Utilize, Implement, and Reflection Paper for Mobile Learning Activity

Meeting Contribution Notes

April 5
● Stephanie created the planning document and sent it to the group.
● Group started the draft and brainstormed ideas for using a mobile learning app.
April 6
● Group continued to discuss topic ideas and mobile app platforms such as Boom
Cards, Seesaw, and Duolingo
April 7:
● Mindy drafted the description and solution.
● Group worked to edit and revise the planning document.
● Stephanie added in the ID model used for this project.
April 13:
● Allyson updated the Description and Context to include information about Atrium
Health, per feedback on the draft.
April 14:
● Mindy recorded a video of the implementation.
● Mindy completed the reflection based on the video recording experience and
feedback from the individual who tested the product.
● The group updated the doc for final submission.

Description and Context

Atrium Heath is a nationally recognized institution that is passionate about patient care,
diversity, and innovative research and education. Atrium Health is a nonprofit healthcare
system with more than 55,000 employees, or “teammates,” across numerous locations
all across North Carolina, South Carolina, and Georgia – eight of which are in Charlotte,
and eighteen total when including the outer perimeter of the city center.

According to the 2019 annual report, Atrium Health has over 15,000 nurses employed
within this health care system.
Figure 1 - Atrium Health 2019 Annual Report (Source: Leading the Way, 2019 Annual
Report)

On average, Atrium Health has approximately 34,000 patient encounters, which is “one
every two seconds.”
Whether it is one of Atrium Health’s hospitals, urgent care locations, emergency
departments, or cancer care centers, nurses serve as the first line of communication
with every patient that walks in the door. Due to this responsibility, and the diversity
within the city and beyond, it is incredibly beneficial if there is a nurse on staff who can
interact with Spanish-only speaking patients, as all deserve vital health care and a
healthcare environment in which they feel comfortable.

Nurses at Atrium Health need to be able to successfully communicate with all patients in
order to administer high-quality, compassionate healthcare. Most nurses speak
English, but some only have limited Spanish vocabulary if any at all. Understanding
Spanish will not only allow staff members to successfully communicate with patients. It
will also enable them to build trust with patients. Bilingual nurses enable a great degree
of care for all patients. They can “serve as translators to communicate very important
information from physicians who do not speak the language” (Wojciechowski, 2018).
Studies state “language barriers limit access to care, reduce patient satisfaction, and
give rise to disparities in care that may compromise health outcomes” (Kalist, 2005).
Overall, the ability to successfully translate breaks down barriers and yields successful
care.

It is clear that Hispanic communities have grown not only in the Charlotte region but
across North Carolina as a whole. In the past decade, Hispanic communities have
grown by 36% (McShane, 2020). Figure 2 illustrates the growth of Hispanic
communities throughout the state. While all hospitals and care centers have a
translator, either through phone or in person, it is important that the nurses who interact
with the patients can provide translation as well to ensure the best care.

Figure 2- Population Growth in Charlotte Region (source: Charlotte Region's Hispanic

Population Grows at a Rapid Pace)
Indicator and Alignment

AECT Standard 2 (Content Pedagogy): Candidates develop as reflective practitioners

able to demonstrate effective implementation of educational technologies and
processes based on contemporary content and pedagogy.

Using - Candidates implement appropriate educational technologies and

processes based on appropriate content pedagogy. (p. 141)

Before selecting and implementing the mobile learning app, we reflected on the need for
caretakers, especially nurses to be able to communicate with their patients. While
looking through data in Charlotte, it is clear that there is a growing hispanic population,
many of whom speak Spanish as their first language. The hospital offers translator
technology that greatly assists patients. Many however, feel more comfortable when
the nurse and staff attempt to communicate with them in their home language. The
hospital needs an app that can enable nurses and other staff members to learn
conversation phrases and vocabulary that can help them better assist their patients.
Based on data, Duolingo uses clear visualization, audio of common phrases, and offers
explanations of grammar rules and vocab in every task. Duolingo is a mobile app that
allows participants to learn anywhere and anytime that is convenient for them. Also, the
learning does not have to take place at the work site. Most importantly, Duolingo is
effective, it enables users to redo tasks and strengthen their skills. For further clarity on
how this project aligns to the indicator, see the reflection of the Justification of AECT
standards concluding the project.

