Rapid Online CE Course Development - A Faculty Workshop

This presentation was designed to introduce faculty members to a method of rapidly generating high-quality continuing education courses by taking existing peer-reviewed guidelines from the literature or from the university clinic materials, applying these to a template I developed, and working in collaboration with an instructional designer to generate interactive components to engage the learner.

These are the slides used in the workshop, along with a transcription of the verbal presentation. The slides will enlarge when clicked on.
Welcome to this presentation and workshop on the rapid development of continuing education courses to be delivered online. Web-based learning is a form of distance learning that is becoming increasingly attractive to field practitioners, and UWS has strategic plans to address this need. This workshop is intended to show how faculty members can develop CE courses without demanding a huge investment in their time.
This 50-minute workshop is intended to help interested faculty members, and other members of the UWS academic family, learn how to design and develop 1 or 2 hour web-based continuing education (or CE) courses. We’ll look at how existing guidelines, such as University Care Pathways, or recent publications in the biomedical literature can be used as the basis of a CE course, thereby decreasing faculty time in content development. Although CE courses are often associated with exclusively clinical topics, I’ll make a case that non-clinicians, such as basic science faculty members, researchers
or librarians, can also design interesting CE courses by addressing the clinical correlation of basic science or research materials, or by helping field practitioners become more adept at literature searches or other ways to learn on their own. I’ll also go over some of the UWS distance learning standards that we want to meet with new courses, thereby assuring a high quality of these courses and compliance with both accreditation standards and best practices in distance learning. To help the instructor assure that all the essential components are included in the course, a course template will be provided and explained. I’ll also talk about how and when to involve our instructional designer in the course development process, and how that can relieve the course instructor from having to become proficient at different software applications. And finally, we’ll briefly talk about how the courses get delivered to the continuing education student, and what role the course author plays in the delivery.
Let’s start by defining the scope and objective of this workshop. Continuing education courses can vary considerably in their length and depth of presentation. Some CE courses are as short as one hour, whereas other course might be presented as a 10-12 hour block. Still others link together many of the 10-12 courses to create a complete program ranging from 100 hours up to 360 hours. So there is obviously considerable variance in the intensity of those courses and in the reasons that doctors are taking them. For instance, a doctor may be desirous of obtaining another credential or certification,
in which case the course work will likely be fairly lengthy. But in many cases, the doctor is simply trying to plug a particular hole. Perhaps the doctor is short an hour or two of continuing education needed to satisfy a state requirement for relicensure. Or perhaps there is a particular subject that the doctor wants a quick update on. We also know that many doctors would like to be able to pick and choose courses to individualize their learning, rather than simply sit through a lengthy presentation that might not address their specific needs. This workshop will focus on helping instructors design and develop 1-2 hour online CE courses, targeted at plugging these holes that the target audience, the field practitioner, has identified. This also helps the novice online course designer develop his or her skills on a more manageable task than designing a full 10-12 hour course. There is no reason that the skills learned cannot be applied to a longer course as the instructor’s knowledge and skill of online course development expands.
Some basic scientists may be skeptical that a field practitioner would want to take a CE course involving a basic science subject. Let me give you a couple of examples of why a practitioner might be attracted to a basic science presentation. Would a doctor want to take an hour course on embryology? Well, if it is provided in the context that may have clinical application they just might. For instance, chiropractors are often asked by their pregnant patients if there is anything that can help with their nausea. Could ginger, a popular remedy for nausea, be harmful or beneficial in the pregnant patient? What
about common pain medications or anti-inflammatories? Having a knowledge of embryologic development can help the practitioner understand what tissues are developing at different weeks of pregnancy and therefore might be affected by ingestion of different compounds. Here’s another example - How about genetics? Can a one-hour CE course focusing on genetic concepts be developed that might be of interest to the practitioner? Consider this - several laboratories are now offering sophisticated genetic-based tests to determine cardiovascular risk. For example, the Taq1B gene on chromosome 16 for Cholesteryl ester transfer protein (or CETP) regulates plasma lipid distribution and HDL levels. Knowing the patient’s genotype for the Taq1B gene may be helpful in determining if a patient with low HDL levels might respond to administration of plant sterols, garlic, statins or the use of exercise. How about the TCA cycle? Remember the looks on student’s faces when they were told to memorize the steps of the Kreb’s cycle? Would they want to take a CE course based on that? Well, if you consider how impairment of the Krebs cycle can lead to changes in intermediary metabolites that can be measured in the blood or urine as part of a laboratory diagnostic panel, this might be of interest to practitioners dealing with chronic fatigue syndrome patients. The point of all this is to reiterate the foundational value of basic science information in understanding complex clinical conditions, and that a basic scientist can play an important role in developing interesting CE courses for the clinician.
