Case Study
An Empowering Company Sets ‘Gold Standard’ in Video eLearning with ExpertusONE LMS
Unique ‘fly-on-the-wall’ production drives learner behavior change, while robust LMS and university-based evaluation focus on refinements and improve outcomes
Company Overview
The company is in the business of saving lives. Developing eLearning that empowers suicide prevention, its video-based programs enable professionals to be more effective so that people at risk of suicide have better outcomes.
Challenge
U. S. clinicians in behavioral health and substance abuse services regularly treat suicidal people. But most have little or no training in the evidence-based practices (EBPs) shown to improve patient outcomes. The result can be treatment that’s at best ineffective, or at worst harmful, by potentially exacerbating suicidality in an at-risk person.
That’s likely one of the reasons why there are 2.5 times more suicides in America than homicides. And yet, global public health officials recognize suicide as one of the most preventable deaths.
A task force for the American Association of Suicidology deemed that eLearning was a viable solution for bridging the life-threatening gap in professionals’ continuing education for suicide risk assessment, management, and treatment (because of its easy access, self-paced design, and affordability). However, practitioners face two huge barriers to receiving it:
- There are only a handful of EBPs that are rigorously research-validated for improving outcomes in suicidal people.
- Of these, none are available online.
Solution
Recognizing the serious gap in the proper training of professionals and how eLearning could easily address it, the company’s Founder and CEO, a 12-year veteran of the suicidology field with 20+ years of strategic communications experience) decided to bring the best EBPs to practitioners via a video learning format.
“We chose to work with the brightest minds in suicide prevention, and assist in the transfer of science to service − that is, to move their evidence-based interventions from research journals to online videos where they could actually inform those in frontline practice,” the Founder and CEO explained.
The result was their first four-hour eLearning course: “Managing Suicide Risk Collaboratively: The CAMS Framework”. It was built around CAMS – the Collaborative Assessment and Management of Suicidality. CAMS is a suicide-specific clinical intervention that practitioners can apply to effectively assess, treat, and manage suicidal patients. It targets social workers, mental health/substance abuse practitioners, marriage and family therapists, psychiatrists, psychologists, case managers, and more.
About the CAMS Framework
CAMS is the Collaborative Assessment and Management of Suicidality. Supported by a 25-year evidence base and globally respected, CAMS was developed by the internationally esteemed suicidologist and clinician/researcher David A. Jobes, Ph.D.
“Prior to our online course, clinicians wanting to learn the CAMS Framework had to attend in-person didactic training; this was inefficient, limiting, and resource-intensive. So we chose to use a video-based format,” the Founder and CEO said. “Clinicians today want ‘show me’ versus ‘tell me’ training. It’s rare that professionals can actually observe a clinician of Dr. Jobes’ caliber in session with a suicidal patient… these experiential scenarios are priceless,” the Founder and CEO said.
“Seeing is believing. Data and case studies provide good info. But clinicians really need to see what you’re talking about,” Dr. David Jobes, CAMS’ developer, said. “We were excited to do something different because clinicians can connect with video better. And if it’s done properly, it should yield better results than live training because of its affective engagement.”
The Founder and CEO agreed, adding, “Video is the best format for conveying an emotional experience – which, in turn, improves learning engagement and knowledge retention. Another reason that we chose to do a video-based eLearning course is that we had the resources ready to deploy with seasoned SMEs as our talent, plus our team of videographers, instructional designers, graphic designers, branding experts, sound engineers and motion picture editors – most with 25+ years of experience.”
The assets required to create this course were not insignificant, but warranted, given the overwhelming need for professionals who treat suicidal people to actually see how a trained, expert clinician effectively engages with patients to mitigate risk – for the clinician, the system where they practice, and for the suicidal individual.
Program Goals
Change Clinician Behavior
The primary goal for the company was to change clinician behavior. They wanted to deliver an evidence-based treatment that’s been shown to more rapidly resolve suicidality.
“We wanted to move beyond the didactic, lecture-based training that’s ineffective at changing clinician behavior, to a more accessible and interactive video forum − one that highly motivates viewers to learn something they can retain and use to improve patient outcomes,” the Founder and CEO commented.
