1. Training & Instructional Design Needs Analysis Unit 2a This material (Comp20_Unit2a) was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003.

2. Lecture Objectives 2 Identify an instructional problem Plan and implement an instructional needs assessment Analyze learner, task, and situational characteristics Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a

3. Needs Analysis: ADDIE 3 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Analysis Design Develop Implement Evaluate

4. Defining Need 4 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a A need is a discrepancy or gap between a desired state of affairs and the current state of affairs (Kaufman, 1976) If employees lack the knowledge or skills needed to successfully perform the various tasks that comprise their jobs, a training need is identified

5. Why Needs Analysis? 5 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Training may focus on the wrong content Training may be incomplete, redundant or incorrect Training may be too easy or too difficult for learners Training may not address the organization's business needs

6. Questions Answered in Analysis Phase 6 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a About the learner What is the learning problem? Who is the learning audience? What do the members of the learning audience already know? What new content do they need to learn? How will success for both the learner and the project be defined? What are the goals and objectives for this training project?

7. Questions Answered in Analysis Phase 7 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a About the Organization What organizational constraints exist? When is the project due? How do the learning outcomes connect to the organizational goals? What resources are already available? What is the budget? What are the training delivery options?

8. Conducting a Needs Analysis 8 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Discovery and planning Learner analysis Instructional analysis Instructional setting design Budget planning

9. Sources of Information Literature research Analyze budget & quality control documents, goal statements, evaluation, scheduling and staffing reports, or other documents. What is the learning problem? Observations and Immersion Work with the employees to gain an understanding of the challenges and opportunities they face on a daily basis, and watch the job or task being performed SurveysSend out written questionnaires Focus groupsLead a group discussion composed of employees and/or their managers InterviewsTalk to key stakeholders such as supervisors, managers, Subject Matter Experts (SME), and target employees and their functional heads, tech support personnel and clients 9 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a

10. Discovery Questions 10 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Questions for Target Employee What prevents you from performing a prescribed task to standards? Why do you think training is needed? What prevents you from performing a prescribed task to standards? Questions for Supervisor Describe specific instances of how workplace productivity has been affected by lack of training? Give specific examples of how performance deficits have affected organizational goals? What specific things would you like to see your employees do, but don't?

11. Sample Assessment Goals 11 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Goal 1: Assess the organizational climate to determine any potential obstacles to the needs assessment or to the training Goal 2: Determine the specific training needs of key job tasks (as determined from the discovery process) Goal 3: Develop an understanding of what the training should accomplish

12. Needs Analysis Methods 12 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Organizational analysis Learner analysis Job & task analysis Instructional analysis Different methods can be used to meet the defined goals

13. Organizational Analysis 13 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a An organizational analysis is conducted to define those components of the organization that may affect the delivery of a training program (Goldstein, 1993) The focus is on factors such as organizational goals, available resources, constraints, and support

14. Case Study 14 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a What were their priorities and how did the employees work together? Look at their communications strategies. Is it directly or through formal hierarchies? Does the organization embrace the change and the new system? Were there past implementations that did not go well? Does the organization value learning and provide sufficient resources for training, including release time for the clinical staff? Training scenario: A community clinic was recently taken over by a larger hospital corporation and the staff has to be trained on a new EHR system. It’s important to understand the previous organization and the new corporation.

15. Learner Analysis 15 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a What is the learning or performance problem? Who is the learning audience? How many employees should be trained? What do the members of the learning audience already know? What new content do they need to learn? How will success for both the learner and the project be defined?

16. Instructional Analysis 16 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Determine the instructional goals and objectives Define and describe in detail the tasks and sub-tasks that the student will perform Specify the knowledge type Select learning outcomes that are appropriate for instructional development Prioritize and sequence tasks

17. Job Analysis 17 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Step 1 Step 2 Step 3 etc Conditions & Environment

18. Conducting a Job Analysis 18 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Document analysis: Required knowledge and skills determined from operating procedures, manuals, administrative procedures, job descriptions Observing the Expert: Observer records an expert performing a task Job inventory questionnaire and Interviews: Individually or in groups subject-matter experts are interviewed

19. Job Analysis Questions 19 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a List all your major responsibilities and prioritize them. Why are these responsibilities important to your job? Describe some specific duties or tasks that you perform in your job What knowledge do you require to perform your job successfully? What prior knowledge, skills or abilities did you bring to your position that helped make you successful in your job? Describe any other contributing factors that you feel have made your successful in your job?

20. Conducting a Task Analysis 20 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Classify tasks according to learning outcomes Generate a list of tasks Prioritize tasks and choose most feasible and for training Identify the component s of the tasks, goals, or objectives Sequence tasks & sub-tasks to define sequence for instruction

21. Case Study 21 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Goal: The learner will be able to register a new patient accurately Definition of Learning: The learner will be able to perform the step-by-step process of registering a new patient accurately in the Electronic Health Record (EHR)

22. Simple Task Analysis 22 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Collect Patient Information Collect patient demographic s Collect insurance information Select third- party provider, plan, and group Identify primary policy holder Verify Patient Insurance Verify insurance enrollment Check for patient co- pays Notify patient of amount due at first visit Schedule Appointment Select care provider Select location Select date and time Validate appointment confirmation

23. Process-Based Training 23 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a If the clinic recently implemented a Colon Cancer screening program the patient advocate would have to involve the call center, nursing staff and patient schedulers to assure the smooth referral of the patient information and needs Needs analysis would focus on the clinic workflow and all jobs in the process, not just one job function or person’s tasks Training should address complex team-based clinical operations

24. Subordinate Skill Analysis 24 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a To be able to register a new patient accurately, an employee will need to know how to operate a keyboard and mouse. These are not really sub tasks in registering a new patient, but required subordinate tasks.