Every online course developed and implemented at UWS is expected to meet our standards for quality. These standards were established by looking at best practices in adult and distance learning, at existing accreditation standards and recommendations, and by adoption of guidelines from voluntary organizations, such as Quality Matters. Quality Matters is a non-profit organization that was the offshoot of a FIPSE grant involving several Maryland institutions of higher learning and other East coast non-profit organizations. It now has hundreds of subscribers, including UWS, involved in the implementation of online learning standards, and in faculty development and involvement in assuring the quality of distance education. I’ll now go through some of the basic standards for distance learning at UWS.
The first distance learning standard we want to address in our CE courses has to do with the introduction to the course. As is the case with a face-to-face course, students need to have a good idea as to what the course is all about. We do that in the online setting by having a welcoming message that orients the student to the course. This message, which is part of our course template, serves as the course syllabus. It is helpful to the field practitioner, especially someone who has never taken an online course from UWS before, to have a brief orientation to how to navigate through the course. Our course template takes care of most of that for you. The syllabus explains the purpose of the course and then gives some background information on the instructor. In the online setting, it helps students when they know something about the course instructor, such as their educational background or professional interests.
The next standard we need to address has to do with the presentation of clear learning objectives of the course. These course objectives should be specific and measurable, and will serve as the basis for assessment of learning. One of our overarching principles in online learning is that there is close alignment between the learning objectives, the learning activities, and the assessment. So the objectives you place at the beginning the course or each section within the course, must be directly supported by the lesson or other learning activity, and then must be assessed to determine if the student has mastered the subject matter. In addition to learning objectives, the introductory section to the course should include any specific instructions for taking the course.
A key part of adult learning is the active engagement of the learner in the lesson. Simply reading text and clicking on a button to advance to the next screen is boring and ineffective. Some methods of learner engagement, such as discussion forums, aren’t particularly useful in short CE courses. But we have other ways to get the learner actively involved. These include pop-up questions, matching activities, puzzles, identification of abnormalities in clinical images, and interpretation of data. Relevant video or sound clips can also be incorporated. We’ll take a further look at some of these activities next.
Hot spot activities use concealed zones on an image that produce some action when the mouse passes over them or is clicked on them. In this example, the learner is asked to click on named parts of the cardiac conduction system. Feedback is provided for both wrong and right answers. This can be a scored activity if desired. The course author needs to provide an image and a drawing key from which the instructional designer can create the activity. Imagine using this activity on abnormal xrays, skin lesions, blood smears, EKGs, and so on.
A labeling activity involves the creation of a list of labels that the learner will drag and drop onto an image. In this example, an EKG tracing is the main image. The learner needs to drag the labels from the bottom of the screen to the appropriate location on the EKG, identifying the parts indicated by the red lines. This can be a scored activity. Note that this example involved interpretation, not just simple recall.
Crossword puzzles are familiar activities and can provide some entertainment while reinforcing learning. All that needs to be provided to the instructional designer is the list of terms and descriptions (or “cues”). Here’s an example of a crossword puzzle with 16 terms and clues that I created for an introductory pathology course. Crossword puzzles are useful when a course introduces many new terms and definitions or concepts.
An ordering activity asks the learner to put a series of items or steps into the correct sequence. In this example, the learner is asked to put a series of substances in a vitamin B12-deficient patient into the correct order in the biochemical pathway.
You can also keep the learner engaged by embedding occasional quizzes into the learning activity. These can be as short as 1 question and can require a correct answer before allowing the learner to proceed with the lesson. Here’s an example from a CE course on hypertension. The screen shows part of a lesson in which blood pressure categories have been explained. Following a summary table, a “Quiz Me” activity is placed. When the learner clicks on the icon, a quiz question pops up. In this case, the learner has been asked to interpret a specific clinical presentation. Feedback can be provided for incorrect and correct answers.
As is the case with face-to-face courses, online courses need to assess student learning. Assessments are used to determine if the participant has attained the course objectives. This can be any combination of formative and summative assessments. Typically a 1-hour course might have a couple of formative quiz questions scattered throughout the learning activities, followed by an end-of-course summative assessment that must be passed in order to earn CE credit. Don’t try to pack too many questions into these quizzes. You can plan to have about 5-8 questions for a one-hour course. Don’t forget in the design of the overall duration of the course to allow about a minute per question for the learner to complete the quiz. Rather than focusing on lower level learning, such as recall of facts, try to mix in questions requiring the clinical application of newly learned information. In this regard, there’s no difference between online and face-to-face courses - the instructor strives to move the learning up Bloom’s taxonomy
UWS is a PACE provider for the Federation of Chiropractic Licensing Boards. PACE stands for Providers of Approved Continuing Education. PACE has criteria for quality continuing education that must be adhered to by its approved providers.
