Patient Safety Gains Were Devasted by the Pandemic — What Can We Do?

Hospitals lost 20 years’ worth of patient safety gains in less than two years, according to an analysis by the Amplifire Clinical Innovation Advisory Board (CIAB), recently published in the New England Journal of Medicine Catalyst. The authors attributed the loss of the progress that had been made in two decades following the initial publication of “To Err Is Human: Building a Safer Health System” (2000) to several factors, which most commonly aggregated around clinician strain and burnout, exacerbated by the heightened stress of the pandemic. Unfortunately, physician reviewers on patient harm data through the years since “To Err is Human” estimate that 40-60% of all care-associated injuries are preventable. Moreover, they estimate avoidable care-associated mortality in hospitals exceeded 210,000 deaths per year. Another analysis concluded in 2016 that avoidable medical injuries were the third most common cause of avoidable death in the United States. If harm is preventable, but patient safety is still declining, how can we better support healthcare workers striving to provide excellent care? 

The first step in preventing patient harm is to identify the source. Patient safety research indicates that the majority of patient harm stems from two causation categories. The Institute of Medicine Committee on Data Standards for Patient Safety research informed the CIAB, who identified the top 10 causes of patient harm; and the top two categories combined — adverse drug events and hospital acquired infections (HAIs) — account for ~80% of all harm. HAIs as a stand-alone category account for ~30% of all patient-harm incidents, including postoperative deep wound infections, catheter-associated urinary tract infections (CAUTI), lower respiratory infections, bacteremias and septicemias, and C. diff, MRSA, etc. Harm categories are organized around clinical processes, and therefore include some areas of overlap. For example, central line-associated bloodstream infections (CLABSI) can be approached as an HAI, or as “Complications of central and peripheral venous lines.” Because CLABSI can fall under either category, prevention methods can be implemented from more than one operational direction.  

CLABSI is a particularly dangerous type of preventable harm. The mortality rate for CLABSI ranges as high as 25%, and each incident costs $48,108. In the intensive care unit, these infections are associated with over 28,000 deaths yearly and cost over $2 billion. Even worse, this immense cost can be prevented. So, what can we do? 

Where can we go from here? 

Upon finding that most patient harm incidents fall under only a few categories, experts have recommended developing standardized best practices around these categories and making them widely accessible and reiterating them through effective training that suits the modern workforce (ex: hybrid, blended, online, etc.). If standard best practices were taught universally, all healthcare workers would have the life-saving knowledge they need wherever their career takes them. Hospitals can trust that their long-term staff, new hires, and temporary support across all roles have the knowledge they need to succeed. 

There are training systems on the market today that work and are moving the needle on improving patient safety. For example, a peer-reviewed study compared Amplifire’s training against a control group (legacy training) at several hospitals in the same health system revealed that cognitive science-based training can help health systems decrease CLABSI rates. In this study, the hospital that implemented Amplifire training saw 79% reduction in the hospital’s CLABSI rate, with zero CLABSIs occurring in the first eight months following training (compared to the nine CLABSI incidents that had been observed during the pre-training period), despite spikes in COVID-19 hospitalizations. The CLABSI rate at the control locations (locations that did not receive the cognitive science-based training) slightly increased in the observed time. This study illustrates the power of aligning standard processes with cognitive science-based, adaptive learning. 

The CLABSI course is just one of many courses co-developed by subject matter experts in the Healthcare Alliance. Some other courses developed around common causes of patient harm include CAUTI prevention, sepsis recognition and management, ICU liberation, and more. Browse healthcare courses in our Safety and Quality Essentials library or reach out for more information. 

From the beginning, Amplifire has relied on innovative brain science to guide its product development to create the most effective learning and training solution, perfectly tailored to the way the human brain works. Learn more about how Amplifire helps people learn better and faster with online learning by requesting a demo. 

63rd Annual Psychonomics Conference: Science Advisory Board Research

By Matthew Hays, Ph.D.

This past November, thousands of cognitive scientists from all over the world converged on Boston for the 63rd Annual Meeting of the Psychonomic Society. The Annual Meeting is better known as the Psychonomics conference, or just “Psychonomics.” It was a triumphant return after a couple of years of COVID disruptions.  

As the premier international conference on cognitive science, Psychonomics features presentations covering a broad range of brain-related topics, including bilingualism, risk tolerance, biases, and even optical illusions. Our primary focus at Amplifire was on the hundreds of presentations about learning, memory, and metacognition. (Amplifire’s founder, Charles Smith, described it as a “science buffet.”) 

Some of this year’s presenters hailed from labs run by members of Amplifire’s Science Advisory Board (SAB). The SAB comprises professors who help us stay on top of the latest research. By incorporating new (and old) empirical findings into our software, we make sure that our platform is doing what’s best for your brain while optimizing the time you spend learning. 

The vast majority of presentations at Psychonomics come in the form of posters. Although that might harken you back to science fairs from when you were a kid, poster sessions are actually a great opportunity to get feedback from world-class researchers about counterintuitive findings or early-stage results. Posters also offer an opportunity for up-and-coming researchers to present their own work. 

We thought we’d share a few SAB-supported posters with you! 

In Roddy Roediger’s lab at Washington University in St. Louis, researchers looked at flashbulb memories — vivid, enduring memories associated with a personally significant and emotional event. A couple of decades ago, the most common flashbulb memory was the 9/11 attacks; Roediger’s lab found that Gen Z most vividly remembers the night of the 2016 election, the cancellation of school due to COVID, and the death of Queen Elizabeth II. But they also found that learning about the event via social media caused the memories to be less vivid than when they were learned about through traditional media or directly from another person.  

For several years, the Bjork lab at UCLA has been researching how people learn from true/false tests. Their recent work demonstrates that competitive true/false questions – questions that contain a contrast – help people learn about what the question is asking as well as what it isn’t. For example, along with other practice, the question “Eris (not Ceres) is a dwarf planet located in the scattered disc” helps people learn Eris is in the scattered disc and Ceres is in the asteroid belt. Their most recent findings show that, when students use true/false questions to learn collaboratively, the boost from a competitive/contrasting structure disappears.   

The Bjork lab is also exploring student strategies that emerged with the advent of online learning and gained popularity during the pandemic. One such strategy is speed-watching recorded lectures. I was stunned to learn that most students speed lecture videos up, and almost a fifth of them watch at double speed. What’s more, students do this despite believing that watching lectures at that rate impairs learning! And they’re right; comprehension is impaired by watching at double speed – although taking notes during the recording can make up the difference. Of course, taking notes during a normal-speed lecture is best of all.  

Rich Mayer’s lab at UCSB was the first to describe seductive details – parts of the learning experience that are interesting but take attention away from the elements of the experience that actually provide educational value. At Psychonomics, they explored a related concept: the extent to which being in an immersive virtual reality educational environment distracted the learners from the content (as compared to a slideshow). They found that, as a person’s individual vulnerability to being distracted increased, their learning was impaired. PowerPoint gets a lot of flak, but there was no such relationship in the slideshow condition, and learning was approximately equal from slides and VR.    

