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Table of Contents
I. Introduction.. 4
II. Methodology.... 4
a. Expected Outcome,...... 4
b. Identified Learning Gap... 5
c. Description of Prototype........... 6
c. Target Audience........ 6
e. Tryout Process.. 7
f. Tryout Conditions. 7
g. Observations.. 8
III. Results..... 8
a. Entry Conditions//...... 8
b. Instruction.. 9
c. Learning Outcomes.... 9
1) Demographic survey outcomes... 10
2) Usability test outcomes 12
3) Observational outcomes...... 12
d. Recommendations 15
IV. Summary ... 16
V. Appendices..... 16
Appendix A: Learner Demographic Survey 16
Appendix B: pretest and posttest Questions 17
Appendix C: Usability test... 19
Appendix D: Observational Notes... 20
I. Introduction
This study evaluates an instructional eLearning module used for determining blood
types and for determining compatibility of potential blood donors. The module, submitted
as a final project for an interactive multimedia class in the Masters in Instructional Science
and Technology program at CSUMB, provides an educational resource for schools
encouraging blood donation by holding blood drives. Using standard multimedia learning
principles, this module teaches both the basics of blood type and the importance of bloodtype compatibility. It also aims to help users realize the importance of blood donation and
how a particular blood type can save lives.
To determine the effectiveness and usability of the eLearning module this
evaluation includes a short demographic survey of seven evaluators (Appendix A), a pre
and posttest (Appendix B), a short usability survey (Appendix C) and observational notes
(Appendix D). Descriptive and inferential statistics (Appendices E - H) were used to
summarize the raw data and test our hypotheses that users completing the training module
increased their knowledge about blood type and compatibility.
II. Methodology
a. Expected Outcome
The specific Learning Objectives of the blood compatibility module are as follows:
Learners will be able to list no fewer than three reasons for the constant need for
donated blood.
Learners will be able to compare and contrast different blood types.
Learners will be able to explain the purpose of antibodies in the test procedure.
Learners will be able to describe what positive and negative mean for blood
types.
Learners will be able to identify the universal donor and universal recipient blood
types.
Learners will be able to identify the most and least common blood types in the
United States.
Learners will be able to recognize that people do not produce antibodies against
dangerous reactions.
Given a list blood types, learners will be able to choose compatible donors.
Given example test results learners will be able identify the correct blood type.
description of the path that donated blood travels. By marginalizing the donor, they
fail to help the donor make a personal connection to the blood donation, thus
reducing motivation to donate blood.
c. Description of Prototype
The eLearning module, designed in Adobe Captivate 8.0, is a 15 minute
multimedia instructional unit on blood compatibility that addresses the need for
donation, the distinctions and compatibilities of blood types and the testing
procedures used to type test blood. In addition to interactive instruction, the module
includes various types of assessments and culminates in a final scenario-based
assessment in which the learner is given information about an injured person that
needs a blood transfusion. Formative assessments are used throughout the
instruction. The purpose of this e-learning is informational rather than evaluative;
users have multiple attempts to successfully answer the questions, which are
provided after several failed attempts.
d. Target Audience
This eLearning is targeted to blood-donation-eligible students in high school
or college (with average ages from 16 to 21) but may also include older adults who
are recruited for community blood drives. Learners may be familiar with the
concept of blood donation but may not know the specifics of the need for donated
blood nor how blood is typed and deemed compatible for recipients.
There are several preconditions. Learners must be able to see, hear, read and
understand English, and be able to use a computer to click, type, open and close
applications and navigate the internet. Delivery of the module as well as pre-and
posttest will be via web link, thus access to a computer with internet access is
required.
e. Tryout Process
The team, which consists of three researchers/authors of this paper (Brown,
Erlin and Hauptman), asked evaluators via email and in-person to test this module.
We asked seven evaluators to participate in the testing process. Of the seven, two
responded to in-person requests while five responded via email message. One of the
team observed those first two evaluators while they were completing the pretest, the
module and posttest) but did not interact with the tester. Appendix C includes notes
from that interaction.
Testers started with a Google forms demographic survey and pretest, then
connected to the e-learning module via a link they found at the end of the pretest.