Even a 1-hour CE course needs a syllabus, although obviously not as lengthy as for longer courses. This is typically formatted as an “Welcome” section on the home page for the course. In this example of a CE course on Hypertension, the Welcome page has an overview of the course, and some overall course objectives. We provide the instructor with a template to fill in with the specific course information; the template already has the general information that must appear in all courses.
Every course must have specific, measurable learning objectives. Rather than cram all the objectives at the beginning of the course, it is often better to break up the learning material into manageable chunks, and then place the specific learning objectives at the beginning of each chunk. In this example, the page of learning activity has a few specific objectives listed at the top. We will provide you with a handout of tips on writing course objectives that are measurable.
All CE courses must contain appropriate academic rigor for the target audience. The material should stimulate the learner to become mentally engaged and to attempt to apply the new information in the clinical setting. This is why we want to avoid simple point-click-read-repeat types of online courses.
Potential conflicts of interest must be properly managed. Any financial relationship of the course instructor with commercial entities relevant to the course material must be disclosed. For example, in a nutrition CE course, if Instructor Smith is on an advisory board to a supplement company, that information must be disclosed. Prohibited activities include: product placement, use of trade names when generic names would have sufficed, or the inclusion of company logos, web links or advertisements. Of course, the instructor may not use the course for personal promotion.
PACE also requires that we provide for getting feedback from course participants, and for answering questions raised by the participants. Feedback is collected by means of an end-of-course survey, as is shown in this example. This is handled automatically - no instructor input is needed. The CE program will also need to contain an e-mail link for participants to ask questions about the material. Instructors should attempt to answer these questions within 2 business days.
The course instructor, also referred to as the course author, has a number of responsibilities, but also can lean heavily on our instructional designer for help in areas outside your comfort zone. Let’s take a look at how these responsibilities are divided up.
As the course instructor, you provide the content expertise. As the subject matter expert, you know what information needs to be provided in the course. The designer can help you make decisions on how to divide the content into manageable learning chunks, but you are the authority on the material itself.

If you are going to use images, you will need to provide those as well. Remember that web-based learning, unlike printed media or high-definition DVDs, doesn’t demand high resolution images. If you use very high resolution images, the user won’t see any improvement in the quality of the images, but will notice that these large files take a long time to download. So the bottom line is that you should use images that have been optimized for display in web browsers. Either the instructional designer or the multimedia production specialist can help you get images ready. The same is true with video clips. Video intended for DVD use is typically filmed at a much higher quality (and therefore file size) than video that is going to be used for online learning. You can get assistance in optimizing video clips for display in a browser. The technologist can worry about optimizing video, still pictures, and sound clips - you don’t need to bother with this stuff if you don’t have the technical know-how. The designer can also help you capture screen images, including animations and annotations.
Next, you need to provide links to any web references that you wish to incorporate into the lesson. You should also provide digital files of any other reference materials that you want the student to be able to download.

As you proceed though the design of the course, you’ll have a course template to guide you. That template will also prompt you to consider the various types of learning activities that I talked about previously. For any of these activities, like image hot spots, crossword puzzles, and embedded questions, you need to sketch out what you want to accomplish and provide enough detail so that the instructional designer can build the activity in its web format, using SoftChalk or other specialized software. The course instructor doesn’t have to know much about Moodle other than how to log on and view their course. The instructional designer will do the heavy lifting to make the course ready for uploading to Moodle.
Finally, a reminder about copyright. When you author a course and use materials that other persons have created, you are responsible for ensuring that you have the rights to reproduce or alter those materials. If you have any questions on the copyright law or the fair use of copyrighted materials in education and what is covered by our institutional annual copyright license, please contact the University librarian. Don’t make assumptions - be absolutely sure.
Now we will take a look at a sample course. This 1-hour CE course is on Hypertension Evaluation.
UWS online courses will all be delivered using the Moodle LMS platform on a server separate from other UWS Moodle courses. This allows us to develop a home page that lists just the CE courses offered to DCs, Massage Therapists, Athletic Trainers, and other interested persons. By early 2011, online CE students will be able to register and pay for courses online. After successfully completing the course, the participant will be able to print out a certificate of completion that can be used for license renewal purposes. The Director of Continuing Education also gets notified of all completions so that the participant’s CE transcript can be updated. The course instructor will not need to be proficient in the use of Moodle because all the Moodle programing and uploading is done by the instructional designer.
Well, that about wraps it up. Thanks for taking the time to go through this presentation on developing online continuing education courses. I hope that it has sparked your interest in becoming an author/instructor in our online CE program. I hope you saw that by providing you with templates and support from an instructional designer, you can concentrate on your expertise with course content and not panic about mastering online course programming and delivery. For a relatively small investment in time, you can gradually become more adept at web-based instruction, learn some new skills, and make a little money. Please contact us if you are interested.
Attribution: Photo (“Robin, Studying”) licensed by Treehugger under Creative Commons License (BY-SA-NC)