The e-learning answer: secure this education solution by setting a vision for its usage and building a sound business plan for its purchase

The e-learning answer: secure this education solution by setting a vision for its usage and building a sound business plan for its purchase

Wendy J. Berke

Ever had to train 500 staff members in 60 days? A combination of vacation schedules, current classes, differing employee shifts, and decreasing numbers of available instructors makes meeting this deadline almost impossible.

Usage Benefits

Rather than waiting for a scheduled lecture to occur, staff members can turn to e-learning programs–available every day, any hour. The “just-in-time” nature of e-learning means specialized training is available at the moment it’s needed without worrying about class room or instructor availability. The result is training that’s accomplished more rapidly, enabling you and your learners to meet tight deadlines while ensuring content consistency and standardization.

In addition, e-learning can streamline the education process by freeing educators’ time to focus on learning transference, supplemental information development, and learners’ educational needs. E-learning’s more efficient use of time can increase productivity and decrease training costs. (1)

Decision Pathway

To successfully implement e-learning, first determine how it fits into your organization’s operation. Identify training needs, articulate how technological tools can help you meet those needs, then search for content that’s appropriate for the training’s intended purpose.

Consider creating a team of stakeholders to facilitate decision making that seeks to design a consistent e-learning strategy. To best understand educational needs throughout your organization, the team should include representatives from clinical education, information systems, human resources/organizational behavior, and executive leadership.

Create a strategic implementation plan that includes all sought after training. Initially, you may have to focus on one set of educational needs rather than tackling every suggested training issue. Prioritize learning initiatives, create phases of a rollout plan, and articulate evaluation guidelines to ensure successful implementation from an educational and business perspective.

Once you’ve defined the strategic value of and appropriate use for e-learning, focus on technological and content-related decisions. First, determine if there’s already an e-learning program in place at your facility. If so, find out whether it’s a forum that can be leveraged across your organization. To accommodate a larger effort, the platform must be “scalable,” meaning that a significant number of employees can access content through its structure. If it’s not scalable, or e-learning isn’t currently in place, articulate necessary performance requirements to guide the search for an appropriate solution (see Figure).

From a technological perspective, a key component to launching a successful e-learning strategy includes an understanding of learning-management systems and their use in a clinical environment. Many companies offer learning-management systems for use within hospital settings. Some are simply technological platforms or structures within which an organization can house its own content; others come complete with content components.


Before determining the structure’s actual technological components, consider content availability. Question each e-learning vendor about the kind of content its platform offers and if the content is included in the implementation cost or if it’s extra. Also inquire if other content can be added to the platform. These steps will ensure that the platform you choose meets both technological and content requirements (Tables 1 and 2).

Implementation: Internal Marketing and Blended Learning

To generate interest, market the program by demonstrating how employees will benefit from its availability. Provide information explaining the efficiencies and increased productivity that they’ll ultimately realize from the training. These efforts will help generate a “buzz” around the initiative that’ll see it through to a successful implementation.

To augment training, consider using a blended-learning approach, which combines e-learning with traditional classroom instruction. The e-learning program can serve as the theoretical foundation upon which participants can build specific skills, either within a classroom or lab setting. (2) Such a model capitalizes on the benefits offered by e-learning and optimizes education with face-to-face activities that can accommodate various learning styles, provide social interaction, and focus on nursing skill development.

To create a blended-learning approach, simply determine what tasks can be performed electronically, which ones need a face-to-face or hands-on approach, and how to mesh the two. Educational outcomes may remain the same as those articulated for the current construct or modified for the new model. Blended-learning environments may enhance educators’ effectiveness, enabling them to use time previously spent delivering basic educational content to focus on specific learning needs of each student (Table 3).

Building a Business Case

Although you should consider numerous logistic issues during any return on investment (ROI) evaluation and presentation, the business justification for e-learning is fairly straight-forward. Due to spiraling vacancy rates in nursing, hospital new hires often go to the patients’ bedside immediately on employment rather than going through a traditional orientation period. This is an indirect cost for the hospital that creates a hiring disadvantage.

Although generally difficult to measure, several direct costs are easy to quantify, including the number of students trained per year, class size, required class hours per student, the number of instructors needed, and staffing solutions used when low staffing levels occur during orientation. Also calculate the cost of copying handouts, resources such as textbooks, fees charged by the vendor for course attendance, and any travel or room rental expenses.

To begin the justification process, quantify the direct and indirect costs for training each student. E-learning programs often undergo more rigorous content and instructional design review, thus making them inherently more efficient. As a result, by the very nature of their development, such programs save time by as much as 25% to 60% when compared to traditional classroom training. The sample model, based on the AACN’s e-learning solution, Essentials of Critical Care Orientation, forecasts that using e-learning solutions will decrease overall training time by 25% (Table 4).

To calculate the “soft” dollar savings, reduce the total training hours by 25% and then multiply the saved hours by the cost per hour. The sample also assigns a certain number of hours to the training time, yielding a total pre-e-learning training time of 80 hours. Assuming each employee earns $15 per hour, the total paid to each employee during orientation training is $4,800.

In the post-e-learning model, if this time is reduced by 25% to 60 hours, the total salary paid is reduced by $600 per employee. Multiply this by 50 employees and you realize a $30,000 savings in salary, which can now be paid to productive employees. As demonstrated by this table, savings in time and training costs is quantifiable.

To continue the justification process, quantify costs associated with the educator currently presenting the training. The educator’s total savings in time and salary dollars is the combined totals of the time and money saved in preparation and teaching, as well as the overall reduction in training time. If the educator doesn’t spend time preparing for and teaching the basic part of the orientation class, then he or she can dedicate that time to other educational activities while the learner still acquires the fundamental knowledge via the e-learning solution. Hence, the educator’s productivity is increased, effectively doubling his or her educational output.

