Beyond ADDIE: Proficiency Based Progression and Bloody Excellence

This paper proposes that the use of ADDIE as an instructional design model should be supplemented by a proficiency based progression approach (Gallagher, O’Sullivan, 2014) for certain task or procedure based training. Since... [ view full abstract ]

This paper proposes that the use of ADDIE as an instructional design model should be supplemented by a proficiency based progression approach (Gallagher, O’Sullivan, 2014) for certain task or procedure based training. Since 2017, an interdisciplinary team has been working on developing a course focused on reducing phlebotomy errors in Cork University Hospital. Proficiency based progression was used to design and develop the course. This was chosen as it has proven very successful for surgical training over almost two decades.  The course was designed to reduce the instances of ‘Wrong blood in tube’ – where the blood in tube does not belong to the patient on the label’. CUH had logged 127 instances of this error in the last year. The consequences of these errors can be grave. In the instance of a blood transfusion  an instance of Wrong Blood in Tube could lead to a patient who does not need a transfusion receiving one and one who need it going without. The course has now undergone two iterations, both hosted on Blackboard’s Coursesites platform prior to the eventual planned migration to the HSE’s Learning and Development (HSELanD) platform later this year. This paper will detail the development process through the initial procedure characterisation, to metrics development to course development and construct validity. This paper argues that proficiency based progression enhances the quality of continuing professional development by providing a curriculum that harnesses metrics and learning analytics to improve course quality and the achievement of learning outcomes. Proficiency based progression as a methodology keeps metrics at the centre of the course while providing the learner with opportunity for deliberate rather than repeated practice during course assessment. Furthermore this course assessment is authentic and make specific reference to the task being carried out and the real world consequences.