The Mayer lab also has a long history of evaluating how multimedia affects learning. Previously, researchers discovered that cartoons and multimedia that create positive emotions can improve learning. At Psychonomics, the Mayer lab presented research that combined previous findings to create positive-emotion-inducing instructional cartoons. The results were promising, with substantially more learning happening from warm fuzzy cartoons than from cold black-and-white schematics.  

Again, this is a tiny slice of the several hundred relevant posters, presentations, symposia, and discussions that the Psychonomic Society facilitated. More than ever before, I feel incredibly lucky to have been able to attend, and I’m eagerly looking forward to getting the gang back together in San Francisco this November.

Meanwhile, we’ve got quite a bit of science to fold into Amplifire’s software! 

And, in case you missed it, check out the Amplifire Research & Analytics Team’s poster. We looked at “The Frequency of Online Learners’ Off-Task Behavior” and the extent to which COVID did – or didn’t — negatively impact online learning habits. 

Using Adaptive Online Learning to Optimize Your Immersive Learning Investment

As we continue to shift out of traditional classroom environments for training, more emphasis is placed on creating opportunities for active learning, even in virtual settings. Adaptive online learning has many benefits, but sometimes, real-world simulation is still necessary, especially in critical professions where lives are at stake. However, this doesn’t mean virtual solutions cannot suffice. In fact, professionals can train with immersive learning technology — like virtual reality augmented reality, 360-degree video, and more — to gain valuable exposure to high-stakes scenarios without associated risk. It’s a win-win situation. 

Immersive learning is booming. In 2020, the immersive training market was valued at $26 billion. And the overall immersive technology market size is expected to reach nearly $300 billion by 2024. Not only is this market exploding, but it’s taking its users to the top. According to PwC analysis, virtual reality and augmented reality have the potential to boost the global economy by ~$1.7 trillion by 2030. Augmented reality is forecasted to provide the biggest benefits to global GDP, accounting for ~$1.2 billion of that total. With all this growth and earning potential, immersive learning is no longer a fringe solution. It’s the new reality in the learning and development space. 

What is immersive learning? 

Immersive learning uses augmented, simulated, or artificial environments for learners to experience scenarios and simulations, delivered through virtual reality (VR), augmented reality, 360-degree video, and other technologies. Founded in behavioral and cognitive science, immersive learning provides an experience that accelerates employees’ proficiency in their roles through an immersive training environment.  

The approach is based on the theory that the brain treats immersive learning experiences just like it would treat real life. A popular hypothesis known as predictive coding “suggests that the brain actively maintains an internal model (simulation) of the body and the space around it, which provides predictions about the expected sensory input and tries to minimize the amount of prediction errors (or “surprise”) (Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine).” One could postulate how this is selectively beneficial. This simulation not only evaluates action, but emotion as well, making it uniquely beneficial for training those working in critical professions. 

Types of immersive learning 

Depending on your training needs, your program may benefit from one or more types of immersive learning.  

Virtual Reality — Virtual Reality is an artificial environment in which the user is fully immersed in an experience. Totally immersive, this option allows the user to virtually pick up and move objects, turn on or take apart a device, walk around a room, and interact with virtual characters. 

Augmented Reality — Augmented Reality (AR) places virtual objects in real-world space. Think of AR as adding layers on top of the real world through the lens of your phone, tablet, or headset. Using individual headsets or AR-capable mobile devices, images appear in front of the user.  

Mixed Reality — Mixed Reality (MR) is a combination of VR and AR. Like AR, it overlays digital content with the real world. This lets digital and physical objects co-exist and interact in real-time. A major difference between mixed and augmented reality is that in MR, digital assets can be obscured by “real” objects. 

360 Film — Video Learning captures scenarios and training environments with 360-degree video to lead the learner through a process or location that can otherwise be difficult, expensive, or dangerous to visit. The employees can view the 360-degree video by dragging with their mouse or finger on desktop or mobile devices while also providing immersive experience using any VR headset.  

Immersive learning in action 

Benefits of immersive learning:  

A safe learning environment 

Immersive learning is a safer way to practice skills that carry a high degree of risk in the real world, whether involving people or expensive equipment (and in some cases, both). For example, flight school often requires hours of simulator training before pilots take the skies to ensure the utmost safety for passengers. Moreover, healthcare has also been implementing immersive learning to supplement medical education as a practice stage before interacting with patients or medical equipment and machinery. 

Better learner data 

Robust analytics are another added advantage to technology-based learning tools, as we in the online learning world well know. These analytics not only report performance data and engagement levels, but also give a keen insight into learner behavior. The data informs intentional instruction and intervention when needed. Learning and development teams can also use analytics to make changes to their training programs as needed. 

Enhanced comprehension and retention 

Immersive learning aligns with a key tenet of adult learning theory — that adults learn differently than children and retain more information under conditions that approximate real-world scenarios. Brain science-based learning is always more effective. Many immersive learning methods involve gamification, emotion, curiosity, and more — all known cognitive triggers that promote faster learning and better retention. 

Increased engagement  

Engaged learners learn and perform better, engaged employees stay at a company longer. Immersive learning is often inherently engaging due to the nature of the technology and becomes even more engaging if it is developed with brain science principles in mind.  

Sustainable training  

Immersive learning presents an initial cost barrier. However, a 2019 study showed that immersive learning, in the long run, can be very cost effective. The researchers compared the cost of training intensive care workers in hospital evacuation procedures using mannequins to the cost of providing the same training virtually. The cost of virtual training was higher initially, but within three years it became the more cost-effective option. So, once acquired, immersive learning technology can be used to train large numbers of people over many training cycles. 

How to maximize your immersive learning investment via adaptive online learning  

Immersive learning is an investment. And for critical professions, it’s an integral part of the training program. So, how do you know this type of training is working and exactly how well it’s working? What if you could enhance your immersive learning program by knowing exactly when to implement it to achieve maximum information retention in your trainees without any wasted time? Here’s an example of how Amplifire’s adaptive learning platform helped an aviation client maximize their immersive learning program. 

Flight operations were training pilots for the 737 MAX, which requires specific flight crew training and awareness. Moreover, flight operations needed to have proof of learning while also gaining insight into which concepts were difficult for pilots to better support continuing education and reduce time spent training. Simulation training is an essential component of pilot training, so they get practice in real-world scenarios without risk to passengers.  

Pairing simulation training with a brain-science based adaptive learning platform is the best way to ensure learning sticks. In practice, the Amplifire course was layered in between the aircraft manufacturer’s computer-based training modules and learning literature to act as a knowledge check and provide evidence of learning. Amplifire training acted as a pretest primer for simulator training; pretest, or priming strategies, are proven to enhance retention over time.  

In addition to brain-science based learning, the Amplifire platform’s algorithm watches learners for knowledge gaps, uncertainty, and misinformation, identifies these cognitive risks that pose a threat to future passengers, and mitigates future mistakes. Confidently held misinformation occurs when a learner thinks they are correct but are, in fact, wrong. This type of cognitive risk is particularly dangerous because confidence is a strong leading indicator of action, that in this case could be a catastrophic mistake. Through the platform, instructors gained insight into learners’ minds that would otherwise be invisible. This behavior, if undetected, would only be reinforced in subsequent simulator training, but was instead preemptively corrected in adaptive platform learning. 