After completing the blood type module, testers completed the posttest. The preand posttests contain the same questions but the pretest includes a demographic
questionnaire portion and the pretest includes a usability section. The pretest had
nineteen questions and the posttest had twenty. The team analyzed the pre- and
posttest demographic and usability feedback results using Fluberoo (a Google
chrome add-on application), Microsoft Excel and StatPlus.
f. Tryout conditions
All testers used similar computers with internet access, and although the
computer hardware configurations were not standardized, all learners had access to
basic keyboard and mouse functions. All tests were administered in the same
setting: a quiet, distraction-free room. Prior to completing the blood compatibility
module, users took a pretest via Google forms. Test administrators informed the
users (in person or in an email message) that: I am completing a class in
Evaluation and Testing as a part of a Masters of Science program in Instructional
Technology. In order to determine the effectiveness of an e-learning module on
blood compatibility as an evaluation technique and to conduct a statistical analysis
on the results, you will take a short pretest, participate in the learning module and
then take a short posttest. The evaluation will take approximately 20-30 minutes to
complete.
g. Observations
While two testers--tester one and tester two--took the pretest, the posttest
and the blood compatibility module, administrators took notes from a position a few
feet away. Interaction between the observer and testers was limited since observers
did not be answer questions during the evaluation process. See Appendix C for
observational notes. After the posttest the observer and tester discussed the module
and each slide to determine if they were confusing and in need of modification.
III. Results
a. Entry Conditions
The observed entry conditions were consistent with expectations. Computer
hardware, software and internet connectivity worked as expected and posed no
challenges and no interruptions occurred. Users successfully navigated the module
and posttest independently, though they required some direction to transition from
and to the instructional module (as it was not integrated with the pretest and
posttest). For users not directly observed, testers were provided with an email with a
set of links to the pretest, the eLearning module, and given written instruction to
conduct their evaluation in a quiet space free from distractions.
b. Instruction
Instruction was consistent with expectations. The module required
interaction, which kept the learners engaged. One user who was observed while
interacting with the module commented that the module was, actually pretty
interesting. According to feedback from the usability test, the instructions and
graphic interface were clear and easy to navigate. All learners completed the test
within the allotted time.
c. Learning Outcomes
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The learner performance on the pre- and posttest was analyzed and the
variance was deemed significant. The mean performance on the pretest was 60.2%,
with a standard deviation of 0.18, and a sample variance of 0.03. While the mean
performance on the posttest was 86.6%, with a standard deviation of 0.07, the
sample variance was 0.0054 (See Appendices E, F & G)
Since the two samples formed a dependent, test-retest type of study, we used a
paired two-sample t-test comparing means. Our hypothesis was that the results of
the posttest would be higher than the results of the pretest. Thus our null hypothesis
was that the posttest performance would be less than or equal to the pretest
performance. Since we are looking for the significant variation to be specifically
higher in the posttest than the, our hypothesis is directional, therefore we used the
one tailed distribution in our analysis.
The results of the t-test, with 6 degrees of freedom, yielded a test statistic of
3.7411. With one tailed distribution, the critical value is 1.9432. This yields a plevel of 0.0048. With the test statistic higher than the critical value, this suggests
that we can conclude, with confidence of approximately 99.52% that the variation
in performance from pretest to posttest was due to something other than random
chance. Given the test-retest design of our study, and our alpha of only 5% (looking
for only 95% certainty) we can reject the null hypothesis, and state that the gains in
learner performance was due to the instructional module on blood compatibility.
In a question-by-question comparison of pretest mean score to posttest mean
scores (See Appendix H), there was an increase in the mean score of 10 out of 14
questions. Specifically questions 1, 2, 3, 4, 6, 8, 9, 10, 11 and 12 showed an
11
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3) Observational Outcomes
Of the two testers observed, Tester 1 took eight minutes on the pretest,
14 minutes on the module and 6.5 minutes on the posttest. Tester 2 took
longer on each task than Tester 1. Each of the two observed testers took a
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shorter amount of time on the posttest than on the pretest, which covered the
same content questions and was of similar length.
During the observation, Tester 1 significantly slowed her pace during
the first drag and drop interaction (slide 12) and asked, So, I just drag this
to the plate? The observer noted that after this first drag and drop slide,
Tester 1 only dragged one of the droppers to the well plate. This occurred for
every drag and drop feature on the module. The tester may have
misunderstood the purpose of the drag and drop function, not read the
instructions, or a combination of both. When asked afterwards, the tester
said that they could not recall why they only dragged one dropped, I guess
I just did not understand what I was supposed to do, she said. Tester 1
slowed again during the pie chart (slide 22) and went through the contents of
the slide twice. When asked after the module, the tester explained that the
text on the pie chart was very hard to see.
When she reached slide 21, concerning Rh factors, Tester 1 went back
to slide 20.
When the observer asked her why she went back a slide, she replied
that she did so to make sure that she had not missed information about Rh
factors on the previous slide. Tester 2 did not repeat any slides.
In the posttest interview, testers said they experienced the most
difficulty on the following slides:
Slide 21 - This slide explained why blood types carry the additional description of
being positive and negative. Both Tester 1 and Tester 2 looked puzzled and were not
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sure exactly what to do during this drag and drop combined with rollover
interaction.
