CCE Theses and Dissertations

Date of Award


Document Type


Degree Name

Doctor of Philosophy in Computing Technology in Education (DCTE)


College of Engineering and Computing


Gertrude W. Abramson

Committee Member

Martha M. Snyder

Committee Member

Marilyn Olander


Allied Health Education, Applied Constructivism, Echocardiography, High-fidelity Simulation, Instructional Design, Randomized Switching Replications experimental design


This report describes the development, deployment, and analysis of an experimental instructional unit using applied constructivism instructional design (ID). The ID template was used to integrate a high-fidelity simulator into an undergraduate health care degree curriculum in a private, not-for-profit university. A switching-replications experimental design was used with random assignment of volunteer participants to initial treatment and control groups. Quantitative analysis of learning outcomes using standardized assessments was performed, including correlational analysis for knowledge transfer of simulator skills to clinical skills. Statistically significant positive effects were found for the educational outcomes of participants when measuring both the knowledge and application of heart anatomical structures and views for examination of the heart with ultrasound. Mild positive correlations were found between performance on the simulator and performance in an actual clinical setting, with limited predictive value between the two. The switching-replications experimental design helped to control for potentially strong social effects that could have endangered internal validity and to maximize the data available for analysis. Many of the constructivist-based ID features of the educational unit resulted in positive feedback and participation from participants. However, cautionary findings relating to the ID features included the need to carefully evaluate their use, as there was a tendency for participants to not value the performance of certain features if they were not going to be graded, despite their likely educational benefit. Future research suggested includes repetition across similar institutions with disparate student populations, and use of the educational unit ID template to implement simulation technology in other educational realms. Other possibilities include determining the effects on learning outcomes of a more-realistic user interface (UI) design and/or increased realism (difficulty) in the simulation itself. Related qualitative-based research could include structured interviews to determine participant satisfaction and learning outlooks, and investigation of the learners’ thoughts and perceptions as they use actual ultrasound machines after practicing on the simulator through think-aloud and active interview techniques.