Comprehensive reflection
Introduction
Individuals recognize certain times or instances in their lives or working career as defining moments. Defining moments can be positive or negative, some bring happiness or sorrow, and others can influence what an individual does for the rest of their lives. There are several defining moments impacting the future of this educational technologist.
A defining moment came while practicing physical therapy in a Skilled Nursing Facility. A resident (an individual who resides in a Skilled Nursing Facility) who by all accounts should have passed on to another life due to an extensive brainstem stroke walked out of the facility under his own power. Words cannot explain the emotions one feels when such an occurrence happens. The rehabilitation process for this individual included many hours of education. Educating the patient, family members and nursing staff. Education allowed these individuals to better understand the functional deficits and “WHY” the resident was behaving a certain way. This allowed everyone involved to better help the resident.
The second defining moment occurred when asked by a supervisor to develop and implement a Restorative Nursing Assistant (RNA) program. The program was developed and implemented even though I had no formal training and experience with instructional design. The program was well received by all the stakeholders. All eight participants reported that they gained knew knowledge and were happy with their experience. Personal satisfaction was the reward for teaching these people to help others.
Due to the orthopedic conditions the final defining moment came when I was told that continuing to perform rehabilitation on other individuals would no longer be an option. A new career and knowledge base was needed. The one who found satisfaction in teaching so many individuals, families, and nursing staff members needed to return to college.
Armed with twenty years of practical experience, wealth of knowledge in rehabilitation services, and finding a personal and professional satisfaction in teaching, a quest for a new profession was embarked upon. Following my investigation into education with friends who are faculty members at San Diego State University, application was made to the Educational Technology Department at San Diego State University. This journey was to learn how to teach more effectively and further enhance my ability to empower others through education to help themselves or to help others.
Having a narrow scope of experience in teaching from single individuals to small groups, education provided was very specific to the needs of individuals or small group. Instruction focused on single task items, techniques, or procedures. Instruction was delivered in the form of text documents, verbal communication and/or visual demonstration. In order to evaluate the level of learning the individuals would be required to demonstrate or verbalize their understanding of what they just learned. In order to be a more effective instructor, it was time to return to school and create a knowledge base in instructional design/educational technology.
Important Ideas I Love
During the course of studies in educational technology, a plethora of knowledge has been bestowed upon me. But two phrase that keep coming to mind are “say more using less words”, and “be more direct and succinct”. Adhering to the principles of the adult learning theories by P. Cross (Characteristics of Adult as Learners (CAL) and M. Knowles (Andragogy), incorporating Gagne’s nine events of instruction, and combining the graphic principles established by Williams and Mayer, will accomplished this.
Adult Learning Theory
Cross’s learning theory is appropriate when instructing a learner. It allows for customization of instruction taking into account their aging limitations, allows them choices, and their prior experiences can be used if and when necessary (Theory in Practice/Cross). This is exemplified when giving the learner a home exercise program to do. If the program is too complicated the learner will probably not do it, if they have difficulty reading the exercise program because the visual graphic and text are to small they wont do it or do it incorrectly. To ensure favorable results, the exercise program should be short (6 to 8 exercises), tailored to the learners needs, accompanying text should be succinct and comprehendible, and clear graphic illustration should be used. It should be impressed upon the learner that being compliant with their exercise program will have a positive benefit on their health.
Dealing with medical staff and nursing professionals, Knowles Andragogy and Sticht’s functional Context theory work well together. Material can be more explicit on why things are being done the way they are, learning tasks can be specific in the context in which they are going to do things, it allows the learner to discover things for themselves, they will practice with the actual equipment they will be using after instruction has taken place (Theory in Practice / Knowles & Sticht). When instructing nursing professional on how to transfer a patient or resident, learning tasks are specific and purposeful. Instruction teaches why they need to do things not just how to do them. It is in knowing the “Why” that allows the adult learner to build on prior knowledge and form new knowledge. It also allows the adult learner to create automaticity following bouts of practice (experience). Learning can be problem solving oriented rather than content specific. According to Sticht, they need to be trained on the actual equipment they are going to use and the learner must be able to draw on prior knowledge (Theory in Practice / Sticht). These points are very important in the medical field. How would you like to be the having a heart attack and the nurse has to look at the manual on how to use the defibrillator or read “How to do CPR in three easy lessons”. It is through affective training and practice that skills and knowledge come together. That is why nurses working in a medical setting do not panic when someone is having a heart attack. They know how to do CPR and use a defibrillator.