Slide 25 - This slide includes a quiz question that challenges users to match blood
donors with potential recipients and was a stumbling block for both testers. Neither
tester got the correct answer in three tries. Tester 1 said that that the slide did not
have clear instructions and that the donor recipient columns seemed to be in the
wrong place. After taking the posttest, Tester 2 admitted that they did not
understand the directions on the slide.
Slide 27 - This scenario-based quiz question asks users to choose the correct blood
type when shown test plate results.
The observer encouraged the testers to speak out loud with a stream of
consciousness while completing the module. Tester 1 made only two comments
during the entire module. During the slide three of the module Tester 1 said, This
is actually pretty interesting, and during the first drag and drop feature of the
module, (slide 12) Tester 1 asked, So, I just drag this to the plate? Tester 2 made
only one comment, which came while they were viewing slide 21, how am I
supposed to know what Rh means? Did I miss something?
Neither tester scored a perfect score on the six-question quiz portion of the
module. Tester 1 correctly answered four of six questions and Tester 2 correctly
answered three of six questions. Tester 1 missed questions on slides 25 and 27 on
the first attempt but answered correctly on the second attempt. Tester 2 missed three
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questions on the first attempt: slides 27, 29 and 31 but answered correctly on the
second attempt.
After completing the posttest, testers were asked two final questions: What
did you like the most and the least about this module? Tester 1 said that, The drag
and drop feature made it interactive, which was fun but added that, The
narration was boring and too long which made it hard for me to keep my
concentration and interest.
Tester 2 said, The module was generally easy to follow and was
interesting. Noting, I liked the way that information was presented in all sorts of
different ways: a video, narration, and interaction. The pictures and graphics were
clear and helped me understand the material.
Tester 2 added that they did not like the YouTube video because it was, not
interesting and they wondered why it was included. Considering the module
content, Tester 2 also felt the quiz questions were too hard and that there should
have been more practice.
d. Recommendations
Although the paired two-sample t-test showed that the module was effective
in increasing knowledge about blood type, usability test results, direct observations
during testing and a drop in mean score of question 13 indicate that improvements
should be made to the module toincrease learner satisfaction and learning outcomes
for future users. Possible improvements to the module include:
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Changing the drag and drop directions (Slides 12-20) to stipulate that both droppers
should be individually dragged to the spot plate. Instructions should be more
prominent on the screen and in the narration.
Adding content to the module to explain what an Rh factor is and how Rh factors
contribute to blood type and compatibility.
Because learners had an especially difficult experience with the question on slide
13, it is likely that there is a problem with the module content, the way the
questions is written or both. The question reads: What types of antigens would a
person with blood type O have? The correct answer should be: no antigens yet a
majority of users marked O antigens. A slide should be added to the module
specifically investigating persons with O type blood and why they are optimal
donors (they have no antigens). Alternatively, the pre- and posttest questions might
be changed to read: Select the blood type that does not have antigens present on
the surface of red blood cells with the correct answer being type O blood.
Omitting (or making optional) the YouTube Video, which was deemed unnecessary
by one user.
IV. Summary
This analysis investigated the effectiveness and usability of an eLearning module on
blood types and compatibility and showed that participants who completed the module
significantly improved their scores when compared to scores recorded prior to using the
module. Mean scores in the posttests were significantly higher than those in the pretests. A
paired two sample t-test showed that there is a statistically significant difference between
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pre- and posttest scores and that the difference is not likely due to chance alone. A
question-by-question analysis shows that a majority of questions had improved mean
posttest scores with only one exception, the question regarding the type of antigens in type
O blood. Based on that statistic, on the results of direct observations of evaluators, and on a
usability test, this analysis produced recommendations for modifications to the module.
These include adding more information on type O antigens and Rh factors and modifying
directions on the drag and drop functions of the module.
Before releasing this eLearning module for use, researchers should engage in
additional testing within the designed target market, specifically high school and
college-age students.
V.Appendices
Appendix A:
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2. What makes one blood type different from another blood type?
a. Different antibodies
b. Different antigens
c. Different carbohydrates
d. Different color of cells
3. Which cells are important when we talk about blood type?
a. White blood cells
b. Red blood cells
c. Platelets
d. Plasma
4. What is the effect of using antibodies when testing for blood types?
a. They change color which we can see with our naked eye
b. They clot (clump) blood of the same type which we can see with our naked
eye
c. They turn the blood sample clear which we can see with our naked eye
d. They make microscopic changes to the blood sample which can only be
seen with a microscope
5. What do the terms positive or negative mean in terms of blood types?
a. Indicates presence or absence of a specific carbohydrate
b. Indicates presence or absence of a specific protein
c. Indicates presence or absence of a specific antibody
d. Indicates presence or absence of a specific antigen
6. Using the list below, what is the universal donor."
a. Type A
b. Type B
c. Type AB
d. Type O
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Anti-A
Anti-B
Anti-AB
Anti-O
20
Tester 1
Tester 2
pretest
8 minutes
11 minutes
module
14 minutes
16.5 minutes
posttest
6.5 minutes
8.5 minutes
21
module?
