This document outlines an instructional unit on shock for paramedic field training using the ADDIE model of instructional design. It includes: 1. An analysis of the learning domains, digital divide issues, and appropriate learning platforms. 2. A design incorporating visual messages, multimedia, modules to change thinking, practice from simple to complex, and blended online/in-person learning based on constructivist and adult learning theories. 3. A development of online access, videos, simulators, and modules on shock types, stages, and case studies for participation. 4. An implementation plan with in-person and online activities to introduce topics, clarify misunderstandings, and demonstrate application through group work

1. Instructional Unit Design
Using ADDIE
Paramedic Field Training: Shock
Nicholas Favazzo
EDF 6284: Instructional Design
Image retrieved from http://www.laerdal.com/images/L/AEOVJABS.jpg

2. Analysis
• Learning Domain?
– Simultaneous Affective +
– Cognitive + Psychomotor
• Digital Divide?
– Social & Economic.
– Technology Training Integrated.
• LMS/ Online Forum
• High fidelity simulators

3. Design
• Visual Messages
– Visually Reinforced Key Objectives
• Hyperlink
• Highlight
• Multimedia
– Sequenced
• Modules: To change thinking process
• Practice: Uncomplicated to Abstract
Related to Transfer…
» Reflexive = Uncomplicated
» Mindful = Abstract
• eLearning
– Blended course
• Improves efficiency
• Allows better student ratio
• Theoretical Foundations
– Constructivist Tridimensional Design*
• Problem Based Learning (PBL)
• Self-Regulated Learning (SRL)
• Adult Learning Theory (ALT)
– Drive Theory
• Permits discovery of weaknesses and
opportunities for correction
• Real/ Contextual
– Live practice = Risk
– High-fidelity Patient Simulation
• Instructional Delivery
– Facilitated Small Group Interaction
• Social Constructivism
• Collective Intelligence
– Terse Large Group Presentations
• New ideas/ concepts
Image Retrieved from
http://www.mdc.edu/main/images/TreatingStan_Top_t
cm6-13855.jpg
*Seo K, Engelhard C. Using the Constructivist Tridimensional Design Model for Online Continuing Education for Health Care Clinical Faculty.
American Journal Of Distance Education [serial online]. January 1, 2014;28(1):39-50. Available from: ERIC, Ipswich, MA. Accessed November 15, 2014.

4. Development
MODULE/ TOPIC REQUIREMENT SPECIFICATIONS
1/Online Access Online Forum Must permit synchronous and asynchronous discussion and media sharing.
1/Online Access Discussion Groups
Asynchronous online discussions should be created following HIPAA-compliant patient
care reports with patients in various stages/ types of shock.
An area to upload images within the following categories should be made available:
“Not shock”, “Compensated”, “Decompensated”, “Irreversible” “Distributive”,
“Obstructive”, “Hypovolemic”, and “Cardiogenic”.
1/Online Access Video < 5 minutes covering forum access procedure.
1/Simulator Use Patient Simulator
Must have features to allow authentic, independent assessment and management of
shock conditions.
1/Simulator Use Video < 5 minutes covering features of the selected patient simulator.
1/Stock Shock “Unfreeze” Video
< 5 minutes depicting key points and contradictions of traditional shock instruction
(i.e. 3 vs. 4 types, different verbiage, etc.)
1/Stock Shock Video Projector AV equipment to display videos to class.
1/Stock Shock Whiteboard/ other
Large enough surface for instructor to document correct responses in groups to
establish proper schema.
1/Online Module Demonstration CPU Projector AV equipment to display computer walkthrough to class.
2/Shocking Shock Presentation
Still/ Time-based media production displaying apparently stable patients in various
stages and types of shock. Should highlight medications, age, and other factors that
alter typical compensatory mechanism and presentation.
2/AKA Shock Presentation
Still/Time-based media production displaying an assessment of the following patients
with discussion correlating :
 “Dehydrated” > Compensated hypovolemia
 “CHF” > Compensated cardiogenic shock
 “Fever” > Compensated septic shock
 “Anxiety” > Compensated obstructive shock
2/Simulator Interaction Video
< 5 minute video demonstrating:
 Proper and improper simulator interaction.
 Evaluator expectations
2/AKA Shock Simulations
Performance-dependent paths reinforcing key decisions in diagnosis and treatment of
shock.

5. Implementation
Module 1: “What We Were Told”
TIME TOPIC ACTIVITY
Start-0:15 Introduction Introduce instructors and review objectives & agenda.
0:15-0:30 Online Access Explain procedure; Have everyone access online module.
0:30-1:00 Simulator Use Explain features; Small group demo of simulators.
1:00-1:15 BREAK Restroom & refreshment break.
1:15-1:20 Stock Shock Class watches “unfreeze” video.
1:20-1:50 Stock Shock
Place each learner in either “types” or “stages” group.
Each group has 10 mins. to plan, then present <10 mins. each, on the major points related to their topic.
1:50-2:20 Stock Shock Instructor starts a facilitated class discussion to clarify identified needs by asking, “Was everyone taught the exact
same thing?” The discussion should explicitly classify and differentiate among the types and stages of shock that
are acceptable in this course.
2:20-2:30 BREAK Restroom & refreshment break.
2:30-3:20 Stock Shock
Divide “types” group into “distributive”, “obstructive”, “hypovolemic”, and “cardiogenic” groups.
Divide “stages” group into “not shock”, “compensated”, “decompensated”, and “irreversible” groups.
Each group to discuss 10 mins, then present <5 mins. each, on the A&P, assessment, and treatment related to
their topic.
During this process, instructor notes the correct responses for class.
3:20-3:40 Stock Shock Instructor reviews all of the correct responses and elicits missing components through Socratic questioning of the
class as a whole.
3:40-4:00 Online Module
Demonstration &
Assignment
Instructor will demonstrate how to access and contribute to online modules by adding some of the responses
noted during the group presentations in applicable categories. NOTE: This process can be completed after
dismissal.
The instructor should communicate times that s/he will be online.
ONLINE ASSIGNMENTS:
1. Share one image for the category of the group you were assigned into. (i.e. If you were in “distributive”
group, post an image of distributive shock patient.)
2. Review patient care reports, then comment in the discussion post as to what stage and type of shock, if
any, exists.
END Dismissal

6. Evaluation
• Satisfaction Surveys +
• Performance Assessment Data
• Qualitative Peer-Assessments
• NREMT Tools as a Guide
• Ongoing Evaluation Process