The learner data collected through platform learning was used to optimize simulator time, showing instructors where learners should focus more time, or confirm where they have mastered concepts. While average knowledge across all pilots was good, the Amplifire platform revealed that knowledge variation among individual pilots was worrisome. By the end of the initial Amplifire training, knowledge variation was eliminated, and all pilots were proficient (both confident and correct) on all the material moving into simulator training, ensuring only best practices were carried over into critical real-time training. 

Pilots took a refresher two months after their initial training in Amplifire. Refreshers represent an opportunity to measure how well the material was remembered. The refresher data showed that pilots retained their training across the organization. In both modules, pilots were more than 80% closer to knowledge mastery of the 737 MAX, with about 60% reduction in misinformation that otherwise would have remained undetected without adding Amplifire training to the immersive learning experience.  

Absent the resources for a major investment in technology, L&D teams can still begin introducing immersive learning in these ways while developing a business case for building future immersive technology capacity with the data to back it up from adaptive online learning.  

Examples of immersive learning without a large up-front cost: 

• Simulations that include branching determined by the actions and decisions of learners 
• On-the-job training with the opportunity for hands-on practice 
• Role playing with a coach or mentor who offers actionable feedback 
• Job shadowing while observing real-world interactions with clients 

Online learning unlocks unlimited combinations of capabilities that are optimizing training for critical professions, from pilots to healthcare professionals. Immersive learning is a great way for such professions to gain real exposure to scenarios they may encounter on any given day, without the potential of endangering real lives in the process. This type of exposure during training — although virtual — has been found to improve “postintervention knowledge and skills outcomes of health professionals when compared with traditional education or other types of digital education such as online or offline digital education,” reported a literature review. Therefore, considering immersive learning options in tangent with adaptive online learning can yield exceptional training results, and inevitably, better customer and patient outcomes.  

From the beginning, Amplifire has relied on innovative brain science to guide its product development to create the most effective learning and training solution, perfectly tailored to the way the human brain works. Learn more about how Amplifire helps people learn better and faster with online learning by requesting a demo. 

Top 5 Online Learning Trends of 2023

In 2022, we took the pandemic “new normal” for what it’s worth and made it our own. The workforce has settled into a spectrum of anything from remote to in-person, and everything in between. Just as fast as we needed virtual solutions, we then needed hybrid and blended solutions to accommodate organizations operating anywhere on the work spectrum.  

Over the past few years, online learning has been used to train and develop workforces across industries in innovative ways with impressive results:  

• Since 2000, the eLearning industry has grown by 900%, making it the fastest-growing market in the education industry by a large margin.  

• 40% of Fortune 500 companies use online learning for professional development with over 72% of American organizations believing online learning gives them a competitive advantage, reported Forbes.  
• In the world of healthcare, a review commissioned by the World Health Organisation (WHO) and carried out by Imperial College London researchers concludes that online learning is likely to be as effective as traditional methods for training health professionals.  

Online learning has been shown to quickly and effectively teach and train employees in critical roles, enabling them to reach their highest potential. Return on investment following online learning implementation is demonstrated in many ways. For many, less time spent, more optimized resources, and fewer adverse incidents means dollars saved. For some, it is patient lives saved.  

Online learning is here to stay, and its expansion is not slowing down any time soon. As each year comes and goes, organizations find new ways to use online learning as it fits their needs. Here are some of the biggest online learning trends forecasted for 2023. 

5 Online learning trends to pay attention to in 2023: 

1. Hybrid and blended training

Again, online learning isn’t going anywhere, but it does not have to be an all-or-nothing solution. Many organizations have adopted blended or hybrid learning in some capacity.  

So, what do blended and hybrid learning really mean? Blended learning refers to combining the traditional in-person setting with any digital technology. Hybrid learning is the comprehensive approach of combining the best parts of in-person learning with the most effective parts of virtual learning. It’s more than just half in-person, half online. It’s a strategic format that puts the learner at the center of the experience, incorporating the best teaching strategies for better learning and stronger retention.  

Hybrid learning has many benefits that suit the modern workforce. For organizations, hybrid learning gives learning and development personnel the freedom to develop training plans that incorporate a variety of teaching tools. Hybrid learning is more flexible and inclusive; it can be done anywhere, anytime, anyhow. It has shown to be more effective than traditional learning. And finally, it can be cost-effective too due to less expenses accrued associated with in-person learning. 

2. Personalized learning

In a post-pandemic world, offering virtual options is now the bare minimum. People expect personalization. One-size-fits-all never works, and as it turns out, it is an expensive waste of time for employees and the organization. That’s where personalized learning makes a difference, and we see it taking a front seat in the online learning world this year. 

An adaptive platform that adjusts to individual learners’ knowledge levels is essential to learning personalization, and thus the overall learning experience. The learning experience is rigorously personalized with adaptive functionality. It cuts learning time in half (sometimes more) by treating each learner as an individual with their own unique mix of mastery, misinformation, uncertainty, and information gaps. By adapting to their knowledge level, trainees don’t waste time relearning things they already know. Instead, they spend more time only on subjects they demonstrate struggle with. 

In action, this level of personalization has powerful effects for both trainees and health systems at large. One such example is how UCHealth cut training time by 87.5%, achieved an 86% learner satisfaction score, and experienced $1.45 million in savings by incorporating adaptive learning via learning platform. Where learners typically spent eight hours in the classroom with their previous training system, learners now spend an hour or less on average in training. This not only respects learners’ time, but also increases their time out on the floor, helping patients.  

3. Catalog courses

As more organizations turn to online learning in some capacity, the benefits of on-demand course libraries become apparent. Training employees at scale and developing effective, quality content to do so is no small undertaking. That’s when having a selection of courses designed by subject matter experts is invaluable. 

For example, Amplifire Healthcare Alliance members benefit from a range of course catalogues, co-developed by Alliance experts: obstetrics, compliance, electronic health records, and more. Alliance members that are challenged to get all their clinicians training online, at scale, in record time implement on-demand courses  or modify the course content to their organization’s specifications. Again, personalization comes into play — but this time, for the learning and development team. 

4. Microlearning

“Mircolearning” will continue to take the online learning world by storm. The Rapid Learning Institute conducted a survey in which 94% of learning and development professionals stated that they opt for “bite-sized” online learning modules over traditional learning because their learners prefer it. And if subjective “preference” isn’t convincing enough, learning architect Ray Jimenez, Ph.D.’s research concluded that by creating micro-courses, learning developers can reduce development costs by 50% and increase the speed of development by 300%. Microlearning makes sense in a world where attention spans are rapidly shrinking. 

There is no official definition of microlearning but as the term implies, all interpretations share the same characteristic: brevity. Perhaps the most familiar interpretation is short-term learning delivered in micro-bursts via text, app notification, email, or other. Another way to deliver microlearning is simply through small learning units. Adherence to brain science principles inherently bring a microlearning feel to learning platforms. Cognitive triggers like motivation, repetition, spacing, and retrieval all create a gamification feel that create a microlearning environment. Features like assessment-based question format, module content breakdown, post-learning refreshers, and adaptive functionality allow for intentionally delivered learning in small bursts at the right time. Learners prefer these “smaller” formats, and businesses benefit from their satisfaction. 

