Introduction

Despite prolific growth in the use of online learning both within and outside of the NHS, there is very little guidance for clinicians/educators in the process of producing such resources. Recognising this lack of support, Cook et al (2004) published a ten step practical guide to developing effective web-based learning. Whilst the guide provides a good basis to work from, it is not wholly comprehensive nor without flaws. Looking outside the healthcare literature, the Joint Information Systems Committee (JISC) provide some useful reviews and guidelines for developing web-based resources, particularly JISC (2004) and JISC (2009). The latter review suggests that the design of web-based materials is likely to occur namely in one of three broad learning perspectives: associative, constructivist and situative. They also discuss associated pedagogies and design principles associated with each key learning perspective. The JISC reviews, along with Cook et al’s (2004) practical guide, were used together to help guide the process of translating the face-to-face training materials into online content.

Methods

Stage One

Taking the BeST training in its entirety, a set of learning aims and objectives were developed. These were contrasted to the three learning perspectives’ assumptions and their associated pedagogies. The majority of the aims and objectives fell under the associative and constructivist approaches. Therefore, the following learning strategies were implemented to ensure the activities matched the relevant theoretical perspectives:

• The content was organised and into grouped into small modules.
• These modules progressed with increasing difficulty.
• Complex skills, for example, the delivery of a group session, were not presented until the underlying smaller parts had been taught.
• Where applicable:
  • Content encouraged experimentation and discovery of principles.
  • Learners were presented with opportunities to take ownership of learning tasks.
  • Guided discovery was used.

Stage Two

Following the recommend steps in Cook et al’s (2004) practical guide, online content was developed synchronously with website design. For this, current content was categorised, sorted and then mapped to visualise the potential structure and look of the course. This process highlighted the lack of depth concerning the majority of the training content. Input was sought from the BeST developers (Zara Hansen and Professor Sallie lamb) as well as from current research and other educational resources to update and expand the training content.
This content was then analysed to establish what type and degree of functionality was required to optimally deliver it. A table of functionality was produced and used as a guide to evaluate the suitability of both open source and commercial software options. After considering the various strengths and weaknesses for a range of software, the decision was made to produce the online content in Adobe Captivate; and to host it within Moodle (an open source virtual learning environment). After tackling the steep learning curve to produce high quality online content in Adobe Captivate, the individual modules were produced. At this point technical assistance was provided by an experienced software programmer (Andrew Williamson) who transformed the adobe captivate modules into a live working online course hosted within Moodle. Andy also developed bespoke software to record detailed user analytics for the online programme.

Iterative evaluation

i-BeST version one, was piloted with the content experts (Professor Sallie Lamb; Zara Hansen); a medical educationalist (Dr David Davies) and five health care professionals naïve to the BeST intervention. They provided feedback on all aspects of the online course from the relevance of the content to any technical problems they experienced. This feedback was essential and resulted in a considerable number of changes to the course, particularly with reference to the course structure; the publishing method; the navigation; the aesthetics; the content; and the addition of online tutorials and a ‘Meet the Team’ section. Following these improvements, the second version of i-BeST was ready for formal evaluation in Phase Three of this project (screenshots illustrating i-BeST can be found below).