision making, and problem solving in students. Bloom’s taxonomy of the six levels of cognitive learning can be used to provide a framework for creating questions. Bloom’s taxonomy starts from the simplest level of learning to the most complex level.  Simplest levels denote Knowledge and Complex levels denote Evaluation.

Sample Question for Knowledge Test:

Intravenous Urogram

Knowledge Test

Asking a learner to define Intravenous Urogram, (IVU) would test his/her knowledge levels.

Sample Question for Evaluation:

Intravenous Urogram

Complex Evaluation

A question is posed to the learner to  assess a request to perform an IVU on a patient allergic to iodine. Experiential activities/ simulations can be built to guide the learner in decision making. In this case, the learner gets to immerse in a simulated scenario, evaluate patient vitals, reports and assess the conditions under which an Iodine-allergic patient can be subjected to Intravenous Urogram.


A baccalaureate nursing program study determined what proportion of terminal objectives for clinical nursing courses are high level objectives (analysis, synthesis, evaluation), and are the kinds of questions asked by teachers and students during clinical conferences of a high level also.  Despite the fact that stated objectives specified higher cognitive-level thinking, lower-level questions comprised 98.94% of the total number of questions asked by teachers and students in the clinical conferences surveyed.

Another study was performed within an Australian nursing program to examine clinical teachers’ use of questioning strategies.   The teachers’ years of classroom and clinical teaching experience, years of clinical experience, and academic qualifications were studied to see if an association between various qualifications and levels of questions existed.  Bloom’s taxonomy of the cognitive domain was used as a framework for the study.  The findings revealed clinical teachers asked more low-level questions (91.2%) than high-level questions (4.4%).

Lower level questioning do not promote critical thinking as they only trigger recall of information in the learner’s mind.  A simple recall of information does not enhance students’ understanding of the information in a meaningful way. Higher level questioning facilitates the development of critical thinking because it is aimed at higher cognitive levels, which involves application, analysis, synthesis and evaluation.   Educators should take advantage of stimulating questions more often to help create meaningful active learning instead of just prompting the simple recall of knowledge from students.

Scenario- based learning stages a context, within which learners live and work in their everyday life. It’s based on the concept of situated cognition, which is the idea that knowledge can not be developed and fully understood independent of its context(Randall 2002). Scenario-based learning puts the student in a situation or context and exposes them to issues, challenges and dilemmas and asks them to apply knowledge and practice skills relevant to the situation (www.ucl.ac.uk).

Scenario- based learning has particular advantages for practice- based discipline areas where the experience of practitioners is especially relevant to what constitutes knowledge and understanding in the field. Using scenario-based learning in the field of Healthcare has brought forward many such advantages to learners that count on practical experience in everyday activities.

Let us consider a case where Indira Gandhi National Open University conducted such a scenario-based learning project. 10 academic programs were chosen to be included into this project.

The following frame work was given to develop the scenarios:
1. Define critical competencies for graduates of the program
2. Identify learning outcomes for students in the program
3. Identify learning context and develop suitable learning scenarios that reflect the events in life and work of persons who have acquired these competencies
4. Define learning activities assessable and non assessable tasks.
5. Identify all learning resources and instructional opportunities
6. Identify and define cooperative and collaborative learning opportunities using technologies.
7. Identification and definition of opportunities for feedback and remediation.

Let us study a sample scenario as an example:

Discipline: Civil Engineering

Topic: Structural Analysis

Learning Objectives:

1) To distinguish between static and dynamic loads
2) To conceptualize the influence lines
3) To differentiate between Influence Line Diagram (ILD) and Bending Moment Diagram (BMD)


It was a shining morning of October. All students of your class are in cheerful mood traveling to Roorkee in Jan- Shatabdi Express for educational trip with Prof. Dutta.
Suddenly, you feel a shock as train stops abruptly. While waiting for the train to re- start, it is leant that due to some accident on the bridge ahead, the train will not move at least for next 5 hrs.
Out of curiosity you all move to the accident site with Prof Datta. You observe that there is a lot of distortion of the track and even the rails have gone out of place. While discussing the reasons of track failure, Amit points out the presence of visible cracks in the side beam
of the bridge. Suresh asks Prof. Datta whether the bridge failure is due to excess loading.

In turn, Prof. Datta asks the students, whether they remember different types of loading on the structures. You all start naming the different types of loading, you have seen earlier.

Learning Activity 1:

a) List out the different types of loading on structures.
b) Categorize the above list into static and dynamic loads.

After going through the list, Prof. Dutta asks you that why the live loads are not considered as dynamic load when the movement of goods and human beings are considered in the live load.

Learning Activity 2:

Identify the characteristics of static loads and dynamic loads.

Prof. Datta asks the learners to tie a rope across two poles tightly. He then asks Suresh to hang four bricks at four different places and observe the deflected shape of the rope.