Lower Training & Treatment Costs
Their primary goal of changing clinician behavior led to a secondary, but highly significant goal… reducing training and treatment costs for healthcare systems.
- In-person training costs average $1,500 per clinician-learner. However, the company’s four-hour video eLearning course costs only $159 per learner.
- Inpatient psychiatric hospitalization for suicidality can average $10,000 per patient. Alternatively, treating suicidal patients in an outpatient setting (when possible) with the CAMS Framework (typically 12 weekly sessions) costs around $3,000 – a $7,000 savings per patient.
Given that more than 40,000 Americans die by suicide each year, and more than 650,000 receive emergency room treatment for an attempt, employing an evidence-based outpatient treatment such as the CAMS Framework can generate enormous savings for health systems, taxpayers, and communities.
Elevate eLearning Production
A final program goal was to raise the bar for the training industry at large by delivering a highly engaging video with exceptional production value.
“The field of suicidology, where life-and-death outcomes are at play, certainly warrants this,” the Founder and CEO explained. “And given the other training options available, we were confident our training would heighten clinician engagement and inspire behavior change.”
“If you’re going to spend the time and money to create video-based eLearning, you might as well do something with the insight, goals, and design to make it successful,” Dr. Jobes said. “There’s a lot of bad training out there. So we wanted to make something of quality and substance.”
Program Design
Unique Real-life Production: Creating a Compelling ‘Fly on the Wall’ Experience
The company wanted to produce its video-based eLearning as realistic as possible to garner a genuine emotional connection, response, and understanding from learners.
“We’ve heard time and again from clinician-learners that they rarely get to see an expert clinician in session with a suicidal patient,” the Founder and CEO explained. “So we decided to present Dr. Jobes and a ‘patient’ (who was actually his graduate student, now university professor Stephen O’Connor, Ph.D.) in a real-life clinical situation with multiple camera angles and cuts to give viewers a true ‘fly on the wall’ experience.”
Before shooting, the company invested significant resources into the Instructional Design of the eLearning program. They ultimately divided it into six units and made it heavily video-based so learners would be more engaged and informed (in ways that words on a slide simply can’t match).
In addition to presenting real-life scenarios between a provider and patient, the company supplemented these videos with interactive activities and exercises to test knowledge gain.
Again, to:
- Keep the learning audience’s interest
- Help them retain their newfound knowledge and skills
- Inspire behavior change – i.e., actually implement the CAMS Framework
Given that more than 40,000 Americans die by suicide each year, and more than 650,000 receive emergency room treatment for an attempt, employing an evidence-based outpatient treatment such as the CAMS Framework can generate enormous savings for health systems, taxpayers, and communities.
Unscripted Storytelling: Boosting Learning Retention & ‘Making It Real’
The company’s SMEs insisted that the video training be unscripted.
Having both worked with scores of suicidal patients over their careers, Drs. Jobes and O’Connor were confident in role-playing the scenes − basing their interaction on real-life experiences in clinical settings with patients. In fact, few retakes were necessary because they hit the mark so well. Not only did this save the company’s time and money, but it also enabled them to create an unscripted, true-to-life scenario.
Ultimately, they wove together one coherent story of a person dealing with their suicidality over 12 weeks of CAMS in an outpatient setting. The result was similar to a weekly television series, following the patient’s progress and setbacks in each episode…
What would happen next?
Would Kevin attempt suicide again?
What would his wife and best friend say?
What would Dr. Jobes do to steer him from death to life?
“We wanted to draw viewers into a realistic story of a highly lethal suicidal patient, and demonstrate on video how to engage and treat the patient with empathy, collaboration, and honesty − all within an outpatient setting,” the Founder and CEO said.
Exceptional Production Value: Creating Empathy
All of the videography was shot in three intensive 10-hour days. The company’s goal was to create the highest production value possible, similar to that of a network TV show.
