EDT 6170 | Fall 2012
Final Report
Blood Pressure Assessment
by Four Letter Word
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TABLE OF CONTENTS
Executive Summary ................................................................................................................................ 2
Needs Assessment ................................................................................................................................... 2
Background of the Problem
Problem Statement:
Needs Analysis:
Rationale for the Need of Instruction:
Goal Statement:
Learner Analysis....................................................................................................................................... 6
Context Analysis ...................................................................................................................................... 7
Course Design .......................................................................................................................................... 8
Unit Design .............................................................................................................................................. 9
Lesson Design ......................................................................................................................................... 9
Formative Evaluation Plan .................................................................................................................... 16
Formative Evaluation ............................................................................................................................. 17
Appendices .............................................................................................................................................. 21
Appendix A - State Standards for ALHS 1040 - Introduction to Healthcare
Appendix B - Blood Pressure Survey
Appendix C - Blood Pressure Survey Results
Appendix D - Course Level ICM
Appendix E – Unit Level ICM
Appendix F – Blood Pressure Captivate Module
Appendix G - Formative Evaluation Plan
Appendix H - Blood Pressure Posttest
Appendix I – Skills Checklist
Appendix J – Attitude Questionnaire
Appendix K - Instructional Strategy Planning Sheet for Lesson 3
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EXECUTIVE SUMMARY
This instructional design project addresses the need for healthcare students to be proficient in
taking a manual blood pressure. The context of the instruction is the ALHS 1040 Introduction to
Health Care course at Gwinnett Technical College and the course is taught in a hybrid format which
includes both classroom and online instruction. The students in this course are working towards
attending advanced healthcare programs. The course includes several units, one of which addresses
the need for student proficiency in obtaining vital signs. The specific lesson for which this
instruction was written focuses on obtaining a correct blood pressure measurement. Needs analysis,
conducted using surveys, determined that improved materials and demonstration would promote
student success. Gaps in instruction and content were identified and corrections were made. In
order to provide students with additional materials and demonstration of how to take a manual blood
pressure, a captivate module was developed to enhance student participation and
understanding. Once this was completed, a formal evaluation plan was developed to assess impact of
using the module as a means of providing students with a clear demonstration of the process of
obtaining a proper blood pressure measurement. The results of the data collected from the formal
evaluation indicated that learning occurred and that the inclusion of the Captivate module was
beneficial to the learners. Additional information extracted from data indicated that there are
additional revisions that could be made that may improve learning. Our goal of improving the
materials used as a part of the blood pressure unit to increase student achievement in mastering the
skill of measuring blood pressure was met.
NEEDS ASSESSMENT
Background of the Problem:
The context or the system of interest that Four Letter Word will be dealing with is the ALHS
1040 Introduction Healthcare course offered at Gwinnett Technical College. This course is required
for many healthcare programs at Gwinnett Technical College. Gwinnett Technical College is one of
25 colleges in the Technical College System of Georgia. At Gwinnett Technical College, the
Introduction to Healthcare course is part of the Allied Health Science department. The course
curriculum includes: history of healthcare; infectious diseases; diseases of concern; patient
assessment; and vital signs. Students entering several healthcare programs are expected to be
competent in these curriculum standards. The different health care programs include: Surgical
Technology; Emergency Medical Services; Medical Assisting; Dental Assisting; Radiologic
Technology; Cardiovascular Technology; Respiratory Therapy and Nursing Sciences.
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The Introduction to Healthcare course is one of the last prerequisite courses students take before
entering their degree programs. Additionally, this course offers students their first “hands on”
experience with patient care. There is a core amount of preliminary knowledge students must have to
be successful in their intense healthcare programs. As ALHS 1040 is one of the fundamental
prerequisite courses for healthcare program admission, it is essential that students are achieving and
retaining mastery of all of the components of the curriculum. Additionally, in concerns for patient
safety, all students and professionals working in healthcare must be competent in patient assessment
and vital signs order to ensure patient safety.
After reviewing the ALHS 1040 Introduction to Healthcare course, we have concluded that not
all students are entering their advanced programs with appropriate competence in the vital signs
component of the course, namely the blood pressure unit. The data collected from a survey
administered to participants in an ALHS course indicates that students who are not succeeding are
not receiving enough instruction and educational materials to properly develop their skills.
Considering the timeline and student/instructor ratio, the instructor cannot extensively work with
each student individually. Therefore, materials need to be provided to the students such that they can
learn through improved instructor demonstration readily available when they are personally learning
or practicing. Additionally, according to the survey data collected by Four Letter Word, students who
have completed the course are not maintaining an appropriate level of skill to transfer into their
advanced program settings. (Appendix B) As a result, Four Letter Word will add available instruction
such as demonstration videos and interactive materials to enhance student learning and retention of
the blood pressure unit.
According to the Georgia State Standards, the ALHS 1040 Introduction to Healthcare course has
a learning outcome centered on vital signs. This outcome is to “demonstrate proficiency in obtaining
and documenting blood pressure, temperature, pulse, respiration, weight and height.” (Appendix A)
In order to effectively address this state standard as well as our course objectives, we will incorporate
technology to develop materials that will optimize both learning and retention of the vital signs unit.
Problem Statement:
The ALHS 1040 Introduction to Health Care course is not adequately preparing students to
successfully demonstrate the ability to take an accurate blood pressure measurement in the vital signs
component of the curriculum.
Needs Analysis:
To verify the need of improving instruction for the ALHS 1040 Blood Pressure Unit, Four Letter
Word constructed a survey for both ALHS 1040 students and students that have completed the
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course and are in advanced programs. By including both current and prior students, our goal was to
gather data that covered intermediate and expert learners. As a result, the data compiled includes
statistics about students’ blood pressure competency skills while in the course and their retention of
the skills upon entering their programs.
In this survey, which can be found in Appendix C, only 50.9% of students responded they felt
they could take an accurate blood pressure on anyone. This is highly alarming because the ability for
a healthcare student or professional to efficiently respond to an emergency situation is paramount.
Furthermore, patients under their care will require an accurate blood pressure reading as part of their
regular care. When asked to rate the instructional materials given on blood pressure measurement
only 35.8% on the students responded they received excellent supportive materials that enhanced
their understanding of the blood pressure unit. That leaves roughly 65% of the students wishing for
improved materials.
There were also low scores about the delivery of instruction. Only 56% of the students responded
they felt their instructor thoroughly covered the skills required to take an accurate blood pressure
while only 41% responded they received ample practice opportunities. Finally, 37.7% agreed they
received highly constructive feedback.
See Appendix C to view some responses to the open ended questions from the survey.
Rationale for the Need of Instruction:
From the students responses, it can be determined that improved materials and demonstration
will promote student success in the blood pressure unit. Although a high percentage of students did
not believe they received enough practice or feedback, the solution to this problem is not only
instructional in nature in that the constraints of time and student/instructor ratio prevent most
improvement opportunities in this situation. Also, the request for better lab equipment such as better
models and stethoscopes is not an instructional problem. This is a consideration that needs to be
explored through the program budget, not improved instruction. Based on the aforementioned, we
are going to focus our instructional design on improving materials through the use of technology and
as a means of providing an increase in the availability of instructor demonstration. By creating these
additional materials, students can obtain additional demonstration resources that will allow for
enhanced quality practice opportunities out of class. This should result in an improved blood
pressure measurement competency.
Goal Statement:
By improving the materials used as a part of the blood pressure unit, students will be able to
master the skills of measuring blood pressure as required by the course objective and the state
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standards for the ALHS 1040 Introduction to Healthcare course. Additionally, students will be able
to continue to refer to these materials to improve retention of this vital skill as they enter their
advanced programs and future careers in healthcare.