Simulation 1: Prof Datta asks you to remove the three bricks from the rope starting from the right pole and observe the deflection of rope at mid point.

simulation activity

Simulation 2: The he asks to repeat the same exercise by moving the brick at points B, C , D and E subsequently and observe the deflection at mid point each time.

simulation activity

Conclusion: The whole scenario-based learning program was developed to be very challenging and was able to completely immerse the learners into the learning cycle.


Roll back to 1985, when Chip Morningstar and Joseph Romero in designing LucasFilm’s multi-palyer online game Habitat.  This is when the word ‘Avatar’ was coined in its then context. Since then Avatars, Actors and Characters have some terms that describe the virtual representation of the player or user in varied contexts.

In the recent years, a stigma of focused effort has been constituted to establish a social context between the learner and the learning platform (be it any form of learning content).

In simple and practical terms, a Character or Avatar creates a social representation of a real person into a designated role within the learning program. Relating this to the current Healthcare Learning and Educational landscape, the involved persons are majorly Physicians, Students, Clinicians, Academicians and other allied healthcare professionals. Each individual applies to its specific competency role in the industry.

As we speak about the industry specific title, each title is entitled to a role which performs its designated role in a Practice-Based environment. A Practice-Based environment demands only and only Practice in Practical.

The challenge here is how does e-Learning transform learning to be virtual yet practical. How can e-Learning in it’s inorganic matter deliver results similar to that of organic and practical methods.

Avatars play the bridging role here. An Avatar can play various social roles.

Expert/ Instructor/ Coach: Here the character is modeled after an expert or knowledgeable human – most commonly a senior surgeon, professor, training manager/head or expert in the field such as a regulation,etc. Effective use of this role with the help of an Avatar ensures social engagement between the character (Avatar) and the student through a conversational tone, interaction, and feedback.

Learner/ User: An Avatar of learning establishes the emotional presence of the learner into the learning scenario. It simulates the learner’s belongingness within the learning context and situation. An Avatar created with situational and curriculum based contextual engagement allows the emotive mind of the learner to dwell into imaginative and experiential learning.

C0-learners or Peers: Avatars of co-learners or learning buddies create a sense of being accompanied. It helps eliminate the loneness factor of the learner and builds a scope of togetherness into the learning environment.

Immersive e-learning

In the study, We Learn Better Together: Enhancing e-Learning with Emotional Characters (2005) by Heidi Maldonado et al., it is discovered that the presence of a Co-learner resulted in learners performing better. Students with a Co-learner scored significantly higher than students without a Co-learner.

There are experts and then there are instructional experts who have brought a huge value by proposing various best-practice instructional approaches to aid web-based science education and training. All such instructional theorems and hypothesis contribute to the foundation grid lines of online training and education.

While physical models and virtual 3 D models deciphers a great value for teaching Fundamentals of Electrons in Atoms and Molecules; the greater need has always been to empower students to read, research and discover underlying facts of such subjects.

Leveraging from emerging e-learning technologies and tools, e-learning inventors have produced innovative and immersive discovery tools that cater to the above said need.  Leading educators like Wiley, Elsevier and other scientific innovators have transformed model-based training methods to discovery-based simulation applets.

A Case Example:

To teach the Motion of  a Projectile, a simulation can be created as an applet. The “Reset” button brings the projectile to its initial position. You can start or stop and continue the simulation with the other button. If you choose the option “Slow motion”, the movement will be ten times slower. You can vary (within certain limits) the values of initial height, initial speed, angle of inclination, mass and gravitational acceleration. Below is an example of similar instruction as created at Walter Fendt.

Another interesting example can be seen at Glovico.org. Glovico provides a social business platform to learn and teach languages. Teachers are native language experts who decide their coaching prices. Students get the liberty to choose teachers based on prices and ratings.

I remember learning about Set Theory and Venn Diagrams in the late 90’s by reading text books and practicing exercises on paper notebooks. I feel envious of what technology has brought to today’s mathematics students. Utah State University has been creating interactive mathematics exercises that allow Discovery-Based learning for student. Using applet-based intuitive functions and guided instruction, students can explore and attempt randomized mathematical problems.

It is heartening to see technology and learning instructions blending into exploratory tools that encourage and empower learners to adopt online learning and training through a Scientific-Discovery based instructional approach. For all ages to come, I firmly believe, in way or other, this would be the best instructional approach to any subject of training, majorly for science education and training.

There are people who want to buy similar products. They just don’t know how your product can help. They want to learn as much as they can prior to talking with a sales rep.

Prior to buying cars, customers spend over 2 months researching models and brands before arriving at a showroom. They download brochures, visit web pages before they actually decide buying their latest mobile phone.

