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Informed Consent in Occupational Therapy


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This is a branching scenario on the appropriate application of informed consent in occupational therapy. It grew out of a conversation with a SME who is the program director of a MS program in Occupational Therapy. She relayed repeated learner errors in communication with clients regarding informed consent. This Module was developed using Articulate Storyline 360, Twine, Affinity Photo, Adobe XD and Well Said Labs.

Identifying the Need

A needs analysis was performed with the SME. We identified a problem with learners' understanding of the concept of informed consent. She described actual situations of inappropriate communication in attempts to adhere to ethical standards around informed consent. Learners were exposing themselves to possible legal complications with clients in an attempt to act in an ethical manner. This also impacted clinical instructors' evaluation of their performance in the area of professional behaviors. Learners did receive instruction on the principles and mandates underlying informed consent but they were not able to appropriately employ it in real-life situations. Learners confused informed consent with self-revelation, support or comradery.

Coming up with a Solution

The SME agreed that the learners would benefit from working through a "test case" before applying what they had learned during in-person simulations. The curriculum load is heavy so the solution design had to fit into the current time frame for facilitating this skill. Learners would read the materials, practice via the scenario Module, then apply what they had learned during an in-person simulation. The scenario would help convert theory into practice and provide the basis of the simulation. Independent completion of the Module would increase the effectiveness of the simulation without increasing the time allotted.

Measuring the Desired Outcome

Providing informed consent is a "soft" skill with professional and legal implications. Effectiveness of the Module is measured via formative assessments built into the eLearning scenario. The evaluation of its effectiveness when independently applied by the learner would come in the form of feedback from clinical instructors in the fieldwork settings. They are required to provide detailed performance evaluations of learners that include appropriately obtaining informed consent from clients.

Inclusive Design and Development

This scenario was designed to improve accessibility for learners with visual, auditory and cognitive challenges. It is estimated that 12-26% of the overall population of western countries is disabled. Seventy percent of all disabilities are hidden like hearing or vision impairments. According to the CDC, 61 million U.S. adults are disabled. Worldwide that number rises to over 1 billion. Only 39% of workers reveal their disability to their managers. This course was designed following the WCAG POUR principles: Perceivable, Operable, Understandable, Robust. As an occupational therapist who is also an instructional designer, I have worked with learners who fall into all categories of disability. Specifically, I have provided training for learners regarding access to technology and eLearning. These experiences have given me a unique perspective on technology access impacting disabled learners. I chose to build accessibility into this Module instead of relying on external technology to provide access. Some of the design steps taken to increase accessibility and decrease cognitive load for all learners include:

  • Making sure all color combinations provided contrast for text that exceeded minimum of 4.5:1

  • Building in text to speech

  • Adding accessibility controls

  • Padded buttons to accommodate screen zoom

  • No use of the colors red and green (affects color blind individuals)

  • No drag and drop answers (difficult for those with motor impairments)

  • No text embedded in photos (causes text to pixelate)

  • No right justify to avoid large text gaps (affects those with dyslexia)

  • Minimizing animations (distracting for some learners with autism or ADHD)

  • No flashing animations (can trigger seizures in susceptible individuals)

  • Consistent placement of Continue button (easier access for vision impaired learners)

  • Trigger added to entire box of each answer response (easier for learners with motor impairments)

The Twine app was used to create the intial storyboard for the SME in this project. It went through several iterations before the final one was approved.


The next step was to design the main slide types in Adobe XD. This app provides an easy UI for designing without all of the interactive elements of Storyline 360. There were many iterations of the slides and buttons. Image assets were obtained from and from Storyline 360. Images were modified using Affinity Photo to change backgrounds or characters.


The Adobe XD models were used to begin building in Storyline. Learners were taken from a short review slide directly into the scenario based on Cathy Moore's Map It approach. The Module was designed using real-life correct and incorrect responses. Information slides were designed to provide additional training and confirm the thinking that led to correct responses. Learners are required to answer correctly on one of the first two questions before advancing. Learners who also answer the third question correctly move on to the Congratulations slide. Learners who fail 2 of the 3 questions are referred to Resources to review.  Repeating the first 2 questions after failing both reduces the chances that the learner will fail the third question as well based on the feedback content. 

Text to speech audio was added to the Module using voice over from the site WellSaid Labs.

Outcome Measurement

Effectiveness of this Module is measured post completion during the in-person simulation as a type of formative assessment. The evaluation of its effectiveness when independently applied by the learner is in the form of feedback from clinical instructors in fieldwork settings. They are required to provide detailed performance evaluations that include obtaining informed consent from clients.

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Olympic Weightlifting for Women

Informed Consent in Occupational Therapy
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Oly Lifting



This accordion style interaction was created in Articulate Storyline 360 to summarize the benefits of olympic style weightlifting for women. It is a unique sport with benefits that extend beyond strength and power. The approach used for this interaction permitted the inclusion of larger amounts of text in a compact but flexible format.

The images used are from Freepik Storyset (<a href="">People illustrations by Storyset</a>). They were modified in Affinity Designer using a color palette from Adobe Color. Images were chosen to get away from the hard-driving emphasis seen on many fitness sites and to inject a bit of fun. Motion Path animations were used to increase engagement and emphasize the dynamic nature of olympic weightlifting. The animations also made room for the large block of text explaining each benefit. Overlays were added to each image to help learners keep track of the benefits they visited.

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