LEARNER ANALYSIS
Characteristics of the Learners:
Students who take the ALHS 1040 course are applying to healthcare programs. Their ages range
from just out of high school to non-traditional students in their fifties and sixties. Recently, there
have been many students returning to school to start a second career, especially after being displaced
from work in a tough economy. The students are also quite culturally diverse. Each section contains
multiple students who were not born in the United States.
What unites the students even with their vast differences is the desire to get into their programs
and ultimately help people. All of their majors and future careers are hands-on, team based and ever
changing. Therefore, it is important that we continue to challenge and develop these characteristics
in their learning.
Prior Knowledge of the Topic Area:
The ALHS 1040 course requires students to have taken the Allied Health Science pre-requisite
courses of Anatomy and Physiology and Medical Terminology. Along with learning the objectives of
the course, it is important that students are constantly challenged to build upon the background
knowledge they have obtained.
Some students have volunteered or worked in clinical settings making their learning needs greatly
different than that of the novice learners. The course standards are centered around novice learners
and it is up to each instructor to evaluate every student's prior knowledge to create an appropriate
learning environment for each student.
Motivation:
The majority of the students that enter this course are highly motivated as the grade in the course
will affect their opportunities to get into a competitive entry healthcare program. Additionally, this
course offers the first opportunity for hands-on patient care. Most students are excited and
motivated to start developing their patient care skills.
Education and Ability Levels:
All students who take the ALHS 1040 course are required to gain admission into the college and
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test out of developmental classes. Students must also successfully complete Anatomy and Physiology
and Medical Terminology at the 70% benchmark score. Although English and Math course are not
prerequisites to the ALHS 1040 course, they are prerequisites for all of the healthcare
programs. Therefore, we encourage students to have also completed these courses before taking the
Introduction to Healthcare course. Unfortunately, there are not prerequisites that test or prepare
students for the physical skill requirements. To successfully complete the ALHS 1040 course,
students will be are required to achieve passing scores on both didactic and skill based
assessments. Since there are not standards to pre-determine student’s psychomotor abilities, this
course will receive a wide range of ability levels.
General Learning Preferences:
The most common learning preference of healthcare students is kinesthetic. By the simple nature
of the career field; healthcare students are attracted to a fast paced “hands-on” learning
experience. However, this can present some challenges when presenting the didactic portion of the
course. Since there are didactic requirements, even in the vital signs unit, it is important materials
are developed that will supplement visual, oral and psychomotor learning styles.
CONTEXT ANALYSIS
Instruction is delivered in a hybrid format. The ALHS 1040 course is a five hour semester
course where students attend one on-campus class a week. The physical class is two hours and
thirty minutes long and mostly consists of psychomotor instruction. This applies to the vital signs
unit. There is laboratory space available along with models and supplies where students can learn
and practice their physical patient care skills. There are also some “open” unstructured lab
opportunities. However, this limited time is not sufficient for most students to master the
skills. Therefore, students are required to practice and hone their skills out of class and without the
aid of an instructor.
The remaining course objectives are delivered through the Gwinnett Technical College
learning management system. Through the Angel Learning site, students have access to materials
such as power points and videos and are expected to independently learn any objectives that are not
covered in class.
The assessment portion of the course is also managed in a hybrid format. All didactic tests
are administered through the Angel LMS, whereas the physical skills are assessed through a “checkoff” performance.
The student’s most likely performance setting is in hospitals or doctors offices. The course
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offers a professional simulation opportunity for students before they work on real
patients. However, this is still an introductory course and students will learn their specific discipline
skills when they enter their program.
COURSE DESIGN
This instructional design will take place in the ALHS 1040 Introduction to Healthcare course
offered at Gwinnett Technical College. According to the Georgia State Standards, the course is
broken down into four major Learning Outcomes: Infection Control; Vital Signs; Basic Emergency
Care; and Basic Life Support. (Appendix A) The Vital Signs Learning Outcome is divided into five
major units comprised of Blood Pressure, Temperature, Pulse, Respiration, and Height and
Weight. The vital signs competency requires that students “demonstrate proficiency in obtaining and
documenting blood pressure, temperature, pulse, respiration, weight and height.” (Appendix A)
Specific feedback from needs analysis further identified a large instructional gap in the blood
pressure measurement unit. Therefore, Four Letter Word has decided to specifically focus the
instructional design on the blood pressure unit portion of the vital signs learning outcome. The
blood pressure unit is broken down into four lessons: Anatomy and Physiology and Medical
Terminology; Blood Pressure Equipment; Measuring Blood Pressure; and Troubleshooting Errors in
Measuring Blood Pressure. (Appendix E) After analyzing the data gathered in the needs assessment
survey, Four Letter Word is designing materials to improve student success relating to the blood
pressure unit to meet the terminal objective which states that students will be able to demonstrate
proper assessment of vital sign by successfully completing a vital signs competency with a minimum
score of 70%.
UNIT DESIGN
To achieve the terminal objective, students will participate in the following five major units of
study:
1.
Blood Pressure
2.
Temperature
3.
Pulse
4.
Respiration
5.
Weight and Height
Each unit is dependent upon the next and will be taught in sequential order. The goal is to create
a learning environment that includes verbal, psychomotor and intellectual skills. For successful
completion of the unit, students must develop and exhibit higher order intellectual skills including
rule-using and problem-solving to support their knowledge of verbal information and attitudes.
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Specific feedback from needs analysis further identified a large instructional gap in the in the
blood pressure measurement unit. Four Letter Word will specifically focus the design to reduce this
gap by developing materials for the blood pressure lesson objective which states that students will be
able to execute the proper skills in obtaining a correct blood pressure reading within two degrees of
accuracy within three attempts. (Appendix E) See Appendix D and Appendix E for Course Level
and Unit Level ICM's.
LESSON DESIGN
Specific feedback from needs analysis further identified a large instructional gap in the in the
blood pressure measurement unit. Four Letter Word will specifically focus the design to reduce this
gap by developing materials for the blood pressure lesson objective which states that students will be
able to execute the proper skills in obtaining a correct blood pressure reading within two degrees of
accuracy within three attempts. (Appendix E)
The following lesson objectives will be addressed:
1. Students will be able to classify normal versus pathologic blood pressure readings and
demonstrate relevance of anatomical and physiological considerations that affect a patient’s
blood pressure. (L1)
2. Students will be able to identify different equipment used to measure blood pressure. (L2)
3. Students will be able to obtain a proper blood pressure reading. (L3)
4. Students will be able to identify and correct common errors in blood pressure measurement.
(L4)
Lesson 1:
The terminal objective for the first lesson in this unit states that students will be able to classify
normal versus pathological blood pressure readings and demonstrate relevance of anatomical and
physiological considerations that affect a patient's blood pressure. This lesson includes two subobjectives that ask that the students be able to list the major terms associated with blood pressure
and state the normal ranges of blood pressure.
This lesson requires entry skills that include the identification of major components of relevant
anatomy that will affect a patient’s blood pressure and identification of the major components of
relevant physiology that will affect a patient’s blood pressure. Other entry level skills involve the
identification of common medical terms that will be used in discussing blood pressure and the major
pathological considerations that will affect a patient’s blood pressure.
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The pre-instructional activities for the lesson involve motivating the learners and gaining their
attention. This will be accomplished by impressing upon the learners the importance of blood
pressure readings in the clinical setting. It is a heavy responsibility to impress upon the learners that
they must take this lesson seriously. Some of the students are going into non-patient critical patient
care arenas where they won’t be asked to take a blood pressure reading often (such as Dental
Assisting or Dental Hygiene). However, a stressful situation like seeing a dentist can create a critical
event and it is important all of our healthcare students are ready to rise to assist in any of these
occasions. Students will be shown a video of a patient entering a critical situation and remind them
this could happen at any time. Additionally, students will be reminded them that one of the
responsibilities of being a healthcare professional would be to jump into action at the sign of an
emergency. This includes assessing vital signs which includes blood pressure. For further emphasis
of the importance of mastering this skill, the visual of a brain aneurysm rupturing will be viewed
followed by a discussion about how high blood pressure can trigger life threatening emergency
situations.