Solution

The mobile learning solution applied is an educational app called Duolingo, focusing on
Spanish. This type of mobile learning is classified as Low Transactional Distance and
Individualized Mobile Learning Activity (LI) due to the low interaction with instructors and
other members of the learning community (Park, 2020). This app offers game-like
lessons where users practice speaking, reading, listening, and writing skills. The games
are set up as a tree where users must work their way through. When users reach the
end, they will earn trophies to build motivation. The game also offers a type of currency
called “lingots'' that allows the user to update various aspects of the game. Parts of the
tree, or lessons, will decay signaling to users that they must revisit and review the
topics. The benefits of Duolingo include the built-in reward system, ability to play
anywhere, a vast selection of languages, and it teaches by content rather than
memorization.
At the moment, nurses at atrium have automated translating services. However, if
nursing staff are interested in additional translating services – via convenient apps –
there are many options available. While the automated translating service currently in
place works well, many patients feel more comfortable translating with one of their
caretakers. To incentivise nurses learning new languages, Atrium will offer incentives to
those who complete the entire Duolingo course.

The FRAME Model

Our group decided to use the FRAME model for evaluating/choosing the Duolingo
program for our project.

Device Aspect: Due to Duolingo being a web-based application, the program can be
used by a variety of devices. The size, memory, and storage capacity, along with input
capabilities will vary depending on which type of device the participant is using, but
doesn’t necessarily impact the use of this program.

Learner Aspect: “The learner aspect is grounded in the belief that the learner’s prior
knowledge, intellectual capacity, motivation, and emotional state have a significant impact
upon encoding, retaining and transferring information” (Koole, 2009). Participants of this
project will all have a background in healthcare as it is geared towards nurses. Since the
participants have prior knowledge of situational contexts, they should be able to jump
right into the lessons offered by the Duolingo app. The nurses have a need for learning
a way to communicate with their patients and are motivated to be successful in doing so.
Duolingo is question-based so participant learning is scaffolded. The more they learn,
the less help they receive.

Social Aspect: This aspect takes into account, the social interactions within this
application. The application allows users to follow friends and celebrate streaks and awards.
The main social aspect behind the program is to be more socially aware and communicative.

Device Usability Intersection: Once the Duolingo application is added to a device, the
participants will have access to the program whenever they would like to use it. The
application chunks the content to make learning a new language less daunting. Duolingo
Also provides simple graphics, and aesthetically pleasing fonts and colors.

Social Technology Intersection:

Interaction Learning Intersection: Duolingo offers learner interaction with audio and
visual information. Learners also receive feedback after responding to matching and
Questioning throughout the application. Duolingo offers the participant with authentic
learning tasks.

Mobile Learning Process: Duolingo allows users to set a starting point for learning.
Learners may choose the level of difficulty when starting each lesson. Learners also
set a goal for daily use and can earn “streaks” when not skipping a day of practice. The
user can also earn points (lingots) to upgrade various aspects of the application.

Implementation:
Video of implementation.

Participant Procedures:

1. Download Duolingo to the desired device.

a. Cell Phone or Tablet: Download from Google Play store or App Store
(Apple)
b. Desktop: Click on this link to begin.
2. Open Duolingo Learning App
3. Click, “Get Started”
4. Select desired language (for this purpose we used Spanish due to high demand
in Charlotte Atrium hospitals).
5. Select “other” to answer, “How did you hear about us?”
6. Select “Job Opportunities” to answer, “Why are you learning a new language?
7. Read Course Overview and click “Continue.”
8. Select a goal and click, “Continue.”
9. Answer if you are beginning a new language or if you know parts of the
language.
a. If you select, “Already know some Spanish,” you will take a baseline quiz
to determine what prior knowledge you already have.
10. After you have completed the baseline quiz or first lesson, you will have a
notification that you have reached your daily goal.
11. You will also “unlock a gift.” Select equip for free.
12. Create a Duolingo profile.
a. Enter your age, name, email address, and create a password.
13. When asked to do a two week free trial, you can pass. Users can still use the
app, there will be add on the free version.
14. You will then be taken to your home page. Feel free to explore.
15. Come back daily to practice skills and advance through the app.

