Instructional System Design

Course description: Systematic design of instruction including task analysis, learner analysis, needs assessment, content analysis, specification of objectives, media selection, evaluation and revision. Analysis of instructional design models.

The learning in the course is split into nine instruction areas: goal analysis, subordinate skills analysis, learner and context analysis, performance objectives, learner assessment, instructional strategy, instructional development, formative evaluation, and summative evaluation. I was assigned to work with a local non-profit organization to improve the human resources segment of their new employee orientation.

Alignment between learning objectives and item types in assessments

Method
Type of Test Item
Sample Behaviors
Conventional
True/False
identify, recognize, select, choose
Matching
identify, recognize, select, discriminate, locate
Fill-in-the-Blank
construct, develop, discuss, define, generate, identify, solve, locate, state
Multiple Choice
choose, discriminate, identify, recognize, select, solve, locate
Short Answer
define, discriminate, evaluate, identify, locate, state, name, select, judge, solve
Essay
construct, discuss, develop, evaluate, generate, judge, solve
Performance
Performance/Product Checklists
construct, solve, develop, generate, locate, perform, operate
Assessment Rubric
choose, construct, generate, operate, perform


Alignment according to Gagne's taxonomy:

Method
Type of Test Item
Learning Domain
Conventional
True/False
Verbal Information Concepts
Matching
Fill-in-the-Blank
Multiple Choice
Performance
Performance/Product Checklists
Procedures/Rules
Assessment Rubric
Problem Solving/Cognitive Strategies

Analysis Phase

The difficult part of this project has not been meeting with the service learning partner or getting the information we need, it has been the deciding on what content is good or bad, correct or incorrect for charting in the goal analysis. At the start, everyone except James wanted to jump into reorganizing the Hospice orientation as we thought it should be, however the assignment called for drawing how the system is currently implemented.

As I sketched out the process of HR orientation with Michelle, we created skill boxes and verbs for what the client wanted to accomplish. Note, what the client wants to accomplish is different from what they are currently presenting, so the charting came to a halt as our group members debated four different interpretations of the assignment. Michelle interpreted the assignment to mean it was possible we were supposed to be sketching how Hospice actually does orientation, now. Since my verbs matched more of an ideal implementation of Hospice, it would have involved a total re-think of the goal analysis. Three of us turned out to be correct anyway, but only in parts. In retrospect, it might have been helpful to have just asked our questions earlier instead of debating our interpretations of the assignment requirements.

One of the most useful things I used during the assignments was the Gagne's list of verbs. I had trouble with adding verbs to the goal analysis because I imagined the verbs had to be some physical action I could observe. I hadn't considered the verb could just as easily been someone speaking a one-word answer to a question. As I started connecting verbal arrows to other boxes in the Visio file I created, I realized I have only a vague understanding of how to create the flow of connections for verbal information. I will need to re-read that section of Dick, Carey, and Carey to properly contribute my input to the team version of the analysis.

In a few partial group discussions, we played with alternative ideas methods for presenting the orientation content in the current program. For example, I think all of my group members believe most, if not all of the paperwork signed during orientation can be done individually, without consuming HR's staff time. By downloading the forms online, receiving them by mail, or coming in to review the current packet on their own shouldn't require as significant amount of time as HR is putting in now. If HR allowed employees alternative methods or opportunities to file personnel paperwork, they could use more orientation time to orient the new employees to the culture of the client's organization.

After reading draft assignments from other students in class, I had a new appreciation for following the flow of charts. Creating the proper breaks in flow for pagination, drawing arrows in the right direction, and picking the best verbs makes a big difference in what information a chart conveys. Even though 2c said the goal statement in the draft I presented in class was acceptable, I believe after re-reading Unit 1 Supplement, it can be improved to better clarify the learner, the real-life context, and the available tools for accomplishing goals. Right now, the goal I stated feels very heavy in what learners will be able to do.
Michelle and James far exceeded my expectations of time commitments to this group project, and I have met with them in person and by phone on several occasions outside regularly scheduled face-to-face class meetings. I will be meeting again with James on Monday to clarify terms in the team learner and context analysis.