The teacher will inform the learners of the lesson objectives which revolve around
listing the
major terms associated with blood pressure and stating the normal ranges versus pathologic ranges of
blood pressure. The teacher will then introduce how students will turn this verbal information into
an intellectual terminal objective and that students will be classifying normal versus pathological
blood pressure readings and demonstrating relevance of anatomical and physiological considerations
that affect a patient's blood pressure.
It is important to vocally discuss the critical thinking element of the objective. The teacher will
discuss how critical thinking will allow students to apply their knowledge of anatomy, physiology,
medical terminology and pathology to determine a normal versus pathologic blood pressure
reading. Each student will be expected to apply blood pressure terms such as diastolic and systolic
and how these two numbers are either kept in homeostatic balance or are affected by different
external or intrinsic factors.
The students will be informed about what they already need to know to be successful in this
lesson and the teacher will lead discussion on how this lesson will call upon prior knowledge from
prerequisite courses. This will present a wonderful opportunity to remind students how their
learning is constantly building and how each of the building blocks is dependent upon the next.
The content presentation will include doing an A&P review on the systems that greatly affect
blood pressure and reviewing relevant medical terminology. There will be discussions of the
relevant terms associated with blood pressure and the difference between normal, hyper and
hypotension. Information on common pathologies that affect blood pressure will be presented.
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As the lesson progresses the teacher will constantly challenge students to recall prerequisite
material along with new terms while presenting the information in a way that requires building
intellectual skills. For example, by starting with the verbal skills of anatomy and medical terminology
and applying the intellectual skills of physiology and pathology, a student must build their
understanding.
Learner participation will include giving the learner opportunities for practice through breaking
the learners up into groups to solve case studies that present patients with abnormal blood pressure
ranges. Each case study will be unique and will highlight a common patient blood pressure
scenario. Each group will decipher their case study and present their finding to the group. The
presentations must combine their prior knowledge of anatomy and physiology with the new
information of blood pressure ranges, correct terminology and pathology considerations.
Instructor and peer feedback will be available as the students work to solve their case studies.
However, the purpose of the assignment is to challenge the student's to problem solve, therefore, it
is important instructor feedback involves the concept of scaffolding and is not just giving the
answer. Additionally, to continue class engagement, while each group presents, the rest of the
groups will act as consultants noting any terminology or pathology considerations that may have
been overlooked.
The assessment of this lesson will include tests, checklists, and observations. Students will be
required to take a traditional paper and pencil test to demonstrate their mastery of the verbal
knowledge. The instructor will use a checklist and observations to assess for learning as the students
present their case studies.
All learners will be to keep all guides, handouts and case studies and will be encouraged to
continue practicing with computer based resources. As this lesson will continue to be built upon
during the course, students will be asked to create their own patient scenarios as they move through
the subsequent portions of blood pressure measurement.
The media used during pre-instructional activities include guest speakers, "real" instructor
experiences, videos of an emergency, and visuals of a brain aneurysm. Both PowerPoint and Turning
Point Technology presentations will be used to review the prerequisite relevant anatomy and
physiology and medical terminology. In presenting the content the media used will include the
teacher, PowerPoint presentations, videos, Poll Anywhere, and computer simulations. Learner
participation will be enhanced by using the computer lab, the school library, and handouts that have
been prepared by the teacher.
To support this unit, media selections have been chosen to enhance the student’s understanding
of lesson material through visual aids, practice and active participation. The rationale for the
technology based media selections used in this lesson include the notion that
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Healthcare lessons are often supported by visual aids. In this lesson, PowerPoint’s will include
images that will allow students to see the physical anatomy and the relationship it has to a particular
pathology. Likewise, video examples through the publisher and YouTube will provide visual
explanations of material.
Active participation is highly important and a motivational key for healthcare students. As the
verbal information is being presented technologies such as Turning Point (clickers) and Poll
Anywhere will increase student interaction. Students will also create Google Docs pages where they
can see and share information and considerations about their case studies. All media selected is free
and available to the students at the college.
The chosen media matches the instructional strategy and supports student learning because the
majority of the media will increase motivation and student interaction. By nature, healthcare students
tend to enjoy learning strategies that incorporate interaction and realistic clinical situations.
Lesson 2:
The second lesson in this unit focuses on the equipment that is used in taking a manual blood
pressure. The goal for this lesson states that given a sample of medical equipment, student will be
able to identify and select proper blood pressure measuring equipment for any given patient.
The pre-instructional activities and media selection for this lesson include engaging learners by
having them view a video on manual blood pressure. Students will be shown a display of the
equipment used in taking a manual blood pressure. The teacher will discuss blood pressure and why
it is important in providing healthcare while also describing the goal of the lesson.
The content presentation includes the identification of a stethoscope, blood pressure cuff, and
sphygmomanometer. The teacher will distribute a handout that describes and illustrates each piece of
equipment used in taking a manual blood pressure. This handout is a copy of a PowerPoint
presentation that will be shared with the learners. Additionally, students will receive a handout that
lists the essential questions of the lesson.
Learner participation will ensue with the viewing of a PowerPoint presentation that deals with
identifying blood pressure measuring equipment. Students will use measuring tapes and a variety of
blood pressure cuffs in order to identify the different sizes of cuffs that are available. Students will
use a measuring tape to calculate the arm circumference of five student volunteers who range in
size. The teacher will assist students in choosing the correct sized cuff for each volunteer.
The assessment for this lesson will be conducted using observation by the teacher. Observation
will be used to determine student ability to choose the correct size blood pressure cuff for a given
patient. Further, observation will be used to determine student ability to identify a stethoscope, blood
pressure cuff, and sphygmomanometer
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Follow through activities will be conducted that will allow students to enhance their learning.
Students will keep the handouts for reference and they will be asked to demonstrate proficiency of
the lesson goal once a month for the duration of the program. As they progress through the
program, students will present the information from the lesson to new students.
The media selection for this lesson includes the use of a video, a variety of medical equipment
including blood pressure cuffs, a PowerPoint presentation, and handouts of the essential questions of
the lesson and the PowerPoint presentation. The video is used to engage students in the lesson while
providing basic information about the content. As the equipment used in taking a manual blood
pressure is a critical component in the lesson, students will be presented with examples of blood
pressure cuffs, stethoscopes, and sphygmomanometers. A PowerPoint presentation will be used to
identify the equipment and the individual components of each piece of equipment.
Lesson 3:
The third lesson of the Blood Pressure unit is titled “Measuring Blood Pressure”. The
instructional objective for this lesson is that students will be able to execute the proper skills in
obtaining a correct blood pressure reading within two degrees of accuracy. The pre-instructional
activities consist of explaining the lesson objective and gaining the students’ attention by discussing
the importance of all healthcare professionals having a level of mastery over basic skills such as
taking a blood pressure reading.
Next the content for the lesson is presented. This consists of the students first navigating
through a Captivate module that demonstrates the entire process of obtaining an accurate blood
pressure reading, followed by a live demonstration from the instructor utilizing blood pressure
equipment to take an accurate blood pressure reading. After the content delivery portion of the
lesson, the students are given the opportunity to practice taking each other’s blood pressure with the
instructor providing close scaffolding and explicit feedback to make sure students understand exactly
where they need improvement.
Assessment consists of a posttest covering the major items related to the lesson objective, and
a skills checklist which is used to grade the students as they take each other’s blood pressure. These
items are returned to the students at the end of the lesson with written feedback. To conclude the
lesson the instructor reminds the students that the Captivate module is available online and can be
used at any time for reinforcement of the lesson concepts.
