The first four steps should be completed before starting the website design. Although it is tempting to skip these steps, their importance cannot be overemphasized. The success of a Web-based educational intervention rests on thorough preparation.
Step 1. Perform a needs analysis and specify goals and objectives
The first step in any educational endeavor is needs analysis, including problem identification, assessment of learners’ needs, and assessment of the teaching environment. Kern et al.'s approach 12
is useful: define the health care problem you hope to address by creating an online course, and identify what is being done and what should be done to address this problem. Describe how the current performance of your learners (knowledge, skills, attitudes, and behaviors) differs from the ideal. Determine learners’ perceived educational needs and preferences. Evaluate resources and barriers in the teaching environment (including those in Steps 2 and 4).
Use the needs analysis to develop goals and objectives that address the gap between current and ideal performance, taking into account available resources and learner perceptions. Objectives for online education tend naturally to focus on medical knowledge, but skills and attitudes can also be taught online. Well-stated objectives focus the design and function of the program, including evaluation. List the goals and objectives on the final website.
Clear objectives help define the role of online learning in your setting. Will it supplement an existing (traditional) course, or be the primary method of instruction? Most online teaching in medical education has supplemented existing courses, but many courses have been successfully taught completely online.
Estimate the class size. In Web-based teaching the classroom never fills up and handouts never run out, but this does not always mean that Web-based classes can expand ad infinitum
. In an automated course—that does not require instructor intervention—an extra learner requires virtually no additional resources (a barely perceptible increase in network usage, and possibly a per-user fee on software or copyright licenses). However, in courses where the instructor plays an active role (moderating online discussion, for example) extra students will have a direct effect on faculty time.13
Step 2. Determine your technical resources and needs
Effective course design requires an understanding of both the subject and the instructional medium.7
The technical details of Web design and programming can be delegated to a specialist, but a multidisciplinary approach—with at least one team member having in-depth understanding of Internet operations—is desirable.9,14
Meet early with an information technology specialist to discuss technical matters. At least one author recommends doing this even before setting goals and objectives.10
You need to know the resources and limitations of your local network, including the number, type, and capacities of computers. Are there tools for multimedia development (digital camera, scanner, drawing and photo-editing software, equipment for recording and editing audio or video)?
Determine what e-learning management software (termed “courseware”) is available at your institution. Content-free courseware provides tools (student registration, security, quizzes with automated grading and personalized feedback, online communication with instructors and other learners, tools to monitor learner participation, etc.) to assist the developer in implementing an e-learning website.15
WebCT (WebCT Inc., Lynnfield, Mass) and Blackboard (Blackboard Inc., Washington, DC) are the most widely used courseware systems, but many others are available. Toohey and Watson review points to consider in selecting courseware.16
If you plan to employ a specialist or team to develop the site, find out whether they have developed an educational website before, and estimate development cost and timeline. Additional questions for those planning to develop the site themselves are listed in the Appendix
Determine the technical resources and needs of your learners. Have they participated in an online course before? Are they comfortable using the Internet? If they will complete the curriculum from home, what computer system (Apple or PC) do they use, and what is the computer's capacity? What software do they use? Do they have high-speed Internet access? You will either need to accommodate the learners’ resources or specify computer system requirements for the course.
Step 3. Evaluate commercial software and use it if it fully meets your needs
It is probably cheaper to buy commercial software on your topic than to develop it yourself. Critically assess how well it meets your needs before purchasing. First decide whether it aligns with your goals and objectives. A perfect match is unlikely, but is it close enough? Next determine whether the product will work on your network (consult your specialist). Most importantly, evaluate how well it capitalizes on Web resources (Step 5), promotes active learning (Step 6), and provides for evaluation (Step 8).
Even if existing software does not meet your needs, you may be able to purchase and implement part of the material you review (for example, an interactive anatomy atlas) as an element in your course. You may also get ideas on content or presentation that you can incorporate into your design.
Step 4. Secure commitment from all participants and identify and address potential barriers to implementation
Technical needs are important in an online course, but the human element is critical. Secure acceptance and commitment from all involved—administrators and faculty in addition to learners. In our experience, potential barriers include resistance to online learning, inadequate computer skills, insufficient time, or perception that the curriculum is a low priority. Identifying barriers early allows you to address them in a timely manner—before implementation begins. Greenhalgh 17
suggests targeting staff development to the needs of a given project, rewarding staff who participate in online initiatives with recognition or promotion, encouraging collaboration between content experts, educators, and technical specialists, and actively working to change organizational culture.