The attached assignment includes a goal and subskills analysis, and learner and context analysis of a non-profit.

AttachmentSize
HOTC Learner&Context Analysis 20051002 blacked out.pdf64.56 KB
HOTC goal&ssa 20051002 blacked out.pdf56.35 KB
HOTC analysis phase feedback.pdf45.45 KB

Bloom's taxonomy

Measurable Action Verbs for Generating Performance Objectives based on Bloom’s Taxonomy for Learned Outcomes.

Knowledge Level Comprehension Level Application Level

Arrange
Acquire
Define
Distinguish
Duplicate
Identify
Label
List
Match
Memorize
Name
Order
Recognize
Recall
Repeat
Reproduce

Classify
Demonstrate
Describe
Discuss
Distinguish
Explain
Express
Identify
Interpret
Locate
Recognize
Rephrase
Report
Represent
Restate
Review
Select
Sort Tell
Translate
Transform

Apply
Classify
Demonstrate
Dramatize
Develop
Employ
Generalize
Illustrate
Interpret
Operate
Organize
Prepare
Practice
Reconstruct
Relate
Schedule
Sketch
Solve
Transfer
Use

Analysis Level Synthesis Level Evaluation Level

Analyze
Appraise
Calculate
Categorize
Classify
Compare
Contrast
Criticize
Deduce
Detect
Diagram
Differentiate
Discriminate
Distinguish
Examine
Experiment
Inventory
Question
Test

Arrange
Assemble
Collect
Compose
Construct
Create
Derive
Design
Document
Formulate
Manage
Modify
Organize
Plan
Prepare
Produce
Relate
Set up
Synthesize
Tell
Transmit
Write

Agree
Appraise
Argue
Assess
Assume
Attack
Challenge
Choose
Compare
Contrast
Decide
Defend
Estimate
Evaluate
Judge
Predict
Rate
Score
Select
Support
Validate
Value

Chunking instructional units

Alternative Methods for Chunking Units into Lessons based on 5E Instructional Strategy

Instructional Unit 1

    Instructional Event (Engage)

 

Lesson 1

    Instructional Event (Explore)

    Instructional Event (Explain)

    Instructional Event (Elaborate)

    Instructional Event (Evaluate)

Instructional Unit 2

    Instructional Event (Engage)

Lesson 2.1

    Instructional Event (Explore)

Lesson 2.2

    Instructional Event (Explain)

Lesson 2.3

    Instructional Event (Elaborate)

Lesson 2.4

    Instructional Event (Evaluate)

Lesson 2.5

Instructional Unit 3

    Instructional Event (Engage)

Lesson 3.1

    Instructional Event (Explore)

 

Lesson 3.2

    Instructional Event (Explain)

    Instructional Event (Elaborate)

    Instructional Event (Evaluate)

Lesson 3.3

Instructional Unit 4

    Instructional Event (Engage)

Lesson 4.1

    Instructional Event (Explore)

    Instructional Event (Explain)

Lesson 4.2

Lesson 4.3

    Instructional Event (Elaborate)

    Instructional Event (Evaluate)

Lesson 4.4

Instructional Unit 5

    Instructional Event (Engage)

 

Lesson 5.1

 

Lesson 5.2

    Instructional Event (Explore)

    Instructional Event (Explain)

    Instructional Event (Elaborate)

    Instructional Event (Evaluate)

Instructional Unit 6

    Instructional Event (Engage)

Lesson 6.1

    Instructional Event (Explore)

    Instructional Event (Explain)

 

Lesson 6.2

 

Lesson 6.2

 

Lesson 6.4

    Instructional Event (Elaborate)

    Instructional Event (Evaluate)

Instructional Unit 7

    Instructional Event (Engage)

Unit Overview

    Instructional Event (Explore)

Lesson 7.1

    Instructional Event (Explain)

Lesson 7.2

    Instructional Event (Elaborate)