There are three main instructional mediums used in this lesson. The first is an instructional
captivate module detailing the entire process of accurately taking a blood pressure reading, the
second is the blood pressure equipment itself, and the third is a human instructor. Learning the
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procedure for taking blood pressure requires a large number of steps and the instructional video will
provide opportunity to pause and replay the module if necessary, and also has the advantage of being
able to use close up animations and precise written instructions. The blood pressure equipment is
crucial to the instructional process for demonstrating how to take a blood pressure reading and will
also be necessary during the student participation and assessment. Finally, the human instructor
provides the advantage of real time scaffolding and corrective feedback.
The Instructional Strategy Planning Sheet fully outlines this lesson design. (Appendix K) The
complete Captivate module can be found in the following link:
http://ldtgrad.com/Blood_Pressure_A/Blood_Pressure_SWF_Newest.swf
Lesson 4:
This lesson has a terminal objective of identifying and correcting common mistakes in blood
pressure measurement, with an attitudinal sub-objective of the student choosing to make corrections
in erroneous blood pressure measurements. As an entry skill, the student will need to be able to
identify unexpected blood pressure ranges.
Taking a correct blood pressure reading is a necessary and critical skill that spans across the health
profession. It is critical not only as a basic health indicator, but is also used in emergency situations to
assess vitals before any medical action is taken. It is a ubiquitous assessment that is used in very
common situations, such as a trip to the doctor or when you give blood.
The instructor will start with an informal activity: list all the situations that you can think of that
would require you to take an accurate manual blood pressure. Students can form groups if they
prefer, or just raise hands. The instructor will consolidate all the lists and discuss the wide variety of
settings in which you might be required to take a blood pressure measurement.
The instructor will then present a brief case study that involves a situation where the blood
pressure was taken incorrectly and how this may have affected the diagnosis. A subsequent
discussion should include consequences of overtreatment or under treatment that may occur because
of an incorrect reading, or consistent incorrect readings.
The instructor will then show a short animation or video that shows the correct way to take blood
pressure. The content presentation will consist of the class breaking into groups. Each group will be
given a scenario that intentionally includes incorrect instruction on how to take a blood pressure. The
groups will act out the scenario and the remainder of the class will respond with what that group did
wrong and if the outcome would have erred on the low or high end. The class discussion afterword
will include information about any other situations the students may have encountered on a personal
basis where the blood pressure was taken incorrectly.
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An in depth case study will be given to each group. They will need to identify what they think was
done incorrectly and how that would change the outcome or diagnosis of the situation.
Learner participation will happen throughout the class, beginning with the in-class discussion
during the pre-instructional activities and continuing during the content presentation with group
work.
Assessment will happen informally through the instructor scaffolding while the group work takes
place. A formal assessment would consist of case studies and short answer questions, and could also
include an individual blood pressure assessment the teacher will watch and evaluate.
The students will be asked to teach someone outside of class how to take a blood pressure.
This can be done with a friend, relative or anyone who does not have prior experience with it. They
will need to record their experience – this exercise should bring to light some common errors in
taking a manual blood pressure. They can discuss any findings in class.
Most of the media is very low tech, since much of the content revolves around the action of
taking a blood pressure and case studies. Group work will be supported with documentation from a
binder. There will be a video or short animation, so that the details of the procedure can be
presented in an alternate way.
The instructor will consolidate group answers onto a large format board of some sort (white
board, presentation paper tablet, etc.) There will be a short video or animation so that the details of
the correct procedure can be seen. Each group will have their own resource binder. At the end of the
class, the students will receive a pdf of an illustrated reference for taking blood pressure correctly.
FORMATIVE EVALUATION PLAN
A four part formative evaluation was planned for the third lesson ‘Measuring Blood Pressure”.
(Appendix G)
Subject Matter Expert Review
The first evaluation will be done by a subject matter expert (SME) from Gwinnett Technical
College. The SME will evaluate the lesson on three levels: the content, the technical accuracy, and
the quality of the instruction. The content review will make sure that no mistakes were made in the
materials and instruction provided to the learners regarding the execution of skills related to taking
blood pressure. The technical accuracy review will help determine if any mistakes were made in the
creation of the captivate module (misspelled words, incorrectly cropped photographs, etc). Finally,
the quality of instruction review will indicate if the expert believes the instruction is effective and
congruent with the learning objectives. The SME review will be completed prior to the one-on-one
evaluations, small group evaluations, and the field test, and should be scheduled as soon as a solid
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draft of the instruction is completed and the expert is available. The SME will be given a checklist in
order to document the review, particularly in terms of clarity of the instruction and relevance of the
material to the learner, and follow up interviews will be conducted to gain further information about
the instruction.
One-to-One Evaluation
For the One-to-One evaluation, sample learners will be selected to evaluate the instruction. They
will include one expert (already in field using skill), intermediate (previously exposed to instruction
but not a professional yet), and beginner (in a healthcare track but has not completed any formal
blood pressure instruction to this point). This evaluation will be scheduled as soon as the expert
review has been completed. The designer will work with each learner as they complete the
instruction, making notes, and marking areas in the instruction that cause confusion for the
learner. In addition, a post instruction interview will be conducted with each learner to gather as
much information as possible regarding the clarity and learn ability of the instruction.
Small Group Evaluation
A small group of three learners from the target audience (ALHS 1040 course) will evaluate the
learnability of the instruction. The session will take place in the learning context (Gwinnett Tech
Health Sciences building) and will be scheduled with the three learners at their earliest availability
once a prototype of the instruction is created. Multiple methods will be used to gather information:
1) Multiple choice posttest administered after the content presentation and learner participation
sections are completed.
2) Skills checklist used to grade learners as they take each other’s blood pressure.
3) An attitude questionnaire will be used to gather learner perception of strengths and
weaknesses in the instruction.
4) Designer observation of learners throughout the lesson.
Field Trial
The Field Trial will consist of a group of twenty to thirty individuals. These will be actual learners
from Gwinnett Tech who will use the instruction once it is completed, and the trial will take place in
the specific learning context where the finalized instruction will be delivered. This level of the
formative evaluation will occur once changes have been made to the instruction following the small
group trial. Multiple procedures and instruments will be used to gather information including
multiple choice assessments, checklists used by the instructional designer to determine if the
instruction can be used in the context for which it was intended, and post instruction interviews with
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learners. These interviews will primarily focus on environmental factors that may be critical to the
success of the instruction.
FORMATIVE EVALUATION
The small group evaluation of the “Measuring Blood Pressure” lesson was conducted in the
Health Sciences building at Gwinnett Technical College with three students from the target group of
the ALHS 1040 course. The learners included low, average, and high achieving students. The
session began with the Evaluator explaining that the instruction was in the development process and
the information and data collected would be used to help improve the instruction. The lesson was
then administered by the instructor using the instructional strategy developed earlier in the design
process. The instructor first introduced the lesson with information intended to gain the learners
attention. The learners then navigated through an online Captivate module which demonstrated the
entire process of obtaining an accurate blood pressure reading, and watched as the instructor
demonstrated the same process at the front of the room. Next the learners were given the
opportunity to practice taking each other’s blood pressure while the instructor observed and offered
feedback. After this, the instructor administered a posttest covering the objective and main
subordinate skills of the lesson. Then the learners once again took each other’s blood pressure, this
time with the instructor using a checklist to assess their ability to perform the subordinate skills and
lesson objective. Finally, the instructor concluded the lesson and the Evaluator administered an
attitude questionnaire to the learners. Excluding the time taken to complete the questionnaire, the
learners completed the lesson in approximately one hour.