During the first drag and drop features of the module (slide 12 , Tester 1
significantly slowed their pace and asked: So, I just drag this to the
plate?
Tester 2 slowed down during the interaction with the pie chart slide 22
and replayed the slide. It was the one slide that this tester looked at
twice.
1. Did the tester repeat any slides? Were there slides or sections of the module that
the tester had to repeat (use the back button)?
Tester 1 went back one slide when they reached slide 21 (concerning Rh
factors) to make sure that they had not missed information about Rh
factors on the previous slide.
2. In general, where did it seem like testers experienced the most difficulty?
matches.
Slide 27 - this quiz question involves a scenario-based response and asks
users to interpret the correct blood types from the test plate results
shown on the slide.
3. Did the users make any comments as they were using the module?
Tester 1 said, This is actually pretty interesting. while using the module.
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During the first drag and drop features of the module (slide 12, Tester 1
significantly slowed his pace and asked: So, I just drag this to the plate?
There are six questions in the quiz portion of the module. Of the two users
who were observed, neither scored 100% on these questions.
Tester 1 missed two questions on the following slides on his first attempt:
slides 25 and 27. Tester 2 missed three questions on his first attempt: slides
27, 29 and 31
5. After completing the posttest, testers were asked two final questions:
a. What did you like the most about this module?
Tester 1- It was straightforward and direct. The drag and drop feature made
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Tester 2- The YouTube video was not interesting and I was not sure why it
was included. Also the quiz questions at the end of the module were too hard
considering what was presented in the content of the module. There should
have been more practice.
Sample size
Mean
Variance
0.602
0.03203
0.866
0.0054
Summary
Degrees Of Freedom
Test Statistics
Two-tailed distribution
Hypothesized Mean
Difference
3.7411 Pooled Variance
0.00E+00
0.01871
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2.44691
1.94318
One-tailed distribution
p-level
Pearson Correlation Coefficient
0.09754
G-criterion
Test Statistics
0.68129 p-level
1.56E-03
0.459
Pagurova criterion
Test Statistics
3.61062 p-level
0.99207
0.02591
0.02
Skewness
0.602 Skewness Standard Error
-0.45613
0.67082
Mean LCL
0.38943 Kurtosis
2.74363
Mean UCL
0.88192
Variance
-0.59121
Standard Deviation
1.18472
25
0.29727
Minimum
0.12829
Maximum
0.02745
Range
-0.00207
Sum
0.00207
0.47347 Median
0.03204
0.55325
Geometric Mean
0.74975
Harmonic Mean
0.54156 IQR
Mode
0.643 MAD
0.643
0.1965
0.072
0.02
7 Skewness
0.866 Skewness Standard Error
0.51314
0.67082
Mean LCL
0.77873 Kurtosis
2.22959
Mean UCL
0.88192
Variance
26
Standard Deviation
0.08484
Minimum
0.05343
Maximum
0.00463
Range
0.00016
Sum
0.00005
0.19439 Median
0.01315
0.83925
Geometric Mean
0.94425
Harmonic Mean
0.86083 IQR
Mode
0.857
0.857 MAD
Appendix H: pretest versus posttest mean comparison for questions 1-14 (q1-q14)
0.105
0.071
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Appendix I: Correlation coefficient data between testers who rated their initial knowledge
level and scores on a pretest.
Tester
Assumed
Knowledge*
% Correct pretest
Curran
60.00%
Aguilar
53.33%
Feroni
80.00%
Brown
66.66%
Kim
26.66%
Erlin
60.00%
Alaniz
46.66%
4=
Very knowledgeable
3=
Moderately knowledgeable
2=
1=
No knowledge at all
* = as self-rated by tester
Assumed
Knowledge
Pearson
Correlation
Coefficient
Critical
value (2%)
3.36493
Assumed
knowledge
%
correct
pretest
R Standard
Error
t
p-value
H0 (2%)
%Correct
pretest
Pearson
Correlation
Coefficient
0.85199
R Standard
Error
0.05482
3.63871
p-value
0.01492
H0 (2%)
rejected
R
Variable vs.
Variable
% Correct
pretest vs.
Assumed
Knowledge
0.85199
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