April 20, 2023By Teresa Gore

ADDIE Model for Healthcare Simulation Improvements

The ADDIE Model is useful to guide the development of healthcare education and clinical simulation. The ADDIE process is a step model that follows a circular pattern that repeats itself until the outcomes are achieved. Each step should be taken in the specific order: analysis, design, development, implementation, and evaluation. In the evaluation step, educators will obtain feedback and data to adapt or adopt the educational process for better learner outcomes.This healthysimulation.com article will explore the ADDIE model in healthcare education and simulation.

The ADDIE Process

ADDIE Model is an instructional design model that most instructional designers choose to create courses and learning material. The ADDIE process can be adopted from the ADDIE Model and used for the ADDIE Training Model. There are five stages in the ADDIE Training Model.

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A is for Analysis. One will need to analyze the learners’ knowledge gaps, their past experiences,and previous strategies that were successful and unsuccessful. Then the goals and expectations, and outcomes need to be explored to determine resources that will be required to be successful. As an educator, ask the “5 W’s and an H” rule.

  • Who is going to receive your training? (Analyze your trainees)
  • What will your training be about? (The context of your training)
  • When is the training going to happen? (Set a time-frame right off the bat)
  • Where is the training going to happen? (Will you deliver the training online or in a classroom?)
  • Why are you doing this? (The objectives of your training)
  • How are you going to achieve this? (The methodology and the requirements)

If one has a clear answer to each one of these questions as well as a general analysis of the current situation, the next move is to the design phase.

The first D is for Design. The next phase is to take the information gained during the analysis step and design the experiential learning opportunity. The first thing to do is to decide what format/modality will be used to meet the objectives. Next the educator must determine the methodology and the strategy of simulation experience. Incorporating the INACSL Healthcare Simulation Standards of Best Practice are important to follow in the design of the simulation experience. Of particular importance are the following standards: simulation design, prebriefing, outcomes and objectives, evaluation, and facilitation. According to the simulation design standard, one must pilot test the simulation design before implementation. The testing can occur in the development phase of ADDIE

The second D is for Development. After the design phase of the experiential healthcare learning experience, the development of the experience begins. This is the stage when the educator brings all of the ideas into action. All the decisions made in the design stage are now operationalized. The development phase will need pilot testing. This is the perfect opportunity to perform a gap analysis after pilot tests. What is missing? What is needed? Were the objectives and outcomes achievable? Is the simulation appropriate for the learners’ level?

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I is for Implementation. Now that you have tested the simulation and made any necessary revisions, implementation of the simulation learning experience for healthcare learners occurs. At this point learners will participate in the clinical simulation as planned.

E is for Evaluation , the final stage of the ADDIE process. During evaluation of the experiential learning, remember to evaluate all aspects of the simulation. Evaluation includes the learner, the simulation, and the facilitator (educator). This is the power of ADDIE and follows the INACSL Healthcare Simulation Standards of Best Practice – Evaluation of Learning and Performance. Through evaluation of all aspects of the simulation and learners improvements in the simulation and learner outcome can be noted. Following the clinical simulation, remember to ask questions about the clinical simulation in the debriefing. What was learned? What could make the simulation better? What will be taken from the simulation into clinical practice? These questions provide the educator with a learner-centered perspective of the simulation.

Application of ADDIE for Faculty Development

To share personal experience with ADDIE, the author of this article would like to discuss the design of a faculty development course at an institution for all faculty involved in simulation. Based on the NCSBN National Simulation Study, the NCSBN Simulation Guidelines Checklist, and the INACSL Standards of Best Practice: Simulation (previous edition of the Healthcare Simulation Standards of Best Practice) a decision was made to develop a Foundations of Simulation Teaching faculty development course. To facilitate accessibility, a decision was made for an online, asynchronous course as the best delivery mode. The course was developed with a simulation subject matter expert (SME) and an instructional designer (ID). ADDIE was the model used in the development of the course.

The design of the course was sequential from Module 1 through Module 8. Learners started with a pretest to determine baseline knowledge prior to the start of the course, then proceeded to the first module. The course was delivered via a LMS. The learners were provided a short overview that outlined the purpose of the course, the objectives, and what learners should be able to achieve by the end of each module. Each module had a five question quiz upon completion of the module.

The course included several formative assignments and a final assignment. The final assignment was the development of a simulation scenario incorporating the INACSL Standards of Best Practice: Simulation. The scenarios developed were peer-reviewed pilot tested and incorporated into the simulations mapped across the curriculum. A post-test was taken to evaluate the knowledge gained through the course.

The collaboration between the simulation SME and ID produced a course that integrated the best practices in course design, online pedagogy education, and appropriate foundational simulation teaching content. The development of the course had an impact on improving simulation content knowledge and teaching practice among faculty. The pretest mean was 27.17 out of 40; the posttest mean was 36.13 out of 40, indicating an increase in knowledge regarding simulation teaching. Faculty exposed to the course incorporated what they learned into practice. This is one example of the ADDIE Model application in simulation education.

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