Posttest Assessment (Appendix H)
The following table shows how well each student performed on the posttest for the lesson:
Posttest Score
Items Correct
Student 1
100%
5/5
Student 2
100%
5/5
Student 3
100%
5/5
The results of the posttest indicate the students learned from the instruction. Each learner
correctly answered all test items after completing the instructional module, viewing the live
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demonstration, and practicing the skill themselves. It’s possible that future evaluations could benefit
from the addition of a pretest to compare with posttest scores and determine if learners had
previously mastered any skills included in the instruction. Before administering the posttest, the
instructor asked the learners to add a written comment if anything was unclear or problematic during
the assessment. Two of the three students wrote remarks about having some difficulty with language
used on the assessment, particularly the word ‘execute’. This issue was a recurring theme on the
assessment and questionnaire, and after further analysis it was determined that some of the language
used in the performance objectives was being integrated into the instruction unnecessarily and
causing confusion for the learners. This will be discussed further in the revision sub-section.
Blood Pressure Skills Checklist (Appendix I)
The following table shows how many attempts it took each student to complete every step of the
blood pressure skills checklist without making any mistakes:
One Attempt
Student 1
Student 2
X
X
Two Attempts
Student 3
X
Three Attempts
The results from the skills checklist indicate that learning occurred. Two of the students
completed every step required to successfully measure blood pressure on the first try, and the other
student successfully completed the process on the second try. The checklist was designed to be
congruent with the lesson objectives and contains every subordinate skill required to accurately
measure blood pressure. Because the checklist requires learners to physically demonstrate their
ability to accurately measure blood pressure, it holds a strong congruence with the lesson objective
and serves as a useful assessment instrument.
Attitude Questionnaire (Appendix J)
A questionnaire was administered to obtain learner reactions and identify strengths and
weaknesses in the instruction. The learner reactions were mostly positive with all three responding
‘Yes’ to the question “Did you feel confident when you were taking your classmates blood pressure
for a grade at the end of the class?” Also, on the question “On a scale of 1 to 5 with 1 being the
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lowest and 5 being the highest, how confident do you feel that the lesson allowed you to meet the
objective of being able to obtain a blood pressure reading within 2 degrees of accuracy?”, two
learners responded with a “4” and one responded with a “5”. The primary weakness indicated from
the questionnaire responses was a level of discomfort with some of the vocabulary used in the
instruction, particularly with the words “execute” and “generate”. As discussed above it was
determined that some of the phrasing used in the construction of performance objectives and
subordinate skills was causing problems for learners during the lesson. (Appendix J)
Recommendations for Revisions
Based on the results of the posttest, skills checklist, questionnaire, and Evaluator observation
throughout the session there are several revisions that should be considered.
1. In an attempt to keep the instruction and assessment instruments congruent with the learning
objectives, some of the language related to the lesson objective and subordinate skills was lifted
directly from the instructional curriculum map and used in the construction of the instructional
module and the posttest. Although this language serves an important purpose to the designers as
they complete a goal analysis and develop objectives, it seems awkward and unnecessary to the
learners when integrated directly into the instructional materials. For example, instead of starting a
multiple choice assessment item by saying “You should execute initial inflation of the blood pressure
cuff while palpating the….” The item should simply say “You should initially inflate the blood
pressure cuff while palpating the…..” We recommend revising the instructional materials to remove
any unnecessary and awkward language before the field trial takes place.
2. We recommend using a pretest to gain a better understanding of learner’s entry skills and have a
comparison with posttest scores
3. Through observation, the Evaluator noticed that several of the learners seemed slightly confused
by the Captivate module at first, but after observing the live demonstration and having an
opportunity to practice the skills, they remarked that the module made more sense and would be
great as a study aid going forward. We recommend further analysis to determine if the instructional
Captivate module might be better placed at a later stage in the instructional strategy, used as a kind of
‘just-in-time’ instructional aid during the practice segment, or revised to fit more appropriately as
introductory material.
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4. One important recommendation related to the learning context; although the online captivate
module was tested offsite from multiple computers and worked without problem, the computers the
learners were using in the Health Sciences building at Gwinnett Tech could not access the
module. Fortunately, we were prepared with a stand-alone version of the content on a usb drive, but
we recommend researching possible internet connectivity or firewall issues before the field trial takes
place.
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APPENDIX A:
State Standards for the ALHS Introduction to Healthcare Course
State Standards for the ALHS Introduction to Healthcare Course
ALHS 1040 - Introduction to Health Care (version 201003L)
Course Description
Introduces a grouping of fundamental principles, practices, and issues common in the health care
profession. In addition to the essential skills, students explore various delivery systems and related
issues. Topics include: basic life support/CPR, basic emergency care/first aid and triage, vital signs,
infection control/blood and air-borne pathogens.
Competencies
1 Infection control/blood and air-borne pathogens 375 0 562 0 0 937
2 Vital signs 375 0 563 0 0 938
3 Basic emergency care/first aid and triage 375 0 562 0 0 937
4 Basic life support/CPR 375 0 563 0 0 938
Learning Outcomes









Infection control/blood and air-borne pathogens
Differentiate the roles, standards and guidelines for the following agencies: Center for
Disease Control and Prevention (CDC); Occupational Health and Safety Administration
(OSHA); and Federal Drug Administration (FDA).
Describe the characteristics of each link of the infection chain.
Define blood/air-borne pathogens.
Identify exposure risks related to health occupations.
Demonstrate pre and post exposure precautions to include hand washing, gloving
(sterile/nonsterile, Personal Protective Equipment (PPE)
Describe causative agent, symptoms, occurrence, reservoir, mode of transmission,
incubation period, period of communicability, prevention and control measures of the
following diseases: Human Immunodeficiency Virus/Acquired Immunodeficiency
Syndrome, all types of Hepatitis (A,B,C,), Tuberculosis, Meningitis, antibiotic resistant
microbes and Herpes Viruses.
Differentiate forms of immunity.
Vital signs



Demonstrate proficiency in obtaining and documenting blood pressure, temperature, pulse,
respiration, weight and height.
Describe factors that affect vital signs including normal and abnormal values.
Basic emergency care/first aid and triage
A course from an accredited agency (American Safety and Health Institute, American Heart
Association, American Red Cross) leading to certification in First Aid is acceptable in lieu of the
following recommended outline.
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Basic emergency care/first aid and triage
 Perform initial assessment.
 Demonstrate various techniques for control of bleeding.
 Describe first aid for various types of shock.
 Apply bandages and splints.
 Describe assessment and treatment of burns, poisoning, seizures, insect stings/bites, heat
and cold exposure, syncope.
Basic life support/CPR
Acquire certification in CPR for Healthcare Providers (including 2 person CPR) by a certified
instructor from American Heart Association or American Red Cross (or) CPR-PRO For the
Professional Rescuer from the American Health and Safety Institute.
Retrieved from
https://kms3.dtae.org/adminscripts/ctredirector.dll?@_DOC_LOADhttps://kms.tcsg.edu/cd/crs/
CrsDisplay.aspx?crsid=1259@_PDF
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APPENDIX B: BLOOD PRESSURE SURVEY
1. How well do you understand the risk factors that affect blood pressure?
I can list and describe all risk factors
I only know a couple of risk factors
I do not remember the risk factors
I was not taught the risk factors
2. Do you feel confident in your ability to take an accurate blood pressure measurement?
I was not taught how to take an accurate blood pressure.
I don't feel I could take an accurate blood pressure.
I feel I could take an accurate blood pressure on a healthy person.
I feel very comfortable in taking an accurate blood pressure on anyone.
3. Please rate the ability of your instructor in covering the skills required to take an
accurate blood pressure.
My instructor did not cover the skills required to measure blood pressure.
I feel my instructor did not appropriately cover the skills required to take an accurate blood
pressure.
I feel my instructor somewhat covered the skills required to take an accurate blood
pressure.
I feel my instructor thoroughly covered the skills required to take an accurate blood
pressure.
4. Please rate the instructional materials given on blood pressure measurement.
PPTs,Videos, Worksheets, etc)
I did not receive any materials.