5. Immersive learning

What was once technology limited to science fiction, virtual and augmented reality are now tools that can be inexpensively brought into any home, classroom, or office. While virtual reality (VR) may not be a tool appropriate for all topics, it can certainly be useful in certain situations. Aviation and healthcare industries often use simulator training reinforced by online learning to invoke an immersive experience, enriching the training process. Immersive learning isn’t only limited to simulation and virtual reality training; it also includes any training, like hands-on training, that makes it easier to practice skills that, in the real world, carry a high degree of risk whether to people or costly equipment. 

Immersive training is a costly investment, which is why online learning is a crucial complement. Often, simulators or VR require pretesting or prior knowledge, which can be efficiently delivered via learning platform. With the learner analytics, learners get the right training at the right time, ensuring no time or resources are wasted. Robust learner analytics capture learner behavior as well, ensuring the efficacy of your training investment when used following an immersive session, therefore maximizing ROI. Smartly implementing immersive learning in 2023 will revolutionize the training world.  

As we gain more and more experience with online learning, we find new ways to optimize the way we learn to maximize outcomes. People are learning better and retaining more information, faster. Organizations are spending their employees’ time wisely, and effectively training highly competent and confident workforces. The beneficiaries of these organizations’ services — patients, passengers, etc. — experience more positive outcomes as a result. In the coming year, we look forward to expanding the ways in which Amplifire’s learning platform can help learners and organizations reach their goals and explore new learning possibilities. 

From the beginning, Amplifire has relied on innovative brain science to guide its product development to create the most effective learning and training solution, perfectly tailored to the way the human brain works. Learn more about how Amplifire helps people learn better and faster with online learning by requesting a demo. 

4 Key Takeaways from the Amplifire Clinical Innovation Advisory Board’s Patient Safety Article

Amplifire’s Clinical Innovation Advisory Board are some of the most accomplished thought leaders in American healthcare, helping target and develop course content and strategic direction in the evolving healthcare landscape. This group of scientific experts examine training solutions and their use in real clinical applications, especially within the Amplifire Healthcare Alliance. In their recent article published in the New England Journal of Medicine Catalyst, “Patient Safety Performance: Reversing Recent Declines through Shared Profession-Wide System-Level Solutions”, the authors investigated the recent troubling decline in patient safety performance, indicated by an increase in errors leading to adverse patient outcomes. In taking a deeper look, they identified commonalities that contributed to that decline. The authors also analyzed decades of patient safety research, determining which practices work, and which do not.  

They found that two systems-level factors contributed to patient safety declines: the first being the fact that patient safety systems vary widely across health systems; the second being unprecedentedly high staff turnover rates. Despite these deeply rooted and complex factors, the authors presented viable solutions to prevent medical errors and improve patient outcomes in the long-term. Their conclusions are supported by the leading research in patient safety practices and draw on real-world applications to propose solutions. Here are the biggest takeaways from their astute article: 

1. Disjointed patient safety efforts result in medical error

“Two decades of patient safety research have found proven best practices for some of the biggest sources of hospital-based care-associated injuries. They demonstrably work,” write the CIAB authors. “Most patient safety breakthroughs came from system design focused on care delivery processes, where errors are considered to be consequences related to upstream systemic factors.” The authors cite studies that show how unified guideline implementation results in subsequent reductions in medication error rates, ventilator-acquired pneumonia, and central-line associated bloodstream infections (CLABSIs) across multiple health systems.  

“Patient safety policy and practice has relied too heavily on the vigilance and heroism of clinicians, rather than the design of safe systems,” found the CIAB authors. And while the public are grateful for such clinicians, clinicians need dependable policies they can rely on when burnout inevitably emerges as a result of their overextended heroism.  

2. Increasing clinician pressure and burnout is largely responsible for declines in patient safety 

As healthcare and health systems have evolved, there became greater documentation requirements on clinical staff, competing against time spent directly caring for patients. At the same time, physicians were still compensated based on volume, despite the effort to switch to compensation by value (in 2021, about 70% of generalist and specialist physician compensation was still based on billing volume). Clinicians found themselves caught in the middle of this dilemma, and then were buried by it when the pandemic maxed out their workload. The moral distress of being forced to weigh their patients’ wellbeing with increased responsibility came to a boil. 

“[Clinicians’] core professional values place patients’ health needs as their top priority, but regulatory and administrative documentation requirements and increasing use of Electronic Medical Record systems demanded more and more time, even as patient loads increased. Moral distress, reflected in clinician burnout, was a significant and growing problem well before the… pandemic struck,” wrote the authors. 

Hospitals experienced an unprecedented worker shortage. As clinicians sought better working conditions (or left their profession altogether), hospitals faced the challenge of high turnover, inexperienced workers, and onboarding bottlenecks. The authors concluded, “The result of this pandemic-prompted disruption, which exposed the systemic fragility of frontline staffing models, was the loss of comprehensive, coordinated care, the foundation upon which safe care rests.” 

3. Establishing and implementing unified patient safety guidelines is proven to reduce medical error

“Going forward, existing patient safety groups — such as the National Patient Safety Foundation (NPSF), the Institute for Healthcare Improvement (IHI) National Steering Committee for Patient Safety, The Joint Commission Center for Transforming Healthcare, and the U.S. Agency for Healthcare Research and Quality (AHRQ) — should gather, along with leading health systems, to coordinate a national patient safety effort,” recommends the CIAB authors. “Working within these frameworks, patient safety researchers achieved impressive advances across a number of high-volume sources of injury.” 

Building on the first takeaway, the authors cited studies that demonstrated how guideline implementation and practice make a significant difference in patient outcomes by reducing errors that lead to patient harm. However, they take it a step further to suggest that all hospitals should follow the same guidelines. “Health care systems, thus, would not compete on patient safety, but instead cooperate to support a baseline level of safety that spans U.S. healthcare,” write the authors. In the event of employee turnover in the stress of another health crisis (such as a pandemic), it would be easier for clinicians to onboard or pick up temporary shifts and treat patients faster with highly standardized care.  

4. Continued professional education on patient safety guidelines is necessary to achieve long-term error reductions

Considering the future of long-term improvement patient safety, the authors suggest continuous, regular training. They wrote, “Continuing professional education can align to safe systems design, directly linking professional knowledge to effective action within standard patient safety practices. Advances in that field now provide education with less time spent on training, higher satisfaction among professionals taking the training, and documented lower patient injury rates.” The study cited follows SCL Health, a hospital that enacted Amplifire’s adaptive online learning platform to eliminate CLABSI with effective training. In the nine months following training, CLABSI rates declined by 79%. 

Notably, the authors inform Amplifire’s Healthcare Alliance, a collaborative ecosystem where the world’s leading health systems. Members of the Healthcare Alliance co-develop both clinical and non-clinical solutions shown to meaningfully improve patient outcomes, reduce training time and costs, and increase revenue generating activities. Members share course libraries developed by leading subject experts, including patient safety courses, that are proven to lead to positive outcomes like the CLABSI course cited above. The Amplifire Healthcare Alliance stands as an example of what continued training in unified guidelines can achieve: a confident, competent workforce and lives saved. 

