Creating reliable and realistic representations of key audience segments, based on qualitative and quantitative user research, in the form of personas, helps the learning designer to understand learners' needs, experiences, behaviours and goals.

Who are our learners?

For use with all Established Radiology Reporters training, 2 learning personas illustrate the typical participants in PET-CT Academy training at this level. 

• Radiologists reporting in PET-CT

• A wide range of experience - from 3 years minimum to 10+ years

• English speakers, not necessarily English as first language

What motivates them?

Their goals are generally the same: to increase their knowledge in PET-CT reporting, and to enable them to report in different speciality areas. These learners are intrinsically motivated to acquire as much knowledge and skill for the reasons of:

• Professional growth

• Professional standing within their field

• Providing excellent care and improving patient outcomes

What are their learning preferences?

There are many commonalities in the learners' professional lives, but they come from different generations, spend their time outside of work in different ways, and have different learning preferences - factors to take into account when designing the training. Learners could be anywhere along the spectrums when considering:

• Experience and comfort levels with digital learning (some learners are less comfortable with technology, so it is important to think about making courses easy to navigate and providing clear instructions for any interactive activities with the course)

• 'Old school talk and chalk' lectures to engaging, interactive, immersive digital learning activities (traditional medical education has consisted of lecture based learning, so many learners who come from this era of education still prefer this style of learning -it's important to consider the right balance between these learners and those who are wishing to have a fully immersive, interactive learning experience)

• Mobile learning (for those learners who like to learn on the go, course design and interactivities need to be considered for how effective these might be on a mobile device)

What are their learning barriers?

Time constraints for busy consultants within the NHS will influence how the training is designed - to be asynchronous, chunked into easy, manageable tutorials. Training will be designed with accessibility in mind and responsive software used for access on different devices, however, it's anticipated that the assessment will be computed-based due to viewing requirements of scan images.

• Limited time availability (in a usual scenario where learners have limited access to time, microlearning would be a great option - in this context, the course is very content heavy, so it's important to chunk the content into manageable modules and sections where the learner can jump in and out of easily)

• Limited access to training resources / assessments (as learners only have access to scan images for assessments on their work desktop pc, it is important to build in enough time for completion of these into the learning plan)

The business need 

NHS NC1 and NC2 contracts1 in England and Wales established to improve patient experience and achieve the best clinical outcomes for patients.  One of the ways to achieve this is through providing specialised training to radiologists so that they have the knowledge and skills to use the most advanced, effective reporting methods.

The problem

• Advancements in technology and reporting trends mean that existing training is outdated and less relevant

• New training needs to be available to established PET-CT reporters to take into account these advancements

Learning gap

• PET-CT reporters need training on current practice in reading, interpreting, reporting and reviewing non-18FDG scans (e.g., PSMA)

• PET-CT reporters need to be upskilled to report on the utility of PSMA in PET imaging

Learning goal

To refresh and consolidate knowledge, but expand disease site capacity and enable work with new tracers (e.g., PSMA).  The focus of this project is the development of online educational modules, however, the overarching goal includes provision of:

• Online educational modules

• Christie-hosted AML national reporters meeting (annual)

• Christie-hosted advanced study days and webinars

Rationale for PSMA course

There is an urgent need for training on how to enable established PET-CT reporters to effectively read, interpret, report and review scans using the PSMA tracer, as PSMA PET-CT for prostate malignancies become more and more prevalent.

PET-CT has been used in prostate cancer imaging for over two decades, but its clinical utility has evolved over time as new PET tracers have been developed and evaluated. In recent years, PSMA (prostate-specific membrane antigen) PET-CT has emerged as the most promising PET tracer for prostate cancer imaging. PSMA is a protein that is overexpressed on the surface of prostate cancer cells. PSMA PET-CT has been shown to be highly sensitive for detecting prostate cancer, including small and low-grade tumours, as well as metastatic disease.