Gagne’s 9 Events
Gagne’s 9 events of instruction allows for greater organization and customization of the delivery of instruction. No matter whom the audience is gaining their attention is the first step. This can be as easy as saying “Hello, I am John Doe and I will be your teacher/instructor today”. The second event is informing the student of the objectives. By informing the learner of the objectives allows the learner to know what is going to learn. Stimulating the learners recall is the third event. Stimulating prior learning can be by reviewing what took place during a previous class or treatment session. Discuss what was taught or what they did, how it was done, and what you want them to do today. Stimulating the learner is the fourth event. A stimulus comes in many forms. It is very individualistic. Some people thrive on positive reinforcement, some thrive on negative reinforcement, and while others nothing motivates them. The trick for the educator is to find out what the motivating factor is. The fifth event, guided learning is accomplished through the demonstration of good examples and non-examples or having the learner follow along with what the instructor is doing. Non-examples should point out the potential for negative outcome. The sixth event, eliciting performance comes from motivating the learner and explaining the positives of the treatment or attending the instruction. The seventh event is providing feedback. When the learner is doing well or poorly, the instructor should provide feedback in a way that encourages the learner. The eighth event is assessment. Assessment is subjective. Therapists use certain standards such as minimal assist, moderate assist, and maximal assist. They have their clear-cut definitions, however, how the therapist interprets assist levels is purely subjective. Enhancing retention and transfer is the final event. This occurs by building on prior knowledge and through repeated practice.
Williams
By adhering to Williams’s Contrast, Alignment, Repetition, and Proximation, (C.A.R.P) principle, creating visually pleasing and well-organized materials is easy. Materials can be created that allow the learner to have consistency from one page to another, from one document to another, and allows for greater organization of a document. If the learner cannot figure out what the document does, is used for, or how to use it, they just put it in the waste paper basket. For a patient to attempt a home exercise program, the exercise text and graphical illustration must be organized in a fashion in which they can read and comprehend what they are suppose to do. The learner should not struggle to make connections between the text and graphic illustration. For the medical professional, if they cannot figure out how to use a certain form or the form is to complicated, vital information could go unreported or undocumented.
Mayer
Mayer feels that graphics play an important role in both book and computer based instruction (p.76). He has categorized graphics into four types: 1) Decorative, 2) Representational, 3) Organizational, and 4) Explanative (p.77). It is vital that the right type of graphic illustration be used. It would not be useful to use a decorative graphic when trying to explain how to do something, an explanative graphic would work best. On the other hand, you would not want to put an explanative graphic on a brochure the admitting room uses to that discusses the hospitals mission statement. Using an appropriate type of graphic can assist the learner in visualizing and/or contextualizing the instructor’s text that is accompanying it.
Why Do I Love Thee
Nadyne Guzman characterizes adult learners as autonomous and self directed, reflective, tolerant of contradiction and ambiguity, having greater critical thinking skills. Guzman also feels that adult learners have many limitations, lack of time and/or money, family and job responsibilities, transportation issues. Adult learners in the medical and nursing professions come from many different ethnic backgrounds, socio-economic backgrounds, and have varying degrees of education and abilities to speak and/or write the English language. It is for these reasons and twenty years of practical experience that I love the ideas as described in the previous section.
Adult learners present many challenges. Using Sticht’s, Knowles and Cross’s learning theories allows for the creation of appropriate instructional material. According to Dolores Fidishun, Penn State Great Valley School of Graduate Professional Studies, Andragogy allows instruction to be created that is not only technology effective but meaningful to the learner. Fidishun feels that instructors who are using concepts of adult education to develop lessons must become facilitators of learning. By knowing and following the six assumptions of Andragogy meaningful instruction can be designed and implemented.
Because of the pace of their jobs, medical and nursing professionals who work in an acute care setting or skilled nursing facility have little time to be inserviced. Many of the personnel have limited ability to take continuing education on their own. Acute care hospitals and skilled nursing facilities provide most of the required continuing education. The facilities I worked at did not have computer labs or computer stations for computer based instruction. The medical and nursing professionals receive education in a small classroom, patient room not being used, or on the ward at the nurses’ station. Using the adult learning theories described above and the principles outlined by Williams and Mayer, instructional material can be developed for any media. All are adaptable to print, computer-based training, or can be put on the web.
Knowles Andragogy is a strong adult learning theory for medical and nursing professionals. In this setting the adult learner can be self-directing, they learn only what they need to learn, and can call on their previous life/work experience to build new knowledge. Most are motivated to learn and want to see the usefulness of what they are learning. Instruction should be designed to be short, direct, to the point, and be shown relative to what they are doing.
Cross’s adult learning theory, characteristics of adults as learners (CAL) is very appropriate for nursing professional, medical staff and the patients. It draws on experience, age limitations, and provides the learner with options. However, to stick to using only one of these three theories is not practical. The learner would be best served if the instructor combined the best characteristics of both. This would provide greater latitude in the design process; yet provide guidelines to adhere to during the design process. By doing so, many more characteristics of the adult learner can be addressed.
According to Mayer, less than 20% percent of all instructional graphics fall into the educational categories, organizational or explanative. It appears that the full potential power of educational graphics is not being met. Great care must be taken to use educational graphics (p.77). My goal as an instructional designer is to use the full power of educational graphics.