The CIAB authors note the benefits of a unified approach as exhibited by the Healthcare Alliance, “Several care systems have deployed standard computerized training around standard patient safety processes that address specific sources of injury, such as central line access and maintenance, or placing, maintaining, and monitoring urinary catheters. These training systems can quickly identify and target learning gaps… such coordinated education tools greatly reduce training time. That approach has allowed some care delivery systems to train every new clinician as they join a clinical team, even if only for a single shift.” What’s more is that this idea is not merely a theory, it’s proven in practice — and the benefits are tangible.  

With these takeaways, preventable patient harm can be prevented. With unified guidelines that are taught at scale with standard, expertly developed training, lives are saved. Interested in learning more about the Amplifire Healthcare Alliance? Find out more. 

EHR Blended Training Plan Examples and Best Practices

As the healthcare industry continues to feel the strain of labor shortages, higher turnover rates, and widespread burnout, learning and development professionals are under pressure to re-evaluate and optimize their organizations’ training plans. To accommodate a higher influx of new clinicians and ensure a positive onboarding experience, many training departments are exploring blended learning by adding online learning to their electronic health records (EHR) training programs.   

Virtual is the new normal and online learning solutions are no longer unchartered territory. Although many organizations are embracing virtual, no one organization is the same; all hospitals and health systems have different needs. They need to onboard and train different roles and specialties with varying EHR experience levels, sometimes in different locations across states or countries. They can see how online learning can save time and cut costs, but sometimes the biggest barrier to making that transition is envisioning how it will actually work in practice. And of course, they want to be sure their trainees have a positive onboarding experience, as well.  

Amplifire’s Healthcare Alliance members incorporate the online learning platform in their training programs in ways that are specific to their requirements. Depending on organization size, capacity for in-person support, resources, and preference, training plans look different for different organizations — with Amplifire as the common link. Here are some strategies that we’ve seen Healthcare Alliance members put into practice: 

EHR Implementation Plan Examples and Best Practices 

1. Journey by experience level

Some Alliance members decide that different learning paths are more appropriate for different skill levels. Although the Amplifire learning algorithm adjusts to each learner’s experience level in real time, some health systems prefer to differentiate onboarding for non-EHR-experienced clinicians and clinicians with EHR experience with the support of their larger, dedicated training team.  

For learners who have never trained in EHR systems and are unfamiliar with the interface, jumping into an online training module can be overwhelming. In that instance, learning and development teams elect to have inexperienced learners begin with some type of pre-learning to prepare for further training. Sometimes, that is an in-person session, resources permitting, or introductory video, or other.  

For experienced learners, teams have opted to start with Amplifire right out of the gate. Since learners are familiar with the content, Amplifire’s Socratic question method is easier to digest, and learners get the information they need quickly. 

From there, there are opportunities for customized learning by specialty function. Finally, all trainees, no matter the experience level, typically end with an Amplifire module to determine mastery of the content and graduate from training. 

In training by experience level, the Amplifire platform has helped teams who prefer this path effectively, efficiently, and quickly onboard experienced clinicians in record time. Inexperienced clinicians get the extra support they need, and experienced clinicians don’t waste time learning things they already know. But an issue organizations face is that experienced clinicians often don’t know what they don’t know; so, rather than running into problems down the line, they complete an Amplifire module which finds and fixes misinformation and /or knowledge gaps and ensures 100% proficiency. It’s faster than the in-person alternative and everyone gets the personalized training they need, even online. Incorporating the Amplifire platform during training helps to ensure all clinicians are on the same page and able to master EHR use cases with expertise and finesse. 

2. Journey by role

For many of our Healthcare Alliance members, it’s ineffective and inefficient when trainees are spending 12-16 hours in the classroom when they could be spending that time out on the floor helping patients. Teams saw the value of incorporating Amplifire to streamline training, but clinical leaders were concerned about employees who were coming in with little-to-no EHR experience and how they’d respond to online learning in their training program. 

Where there is concern about onboarding clinicians of varying experience levels, personalization is a priority. For Alliance members who experience this pushback, they’ve designed different learning paths for different roles. Nurses and providers beginning in the EHR training and onboarding program usually have similar, but not quite identical paths. In one example, both nurses and providers begin with brief instructor-led training (ILT) followed by Amplifire. Then, they move on to either eLearning videos or skills lab and coaching depending on their needs, ending with one-on-one follow ups. 

In breaking up training by role, learning and development teams are then able to reap the benefits of Amplifire learner analytics to inform the coaching sessions that follow. Oftentimes, trainers see experienced learners struggling more than inexperienced learners — they tend to carry bad habits. By offering Amplifire to everyone early in training, trainers can gather more trends in learner data and adjust from there. They see patterns that would be invisible in ILT but are picked up by the Amplifire platform. 

Even though a common concern in incorporating online learning is how inexperienced learners will respond, clinicians can still struggle no matter what level they enter training. While clinical leaders are often concerned about inexperienced trainees, Amplifire reveals that clinicians with years of EHR experience can struggle just as much. The platform detects these learner behaviors and corrects the knowledge gaps, misinformation, and uncertainty, improving EHR proficiency when clinicians return to the floor. Furthermore, when learning behavior patterns such as this are exposed, organizations use these insights as a multi-pronged solution to inform their blended learning strategy and personalize the learning experience for their employees.  

3. Journey by Amplifire

One of the things that makes the Amplifire platform uniquely effective is personalization. With an adaptive learning algorithm, robust analytics, and brain-science based techniques, Amplifire is conducive to the way the human brain naturally learns and the learning experience is rigorously tailored to meet individual needs in real time, and in extended coaching scenarios. So, while some health systems elect to incorporate Amplifire EHR training after some type of ILT, video, or other pre-learning, some jump right in and offer Amplifire modules from the start. 

We’ve seen Alliance members that have the benefit of early leadership buy-in and are challenged to get all their clinicians training online, at scale, in record time. In this case, members have the option to choose an on-demand Amplifire EHR course already developed by other Healthcare Alliance members and modify the course to their organization’s specifications.  

Next, teams can elect to send trainees through a simulation lab for hands-on experience and EHR specialty-specific training. Learners later complete a refresher course in Amplifire and any providers who are identified to have struggled with the material are coached with at-the-elbow support with Amplifire intervention report data. 

Clinicians report higher satisfaction rates with the inclusion of Amplifire training rather than hours-long ILT and classroom work. Since the Amplifire platform adjusts to their individual knowledge level, clinicians of any experience level only spend time where they need to and end up back on the floor in record time, confident in their EHR knowledge and skills. In some instances, Amplifire cuts EHR training from eight or more hours to only two hours total. Organizations respect their learners’ time and expertise while giving time back to patients. However, communication is the key to success in the transition from in-person learning to blended. The more organizations communicate with learners and offer support, the more receptive learners are to the transition to online learning as the primary training tool. 

Did you know: Doctors with high electronic health record (EHR) satisfaction are nearly five times more likely to report they’ll stay at their organization. In a time of labor shortages and widespread burnout, organizations cannot afford to overlook how their EHR training delivers in terms of efficacy and quality of learning experience. For a deeper look into how Amplifire helps organizations onboard employees with EHR training in record time by personalizing the learning experience for clinicians of all experience levels, follow up with our blog: “Improve EHR Training Satisfaction by Personalizing the Online Learning Experience”. Or, contact us if you would like more details on our EHR courses.  