I did not learn from any materials used to support my learning of the Blood Pressure
Unit.
I received decent supportive materials to support my learning of the Blood Pressure Unit.
I received excellent supportive materials that enhanced my understanding of the Blood
Pressure Unit.
5. Please rate your Blood Pressure Assessment practice opportunities.
I did not receive any practice opportunities
I received inadequate practice opportunities
I received moderate practice opportunities
I received ample practice opportunities
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4 LETTER WORD FINAL REPORT | EDIT 6170
6. Please rate instructor or assistant feedback when learning the skills of measuring
blood pressure.
I did not receive any feedback.
I received little or non-helpful feedback
I received moderately helpful feedback
I received highly constructive feedback
7. Please rate you Blood Pressure Check-Off Assessment
I felt both the assessment and rubric (standard of performance) were not appropriate.
I felt the rubric (performance standard) was unclear.
I felt the assessment was unfair.
I felt that the blood pressure assessment and rubric (standard of performance)
were appropriate for the Unit.
8. Please describe how the instruction for the Blood Pressure Unit can be improved.
9. Please describe how the materials used in the Blood Pressure Unit can be improved.
10. Please describe how the Check-Off Assessment for Blood Pressure can be improved.
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4 LETTER WORD FINAL REPORT | EDIT 6170
APPENDIX C: BLOOD PRESSURE SURVEY RESULTS
http://www.surveymonkey.com/MySurvey_Responses.aspx?sm=VZD2OyHHQM47bTyUV04YaS
5z6vEGRtuI%2bzZbLVC3OFw%3d
To access the results, please enter:
User Name:
fley44
Password:
jordan44
Blood Pressure Survey
1. How well do you understand the risk factors that affect blood pressure?
I can list and describe all risk factors
I only know a couple of risk factors
I do not remember the risk factors
I was not taught the risk factors
Rating Ave.
Responses
46.8% (29)
46.8% (29)
1.6% (1)
4.8% (3)
3.35
62
2. Do you feel confident in your ability to take an accurate blood pressure measurement?
I was not taught how to take an accurate blood pressure.
8.1% (5)
I don't feel I could take an accurate blood pressure.
12.9% (8)
I feel I could take an accurate blood pressure on a healthy person.
27.4% (17)
I feel very comfortable in taking an accurate blood pressure on anyone.
51.6% (32)
Rating Ave.
3.23
Responses
62
3. Please rate the ability of your instructor in covering the skills required to take an accurate
blood pressure.
My instructor did not cover the skills required to measure blood pressure.
4.8% (3)
I feel my instructor did not appropriately cover the skills required to take
11.3% (7)
an accurate blood pressure.
I feel my instructor somewhat covered the skills required to take an
25.8% (16)
accurate blood pressure.
I feel my instructor thoroughly covered the skills required to take an
58.1% (36)
accurate blood pressure.
Rating Ave.
3.37
Responses
62
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4 LETTER WORD FINAL REPORT | EDIT 6170
4. Please rate the instructional materials given on blood pressure measurement.
(PPTs, Videos, Worksheets, etc)
I did not receive any materials.
8.1% (5)
I did not learn from any materials used to support my learning of the Blood
Pressure Unit.
11.3% (7)
I received decent supportive materials to support my learning of the Blood 43.5% (27)
Pressure Unit.
I received excellent supportive materials that enhanced my understanding
37.1% (23)
of the Blood Pressure Unit.
Rating Ave.
3.10
Responses
62
5. Please rate your Blood Pressure Assessment practice opportunities.
I did not receive any practice opportunities
I received inadequate practice opportunities
I received moderate practice opportunities
I received ample practice opportunities
Rating Ave.
Responses
0.0% (0)
21.0% (13)
35.5% (22)
43.5% (27)
3.23
62
6. Please rate instructor or assistant feedback when learning the skills of measuring
blood pressure.
I did not receive any feedback.
4.8% (3)
I received little or non-helpful feedback
17.7% (11)
I received moderately helpful feedback
38.7% (24)
I received highly constructive feedback
38.7% (24)
Rating Ave.
3.11
Responses
62
7. Please rate you Blood Pressure Check-Off Assessment
I felt both the assessment and rubric (standard of performance)
were not appropriate.
I felt the rubric (performance standard) was unclear.
I felt the assessment was unfair.
I felt that the blood pressure assessment and rubric (standard of
performance) were appropriate for the Unit.
Rating Ave.
Responses
1.6% (1)
11.3% (7)
8.1% (5)
79.0% (49)
3.65
62
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4 LETTER WORD FINAL REPORT | EDIT 6170
8. Please describe how the instruction for the Blood Pressure Unit can be improved.
Responses: 42
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
By providing more lab hours for practice and good instructors who are willing to teach by
providing instructional materials such as PPTs, Worksheets and so on...
I wish that the teacher could take a real persons BP, then let the student take it to compare.
The "arm" is wonderful, but it’s so easy to hear. When I do it on my classmates its hard to
hear because I’m listening for the should like in the arm machine.
the instruction is ok. but the material does not reflect the equipments in the lab. eg. height
and weight is in 1/8. but instruction material is in 1/4.
Have more time to practice.
One on one instruction, or small group instruction would have been so helpful, instead my
class was so nervous about failing the check off. I feel that we just needed to be watched to
see how we were doing, take that info & keep on practicing.
she call actually go around and tell everyone if they are doing it right or wrong. every time we
ask a question she would not answer it or she would tell us to figure it out on our own. She
showed us a video instead of showing us how to preform herself.
Experience on taking blood pressure on an ill person or a person that has an unusual BP
condition
n/a
more demonstration
The instructions were very clear and anyone could understand.
Na
more material.
The instructor should give a little more time to practice before the assessment.
None. Ms. Laurent was fabulous!
Someone who takes blood pressure all the time could teach it
More hands on instruction
by letting the student practice on each other
Spend a little more time in it. It was very rushed
More involvement hands on
I think more one-on-one help would be helpful (such as signing up for block of time maybe
just 20 minutes). In addition, there needs to be more communication between instructors so
that students can make sure appropriate steps to take blood pressure and document
properly. I felt that instructors were not on the same page, if you will, as far as the steps
involved in taking blood pressure.
By the instructor demonstrating in class on others.
It should be practiced in a quieter environment.
Needs No Improvement
It's appropriate
More organized teacher with more experience in teaching.
I do not believe the instructor I had is here anymore, however, she could of been much
more informative from a "real world" stand point and gotten away from finding the baseline.
She focused more on baseline then the actual blood pressure.
Provide students with practice equipment that they can take home to practice on.
Good
I feel that there should be more practice time allowed
I feel it can be improved by having it shown, heard and doing it on a LIVE person.
The instructors should be more helpful in showing us exactly how to do it rather than to just
explain it in using worksheets.
Can be explained and taught more in depth for us to understand the different ranges
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4 LETTER WORD FINAL REPORT | EDIT 6170
o
o
o
o
o
o
o
o
o
o
The time to learn could be extended and one on one time would be helpful in learning such
a skill.
Show how and where we can hear the pulse. Walk around making sure people are hearing
the correct numbers.
It's great the way it is
It is exceptional.
I believe we had one day to practice and run through the process in class. Something as
important as bp should be given an ample amount of time to ensure students can take an
accurate reading. It could be someone's life at risk.
I felt the instruction I received along with my classmates was very thorough. The instructor
of my Intro to Healthcare course was very helpful and concerned with making sure each
student completely understood the competencies. She would take ample time to help any
student on a one on one basis if needed. She cared deeply for the success of her students.
each student need to be able to take a B/P with the dual stethoscope with the instructor to
verity outcomes
I think more practice should be given on blood pressure.
I feel like there is much need for improved one on one time. My instructor was too busy
and too stressed to check on every individual's progress during the one open lab we had.