Combining William’s and Mayer’s principles of graphic illustration organizes the material, creates a clean and consistent layout, allows the learner the greatest potential to learn and comprehend the material, and almost guarantees the appropriate use of graphics. Using good contrast, proper alignment, doing things with repetition, and creating proximity of like items, (C.A.R.P.) for print, computer or web based material, or other forms of media provides consistency, ease of use, ease of readability, allows the learner to know there is a beginning and an end, increases organizations, creates cohesiveness, creates a hierarchy for information, and allows for a unified design. This is extremely important because there are so many different types of learning styles. Some adults learn through verbal or written communication, others learn through practice and drill, others are very visual, they learn by seeing others perform the task or through graphic illustrations.
There are many medical and nursing professionals where English is their second language, especially in southern California. By augmenting the instructional text with appropriate educational graphics, organizational or explanative, the learner will be assisted in contextualizing and comprehending the learning material. Later, with minor modifications, job aids can be created (appendix A).
Change is constant in the world around us. Individuals are required due to a variety of reasons to continue to learn. By utilizing the above methods, change and learning can be done by all who need or want to. The above are methods that just make it easier.
Current trends
Change is not always using the latest and greatest in technology. However change may mean creating a balance between the use of technology and instruction. For example, distance education programs benefit a large population by making learning more accessible. A Distance Education program would allow a geographical remote population of individuals that may not have the time, finances, or opportunity to attend a traditional classroom-setting take a course. Distance Education allows an individual whose company does not offer continuing education an opportunity to obtain new knowledge, skills, and potentially a certification or even a college degree. Distance education also allows a mother to stay home and take care of her children while still in pursuit of her Bachelors/Masters Degree.
According to Rossett and Sheldon, current trends in technology and distance education include: video conferencing, audiotapes (books on tape), videotapes (videotape series), interactive CD-ROM (computer based training), digital videodisks, computer-based training (CBT) and wireless technologies (p165-176). Other trends for distance education include: web based education, public broadcasting television e education, black board, web Television, Correspondence Courses like years ago (paper and pencil), NetMeeting. These technologies do not provide a medical or nursing professional an opportunity to practice with the new equipment, practice the new procedures or techniques they have just learned.
Whether a learner likes the comfort of the traditional classroom, learning on the fly standing at a nurses station or sitting in front of a computer, individuals have their own learning style and preferences. What is good for one individual may not be good for another. I like the traditional classroom and prefer to use technology to teach, not let technology teach for me.
Change
Individuals return to education for a variety of reasons. For some individuals it is due to medical necessity, for others it is part of their job description, and for others it is to better their lives and way of living. The instructional designers must know who his audience is and why they are there. As an instructional designer I must also be able to change with time. I fell in love the above theories and concepts because they presently fit well into the medical and nursing professions. Much like everything else in the world and in education, these fields are constantly changing too. The ideas I chose help individuals learn on many different levels and take into many different learning styles. I can facilitate learners who might otherwise feel unable to participate in education realize their ability to learn.
As long as there are individuals, there will be many different types of learning styles. As long as there are different learning styles, research will continue to define better approaches in creating instructional material. When something new comes a long and better fits the population I serve, the old shall be put out to pasture. Knowing if new ideas warrant use will only come with time, growth of my experience, keeping up with the latest in research/educational articles and taking continuing education. Being open to change means being observant, alert, and aware of where the focus of education is headed. Education is every changing and ongoing. To stop learning is to stop change.
References
Cross, P. (2002). Adult Learning. [On-line] Available: http://tip.psychology.org/cross.html, (downloaded 11/1/02)
Fidishun, D. (2002). Andragogy and Technology: Integrating Adult Learning Theory As We Teach With Technology. Retrieved November 1, 2002, from Penn State Great Valley School of Graduate Professional Studies Web site: http://www.mtsu.edu/~itconf/proceed00/fidishun.htm
Guzman, N. (2000). Applications of Adult Learning Theories to Constructivist Learning Environments. Retrieved November 1,2002, from University of Colorado, Science Learning Center Web site: http://web.uccs.edu/bgaddis/leadership/topicfocus2D1.htm
Knowles, M. (2002). Andragogy. [On-line] Available: http://tip.psychology.org/knowles.html, (downloaded 11/1/02)
Mayer, R. E. (2001). Multi-Media Learning. New York, USA: Cambridge University Press
Rossett, A. & Sheldon, K. (2001). Beyond the Podium: Delivering Training and Performance to a Digital World. San Francisco, CA. Jossey-Bass/Pfeiffer
Sticht, T. (2002). Functional Context. [On-line] Available: http://tip.psychology.org/sticht.html, (downloaded 11/1/02)
Thomas, C. MD (Ed). (1989). Taber’s Cyclopedic Medical Dictionary (16th edition). USA: F.A. Davis
Williams, R., & Tollett, J. (1998). The Non-Designer’s Web Book. Berkley, CA. Peachpit Press
Williams, R. (1994). The Non-Designer’s Design Book. Berkley, CA. Peachpit Press
Appendix A
Slide board transfer
The explanatory graphic (frames) illustrates the process and procedure on how a slide board transfer is supposed to be done. By illustrating the procedure and what the text is saying, learning can be enhanced by its use.
This graphic also utilizes the Williams CARP principle.
[This sample comprehensive reflection was written by Brian Josephson]