From the beginning, Amplifire has relied on innovative brain science to guide its product development to create the most effective learning and training solution, perfectly tailored to the way the human brain works. Learn more about how Amplifire helps people learn better and faster by checking out a demo.

Does Microlearning Work?

As our collective human attention span continues to shrink (thanks, TikTok), it’s a wonder we get anything done. A recent study by Microsoft concluded that the human attention span has dropped to eight seconds – shrinking nearly 25% in just a few years. This phenomenon has widespread implications. How does this shortened attention span affect our ability to learn? Is it worth adapting the way we learn? Is there a way to work in tandem with shortened attention spans in an engaging way? Can we retain as much information with shortened learning? Some think microlearning may be the answer. 

Whether you accept the idea that attention spans are shrinking or not, it is a fact that people prefer shorter content. According to a report by Software Advice, more the 50% of the 385 employees who took part in a survey indicated that they would use their company’s learning tools more if the courses were shorter. Rapid Learning Institute conducted a survey in which 94% of learning and development professionals stated that they opt for “bite-sized” online learning modules over traditional learning because their learners prefer it. And if subjective “preference” isn’t convincing enough, learning architect Ray Jimenez, Ph.D.’s research concluded that by creating micro-courses learning developers can reduce development costs by 50% and increase the speed of development by 300%.  

But, does microlearning really work? Microlearning can look different in different practices, but it always comes in one size: small. Let’s talk about when microlearning works and how to implement it for the best results — and what common microlearning mistakes to avoid. 

What is microlearning? 

There is no official, formal definition of microlearning but as the term implies, all interpretations share the same characteristic: brevity. Perhaps the most common or most familiar interpretation is short-term learning delivered in micro-bursts via text, app notification, email, or other. Another way to deliver microlearning is simply through small learning units. 

Microlearning can be delivered in many ways. Examples of microlearning content include text, images, videos, audio, tests and quizzes, and games. In addition to traditional eLearning platforms, microlearning is often hosted on smartphone applications, too. 

Microlearning has been shown to improve retention when delivered in the right way. However, not all microlearning is created equal. Just because something is quick and easy does not necessarily mean it is retained in our minds. We can watch all the quick social media reels we want, but that doesn’t mean the content has made an impact. Implementing an effective microlearning program comes with challenges and limitations. Just because we successfully (and quickly) complete a micro-lesson doesn’t mean the information stuck.  

Limitations of microlearning 

Relying on microlearning to teach important concepts runs the risk of not landing crucial information. In a training context — whether you’re teaching sales strategy, code, or infection-prevention guidelines — forgotten information or misinformation can lead to poor outcomes. Here is when not to use microlearning: 

Not for complex concepts or in-depth training 

If you can’t scale your solution to include multi-tiered lessons and complex concepts, your employees will miss the big picture (which can be critical to your organization’s success).  

Not to sacrifice substance for brevity 

Short does not automatically equate to engagement. If microlearning does not employ known cognitive science principles, information likely isn’t sticking you’re your learners — no matter how short it is, or if employees like it. 

Not for multi-tasking 

It may seem that microlearning can be completed while also being productive elsewhere. However, multitasking leads to fragmented learning. Fragmented learning occurs when there are not clear objectives for time spent learning, or when learning time is not clearly delineated from other activities. This is not conducive to information retention. 

While microlearning can be misused in these ways, learning and development professionals can avoid these common mistakes by implementing best practices.  

How to incorporate microlearning the right way 

Microlearning can fall short of its long-term retention promises by some delivery methods, but when applied from a cognitive-science perspective, it is an effective learning tool. If you’re considering how microlearning can fit in your training program, here are some things to look for to ensure your microlearning works. 

Qualities of effective microlearning 

For microlearning to work, it should adhere to brain science principles that are known to create lasting learning. Amplifire’s eLearning platform employs cognitive triggers — mental mechanisms identified through research by the world’s leading cognitive scientists — that induce fasting learning and longer retention. When it comes to microlearning, it’s not the shortness of the lesson that is engaging. It’s a whole host of factors working behind the scenes to enrich the learning experience, making learning happen faster. Here are some examples of if cognitive triggers that Amplifire’s platform uses to make shorter learning engaging, fast, and effective: 

Motivation 

While shortening attention spans may suggest a general lack of motivation, motivation readily exists in our minds — we just have to trigger it. On a molecular level, motivation is generally facilitated by the neurotransmitter called dopamine. While many people associate dopamine with pleasure, it is actually responsible for kickstarting pleasure by prioritizing human attention and interest. Motivation compels us to acquire the necessary information to get us from where we are to where we want to be or what we want to do. Understanding the motivational feedback loops can help us channel them into long-term learning. Stimulating curiosity, implementing rewards, creating uncertainty and risk factors, generating optimism through progress (that rewarding feeling when you complete a session), and gamification can boost motivation, thus keeping learners engaged and focused on learning. 

Spacing 

The spacing effect shows that “cramming” information in one massed setting is about the worst of all possible ways to learn anything for the long term. Research reveals that the optimal study gap to test interval is 10% to 20%. That breaks down in the following practical manner: 

• If the time to the test is 1 week, the optimal study gap between initial study and restudy is 1 day. 
• If the time to the test is 1 year, the optimal study gap is 3 weeks. 

When restudy takes place too closely following the initial study session, there is little effect on memory. However, learners can achieve 300% memory gain if the proper study gap to test interval is used. Microlearning makes it easier to deliver spaced learning.  

Repetition 

Science has shown time and time again that repetition is an effective way to commit information to memory. Psychologist Herrmann Ebbinghaus demonstrated that a first learning attempt creates a memory trace, but that trace is vulnerable to rapid forgetting. He also discovered that memory improves through repetition and flattens the rate at which we forget things. 

In the 1950s, psychologist Donald Hebb postulated that repetition is linked to the strength of the synaptic connections between neurons — memory formation. He pointed out that “neurons that fire together, wire together.” The more something is repeated, the stronger the memory pathway is forged. You can maximize repetition both within a microlearning session and by delivering the same information over multiple microlearning sessions.  

Retrieval 

Repeating information in an assessment format during microlearning also triggers the retrieval process — a powerful technique for better learning (known as the test effect). And assessment can be one of the most effective ways to learn. Microlearning through assessment format is a potent combination. In a study (Roediger and Karpicke) where groups of students were asked to 1) read a passage four times, 2) read the passage three times and test memory once, and 3) read a passage once and test memory three separate times, the third group that prioritized memory testing rather than merely repetition retained 62% of the original information, whereas the first group retained only 39%. This demonstrates the power of activating the brain’s natural retrieval process to commit information strongly to memory. 

Microlearning best practices 

In Amplifire, learners can complete smaller, shorter modules within a larger course, creating a microlearning effect without missing the “big picture.” Delivered through our eLearning platform, these modules are more effective than say, app learning, because they incorporate cognitive triggers like other methods can’t. We’re sharing some of our best practices so you can implement microlearning in a meaningful way.  

Modules 

As we mentioned, within Amplifire, courses can be broken into modules so learners can work in shorter segments without losing context. While microlearning sometimes isn’t suitable for complex topics, modules can help build the depth you need for your training.  

