Technology-driven or technology-enhanced design? How to choose the right digital tools for your training programs and avoid digital fatigue

In a world where technology is omnipresent, are we making it work for us or is it making us work harder?

The COVID-19 pandemic required many areas of the healthcare industry to transition from face-to-face interactions to virtual meetings, processes, platforms and training at an unprecedented level. The resulting excess of screen time, with content and communications often split between myriad tools and tabs, has generated a secondary and equally viral pandemic: digital fatigue. Digital fatigue is posing real problems for healthcare companies and individuals in terms of business success, productivity and professional development. With a return to pre-pandemic levels of technological engagement unlikely as we step forward into a hybridised future, especially when it comes to training, we need to take a closer look at how we design our training programs to make sure that technology is not a barrier but is actually driving learning success. In this article, we will explore the design phase of the instructional systems design process, ADDIE, to see how choosing the right digital tools early on in your training program creation, and using human-centred design, can help to overcome digital fatigue and enable technology to enhance our learning experience?

What is digital fatigue?

Digital fatigue is a state in which an individual becomes disengaged from digital processes or interactions due to the:

• Constant use and overuse of apps, digital tools and screens
• Cognitive intensity required to manage multiple digital resources and interactions often simultaneously
• Complexity of and time required to use the digital tools or processes, especially if they require multiple steps, which ranges from relatively minor things such as expenses claims and personal information updates to those with a far greater impact, such as onboarding training, patient-monitoring questionnaires, or recording adverse events or insights
• Demands to sustain prior levels of productivity without additional time available for managing the additional digital demands

Digital fatigue presents physically, mentally and financially. It is strained eyes, headaches and poor posture. It is fractured concentration, reduced engagement with tasks or meetings, tiredness and irritability. From a business standpoint, it is lowered productivity and performance, an increase in sick days, non-sanctioned workarounds on official processes, inaccurate information recording, missed business opportunities and, of course, loss of impact in training.

Battling digital fatigue for the well-being of your learners

Digital fatigue needs to be addressed on multiple fronts to reduce its impact on your people and business. In terms of managing it within the experience of digital learning and training, we can use the design stage to think beyond what our learners need in terms of scientific content and professional skills and to get to grips with how they learn as part of their working lives. Here are some ideas for managing digital fatigue during training:

• Chunk content and focus on need-to-know information: use your needs analysis to establish clear intended learning outcomes. Then, use these to help you identify what you need to assess and what learning activities are required, as well as, crucially, which technologies are best suited to enabling your learners to engage with training. For instance, asking a nurse or a field-based Medical Science Liaison who are constantly on the go to train in 15-minute bursts via a podcast or mobile app may be more efficient than making them train for an hour via a desktop. By fitting the duration, format and amount of content to the digital tools and time your learners have available to devote to training, you can facilitate engagement with the resources.
• Minimise multitasking and meeting demands: studies show that multitasking can reduce productivity. From the perspective of positive psychology, people perform best when they can get ‘in the zone’.[i] Make sure your learners are given workload time to participate in training, set expectations that they will switch off notifications from other applications, such as email and collaboration platforms, and reduce the number of other meetings where possible to free up time to learn.
• Encourage short breaks and movement: learning and information processing requires the brain to have ‘quiet time.’ Shorter training sessions, such as 45 minutes instead of 60 minutes, or longer workshops with built-in breaks during which learners can socialise or even step away from the screen, are great ways to battle the physical aspects of digital fatigue and help with information processing. For example, it may be more realistic to adapt a 2-day in-person training event to remote 45-minute sessions staggered over 2-weeks, allowing greater interleaving of content and more opportunity to fit training into busy working lives. Offering meditation or exercise sessions as part of a training agenda may help to promote well-being and allow the brain to ‘sort things out’ too[ii].
• Diversity, inclusivity and belonging solutions are worth the investment: all learners benefit from training programs that are produced using universal design principles, with accessible materials and flexible delivery that enables all staff to engage in self-directed study as part of their working routine.

Hybrid learning can be the answer

Hybrid learning draws on the same potential as blended learning to mix synchronous and asynchronous opportunities, allowing learners to capitalise on the benefits of both forms and minimise the pitfalls of relying solely on one or the other. Hybrid learning also allows staff to engage remotely or face-to-face with synchronous sessions as best fits their needs, preferences and other demands on their time.

The design phase of your program is the moment to decide on the types of assessments and activities needed for your learners to meet the desired outcomes based on their learning needs, and to marry these up to the most effective delivery methods. However, there is still space to refine them at the development phase. Here are some of our suggestions for deciding whether to go digital or traditional to deliver assessments and content.