Ms. Laurent is AWESOME! She gave us things that were not in our book or notes. I have
no complaints.
9. Please describe how the materials used in the Blood Pressure Unit can be improved.
Responses: 44
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
INSTRUCTORS MUST MAKE SURE MATERIALS ARE WORKING PROPERLY
PRIOR TO TESTINGS
so far the materials are ok
They were just fine.
I do not remember what material we had to help except for the book.
see question 8
It would have been nice to have more Mr. Arms to work with or the chance to do BP on a
classmate while the instructor or another classmate was listening to see if we got the same
reading. It may have been helpful to go into more detail on the actual risk factors so we can
use it in our everyday life like which foods to eat.
n/a
everything seems fine
Na
better stethoscopes--hard to hear. borrowed some from a physician.100% better.
na.
more practice. Not everyone can catch on easy. I heard many complaints
There was enough material so I do not have any suggestions.
None
The materials could be available for rent and/or more use on campus
More time should be spent in that section
by adding more equipments for the students
More hands on teaching
more pertinent hands on materials
I think there needs to be more dual stethoscopes so not only instructors can listen, but peers
as well. I believe that students can also learn from each other to an extent, such as those who
may be more skilled than others. There also needs to be some common ground, as I said
before, as to how we are instructed to take blood pressure.
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4 LETTER WORD FINAL REPORT | EDIT 6170
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
I feel the fake arm is not very suitable for taking blood pressure. I was very difficult trying to
find a pulse and at time the arm would cut off.
No need to improve
Equipment is up to par
make them more accessible for those who were unable to purchase their own
It's appropriate
enough materials for everyone in class. Lab use.
They were slightly dated and but overall good enough for learning purposes.
Good
I think the stethoscopes were a little outdated but, still effective
I feel it was pretty much done and described very well.
Better stethoscopes that can help us here the pulse better.
not sure if any of the materials have been calibrated. of course I didn’t know what that
meant until I got into my program.
Actually provide materials.
more Mr. Arms to practice on.
I liked all the materials
They are highly adequate.
BP cuffs should be correct size, better quality stethoscopes.
The materials utilized were great!
The material needs to be more clear and relate the information to improve understanding
more videos on how to do blood pressure
I don't remember receiving materials on blood pressure.
I think the materials (PPT, lectures, the book) were adequate.
Maybe add how many points would be deducted on the practice sheets. So we know ahead
of time.
ppt, video and workshop
10. Please describe how the Check-Off Assessment for Blood Pressure can be improved.
Responses: 38
o
o
o
o
o
o
o
o
o
o
PROVIDE A LAB FOR STUDENT TO PRACTICE W "CREDIBLE AND GOOD
INSTRUCTOR WILLING TO TEACH THE CLASS WELL.
Especially on check off, a student should have option of using two students. especially when
in doubt with finding the brachial pulse. because, some people pulse are really very feint, it
makes it heard to hear it.
it was just fine
We needed more time to practice with an instructor watching us and giving feedback, open
lab was great, but only lasted for three days right before check offs. That was not enough
time, my classmates & myself did not feel so confident until Mrs. Laurant helped us during
an open lab for about 6hrs, that is how I gained my confidence enough to pass the check
off. Without her help I do not know if I could have passed the bp check-off.
I felt that it was a good experience to use Mr. Arm; we got a chance to practice ahead of
time and were able to use the skills we were taught to take Mr. Arm's BP. If there were more
dual stethoscopes it might have been nice to take a classmates BP.
n/a
haven’t yet taken it
na
organization.scheduled check-off time and was seen 3 hrs later.
Na
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4 LETTER WORD FINAL REPORT | EDIT 6170
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Instructor should make sure everyone is clear before starting
The instructor should give a littler more time in between students.
None
The check- off went really smooth
by given the students more time to practice
Instructor needs to become more involved
In my opinion, it was fair for everyone.
By taking blood pressure on better equipment or on a real arms
No need to improve
No improvement needed
It's great
Have more practice time. More than one check off to pass.
I had to listen (with the instructor) to someone's blood pressure, tell her what is was and she
said if I was right or wrong.
Good
I think that we should not check BP on the dummy. Humans only with double stethoscope
This can be improved by doing it on a LIVE person with an instructor also being able to
hear it as well. The 'arm' was unreal like and it had problems as well.
The instructors when performing check offs should perform it in a quiet place away from
classmates to prevent the noise from interfering.
needs to be taken more seriously. I was told from an M.A student at the time to just forget
what I learned because I will be taught better when I make it into the M.A. program. I hope
this helps!
This depends on the instructor.
It's good
The Assessment is great.
Instructors need to focus on the student who is checking off. Maybe limit the number of
people in the room at the time of check off. This will help the student focus and the
instructor to provide detailed feedback.
I have no complaints on how the check-off was performed in my class.
If you are going to check-off on the dummy arm you should be able to practice on it and
there needs to be less noise in the room
I remember feeling very unprepared to check off and felt I had not really learned how to do
it.
I feel it is already fair.
It wasn't a problem for me, but the instructor should either add more time or at least stick to
the time allowed. Also they need more help during checkoffs. people kept going over.
check three more times
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4 LETTER WORD FINAL REPORT | EDIT 6170
APPENDIX D: COURSE LEVEL ICM
(Please click on image to access it on the website)
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4 LETTER WORD FINAL REPORT | EDIT 6170
APPENDIX E: UNIT LEVEL ICM
(Please click on image to access it on the website)
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APPENDIX F: BLOOD PRESSURE CAPTIVATE MODULE
This module can be found online at:
http://ldtgrad.com/Blood_Pressure_A/Blood_Pressure_SWF_Newest.swf
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4 LETTER WORD FINAL REPORT | EDIT 6170
APPENDIX G: FORMATIVE EVALUATION PLAN
Formative Evaluation Plan
Lesson Objective: SWBAT execute the proper skills in obtaining a correct blood pressure reading
within two degrees of accuracy.
Who
What
When
How
Experts
Will have an expert from Gwinnett Technical College review the lesson on three levels
1. Content
2. Technical Accuracy
3. Quality of Instruction
The content review will make sure that no mistakes were made in the materials and
instruction provided to the learners regarding the execution of skills related to taking
blood pressure. The technical accuracy review will allow us to know if we made any
mistakes in the creation of the captivate module (misspelled words, incorrectly cropped
photographs etc). Finally, the quality of instruction review will let us know if the experts
believe the instruction is effective and congruent with the learning objectives.
Will be completed prior to one-on-one evaluations, small group evaluations, and the field
test. Should be scheduled as soon as a solid draft of the instruction is completed and the
expert is available.
The SME will be given a checklist in order to document the review, particularly in terms
of clarity of the instruction and relevance of the material to the learner, and follow up
interviews will be conducted to gain further information about the instruction.
Who
Learners: one-one one
What
Sample learners will be selected to evaluate the instruction. They will include one expert
(already in field using skill), intermediate (previously exposed to instruction but not a
professional yet), and beginner (in a healthcare track but has not completed any formal
blood pressure instruction to this point).
When
Will be scheduled as soon as the expert review has been completed
Multiple methods will be used to gather information
How
1. M/C assessment administered after the content presentation and learner
participation sections are completed.
2. Check-list Rubric used to grade learners as they take each other’s blood pressure.
3. An attitude questionnaire will be used to gather learner perception of strengths and
weaknesses in the instruction
4. Evaluator observation
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4 LETTER WORD FINAL REPORT | EDIT 6170
Who
What
When
How
Learners: small group
A small group of three learners from the target audience (ALHS 1040) will evaluate the
learnability of the instruction.
The small group session will take place in the learning context and will be scheduled with
the three learners at their earliest availability once the prototype of the instruction is
created.