Reflection of Implementation:

I. Device
The mobile device that was selected for implementation was a cell phone.
Duolingo can also be accessed from a tablet or personal computer. The
participant used a cell phone in this implementation to reflect what participants
typically use.

II. Learner
 The learner in this recording is a nurse at Atrium. She has done prior lessons in
previous days. She has some background knowledge of Spanish from previous
academic courses, but struggles to be able to have conversations in Spanish.
The participant has taken previous assessments on the mobile learning app to
receive lessons that best suit her current needs. The learner has many options
for lessons that are catered to her level of learning. She at first struggles to
determine which lesson to do, then chooses an “Interest” lesson. The lesson
contains speaking, listening, and translating between languages. The learner
receives instant feedback helping her stay focused and engaged in the lesson.
There are also rewards for answer streaks and is upset when her streak is
broken by an incorrect answer.

III. Social Aspects

Within the profile page, the learner can follow other users on Duolingo. Learners
can also invite friends to earn rewards, such as removing ads and enabling
offline mode. When learners follow others on the app, they can see others
statistics as well as achievements. The learner currently does not have any
followers and is not using the social aspect of the app. When questioned about
the social aspect, she stated she was unaware of it and is looking forward to
connecting with others.
As stated previously, the biggest social impact this will have is enabling more
frequent and clearer communication with patients who speak another language.
The learner stated that even though she uses a translating technology, many
patients have appreciated when she can speak with them using small phrases.
She believes that it has helped form relationships with the patients and has
enhanced her level of care.
 Learner’s Social Page of Duolingo

IV. Future Implementation

After reflecting on the use of the Duolingo technology, there are many positive
points and a few suggestions for improvement.
a. The learner was able to thrive using a cell phone to complete the lesson.
The text, and cues were visible to the learner. This is beneficial for most
learners. However, if there are learners with visual impairments, it is
suggested that a tablet or a desktop is used for implementation.
b. The learner had not logged in daily as the app recommends. This caused
initial confusion as to which lesson she should choose. When using, it is
recommended that users engage in the app daily.
c. The user was able to clearly speak her responses using her phone. For
users practicing in loud rooms, it is recommended to use a microphone.
 d. The user could clearly hear the directions and phrases spoken to her. If
users have difficulty hearing or are in a loud environment, headphones
should be used for best sound quality.
e. The learner did not fully understand the profile and social connection
aspect of the learning app. In the future, it will be recommended that
participants connect with friends to increase the likelihood of daily
engagement.

V. Justification of AECT Standard

The AECT Standard used for this project was Standard 2, Using – “able to demonstrate
effective implementation of educational technologies and processes based on
contemporary content and pedagogy.”
Throughout this project, the group was able to create a technology-based, relevant, and
contemporary learning activity. Furthermore, as the standard addresses, the group was
able to directly implement the learning activity with a fellow colleague, who is not
enrolled in this course. The group felt as though this standard best aligned with this
specific project.

References:

Atrium Health (2019). 2019 Annual Report.

https://atriumhealth.org/files/build_annual_report/index.html?active-section=diversity-
and-inclusion
Kalist, D. E. (2005). Registered nurses and the value of bilingualism. ResearchGate.
https://www.researchgate.net/publication/5119577_Registered_Nurses_and_the_Val
ue_of_Bilingualism.

Koole, M. L. (2009). A model for framing mobile learning. Mobile learning: Transforming
the delivery of education and training, 1(2), 25-47.

McShane, C. (2020, July 7). Charlotte region's Hispanic population grows at a rapid
pace. Charlotte region's Hispanic population grows at a rapid pace | UNC Charlotte
Urban Institute | UNC Charlotte. https://ui.uncc.edu/story/charlotte-regions-hispanic-
population-grows-rapid-pace.

Park, Yeonjeong. Audience analysis: different types of audience. (2020, September 10).
Retrieved April 02, 2021, from https://harappa.education/harappa-diaries/audience-
analysis-and-its-types

Wojciechowski, M. (2018, July 13). The growing need for bilingual nurses.
https://minoritynurse.com/the-growing-need-for-bilingual-nurses/.