As e-learning maximizes student and educator time, it also decreases additional direct, “hard” dollar costs incurred from new employee orientation. For instance, hospitals often use registry nurses or overtime for staff nurses to cover for low staffing levels. Decreasing training time by 25% allows new nurses to become productive more quickly, reducing the reliance on these extra costs by an associated 25%. If the current training method incurs a cost of $11,200 per person, a 25% reduction in this cost decreases it by $1,400 to $9,800. Multiplied by 50 employees, this reduction saves $70,000 in direct costs (Table 5).

Compare the identified costs of the student and educator, and any direct costs associated with the current training method, against the direct costs associated with implementing e-learning. Such direct costs may include a site license, user fees, content access fees, technical support, or training costs. In addition, be sure to includes a indirect costs the staff time necessary to implement e-learning.

Postprogram Evaluation

Conduct a thorough evaluation of your e-learning solution within 6 months to 1 year of implementation. Assess for the educational effectiveness of e-learning–including employees’ satisfaction level with the training offered–and such business efficiencies as cost and/or time reduction gained by its implementation. (3)

You may also need to evaluate whether or not participants are achieving competencies at the same or higher levels than with instructorled classroom training. In the absence of a previous model with which to compare them, evaluate the new competencies as a result of the newly implemented e-learning initiative. For example, track a nurse’s competence over time using a defined clinical pathway to ensure the development of appropriate nursing skills and the delivery of quality patient care. (4)

Revisit the metrics originally articulated for e-learning: shorter training time, just-in-time delivery, flexibility to meet tight deadlines, and education consistency. Update your projections with actual data from conducted training. If the analysis yields positive results and demonstrates that the solution met the expected educational and business goals, phase two of your implementation plan should meet with little resistance and continue to provide additional productivity gains.

Table 1 Decision-making steps

Process steps Operational tactics

Initial internal inquiry Conduct education needs assessment

Organization assessment Begin institutional approval process

Identify key influencers and decision


Assemble collaborative decision-making


Technology investigation Assess current level of e-learning use

Ensure compatibility between e-learning



Content review Check educational design

Ensure that it meets identified training


Demonstration of program Review Web site for online demo

Obtain supporting documents such as:

Content outlines

Implementation timelines

Competency checklists

References from current users

Obtain documents from vendor Review pricing, model for economic

justification, technical specifications,

and white papers

Request funding Align with business goals

Frame education as a business strategy

Demonstrate return on investment

Purchase Conduct a legal review of site license


Review technical support options

Implementation Identify system administrators/managers

Select students

Schedule training

Market internally

Measure postprogram metrics Conduct student evaluation of

self-directed learning and review

efficiencies gained, student/educator

time saved, reduced overall training

costs, and competencies achieved

Table 2 Evaluating learning-management systems

Features and characteristics

* Online registration, course catalog, and launch mechanism


* Ability to maintain user history database

* Detailed reporting capability

* Ease of navigation for users having various levels of computer


Technological perspective

* Integration/compatibility with current operating systems

* Required speed of access to the Internet

* Amount of computing power necessary for optimal program performance

* Plug-ins or special software needed

* Training and technical support

Content perspective

* Components of content (eg, graphics, animation, audio)

* Development process (writing/reviewing/pilot testing)

* Schedule for updates

* Ancillary learning materials bundled as part of the course offering

* Assessment tools

Table 3 Blended learning approach

Activity Purpose

Classroom collaboration Allows for social interaction

Builds on group synergy

Clarifies content


Case study review Develops critical thinking

(evaluation, synthesis, application)

Printed materials Supplement e-learning content

Provide documentation for future review


Team presentations Accommodate kinesthetic learners

Skills labs Provide hands-on activities and specific

skill development

Post-clinical conferences Target required competencies

Table 4 Sample learner economic table

Before e-learning

program After e-learning program

# hrs # hrs Total $ paid # hrs # hrs Revised

current preceptor to employee revised preceptor total $

classroom portion for program with portion paid to

program orientation e-learning employee



160 150 $4,800 120 160 $4,200

(4 wks @ (4 wks @ (assumes (decrease (4 wks @ (assumes

40 40 employee of 25%) 40 employee

hrs/wk) hrs/wk) earns (3 wks @ 40 hrs/wk) earns

$15/hr) hrs/wk) $15/hr)

Table 5 Sample educator economic table

Before e-learning

program After e-learning program

Prep time Teaching Total prep Prep Teaching Total prep and

time and time time teaching time



11 hrs @ 45 hrs @ 56 hrs @ 0 Reduced Time savings:

$25/hr= $25/hr= $25/hr= overall 96 hours

$275 $1,125 $1,400 training (11 hrs prep + 45hrs

time by teaching + overall

25% (40 trainingtime of 40 hrs)

hrs) Salary savings: $2,400


1. Smith, J.: “Blended Learning,” Executive Update Online. Available at:

2. Rosenberg, M.: E-Learning. McGraw-Hill, New York, N.Y., 2001.

3. Raths, D.: “Measure of Success,” OnLine Learning. 5(5):21-26, 2001.

4. Good, V., and Schulman, C.: “Employee Competency Pathways.” Critical Care Nurse. 29(3):75-85, 2000.

Wendy J. Berke, RN, BSN, MHA

Tina L. Wiseman


Wendy J. Berke is director of professional practice at the American Association of Critical-Care Nurses in Aliso Viejo, Calif.

Tina L. Wiseman is education resource specialist at the American Association of Critical-Care Nurses.

Reprinted with permission from Nursing Management, IT Solutions (suppl), 33(10):26-29, 2003.

COPYRIGHT 2004 American Association of Critical-Care Nurses

COPYRIGHT 2004 Gale Group