Examination of An Online Nutrition Curriculum from An Instructional Design Perspective

Concurrent Session 4

Session Materials

Brief Abstract

This presentation will share the results of examination of the instructional design properties used in 18 interactive nutrition modules. The levels of analysis included pedagogic strategies used in the interactive modules; level of cognition related to the module objectives; six domains of instructional design and interactivity level of the modules. 


Kadriye O. Lewis, EdD, is the Director of Evaluation and Program Development in the Department of Graduate Medical Education at Children's Mercy Hospital CMH). She is also Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine (UMKC SOM). Prior to coming to Children’s Mercy, Dr. Lewis worked for Cincinnati Children’s Hospital Medical Center (CCHMC) for more than 13 years. She played a major role in the development of the Online Master's Degree in Education Program for Healthcare Professionals. This program has developed a national and international reputation for excellence and played an important role in training future leaders in medical education. Dr. Lewis served as an education consultant to the medical center's faculty development program. She applied her educational background and academic skills to health literacy by establishing a Health Literacy Committee at CCHMC in 2007 and chaired this committee successfully for three years. Along with her many accomplishments in the area of scholarly activities, she also established the e-Learning SIG in Medical Education for the Academic Pediatrics Association (APA) in 2008 and served this group as the chair person for six years. Dr. Lewis is active in medical education research and her scholarly interests include performance-based assessment, the construction of new assessment tools as well as the improvement and validation of existing tools and methods. She also has a particular interest in instructional design and implementation of innovative technologies for curriculum delivery at many levels in healthcare education due to her extensive experience in e-learning and web-based technologies. Currently, she is involved in an NIH funded grant project on genome, various curriculum development projects for the graduate medical education programs at CMH and teaches an online/blended course in the Master of Health Professions Education program at UMKC SOM (http://med.umkc.edu/mhpe/). Dr. Lewis presents extensively at many professional meetings and conferences, and has been an invited speaker at many national and international universities.

Additional Authors

Cheryll Albold, PhD is an Assistant Professor of Medical Education and currently serves as the Designated Institutional Administrator (DIA) and senior administrator for the Mayo Clinic School of Graduate Medical Education, one of five accredited schools in the Mayo Clinic College of Medicine and Science. Together with the Dean and Designated Institutional Official (DIO), she provides oversight for sponsoring institution and program accreditation activities governing 284 graduate medical education programs with over 1600 physician residents and fellows enrolled across three campuses; located in Rochester, Minnesota, Jacksonville, Florida, and Scottsdale/Phoenix, Arizona. Dr. Albold has been a passionate educator for over 25 years. Prior to joining Mayo Clinic in 2000, she held other administrative roles at the University of Missouri-Columbia, Macalester College, and Bronx Community College, where she provided leadership for institutional initiatives focused on enrollment management, multicultural affairs, student affairs, adult learning, and student development. Dr. Albold received a master’s degree in Counseling and Student Personnel Services from Fordham University, in New York and earned a doctor of philosophy degree in Higher Education and a minor Certificate in Educational Research Methodology, both from the University of North Carolina at Greensboro. Dr. Albold holds the academic rank of assistant professor of medical education. She is a chapter author in the book, D.I.V.A. Diaries : The Road to the Ph.D. and Stories of Black Women Who Have Endured. Her presentations and published works focus on ethnic and cultural identity development, adult learning, graduate study, and student development.

Extended Abstract

Upon successful completion of the session, participants will be able to:

  • Describe the levels of instructional design analysis and pedagogical strategies used in the interactive online nutrition modules
  • Identify the level of cognition related to the module objectives, including six domains of instructional design (content design, assessment items, feedback mechanism, media design, visual design, and navigation); and interactivity level of the modules. 
  • Discuss the synthesis of design strategies for instructionally and pedagogically sound interactive online modules, including limitations and challenges in the design process  

Background: The use of interactive online modules has gained momentum in medical education due to learner demand for more self-directed/independent learning. However, the design and development of these type of modules is a labor-intensive process, and a large-scale project is costly as well. Although the literature offers a variety of models and concepts for development of an online module, there is not a singular recipe that fits for all projects. We used a corporate partnership model, which likely helped to mitigate the most common barriers that hinder nutrition education, i.e. lack of funds to develop compelling and effective educational materials, lack of clinicians with expertise in nutrition, lack of time for curriculum development, and high costs of constructing top quality online materials. In this study, we described a step-by-step approach to evaluate the presence of desirable, intentional, and systematic instructional design properties in an online Pediatric Nutrition Series (PNS) curriculum developed by educators from six academic institutions.

Methods: This descriptive study utilized four unique techniques to examine the instructional design properties and interactivity level of the 18 PNS modules. These techniques included analysis of pedagogic strategies; assessment of cognitive levels of the module objectives; review of the six domains of an instruction design framework (content design, assessment items, feedback mechanism, media design, visual design, and navigation) To evaluate the six instructional design properties, we developed an Instructional Design and Interactivity Scale (IDIS). Content validity evidence for the IDIS items were obtained through expert reviews. The IDIS was first developed as a 72-item Likert-type scale applying a quality value ranking to each item (0.00-Poor; 0.25-Fair; 0.50-Good; 0.75-Very good; 1.00-Excellent). We assigned these points to calculate the instructional design passing scores to the modules. The desire was that each module should score a minimum of 80 points when we converted 72 points into a 100-point scale. The IDIS scale was revised after the pilot implementation when all of the PNS modules were evaluated by two reviewers who are experts in the field. The refined IDIS has 50 items with an updated ranking score totaling a100-point quality score (0.00-Poor; 0.50-Fair; 1.00-Good; 1.50-Very good; 2.00-Excellent). The minimum score was set at 80 points again. We randomized the modules, and six reviewers completed the second-round module evaluation using this refined scale. Both versions of the IDIS included questions regarding the interactivity level that was adapted from the Virtual College’s four levels of interactivity scale. We analyzed the data using descriptive statistics and interclass correlations, and Bloom’s Taxonomy to examine the cognitive levels of the module objectives.

Results: Six unique pedagogic strategies were most frequently used in the PNS interactive modules to support content and convey the message in a multisensory mode in an e-learning environment (1. Problem-Based Learning; 2. Discovery Learning with Gaming; 3. Segmented Content with Graphics; 4. Testing with Teaching; 5. Progressive Disclosure; 6. Categorization and Segmentation of Questions and Answers Session). Out of 66 learning objectives used in the modules, only three were vague/not measurable. A majority of the objectives were grouped under three cognitive levels: knowledge, comprehension, and evaluation. All 18 modules passed the requirements of the six domains using both 72-Item and 50-Item Instructional Design and Interactivity Scales (IDIS). Average scores for overall PNS interactive modules were 1.91 for “content design,” 1.96 for “assessment items,” 1.83 for “feedback mechanism,” 1.78 for “media design,” 1.91 for “visual design,” and 1.84 for “navigation,” where a score of 2.00 indicated quality-ranking value of “Excellent.” All of the modules demonstrated either second or third level interactivity, although there was no absolute agreement between the raters.

Conclusion: Well-designed modules may dramatically improve teaching and learning since interactive technologies can capture learners’ attention and enhance the learning process. From this perspective, the instructional design of the PNS modules was successful and pedagogically appropriate. The instructional design framework demonstrated by these modules has the potential to be a model for other e-learning applications. The IDIS can guide development of effective e-learning applications and be used as a comprehensive scale to evaluate currently available e-learning practices in any field of study.