designers, and students may be part of the course design team (Stewart, Cohn, & Whithaus, 2016).
There are a number of different models for online course design that are important for instructional
designers to be familiar with. At our institution, we designed our own courses using a combination of
a simple linear instructional development process known as ADDIE, along with some important
features from Dee Fink’s (2013) integrated course design. The ADDIE process, as discussed by
Stavredes and Herder (2014), includes the phases of analysis, design, development, implementation,
and evaluation. Many other models found in the literature are variations of this linear model.
Table 8-1 provides a brief description of each phase of the ADDIE process.
Table 8-1 The ADDIE Process
Dee Fink (2013) describes the process as steps in an integrated design, as follows: (1) initial phase:
build strong primary components, (2) intermediate phase: assemble the components into a coherent
whole, and (3) final phase: finish important remaining tasks. The first phase is comparable to the
ADDIE analysis and design phase because it involves identifying important situational factors and
learning outcomes, formulating appropriate feedback and assessment procedures, and designing
teaching and learning activities, ensuring they are all integrated. The intermediate phase is
comparable to the remaining ADDIE phases because it includes creating a thematic structure for the
course by selecting and creating teaching strategies. The final phase consists of tasks that are built
into the design phase of ADDIE as well as the evaluation phase; it consists of developing the grading
system and syllabus, correcting problems, and planning for an evaluation of the course and faculty
ADDIE and the integrated design processes are also consistent with the best practices discussed
previously. Linear models are necessary for teaching because we believe integration is a process that
starts with linear thinking and making connections. Integration, which goes beyond making
connections, is critical to nursing practice and education. Integration is very much in keeping with
our collaborative model, as discussed in Chapter 1, and the holistic model, as discussed in Chapter 4,
because different perspectives are valued, considered, and merged as appropriate for a successful
online program with very high retention and persistence rates.
The analysis section is the first step of the process and critical to the success of course design. We
have devoted Chapter 3 to understanding the online nursing student and Chapter 7 to curriculum
development. Chapter 7 provides an overview and example to demonstrate how a course fits within
the School of Nursing’s program outcomes, including course learning outcomes, module learning
objectives, assessment strategies, and learning activities This chapter is focused on the design and
development phases, which are integrated. Implementation is discussed in Chapter 9, which
addresses online teaching strategies. Chapter 6 addresses course and program evaluations.
Collaborative Design and Development Process
We have developed a model (Figure 8-1) for the design and development process based on our
experience, taking into account both the linear and integrated processes discussed previously. We
believe ongoing reflection and collaboration are needed until the course is ready to launch. It is
important to note that designing course learning outcomes is an integral part of the design process.
However, in practice, learning outcomes cannot be changed once approved by the School of
Nursing, and often the university curriculum committee, without going through what is often a
lengthy process. The role of faculty in committee work is discussed in Chapter 5 in relation to the
inclusion of online programs and in Chapter 13 in relation to faculty development and service to the
Figure 8-1 Collaborative design and development process
Design and Development
The design of an online course can either facilitate student success with persistence or create
barriers to student learning. In addition to over a decade of online teaching experience in various
settings with different learning management systems, we have also been online students. We have
learned that keeping it simple, consistent, and challenging, with opportunities for deep thinking,
facilitates professional growth. Further, it is critical to value and respect the knowledge and skills
that postlicensure students bring to the online classroom, not only in our teaching but also in how
we design the course. We have learned that when we get many similar questions about an element
in the course, something is amiss and needs to be corrected. This section of the chapter addresses
all the core elements based on the model in Figure 8-1.
The course learning outcomes need to be in alignment with the program outcomes, regardless of
the delivery model. Course outcomes should communicate the following to learners: (1) what they
are expected to know at the factual and conceptual levels, (2) the attitudes they need to develop in
keeping with nursing values and ethics, and (3) the skills or competencies they will achieve as a
result of taking the course (Scheckel, 2020; Stavredes & Herder, 2014). Given that many nursing
programs have moved to a concept-based curriculum, decisions also need to be made about which
concepts to include and to what level they will be addressed (Scheckel, 2020). We have a list of
concepts that are integrated throughout the online registered nurse (RN)–bachelor of science in
nursing (BSN) program, as discussed in Chapter 7. The depth of understanding of the concept
evolves as the student progresses through the program.