“We needed to teach empathy as the cornerstone of successful treatment. Often, clinicians don’t have compassion and understanding for the suicidal desire. So if we only used one camera angle, for example, our role players’ reactions, nuances, facial expressions, and more wouldn’t have been conveyed as well to the learner,” the Founder and CEO explained.
“Some training videos look like they were shot with a security camera. There’s no intimacy, no close-ups; they’re poorly lit and use straight shots that don’t draw viewers in,” Dr. Jobes commented. “In fact, one training we viewed actually had subtitles because the sound engineering was so poor! Talk about undermining the value of that video − the voices’ inflection, tone, and influence were lost. Thus, we were inspired not to repeat the same mistakes.”
That’s why the company’s spent so much time planning the video’s logistics: selecting sites and sets, testing camera shots and angles, and exploring the right lighting. The result was a new level of quality, detail and nuance for training videos.
“You can see the faces of our role players so clearly; you can truly read their emotions,” the Founder and CEO remarked.
Sound design and audio engineering were also top of mind during planning and production. The company commissioned an original soundtrack and used the best audio engineering tools/techniques to ensure a clear, crisp audio track with minimal background noise.
The company used Final Cut Pro to further enhance and optimize the audio before overlaying and syncing it with the video. They also employed a resource-intensive editing process (splicing together different camera angles, scenes, and B-roll) to create a cohesive, compelling storyline with a television-quality look and feel.
“There’s a shot where the patient credits his wife for motivating him to seek help. One of our cameras filmed him fiddling with his wedding ring during this scene, and our editor cut right to it when he mentions his wife. That’s good storytelling. The editor splices together shots that reinforce the story that’s being told. So the viewer actually feels the angst and agony of the patient. And that doesn’t usually happen in Instructional Design, at least in our industry,” the Founder and CEO remarked.
Engagement Activities: Keeping Viewers’ Attention & Participation
In addition to their compelling, high-quality video and audio, the company developed an overarching Instructional Design strategy to reinforce message clarity.
The result was editing 30 hours of video into 30-second to three-minute segments, each tied to a CAMS clinical concept. This bite-sized video approach also allowed the company to add activities that: 1. tested knowledge gain and 2. bolstered learner engagement.
“Everyone learns differently. Some people want to read what they’re going to learn first, then watch it. Others like to dive right into the video and read supporting text later. So we created a flexible design that allows viewers to pick their own learning path, while still getting all of the relevant and required content,” the Founder and CEO explained.
The next step was to use black-and-white videography for Dr. Jobes’ direct-to-camera commentary – to set it apart from the full-color role-playing scenes. This artistic treatment made these “Expert Insight” commentaries, where the SME addresses the learner personally to further explain and reinforce the CAMS Framework, stand apart from the rest.
The project’s Instructional Designer explained, saying, “Some concepts in CAMS are tricky to understand, so we needed to reinforce them. Our solution was to add a subtle entertainment factor that kept viewers engaged by seeing what’s next and kept them progressing through the course.”
This strategy also helped viewers apply what they were learning.
“We were able to say, ‘Look at these clips and explain what you’re seeing’ to ensure they retained and applied the right concepts,” Instructional Designer continued. “By mixing up their learning delivery, the course doesn’t get boring. It continually gives learners something to do and helps them actually retain and use the CAMS strategies in their workplace − which was our ultimate goal.”
Program Delivery
1. Easy-to-Use and Accessible User Interface − “Usability was key because our learners don’t have time to take training on how to use an LMS. So we selected the ExpertusONE LMS since it has the best, most intuitive UI… where our learners can quickly locate, register for, and consume their training, as well as take assessments and collaborate with peers via its robust social features,” the Founder and CEO explained.
ExpertusONE also has a native mobile app that allows the company’s learners to view video training from their phone or tablet, whether they’re on or offline. So it makes learning on-the-go (something important to clinician-learners) incredibly easy.
2. Excellent Scalability and Global Reach − “The course is currently being used in seven U.S. states and two Canadian provinces. We’re also getting inquiries from Europe, Australia, Asia Pacific and South America. This rapid growth requires multiple languages and scalability. So a cloud LMS enables us to quickly and easily extend the program’s reach, as well as update course content and release new programs,” the Founder and CEO remarked.