The designer will work with each learner as they complete the instruction, making notes,
and marking areas in the instruction that cause confusion for the learner. A post
instruction interview will also be conducted with each learner to gather as much
information as possible regarding the clarity and learnability of the instruction
Who
Learners: field test
What
A larger group of twenty to thirty individuals. These will be actual learners from Gwinnett
Tech who will use the instruction once it is completed
When
The field test will occur once changes have been made to the instruction following the
small group trial.
How
Multiple procedures and instruments will be used to gather information including multiple
choice assessments, checklists used by the instructional designer to determine if the
instruction can be used in the context for which it was intended, and post instruction
interviews with learners that primarily focus on environmental factors that may be critical
to the success of the instruction.
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APPENDIX H: BLOOD PRESSURE POSTTEST
1. You should execute the initial inflation of the blood pressure cuff while palpating thea) brachial pulse
b) radial pulse
c) carotid pulse
2. After recording the first entry for systolic pressure, you should execute reinflation of the cuff toa) 20-30 mmHg above recorded pressure
b) 30-40 mmHg above recorded pressure
c) 50-60 mmHg above recorded pressure
3. After slowly releasing the pressure via the pressure knob, you should note the level of the first
auditory pulse as the
a) diastolic pressure
b) systolic pressure
4. During the release of pressure, after noting the first auditory pulse, you should note the level at
which all auditory pulse disappears as
a) diastolic pressure
b) systolic pressure
5. True or False:
The execution of a medical hand wash is necessary after taking a patient’s blood pressure
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APPENDIX I
PROCEDURE #4 Measuring Blood Pressure
Student _____________________________________
Equipment and Supplies: Stethoscope, sphygmomanometer, pen, paper
Time for Completion: 3 minutes
Completed
Satisfactorily
on Attempt #
1
2
3
Steps in Procedure
Observe Standard Precautions
1. Execute inflation of blood pressure cuff while palpating the brachial pulse
(3.12)
2. Note loss of the auditory pulse as the systolic pressure (3.11)
3. Execute the deflation of the cuff (3.10)
5. Execute the first recording of the two step method of blood pressure
measurement (3.9)
5. Determine auditory sound of brachial pulse through a stethoscope (3.8)
6. Execute reinflation of cuff to 20-30 mmHg above recorded pressure. (3.7)
7. Execute the slow release of pressure via the pressure knob (3.6.)
8. Note the first auditory pulse as the systolic pressure (3.5.)
9. Note the loss of auditory pulse as diastolic pressure (3.4)
10. Execute the deflation of the cuff (3.3)
11. Execute a medical hand wash (3.2)
12. Generate a recording of a blood pressure readings (3.1)
13. Terminal Objective- execute the proper skills in obtaining a correct
blood pressure reading within 2 degrees of accuracy (3.1)
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APPENDIX J: ATTITUDE QUESTIONNAIRE
Was the instruction
interesting?
Did you understand what you
were supposed to learn?
Were the materials directly
related to the objective?
Do you feel like the online
module provided appropriate
introductory content on how to
take a blood pressure reading?
Student 1
It was interesting to do it on
ourselves so that we can see what
our own blood pressure is.
Confusing at first but after
getting to practice it, I
understood it.
Student 2
Student 3
Yes
Yes
Yes
Yes. Video and
visual instruction
helped
Yes they were
Yes. Very detailed
and step by step
Yes; only the wording was a little
confusing.
Yes, however the
wording was a little
confusing
Yes
Were sufficient practice
exercises included?
Yes, my favorite was knowing
my own blood pressure
Yes, once I got to do
hands on, I felt more
confident
Yes
Were the practice exercises
relevant?
Yes, a little confusing to practice
it at first but after doing it a
couple of times it was easier
Did the multiple choice quiz
really measure your knowledge
of the lesson objective?
Did the examination where you
were asked to take your
classmates blood pressure for a
grade really measure your
knowledge of the objective?
Did you receive sufficient
feedback on your practice
exercises?
Did you feel confident when
you were taking your
classmates blood pressure for a
grade at the end of the class?
On a scale of 1 to 5 with 1
being the lowest and 5 being
the highest, how confident do
you feel that the lesson allowed
you to meet the objective of
being able to obtain a blood
pressure reading within 2
degrees of accuracy?
Do you have any other
comments or concerns related
to the lesson?
Yes
Yes
Yes. Very step by
step, hands on
learning
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes. I got as much
practice as I needed
to get a more
accurate
measurement
Yes
At the end, yes
Yes
Yes
4
4
5
No, Yall were great!
Just make the
wording on the
module more
relatable. Other than
that, great
presentation!
Pictures were
amazing.
I would not have
them put thumb
on hole in
module
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APPENDIX K: INSTRUCTIONAL STRATEGY PLANNING SHEET FOR LESSON 3
Instructional
Component
Instructional Plan for Each Component
Media Choice
(Flash, HTML,
etc.)
1. Pre-instructional
activities
a) Motivating the
learners/gaining their
attention
b) Informing the
learners of the lesson
objectives or purposes
c) Informing the learner
of what they already
need to know to be
successful in this lesson
(i.e. prerequisite skills)
1. Pre-instructional activities
Pre-instructional
1a. Begin by again impressing upon the students the activities
importance of all health care professionals having a
1a. Instructor
level of mastery over basic skills like taking a blood
1b. Instructor
pressure reading.
1c. Instructor
1b. Describe that the goal of the lesson is for
students to be able to obtain a correct blood
pressure reading within two degrees of accuracy.
Explain that there are a number of sequential skills
that must be developed in order to achieve this goal
and that by the end of the lesson students should be
able to demonstrate each of the skills and thus
obtain an accurate reading.
1c. Explain that in order for students to be prepared
for the lesson they must already have the following
pre-requisite skills; the ability to identify pulse
points, the ability to obtain a pulse rate, the ability to
identify and read numbers on the
sphygmomanometer, and the ability to execute a
medical hand wash before and after touching a
patient
2. Content presentation
a) Presenting the content
to be learned (i.e.
stimulus material)
b) Guiding the learners
as they are presented
with the content
Content Presentation
2a and b. Have the students watch a captivate
module that demonstrates the entire process of
obtaining an accurate blood pressure reading. After
the students complete the module provide a live
demonstration of the process for
reinforcement. Make sure the students understand
that they will have an opportunity to practice taking
a blood pressure reading themselves and that they
will later be quizzed on process and terminology and
asked to demonstrate taking a blood pressure
reading for a grade
Content
Presentation
2a and b.
Instructional
module on
computer;
Instructor; Blood
Pressure
equipment
3. Learner participation
a) Giving the learner
opportunities for
practice (i.e. eliciting the
performance)
b) Giving the learner
feedback during practice
Learner Participation
3a. Have the student’s pair off and practice taking
each other’s blood pressure. Instructor should walk
around to every team and provide scaffolding and
feedback, making sure each team is completing the
steps correctly.
3b. Make sure feedback is explicit and students
understand exactly what it is they are doing
correctly/incorrectly
Learner
Participation
3a and b.
blood pressure
equipment
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4. Assessment
Tests and other
assessments to see if
anything has been
learned as a result of this
lesson
Assessment
4a. Have the students complete a short multiple
choice quiz covering the major items involved in
correctly taking a blood pressure reading. This quiz
should be graded and returned with
feedback. Second, have students once again pair off
and take each other’s blood pressure readings. Use
a check-off rubric to grade each attempt, and
provide no scaffolding or assistance during each
attempt. Once the students have finished return the
check-off sheet with a grade and written feedback.
4. quiz; blood
pressure
equipment
5. Follow-through
activities
a) Memory aids for
retention
b) Activities to help
learners transfer their
learning to other
contexts
Follow-through activities
5a. Remind the students that the instructional video
from the beginning of class is posted online and
available for review at any time.
5b. Advise the students that they can check out the
blood pressure equipment to take home and
practice on friends and family
5a. Instructional
video
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