Guess how much research one would put, before purchasing a complex business solution/ product. What is that you offer to help the customer select your product.
Your sales rep will have the chance to demo or feature the product only when either the customer contacts the rep or the rep connects to the customer.

Will you ignore open prospects who are always there, searching, researching and hunting for products? If yes, well the your sales process only gets to hardly 10% of the active customer base at any point of time.

Whats the deal then?


This not only adds as a powerful tool to your marketing arsenal but also initiates a silent-sales cycle much before you even know about it.

Some key areas you may consider in such presales customer trainings are:

* Level of depth: Access the level of features/ details you may want to provide to the customer to make informed decisions.
* Customer Speaks: Include customer testimonials and how each customer benefitted by your product.
* Self-help/ Self-explore: Design functions for your customer to self-explore your product features and benefits.
* Gift them: After they explore your training, gift them with tokens to be redeemed with a sales-rep appointment.
* Comparative Manual: A comparative product manual which maybe downloaded or recieved at the customer email.

There are many such empowering presales widgets that help/ train your customer of how they pride their decision with your product.

Early to train, early to win. Try it to earn it.


Customer Training

Online Training for Customers

Medical Reimbursement

Medical Reimbursement Training

The healthcare environment has dramatically changed over the past decade and evolved to be a “dynamic” rather than “static” arena.

Healthcare providers have become increasingly aware of the importance of reimbursement to their practice of medicine, and as a result, you will need strong reimbursement skills to address this critical segment of your customer’s practice.

Home Study Training manuals have served to be the best guides for your Medical Reimbursement Managers (RBMs). The information contained in any such training manual when coupled with Instructor Led Training classes, equips the RBMs for success in the important role of an RBM.


Ground reality is:

1. Instructor Led Trainings create a unified and common session for knowledge enhancement- But only when your RBM is knowledge-ready with foundations.
2. Home Study Manuals are monotonous and fall flat when knowledge dissemination and retention is concerned.
3. Result- complete failure of your training program and a total Output-Miss.

What’s the solution then? How to make Home Study Manuals the real and best guides for your RBMs.?

Answer is – Blend it to the Business

Transform your Home Study Manual into a self-paced online interactive course that serves as the foundational curriculum.

Since the training manual is meant for self-paced home study, the content is organized in the format of a book/e-book. However, the same content organization cannot be utilized while converting the manual into a WBT. Conversion of a manual into a WBT is somewhat similar to making a movie from a novel.

Here comes ‘intelligent’ instructional design into play! Based on a comprehensive analysis of the training manual, we can see that a lot of content that can be ‘abridged’ or can be presented in a ‘feature’ format, instead of presenting it ‘as is’. Some of the ‘key features’ that we may consider are:

•Factoid/Trivia: Content in this section will be maintained, but learners will access the information from an icon embedded in a content screen. Such information will appear as a ‘pop-up’ or on ‘mouseover’.
•Terms & Definitions: (A compilation of various technical definitions used throughout the course) It can be accessible as a separate feature, but also linked within the content.
•Abbreviations & Glossary: (A compilation of abbreviations & technical terms) It can be accessible as a separate feature, but also linked within the content.
•Learning Links: This feature can provide links to useful Websites/documents. Very generic content can be presented with an overview and a link to website/document will be provided for further reading.
•Interactive Activities: Self-contained Flash interactions such as multiple choice, drag and drop, listening to terms and typing them, etc can be designed to provide self-assessment of subject material throughout the course.

It is worth to consider employing an assorted instructional approach for such content development. The assortment of instructional strategies will be chosen such that it maps to the principles of Adult Learning Theory, Gagne’s Nine Events of Instruction, and Bloom’s Taxonomy. We now can treat the existing content with an assortment of following three instructional strategies:

•Activating Strategy: The purpose will be to activate learners’ prior knowledge through the use of strategies that stimulate recall of prior learning.
•Cognitive Strategy: The purpose will be to provide a structured learning that actively promotes the comprehension and retention of knowledge.
•Summarizing Strategy: The purpose will be to promote the retention of knowledge through the use of engaging strategies designed to rehearse and practice skills for the purpose of moving knowledge into long-term memory.

Media Strategy- Multimedia can be employed for reasons of efficient encoding of learning and to sustain the interest of learners. Therefore, to support the instructional content with conceptual graphics, animations, and simulated demos and interactions, we can use media elements such as TEXT ELEMENTS, GRAPHIC ELEMENTS, ANIMATIONS, DEMOS & SIMULATIONS.

Measuring your RBMs on their knowledge acquisition is as important. We can now use PRE TESTS, INLINE KNOWLEDGE CHECKS & POST TESTS for the same.

Once through with such a self-paced web-based interactive home-study course, BET IT, your RBM will be pre-equipped to leverage an ILT session.

What have we done here? Created an amazing blended learning model. Whaddya Say?