Lesson Plans: Classroom v. eLearning in Healthcare

Quote from Lesson Plans Classroom v. eLearning in Healthcare blog post that states, "Let’s consider using eLearning combined with classroom learning."

Ah, the great debate: classroom vs. online. We have seen a huge movement toward computer-based training in every industry thanks to its cost effectiveness and ease of delivery and tracking. Despite those benefits, however, we still need to ask if it’s the best way to train, and how much, or even, how well information is retained long-term. Additionally, development of online tools can often be time consuming, and requires both eLearning developers and subject matter experts to be involved. With that kind of investment, it’s important to carefully evaluate eLearning before jumping in with both feet. In my opinion, there can certainly be a time and a place for both.


Let’s assume that you are planning the implementation of a new Electronic Health Record. You will need to assess the materials to cover, the audience, the resources you have, and the timeline in which this all must occur. Here’s an example of what your situation might look like:

  • What: New EHR
  • Who: 80% of all employees in the organization
  • When: Go-live is one year out; your training program will need to be ready ten months out
  • Time with material: Up to the 10 month’s mark the new build is in near-constant change, so training materials will need to be continuously updated during the progress
  • Time to train: Two months

Determining the Approach

As the Training Manager in the scenario above, I will need to train a large group of people in a short amount of time. Your initial response may be to push eLearnings out to each of them and save your organization a large amount of capital on classroom training resources. However, let’s back up a bit and review (or evaluate) how eLearning lessons are built and received.

The average build time of 40 hours is typically required to produce one hour of eLearning (yes, really). With these build times up against your tight training deadlines, this may result in out-of-date eLearning, before you even begin assigning them.

Think back to the last time you watched an eLearning or a Classroom Based Training (CBT) session.  Did you really watch it? Or did you figure out how to advance to the next item with the least amount of time and energy spent?  Maybe you did pay attention, but how much of that material could you recall a day, week, or month later?

Exclusive eLearning

When disseminating a lot of information to an audience, with little to no experience, exclusive eLearning is very likely not your best approach.

Chances are that online training alone is not going to work in this situation. So let’s consider using eLearning combined with classroom learning. This could work in my scenario, but only with careful consideration of the following:

  • What is the “right” amount of eLearning? 5 minutes? 15 minutes? 1 hour?
  • Where will the eLearning sessions be viewed?  Do I need special workstations with speakers set up outside of patient care areas?  How many of these types of stations would I need?
  • How will my end users access these eLearning sessions?
  • How do I track completion?
  • Can the eLearning sessions be accessed outside of our organization for exempt employees and providers who may want to view at home?
  • Will these be required as a pre-requisite to a classroom, and will they be turned away if they arrive at class without completion?

After carefully reviewing the material, I find there are some basic functions that can be conveyed via eLearning with little risk of it becoming obsolete due to changes in the build. These eLearning lessons could also be reviewed during a classroom break to for those who were unable to complete the eLearning prior to class. I would also post the eLearning sessions for review in staff meetings and have them readily available as the organization prepares for changes.

Setting Up for eLearning

Here are some examples of eLearning lessons I would have developed based on our scenario above.

  1. Accessing the new system and logging in (Length: 3 minutes)
  2. Basic navigation to include screen layout, menu options, locating a patient, and reviewing their chart (Length: 5 minutes)

Reviewing your inbox and responding to incoming messages (Length: 5 minutes)

The items selected for eLearning have a couple things in common:

  • They all address items that every person will need to know.
  • They are short.
  • They would be interactive.

They will all be readdressed in classroom training, allowing for us to remove the awkward scenario of having to turn someone away due to incomplete eLearning.

In the described scenario, there will be a lot of classroom training needed to adequately prepare the organization for the new system. As with eLearning, classroom training can be difficult for many adult learners. A classroom approach needs to be outlined just as carefully, with adult learning processes in mind.

  • Are you limiting your classroom sessions into easily digestible amounts of time? Or do you have 2-3 days of straight technical training planned?
  • How is your material organized? Does it truly follow a workflow as performed on the job, or just the “steps” outlined in the project documentation? Is it relatable? Does it lend to frequent changes in classroom dynamic (i.e. group discussion, end user led discussion and exploration)?
  • What materials are available to your learners post-training?  Is there a process for their learning to continue outside of the classroom?
  • Are you ready to respond to requests of extra training required, or extra practice time for those learners who may take more time with the material to retain it?

Layout of eLearning Classes

Ideally, I would limit all classes to four hour blocks. In addition, I’d require end users to attend each four-hour block of training with at least one day off in-between. This would prevent cognitive overload and allow time for memories to convert from short-term to long-term, making it easier to recall information in their second session. Each day they return, their recall will strengthen as they incorporate and apply new information with material from previous lessons, better preparing them for when they need to perform on their own.

Setting up lesson plans for effective classroom training can be tricky. I use a fairly straightforward outline:

  • Review the Big Picture
  • Identify a subset of the big picture to focus on
    • Where does this process/workflow fit in the big picture
    • Instructor Demo — hands off the computer
    • Do one together — hands on the computer
    • Do one on your own — hands on the computer, self-guided exercise
  • Review and questions
  • Repeat Step 2 as needed throughout the session
  • Use real life scenarios
  • Include realistic details (ie, you have just finished your morning huddle. Now let’s review our hand-off report in the new system)

Final Thoughts on eLearning

In the described EHR implementation scenario we used as an example and based upon the objective analysis of the particulars decided it made sense to use a classroom-heavy training program, with some eLearning enhancements.

If I were to analyze this organization a few months later on and started preparing for their onboarding training then, my approach would shift significantly. Knowing that the EHR build is stable and an end user base has an experienced preceptor to assist with long term learning, I can change my strategy. This new  heavy eLearning base, minimal classroom training, and extensive preceptor involvement.

I would love to say there is a simple “one-size-fits-all” solution out there, however, that’s never really the case. Having a good understanding of details and required outcomes is the first step towards improving your program.

If you’re evaluating your technical training program, consider bringing in an experienced consultant to create a game plan.