Assessment format 

Speaking of building, microlearning can also act as a primer for hands-on learning. In situations where online learning can’t quite replace hands-on practice (ex. Flight simulators, patient care), it can be a great way to prepare for real-world scenarios. Priming is a cognitive trigger (as identified by Amplifire’s Science Advisory Board); the process of pretesting “primes” the mind for learning and improving long-term retention, maximizing your training efforts. The Amplifire platform uses the Socratic method of questioning to incorporate the pretest primer in the learning process. This way, learners are actively engaged in learning, rather than simply watching a video or reading a passage. If microlearning can’t replace all training, it can certainly give it a much-needed boost. 

Data 

Another benefit of online-hosted microlearning is backend data. Amplifire’s AI collects learner data based on their interactions through the answering process. It sees when learners struggle, where they were misinformed and when they were uncertain. Microlearning might not come easily to all of your learners, so learner analytics can help you identify which learners struggle with what, so no one gets left behind. Amplifire’s in-depth reporting gives you the tools to offer highly personalized coaching when learners need it. 

Refreshers 

When learners present a large amount of struggle during learning the first time around, Amplifire creates a refresher course for them to briefly review those topics. Forgetting is inevitable, but when learners who struggled take the time to complete a short — dare we say “micro” — refresher, that information they worked hard to learn becomes solidified. These smart refreshers are short because it only serves up content where they didn’t have prior knowledge, saving time in the process.  

Faster learning does not have to compromise the quality of our learning. As we evolve socially in the world of endless tech and seemingly shorter focus, our wiring remains the same. Learners can enjoy shorter and smaller learning sessions, but still retain the same amount of information with an eLearning platform that adheres to brain science principles. Microlearning is not merely a learning trend when implemented appropriately, powered by cognitive science. Boost learner engagement and satisfaction with the flexibility that microlearning offers. Furthermore, shorten training time, reduce costs, and maximize scalable learning opportunities for your organization.  

From the beginning, Amplifire has relied on innovative brain science to guide its product development to create the most effective learning and training solution, perfectly tailored to the way the human brain works. Learn more about how Amplifire helps people learn better and faster by checking out a demo.

101 Series: Building Online Learning Platforms with Cognitive Triggers and Switches

Not all learning is created equal. And when it comes to online learning, there are many routes you can take. People develop platforms to create different learning experiences and objectives, whether they simply want learning to be enjoyable, they need to just check a box that the course was completed, or they want the fastest and cheapest path to completion. But, in many cases, online learning platforms can’t demonstrate proof of learning. It’s not that fun isn’t valuable to learning, in fact, it can be when used appropriately. It’s not that the fastest options aren’t effective, because learning can be fast when people are engaged. But when evidence of learning matters and people need to retain important information longer, online learning platforms informed by brain science principles is the most effective route. 

Cause and effect drive the learning process. Causes out in the real world can lead to learning effects in the brain. Some “causes” are more potent than others, since people tend to remember some things better than others. In the cognitive science world, causes are known as “triggers” and the effects in the brain are known as “switches.” Amplifire’s learning platform was built from the research of some of the world’s most renowned cognitive scientists, who have discovered which triggers are more conducive to faster, lasting learning compared to others — in other words, the platform is designed to foster better learning. During learning, not only does Amplifire track and report on completion in online courses, but it also measures each learner’s path to mastery, demonstrating evidence that real learning took place.  

So how can triggers flip mental switches, and how do they translate into online learning platforms that facilitate faster learning and better retention? 

4 Steps to devising techniques in online learning 

One of our tasks is to describe useful distinctions between the triggers in the real world (which Amplfire’s engineers code into techniques in our platform) from the switches in the brain they affect. Here are four steps that describe the translation into online learning. 

• The first step considers the most useful model of what it is to be a human being that learns about the world, encodes a representation of it in their mind, and remembers it at will.
• The second step describes the learning switches in the brain that are active during learning and the memory formation.
• The third step identifies triggers in the world that switch on those circuits that are responsible for learning and memory.
• The fourth and last step invents techniques that can be coded into learning platforms. This stage is working through the cause-and-effect model and figuring out how information can be presented, tagged, timed, organized, and communicated to trigger the brain’s learning switches.

So if learning effectively in an online setting is reliant on these triggers and switches, what are they and how do they work? 

The learning switches in the brain 

These 14 switches are the result of decades of scientific research and have been previously identified by Amplifire in various papers (see our blogs on cognitive, emotional, and motivational triggers). These are the switches that Amplifire has discovered so far that have a direct bearing on memory, cognitive processes, and the emotional and motivational drives to learn. 

Turning triggers in the real world into online learning techniques 

Triggers and switches correlate to causes and effects. However, the distinction between a cognitive trigger and a mental switch is not always clear. For example, take the phrase “fun and games.” The two words seem nearly synonymous, but upon inspection we can see that fun is an internal experience that a person feels inside their brain. It’s an emotional state that derives from some combination of valence and activation on the map of human emotion and it has a biochemical source which originates in a lovely combination of the neurotransmitters serotonin, dopamine, and norepinephrine.  

Games, on the other hand, exist out in the world. Monopoly and baseball exist outside the brain, nevertheless, they have a profound effect on the feelings the brain generates. A game is a trigger that throws the internal switch called fun. This is also an example of what the Amplifire platform achieves in the learning process. Amplifire’s task is to find the triggers that throw the switches that lead to learning, and then code those triggers into online techniques. 

Here are some ways that triggers appear in Amplifire: 

Multiple-choice questions: According to research by some of the world’s leading cognitive scientists, the multiple-choice format is the best type of test question to truly promote better, long-lasting learning. The multiple-choice format used by Amplifire presents a prompt with several answers in which one or more choices are correct, and one or more choices are incorrect. The test-taker must read and contemplate all the answers to determine which is correct, invoking a “search and retrieval” of information stored in the brain. Therefore, multiple choice is not merely about recognizing the correct answer. It is a combination of recognition and recall, tapping into the cognitive process that increases memory retrieval and storage strength. 

Feedback: Feedback is a great way to directly access the brain’s natural memory-storage process to help learners retain more correct information. Studies have shown that feedback in the form of a correct answer and explanation can improve retention dramatically. This is especially true for low-confidence, correct answers. Let’s face it, we’re not always confident about the answers we give, but feedback including the right answer can help solidify correct information in learners’ minds. Therefore, offering an opportunity for feedback (slightly delayed after a learner answers a question) can greatly enhance retention. Amplifire includes feedback for every question and response type. 

Repetition: The rehearsal process is one of the most effective ways to create long term memory. Science has shown time and time again that repetition is an effective way to commit information to memory. Psychologist Herrmann Ebbinghaus demonstrated that a first learning attempt creates a memory trace, but that trace is vulnerable to rapid forgetting. He also discovered that memory improves through repetition and flattens the rate at which we forget things.  

In the 1950s, psychologist Donald Hebb postulated repetition is linked to the strength of the synaptic connections between neurons — memory formation. He pointed out that “neurons that fire together, wire together.” The more something is repeated, the stronger the memory pathway is forged. In Amplifire, the platform repeats a question until mastery is achieved, showing that learning has occurred. 

