Soft Skills for Nurses E-learning
This concept project addresses high-conflict patient interactions in hospital settings, a factor contributing to burnout and turnover among nursing staff. The training targets soft skills, such as active listening, assertiveness, and boundary setting to help nurses navigate challenging interactions more effectively.
Audience: hospital nursing staff
Responsibilities: Instructional Design, eLearning Development, storyboarding, video and sound editing, graphic design, style guide development
Tools Used: Articulate Storyline 360, Adobe Illustrator, Adobe Photoshop, Figma, Affinity Photo, Affinity Designer, Audacity
The Problem
I interviewed several industry leaders to identify the training need for this project: reducing nurse turnover by improving stressful nurse-patient interactions. Hospitals can position their nursing staff for success and combat burnout by giving nurses the communication skills to navigate these inevitable challenges. The ability of nurses to set reasonable expectations with patients, to prioritize self-care, and to de-escalate conflicts emerged as important learning targets in conversations with nurses and physicians SMEs.
The Solution
I proposed a scenario-based, story-driven eLearning solution to address these needs in an accessible and easy-to-implement format. The module takes learners through a day in the life of a critical care nurse and confronts them with multiple challenging patient interactions. They experience different approaches and their consequences, and receive coaching from a virtual mentor on how to respond effectively to patient concerns.
My Process
I followed the ADDIE model, with a needs assessment and learner profile preceding the design process. Development was carried out in Articulate Storyline and the eLearning experience made available both via Articulate Review and an external site for multiple rounds of stakeholder and SME feedback and revision.
Action Map
In the Analysis phase, I worked with SMEs to develop an action map based on high-priority actions. The focus in action mapping is on behavior change: on what people should do rather than what they should know. For this project, this meant skillful use of verbal communication to address provider-patient conflicts and reduce turnover by 30% over the next 12 months. We identified several high priority actions:
Addressing abusive behavior (particularly profanity)
Mirroring patient concerns
Grounding techniques to reduce stress
Setting expectations and boundaries about availability to patients
Text-based Storyboard
In the Design phase, the action map was transformed into a text-based storyboard. Drawing on Mayer’s Principles for Multimedia Learning, I limited text and incorporated sound and images when appropriate. A mentor character (Beate) allowed me to convey learning content on-demand while avoiding an overly didactic tone--I strove for a conversational tone instead. I immersed the learner in the situation and allowed them to make choices and explore the consequences of their choices on patient outcomes, based on real-world examples provided by SMEs.
Style Guide
Mood Board
Wireframe
High-fidelity Mockup
Visual Mockups
I developed a mood board for inspiration, integrating colors and visual elements commonly present in healthcare designs such as the use of blue and white colors, clean geometric designs, and bright saturated hues. The hexagonal geometric design element was inspired by the clean lines and precision of the hospital setting, the smooth efficiency of a honeycomb tended by worker bees, and the use of technology in the learning solution. Designs were then iterated as wireframes and high-fidelity mockups for multiple rounds of feedback to solidify the layout.
Interactive Prototype
Once I finalized the visual mockups, I developed an interactive prototype including several slides and the first scenario-based question in Storyline and submitted for feedback on functionality. The revised prototype slides then could serve as templates for the full version of the project.
Full Development
The full version of the project included a number of unique features. Ambient sound effects were integrated throughout, such as background noise for the hospital setting and audible feedback on question responses. The experience also integrated a guided grounding exercise in the form of box-breathing as the positive outcome to the first question. I am also very happy with my question design and distractors, drawing on my background in developing assessments for medical education. The final screen presented a cinematic epilogue and acknowledgment inspired by my background as a filmmaker.
Results and Takeaways
The final result was an immersive patient-care simulation that met the learning objective of equipping nurses with the skills needed to de-escalate conflictual situations and improve patient outcomes. In the Implementation phase, the project was uploaded to Review 360 and to a public website hosted by Amazon Web Services and made available online. In the Evaluation phase, the full project was reviewed by colleagues in the ID field as well as by physician and nursing SMEs for usability and accuracy. Edits to the scenarios, answer choices, and distractors were made to increase the relatability and clinical relevance of the scenario. Many reviewers commented on the visual appeal and immersive quality of the eLearning experience:
"I loved this project! You have a consistent visual theme (particularly with the hexagons as buttons) and the experience is immersive. I really liked the breathing exercise activity where the learner can actually put themselves in the shoes of that very person in that break room. I thought that was a really smart decision for the immersive quality of the experience.
I also really liked the ending slide/sequence. The music was the cherry on top and even reminded me of an awesome movie end credits sequence!"
-EJ Edwards, Instructional Designer
One key takeaway for me as a designer was the importance of multiple rounds of SME feedback at all stages of the project. Edits on the final project were required because of SME feedback on the realism of certain clinical details (medications, treatment outcomes, etc.). An additional round of feedback on the text-based storyboards would have prevented the need to make these edits at a late stage of the development process. I am excited to work more closely with SMEs in the future as I develop new learning experiences.