Learning Outcomes

There are 3 high-level learning outcomes (LOs) for this course, which reflect the SMART goals framework as a benchmarking tool and Bloom's taxonomy. Good LOs:

• Focus on the knowledge and skills delivered via each course module/section

• Define a learner's intended performance after consuming targeted content

• Need specific action verbs to make sure learners are aware of what they will be assessed on

• Should align the learners' goals and the business need

The SMART methodology for creating LOs ensures fosters an efficient, meaningful learning experience.2 When creating SMART goals, you should ask yourself:3 

1. SPECIFIC: What will the learning accomplish? 

2. MEASURABLE: What assessment will measure the LOs? 

3. ACHIEVABLE: Is the LO doable? 

4. RELEVANT: How do the LOs align with broader goals? Why is the result important?

5. TIME-BOUND: What is the time frame for accomplishing the broader goals? 

For example, using the SMART methodology to create the overall learning outcomes, the thought process was:

SPECIFIC - the learning is designed to enable learners to define basic principles of PSMA PET-CT imaging. 

MEASURABLE - case-based quizzes at the end of the modules will measure if learners can apply PSMA PET-CT findings to diagnosis.

ACHEIVABLE - content is designed to enable learners to define basic principles of PSMA PET-CT imaging and apply PSMA PET-CT findings to diagnosis and allows learners to utilise PSMA PET-CT for treatment planning upon successful completion of the course.

RELEVANT - all LO's are based on real-world scenarios and content that uses real case-based examples.

TIMED - it is expected that upon successful completion of the course learners will be able to apply their knowledge immediately and continue to improve their skills as they begin reporting on PSMA PET-CT. 

The learning outcomes for this course have different levels of complexity, corresponding with Bloom's taxonomy4 from lower order thinking skills (LOTS) to higher order thinking skills (HOTS) as demonstrated in the module learning outcomes graphic above.

The course materials and level of complexity provided by the SME are based on the assumption that the learners accessing this course already have several years of reporting experience and expertise in reading scan images. However, a bottom-up approach is still needed to first introduce all of the intricacies of content related to this specific context of PSMA and prostate malignancies.  The modules are ordered so they flow in order of skill and complexity. To this end, the course has been structured to include three teaching tutorials (Modules 1-3) followed by a series of case-based quizzes/assessments (Module 4) to reinforce learning from the first three modules. 

The course will be asynchronous in mode to allow learners to complete at their own speed and in their own time. Given that the learners are often time poor, the course is designed for each module to take around 30 minutes to complete, taking the total course time to around 2 hours. The way each module is divided into individual lessons means that the learner can access smaller chunks of learning and return to where they left off easily. Each module has links enabling the learner to read referenced journals and other materials in full, should they want to take a deeper dive into the material.

In this heavily theory-based course, it would be very easy to get carried away and add a lot of superfluous presentation of information. To help prevent this, we used Cathy Moore's Action Mapping framework5 to decide on what content should be included in the course, and in collaboration with the SME we have settled on four tutorials (learning modules). After identifying what learners needed to do to reach the business goal (expand disease site capacity and enable work with new tracers) and what activity they needed to do to achieve this (report on PET-CT image scans using PSMA tracer) we looked at content that would be absolutely necessary for the learning pathway.

Due to the nature of content, the types of learners and their perceived learning needs (see learner personas), the course will be designed as flexible, online asynchronous eLearning. It will be hosted on our Moodle LMS. The course will take a linear approach, whereby each tutorial builds on the previous. Within the course, the tutorials will contain multimedia eLearning content in the form of text, infographics, animations, interactive knowledge checks, case studies and downloadable PDFs. Alongside the tutorials, a discussion forum will hopefully encourage social learning where learners can reflect on their learning and draw from one another's experience. 

For the purposes of this project, the focus is on Module 2, titled: Tutorial 2: Normal Distribution and False Positives. The graphic in the Part One Deliverables section illustrates where this tutorial sits in the course structure and what the related topics are. The graphic detailing building blocks shows the basis of what types of content and activities will be included within each tutorial and within the course as a whole, which helps to inform the macro-design process. Module 2 is comprised of multi-media eLearning, which will be expanded on in Part Two of this assignment.