Additionally, ExpertusONE has a Group-based architecture that automatically updates its interface to the user’s geographic location (i.e. the language, date, time, currency, etc.) – which is perfect for the company’s future national and
global audiences.
3. Video-friendly Functionality − Modern LMSs such as ExpertusONE were built on and for the cloud. So they’re the ideal host for video formats (similar in design and scope to YouTube).
“Not only does ExpertusONE run videos at high speeds, but it also supports mobile video viewing. So our learners can start their CAMS training on their tablet, move to a PC, and then continue watching it on their phone seamlessly,” the Founder and CEO said.
4. Exceptional Reporting − ExpertusONE has multiple ways to measure video content success, including: built-in assessments and surveys, learning plans that can bundle content, and advanced reporting tools that track usage and test results.
Measuring Results
In addition to using ExpertusONE’s robust reporting program to measure results, the company enlisted university-based evaluators to determine if learners integrate the CAMS Framework into their clinical practice.
Pilots were launched in Texas and Oklahoma’s public mental health systems in February 2015. ExpertusONE is currently gathering results data, and the company’s university evaluators will also periodically follow up with the CAMS-trained clinicians post-training to determine:
- If they’re implementing the eLearning in their practice
- If they’re doing so with fidelity to the CAMS Framework
- How employing CAMS with at-risk patients is improving their health outcomes
The company will then update their video training program based on these findings. Additionally, they will gather feedback from learners’ managers, clinical supervisors, and those overseeing their training contracts (such as administrators within state Departments of Health) to determine their preferred LMS reporting insights, and then deliver customized reports to them.
“It took a lot of work and planning to get to this point,” the Founder and CEO said. “But one thing that made it easier was that our LMS provider, PeopleONE, actually worked with our university evaluators to develop reporting that’s best suited to our needs and end goals. So we’re all really excited about the capabilities of our LMS’ reporting.”
Program Results
Immediate Benefits & Outcomes
Since launching the program in early 2015, the company has contracted with seven state programs and healthcare facilities in two Canadian provinces. Learner feedback has also been very positive and speaks to the transformative impact that this asynchronous training is having in behavioral healthcare systems.
“Our primary goal was to change clinician behavior so they deliver CAMS as an evidence-based treatment to suicidal patients, thereby avoiding the need for psychiatric inpatient hospitalization (and its associated high costs) and resolving patient suicidality faster than other interventions,” the Founder and CEO commented. “So far, post-training data shows that 77% of learners do plan to make changes to their clinical approach.”
Return on Investment
- Given the need for evidence-based treatment of suicidal people, and considering the number of Americans who each year attempt (>650,000) and die (>40,000) by suicide, the company’s budget of $500,000 for this CAMS Framework training was appropriate and warranted.
- The investment was also impactful for the organization’s profitability and sustainability, and for driving the development of more training in the suicide prevention arena.
- Further impact is being achieved within national healthcare systems, with a focus on global training usage in 2016.
The company also (as discussed earlier) plans to use a combination of LMS-based analytics and face-to-face post-training evaluations to further track, measure, and improve their program’s effectiveness in:
- Changing and retaining clinician behavior
- Continuing to practice CAMS with fidelity to the framework
- Improving outcomes in suicidal patients by resolving their suicidality more rapidly
Next Steps
The suicide prevention company is currently rolling out its eLearning program nationwide and globally in 2016. They plan to expand the CAMS training from a four- to six-hour course for advanced practitioners, and adapt CAMS for professionals in other workplaces that deal with suicidal individuals, such as juvenile justice, school, and military settings.
Beyond this… the company also looks forward to working with other SMEs to extend their best practices from in-person training to the eLearning market.
“We aspire to be the ‘gold standard’ for suicide prevention training. We’ve set the bar high, and this first program in the CAMS Framework has proved to be an excellent start… a full realization of our goals and capacity to fulfill our brand promise,” the Founder and CEO concluded.