25. Classifying Tasks & Learning 25 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Cognitive: mental skills (Knowledge) Affective: growth in feelings or emotional areas (Attitude) Psychomotor: manual or physical skills (Skills) In 1956, Benjamin Bloom headed a group of educational psychologists who identified three domains of educational activities

26. Cognitive Domain (Bloom, 1956) 26 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Evaluation: Ability to judge the value of learned material Synthesis: Ability to put parts together to form a new whole Analysis: Ability to break down material into its component parts Application: Ability to use learned material in new situations Comprehension: Ability to grasp the meaning of material Knowledge: Remembering of previously learned material

27. Revised Bloom’s Cognitive Domain 27 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a CreatingEvaluatingAnalyzingApplyingUnderstandingRemembering

28. Affective Domain 28 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Internalizing values: Has a value system that controls their behavior Organization: Organizes values into priorities; comparing, relating, and synthesizing values Valuing: The worth or value a person attaches to a particular object, phenomenon, or behavior Responding: Active participation on the part of the learners Receiving: Awareness, willingness to hear, selected attention

29. Psychomotor Domain 29 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Origination: Creating new movement patterns to fit a particular situation Adaptation: Skills well developed & can be modified to fit special requirements Complex Overt Response: The skillful performance of complex movements Mechanism: Learned responses have become habitual Response: Early stages in learning a complex skill - imitation and trial and error Set: Readiness to act Perception: Ability to use sensory cues to guide motor activity

30. Gagné’s Taxonomy 30 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Intellectual skillsLearning how to do something, Also, known as procedural knowledge, Includes: discrimination, concrete concept, rule using, & problem solving Cognitive Strategy Process by which the learner controls own learning, remembering, and thinking behavior Verbal Information Knowing that something “is”, e.g. labels and facts Also known as, declarative knowledge AttitudeInternal state which affects an individual's choice of action toward some object, person, or event Motor SkillsRefers to bodily movements involving muscular activity Gagné’s Learned Capabilities

31. EHR Intake Task Analysis 31 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Collect Patient Information Collect patient demographics Collect insurance information Select third- party provider, plan, and group Identify primary policy holder Verify Patient Insurance Verify insurance enrollment Check for patient co- pays Notify patient of amount due at first visit Schedule Appointment Select care provider Select location Select date and time Validate appointment confirmation

32. EHR Intake Task Analysis 32 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Collect Patient Information Collect patient demographics Collect insurance information Select third- party provider, plan, and group Identify primary policy holder Verify Patient Insurance Verify insurance enrollment Check for patient co- pays Notify patient of amount due at first visit Schedule Appointment Select care provider Select location Select date and time Validate appointment confirmation

33. EHR Intake Task Analysis 33 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Collect Patient Information Collect patient demographics Collect insurance information Select third- party provider, plan, and group Identify primary policy holder Verify Patient Insurance Verify insurance enrollment Check for patient co-pays Notify patient of amount due at first visit Schedule Appointment Select care provider Select location Select date and time Validate appointment confirmation

34. Other EHR Intake Skills 34 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Are there special protocols for when there is an emergency and the triage is flooded with new patients? If training staff to work in the emergency room Communicating with the patient in a public setting Computer screen orientation Logging out when leaving the computer terminal How do HIPAA privacy and confidentiality affect the patient registration process?

35. Sample Learning Objectives 35 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Recall the steps of the intake process Assist patients who have incomplete information Resolve any potential complications adequately Select the appropriate registration protocol given the intake environment Apply HIPAA regulations to the registration process By the end of this lesson intake personnel will be able to:

36. Training Format and Budget 36 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Training format Instructor-led In classroom or computer lab Online and self-directed One-on-one tutorials Blended learning Other questions Should consultant subject-matter experts be hired? How many sessions? How should training be tailored for different personnel?

37. Summary 37 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Discovery and planning Learner analysis Instructional analysis Instructional format design Budget planning

38. Summary 38 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a Analysis Design Develop Implement Evaluate

39. References Clark DR. Bloom’s Taxonomy [monograph on the Internet]. Big Dog & Little Dog’s Performance Juxtaposition; c2004 [cited 2010 Jun 21]. Available from: http://www.nwlink.com/~donclark/hrd/sat.html. Clark DR. Instructional System Design (ISD). Big Dog & Little Dog’s Performance Juxtaposition; c2004 [cited 2010 Jun 21]. Available from: http://nwlink.com/~donclark/hrd/ahold/isd.html. Carkhuff RR, Fisher SG. Instructional systems design: volumes I & II. Amherst, MA: Human Resource Development Press; 1984. Carliner S. Training Design. Danvers, MA: American Society for Training and Development; 2003. Gagne RM, Wager WW, & Golas K. Principles of Instructional Design (5th ed.). California: Wadsworth Publishing, 2004. Reigeluth CM. Instructional-design Theories and Models: A new paradigm of instructional theory. New Jersey: Lawrence Erlbaum Associates, Inc, 1999. 39 Health IT Workforce Curriculum Version 3.0/Spring 2012 Training & Instructional Design Needs Analysis Unit 2a