These are just a few examples of how learning that’s guided by brain science is uniquely effective, and we’ve seen our clients enjoy the benefits of science-based learning time and time again. For further detail on cognitive triggers, emotional triggers, and motivational triggers, continue reading about the psychology and science of learning on our blog. 

From the beginning, Amplifire has relied on innovative brain science to guide its product development to create the most effective learning and training solution, perfectly tailored to the way the human brain works. Learn more about how Amplifire helps people learn better and faster by checking out a demo.

Psychonomics 2022: “The Frequency of Online Learners’ Off-Task Behavior”

By Matthew Hays, Ph.D.

COVID-19 catastrophically disrupted classroom learning. Dormitories were emptied. High schoolers had lunch in virtual cafeterias. Kindergarteners tried to learn what personal space was over Zoom. The cost to social and interpersonal development is immeasurable and the impacts will be felt for generations.  

But what about the cognitive cost? There is substantial evidence that learning suffered during the pandemic. The average student’s test score has plummeted and former honor-roll students are failing. Some students are now four grade levels behind.  

The easy conclusion to jump to is that online learning doesn’t work. It’s an intuitive leap; it’s much harder for a teacher to see if a student is paying attention when they’re a tiny tile on a laptop screen than when they’re a real human in a classroom. And getting distracted can certainly cause learning to suffer.  

But there’s not a strong relationship between how long students were in remote school and how much educational impairment they suffered.  

So is distraction really the culprit? Is online learning so plagued with interruptions that learning is impossible? Or were the social and emotional stressors of the pandemic and lockdown more than enough to impair education? 

To investigate how often online learners were distracted, we analyzed data from 2,145,977 university students across the world as they completed textbook companion modules from 2019 through September 2022. We used a standard mathematical outlier calculation to define when online learners were interrupted. We then looked at the overall interruption rate to see how often online learners were distracted. We also looked at changes in that interruption rate by month to see the impact of COVID-19.  

We’ll be presenting the results at the 63rd Annual Meeting of the Psychonomic Society in Boston at noon on Saturday, November 19. Come on by to see what we found! If you can’t make it in person, join us online. 

Getting K-12 Math Back on Track with Adaptive Online Learning

Last week, the Education Department released a report revealing the largest year-over-year decline in scores in every state. The numbers exposed a bleak reality: only 26% of eighth graders and 36% of fourth graders are proficient in math (down from 34% and 41% in 2019, respectively). This decline has occurred despite the federal government making the largest single investment in American schools — $123 billion, or about $2,400 per student — to help students catch up after the pandemic.  

Americans are trying to make sense of any trends in the report, but nothing is neatly adding up. During the pandemic, school closings did not necessarily correlate to bad test scores. For example, California, which closed schools longer, and Florida, which was known for staying open, both declined slightly less in math scores than the national average. Texas, which was among the soonest to reopen, saw math scores plumet.  

There are some telling metrics that divulge some significant gaps in American math education. In fourth grade, students in the bottom 25th percentile lost more ground in math compared with students at the top of their class, leaving the low-performing students further behind. Moreover, only half of fourth graders who were low performing in math said they had access to a computer at times during the 2020-21 school year compared with high-performing students. 

Some have responded to the report insisting that the $123 billion investment isn’t enough to close the gap, yet, just under 5% of the investment was spent as of Jan. 31, 2022 — some 10 months after funds were disbursed. “Many districts do not have a concerted plan for math,” said Marguerite Roza, the director of the Edunomics Lab at Georgetown University, who is tracking pandemic relief spending. Between district leaders’ demands, the time it takes to vet proposals, issue contracts, and hire and onboard teachers and counselors who then draw down salaries, the delay in spending is not surprising.  Although, the longer spending is delayed, the larger the math gap will become. Not to mention, the funds expire in September of 2024.  

As school districts start spending the funds in a variety of ways, only time will tell which solutions work, and which do not. The growing knowledge gaps, lack of equal access to technology, teacher burnout, and absence of any proven-effective solution are daunting and will continue to catch up to students. ELearning platforms, like Amplifire, provide a uniquely intersecting solution for these nuanced issues. According to a 2021 study that analyzed data from more than 2,500 K-12 students using curriculum-based online learning software both before and during the pandemic shutdown found that students’ performance actually increased during the shutdown. While there is no unified plan to attack the U.S.’s K-12 math problem, online learning stands out as one solution that is proven to work, despite speculation.  

Closing the math gap with online learning 

Flexibility 

During the pandemic, schools closed, then reopened, and closed again, and grappled with opening and closing. They navigated hybrid solutions, software, technology access, learning curves, and other obstacles. As hybrid learning gained momentum even before the pandemic, it became a necessity after 2020.  

The silver lining of needing a remote solution is gaining the infrastructure for a hybrid or blended learning solution, which makes learning much more flexible for both teachers and students, thus increasing the amount of learning that can be achieved in variable circumstances. For example, if students or teachers get sick, learning can continue uninterrupted through an online platform. Schools can offer more choice, so students don’t fall behind.  

Personalized learning experience 

What the Nation’s Report Card shared is that the bottom 25th percentile fell even more behind than the top students. Therefore, a one-size-fits-all solution simply will not work. With staffing shortages, schools struggle to offer personalized learning for every single student. But Amplifire’s adaptive platform does just that. People in general have vary levels of base knowledge. Amplifire’s adaptive learning algorithm tailors learning to students’ individual knowledge gaps, uncertainties, and misinformation, making sure no one falls behind and everyone achieves mastery. 

Instructor support 

From the adaptive learning algorithm, Amplifire collects data based on numerous student interactions throughout the learning process. This data provides learner analytics to teachers, who gain a window into their students’ minds. As the math gap widens, it makes teachers’ jobs more difficult as they strive to ensure their students get the help they need to be proficient. Amplifire’s learner analytics offer detailed remediation plans so teachers can offer personalized coaching to struggling students. For schools with staffing shortages or for teachers experiencing burnout, these analytics do more of the technical heavy lifting so teachers can do what they do best: teach! 

Proof of learning 

Data not only helps inform instruction, but it also provides evidence of learning. At a time when educators and school districts are under a microscope, having rich data to show how learners have mastered material proves progress has been made. For many school districts, the path to raising math scores is ambiguous; with eLearning, progress is clear and trackable. Learner data can also inform education strategy, as improving scores after such a sharp decline will take longer than one year.  

While the education funds spending deadline will come and go, an upfront investment in technology and training is a lasting solution that will support staff as they continue to tirelessly serve students — and an investment that has already happened for many schools that relied on hybrid and remote instruction throughout the pandemic. While math scores have declined, there is no evidence to suggest that closures or early reopenings were the culprit, so why not lean into the future of learning without temporary solutions?  

Moreover, Amplifire’s eLearning platform is built on brain science discoveries, which have been shown to help people learn faster and retain more information. Just as the platform offers learner analytics to inform instruction and teaching strategy, it also employs cognitive science-backed learning principles that are proven to foster better learning and recall. School districts can be sure they’re using every possible (and scientifically proven-effective) method to get students back up to speed and ahead of the game with stronger recall than traditional learning settings. 

Learn more about how eLearning will close the gaps in K-12 math or see how Amplifire and the science behind learning can benefit your educational needs and download our education case study or check out a demo.