Taxonomy of Learning
A good source to use in the development of learning outcomes is the American Association of
Colleges of Nursing (AACN) Essentials at the baccalaureate, master’s, and doctoral levels. An
understanding of both Bloom’s and Dee Fink’s taxonomies of learning guides the development of
our learning outcomes. Benjamin Bloom led a group of researchers to initially formulate the three
domains of learning in 1956. Bloom and his colleagues (Krathwohl, Bloom, & Mases, 1964) further
developed the cognitive domain. The affective domain was broadened to include five behavioral
categories: (1) receiving, (2) responding, (3) valuing, (4) organization of values, and (5)
characterization by a value or value complex (Krathwohl et al., 1964). The psychomotor domains
were further developed by Anita Harrow, among others (Hoque, 2016).
The domains of learning are well known among educators. L. Dee Fink’s (2013) work is less known or
used in nursing education, but we found his work to be an excellent resource for nursing education,
which is also discussed in Chapter 7. See Table 8-2 comparing Fink’s integrated taxonomy of
significant learning to Bloom’s domains of learning, along with verbs and behaviors to help in the
writing of learning outcomes. An example is provided for each. In this table, we are comparing a
linear process to an integrated one. Both models are excellent resources for the development of
In keeping with backward design, the next step is to develop assessment strategies that are
appropriate based on the learning outcomes. The key to this element of the design process is to
create a variety of strategies that will demonstrate progress toward achieving the learning outcomes
(formative assessment) as well as achievement of the course outcomes (summative assessment).
Table 8-3 provides examples of formative and summative assessments.
Further, when considering the design of assessments, all three domains of learning need to be
considered (Kirkpatrick & DeWitt, 2020; Stavredes & Herder, 2014). Developing the assessments at
this time in the design process ensures that learning activities are in alignment with what is required
to demonstrate that the learning outcomes have been met. However, the assessments may be
revisited at any time during the design process.
We do want to mention that in the literature, assessment and evaluation may be considered
separate concepts, and both are important aspects of course design. The main difference between
the two concepts lies in how the completed work by the student is used. Faculty use the information
from assessments to assess current learning that may result in a need to make revisions. Evaluation,
on the other hand, involves judgment and occurs at the end of the course or program (Oermann,
2017). Kirkpatrick and DeWitt (2020) encourage educators practicing in clinical fields to “evaluate
student attainment of course outcomes and defined program competencies to ensure that
graduates are prepared for safe practice” (p. 451).
We believe evaluation is particularly important for prelicensure and advance practice nursing
programs, given the emphasis on preparing graduates for direct patient care, clinical practice, and
national licensure exams. Other postlicensure programs have more of an emphasis on the cognitive
and affective domains of learning, in which grasping the role of nursing within the bigger picture of
health care is important. Postlicensure programs build on prelicensure programs to advance higher-
level thinking. Advance practice programs also have an emphasis on higher-level thinking, but
students are required to learn and demonstrate higher-level skills in direct clinical care. For the
purposes of this text, we refer to this element of the design process as assessment. This is not to
negate that, as faculty, we need to evaluate students’ work because grading is a requirement for
progression. However, we want to ensure there is an emphasis on continual, progressive student
learning, which requires ongoing assessment.
Dee Fink (2013) also discusses assessment as auditive versus educative assessment, a concept
initially posited by Grant Wiggins in 1998. We thought it was important to highlight this distinction
as something to think about compared with how assessment and evaluation are discussed in the
previous paragraph. Auditive assessment mainly consists of a midterm and a final exam. It serves the
purpose of providing a grade based on whether students were able to pass, indicating that they
learned the content. In other words, it is a backward-looking assessment. Educative assessment, on
the other hand, is ongoing, with the aim of helping students to learn better. It needs to be frequent,
immediate, based on clear criteria, and delivered in a caring way.
Types of Online Assessments
There are many types of assessments that can be used within online courses—for example,
authentic assessment, testing, self-assessment, reflective assessment, portfolio, WebQuests, and