Image of Dr Peter Stuart
Dr Peter Stuart

Dr. Peter Stuart RGN, MSC, PGCTHE, FHEA Senior Lecturer in the Faculty of Health, Education and Society was pleased to have been notified in October 2019 of his success in his bid submitted to the ILT Learning Enhancement and Innovation Bids 2019-20.

The intended project outcome is to use a Professional Artistry (PA) approach to learning for end-of-life nursing care. Peter states: “The intention is to build two online resources: Advanced Care Plans and Do Not Attempt Cardiac Pulmonary Resuscitation.


The additional learning using an online platform regarding Advance Care Plans and decisions, will supplement and support the students practice knowledge, developing a deeper, more intuitive and principled based Professional Artistry (PA) understanding of patient decision making in end-of-life. Do Not Attempt Cardiac Pulmonary Resuscitation (DNACPR) can cause confusion with understanding among students in end-of-life care, and a similar approach using PA and ABL could address this”.

In September 2019 Peter met with Anne Misselbrook E-Learning/Multimedia Resources Developer at the University, who’s role in the project was that of ‘Technical Advisor’ to provide technical support to Peter who was developing the two Xertes e-learning packages. Xerte Toolkits is the browser-based suite of online tools chosen for the project because of the range of interactive page types and easy access for Peter to use. Xerte as a reusable learning object can be replicated across a number of different platforms to facilitate learner access. The ability to include a pre-learning and post learning quiz was also an important feature of Xerte Toolkits ability.

In November 2019 Peter started work on his first Xerte. Using the Shared settings function in Xerte Toolkits proved invaluable, and from 26 November 2019 onwards Anne could review and co-work on the Xerte projects which had been shared with her. From that point onwards Peter and Anne liaised either face to face, virtually or by email until the Xerte packages were completed and released to students in 2020.

The requirement of Xerte to perform in the intended way meant that some customisation was required. Different page types were experimented with, and as Peter became familiar with Xerte page types and gained experience in using the software, he could understand Anne’s suggestions for improvements, changes and enhancements to pages within the Xerte resources. Changes were made, and initial ideas were challenged by the availability of page types, features and by the learning design.

In December 2019, Peter expressed concern that the Xerte packages were not active enough and that he needed to re-think as he felt stuck and ground to a halt with the Xerte for DNACPR. It was also noted in Peter’s blog that it was found that the time taken to produce the Xerte packages was underestimated and this was now a factor of concern for Peter.

There were interactive, design, time and emotional challenges to overcome. The project was a learning curve for both Anne and Peter. But the clear message to come from this project is to not give up and have determination to complete. The quizzes are part of the evaluation research and therefore needed to provide data that can be captured. With good design principles and the use of the Results page, the evaluation research was achieved.

Unexpected results from the build were interesting and Anne could identify where the build was causing problems. A lot of User Acceptance Testing(UAT) took place and Anne benefited from the support from the external Xerte developer.

It became apparent that only by simulating how the end-user (students) may play the Xerte packages, can replication of problems encountered by students be experienced by the tester in UAT. Subsequently, adjustments can be made to make the Xerte more intuitive for the end-user if this is possible. It is important to provide clear instructions to students, even if it seems obvious how to use the resource, never assume.

Consider the student’s demographics and their available time to study. Do they have control of their study time? Are they interrupted? Will the students be able to complete the Xerte in one go? Can this e-learning be completed in one session or is the e-learning quite lengthy resulting in some students exiting part-way through? Could the resource be chunked in to two shorter resources?

Xerte Toolkits benefits from being agile because of the active collaborative development team. This means that requests for new functions and features will be considered and solutions evolve for implementation which can be provided in future releases.

Student feedback from Peter’s Evaluation Report dated 1 March 2021.
The feedback from students proves that the learning material and its design does positively support student learning.

Some quotes from students include:

  • 95% of students responding to the survey reported the different activities helped them to understand.

    The different activities helped me to understand
  • Strongly agree = 27
  • Agree = 34
  • Disagree = 2
  • Strongly disagree = 1

Excerpt from report: The pre-learning and post learning quizzes were a popular learning resources among the students.

A quote from a student: “Yes my results the second time around were much better than the first attempt which shows that this activity was extremely helpful and aided my learning”.

Screenshot of Advance Care planning Quiz results
Screenshot of Advance Care planning Quiz results pre-learning and post-learning.
Screenshot of DNACPR Quiz results
Screenshot of DNACPR Quiz results pre-learning and post-learning.

Summary
Make sure that you undertake a needs analysis at the beginning of the project to gain an understanding of the students. Put yourself in the position of the student. As the academic subject matter expert and creator of the Xerte, allow time for testing the Xerte packages, and if possible, log in and test as a dummy student. Anticipate how the students may play the Xerte, and be aware that not all students will have the time to view all the content in one sitting. Useful constructive criticism comment from students state that for some of them, the Xerte took too long to complete. Advice to creators of Xerte packages, is to aim for a 20-minute duration for engagement.

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