• Theory or practice for remote or in-person? Whether you are assessing your learners or using learning activities to prepare them to complete their assessments, think about what they need to be able to do with their learning. Information-driven sessions may be delivered effectively in person or virtually if they are kept short and/or interactive, offering scope for learners to engage in a hybrid form as they see fit. However, if your learners need to be able to do a hands-on task, such as administer medication to a patient through a medical device, having your learner click multiple choice boxes to describe the process is a lot less effective than enabling them to carry out or simulate the task in person, talk an expert through it and receive feedback. By contrast, selecting relevant data sets and highlight trends to explain the value of a particular drug over its immediate competitors to an HCP can be achieved through the creation and submission of a short slide deck or a presentation, which can be done using a learning management system or a virtual meeting set-up. Whether these activities are for practice or a demonstration from an expert, learners can attend remotely or in-person to maximise the use of space, resources and time. Thinking about the end goals, what the learner must be able to do with their knowledge and skills, and then positioning those goals in the context of budget constraints and, currently, pandemic adaptations are good ways to determine what the learning activity or assessment mode needs to look like. This will allow you to consult with your digital team about whether a technological solution is viable and whether attending in-person, virtually or as a hybrid cohort is most appropriate.

• Innovation to enhance engagement: When people talk about innovation, they often jump to the flashiest and most up-to-date digital solutions, but innovation can involve much smaller changes, such as presenting information in a new way or asking learners to approach a task differently. For instance, having a learner demonstrate a hygiene protocol via a virtual simulation, report an insight or adverse event via a dummy system or engage in a role-play with a facilitator acting as an HCP to handle an objection encourages deeper real-world learning than answering a few knowledge-check questions. Equally, having an app for learners to answer regular knowledge-check questions on key data, trends and other recall-based information can be a great way to promote knowledge reinforcement in little pockets of time, such as waiting between appointments or for public transport or even while making a cup of tea. Having opportunities to do both as part of a blended or hybrid learning program means that lots of little innovations, carefully chosen to target significant learning gaps, energise and motivate learners, and reinforce interconnected elements of the training can add up to quite a lot of innovation collectively.

• Synchronous versus asynchronous? Synchronous learning is great for bringing people together, enabling conversation and creating social presence, but it is renowned for causing digital fatigue. Intensive, forced synchronous learning is often counterproductive in-person or virtually. Design is key, with short, focussed, interactive sessions that are well-run, with lots of opportunities to contribute via different, carefully managed methods such as raised hands, chat boxes and on-screen editing tend to be most effective. Synchronous sessions can work well for solo events or for a series of connected events, and interleaved with asynchronous learning too. Key questions to ask yourself are: why do you need people to be together for this particular topic or task, and what will they gain from being in the same space that they cannot get by working asynchronously? Be honest! Keep in mind too that synchronous hybrid sessions, supported by appropriate technologies to enable interactions between remote and in-person participants, can be very inclusive and enable collaboration across a workplace, country or the globe.

Asynchronous learning offers more flexibility for many, supporting self-paced development. Isolated events may be less productive than integrating multiple activities into a learning platform as part of a clear curriculum with a strong learner journey, structured activities, deadlines, opportunities to collaborate with other learners, regular feedback provision and designated sources of support. Asynchronous delivery is suited to most forms of learning activity and, if digital security is carefully managed, assessment too. Learners are often empowered by the advantages asynchronous learning brings in terms of consistent access to content, interleaving of topics, self-pacing, processing and reflection time, practice and application opportunities, and feedback at group and individual levels.[i] Learning management systems with notifications, progress trackers, multi-device accessibility and collaborative capacity can drive behaviour change and help to craft cultures of continuous learning for the benefit of your staff, as well as enabling people to manage their own development, pace themselves and stave off digital fatigue.

Why this tool and not that tool? The variety of digital solutions available offer all sorts of energising prospects for creating or updating your healthcare training programs. However, you need to keep in mind what the tool does and what its purpose is within the context of the learning need and training program as a whole. Even something as simple as polling, knowledge-checks and temperature assessments of a cohort, which are now standard practice in virtual meetings, need to be thought through. Why are you doing it? What does it achieve in terms of the program goals, the individual session and the related activities? Engagement and impact are not created by throwing interactive features at your learners but by designing meaningful learning experiences. A key feature of digital fatigue is the intensity and complexity of the interaction with digital tools and resources, so constantly asking your learners to engage with the new and unfamiliar can demotivate too. Choose your tools wisely and ensure there is a logical alignment with the learning needs, as well as a chance for your learners to become confident and proficient in the tools that they are most likely to need again in their professional roles via your training program. Hybrid learning has advantages in this arena too, as it allows people with different digital skill levels to select the format that they are most comfortable with, and to grow accustomed to other formats by gradual exposure to alternatives.

Keep it simple with the right amount of the right technology

Blended or hybrid learning solutions are a great way to step forward into the future of training. The key to creating meaningful hybrid learning experiences is to focus on the end user, the human learner and to keep your digital solutions aligned to best practice in learning design. Therefore, make sure you encourage your learning specialists, knowledge experts and digital teams to work together at this phase for the best results.

[1]Csikzentmihayli M. Flow and the Foundations of Positive Psychology. 2014. Available at: http://biblioteca.univalle.edu.ni/files/original/cb851fc2405f5c05d3ca12575f49db22dd2d5c4d.pdf

[2]Oakley B. Mind for Numbers. 2014.

[3]Fox D. Overcoming digital fatigue with learning design that activates learning. 2020. Available at: https://www.novoed.com/resources/blog/overcoming-digital-fatigue-learning-design-that-activates-engagement/

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