Lesson 7.3

    Instructional Event (Evaluate)

Unit Summary

Instructional Unit 8

    Instructional Event (Engage)

Unit Overview

    Instructional Event (Explore)

Lesson
8.1

 

Lesson
8.2

 

Lesson
8.3

    Instructional Event (Explain)

    Instructional Event (Elaborate)

    Instructional Event (Evaluate)

Unit Summary

Defining performance objectives

Dick, Carey, and Carey (2005) outline a set of requirements for performance objectives in an instructional unit, including audience, behavior, condition, and degree. The audience is the target population to complete the assigned objective. Behavior includes an action verb to describe what the learners are expected to know and/or be able to do. Cues, stimuli, tools, scope, and complexity are part of the condition in a performance objective. Finally, the acceptable performance is defined by the degree. A complete objective would have all four components, for example, "provided with a list of insects, first graders will write the list of insects in alphabetical order with 90% accuracy."

Gagne verbs

Domain

Measurable Verbs/Behaviors

Verbal Information
Names, labels, facts or a collection of propositions

Arrange
Acquire
Define
Distinguish
Duplicate
Identify

Label
List
Match
Memorize
Name
Order

Recognize
Recall
Repeat
Reproduce

Concepts
A set of objects, symbols or events grouped on basis of shared characteristics that can be referenced by a name or symbol.

Classify
Describe
Discuss
Distinguish
Explain
Express
Report

Represent
Identify
Interpret
Locate
Recognize
Rephrase
Restate

Review
Select
Sort Tell
Translate
Transform

Procedures & Rules
Relational rules or principals and procedural rules or procedures.

Apply
Classify
Demonstrate
Dramatize
Develop
Employ
Generalize
Illustrate

Interpret
Inventory
Operate
Organize
Prepare
Reconstruct
Relate
Practice

Set up
Schedule
Sketch
Solve
Transfer
Use

Problem Solving
Combine learned principles, procedures, verbal information and cognitive strategies in a unique way within a domain to solve original problems

Analyze
Appraise
Assemble
Calculate
Contrast
Criticize
Compose
Construct
Create

Deduce
Detect
Derive
Diagram
Design
Estimate
Examine
Experiment
Formulate

Hypothesize
Plan
Produce
Question
Synthesize
Test
Validate

Cognitive Strategy
Internally organized skills whose function is to regulate and monitor the utilization of concepts and rules

Agree
Appraise
Argue
Assess
Assume
Attack
Challenge

Choose
Compare
Contrast
Decide
Defend
Evaluate
Judge

Modify
Predict
Rate
Select
Support
Synthesize
Value

Instructional Treatment Plan

The instructional treatment plan builds on the analysis phase of the instructional design process. Some of the elements of the subskills analysis could be plugged right into the assessment alignment table. The organization I've been working with has an uncommon element of attitudinal and emotional importance, therefore the objectives of this plan include attitudinal elements otherwise not seen in a "proper" instructional treatment plan. Version 2.1 is a draft and the name of the organization has been removed since I didn't ask them about posting this to the internet.

One of the major stumbling blocks in completing this assignment was choosing a grounded instructional strategy. The assignment had a template, however the default Gagné instructional strategy seemed to be better suited for classroom, face-to-face instruction. Part of the effort in this project has been to present a large part of the orientation material in a web-based form, and WebQuests, paired with job aids, seemed like the closest grounded instructional strategy to our goal.

In the process of researching WebQuests, I developed a list of helpful resources such as the WebQuest template. I even signed up for a QuestGarden account, a PHP-based site for generating WebQuests. My professor, Dr. Hirumi, studied under faculty at SDSU. A guide on the building blocks of a WebQuest was also helpful in guiding the instructional strategy details for the treatment plan in my assignment.

During this assignment, I realized I'm rusty on rules for creating surveys. I used to know some good tips on trying to dumb-proof surveys, but I need a refresher. I think the Ph.D. program will have a survey course later in my plan of study. During the implementation of assessment tools later in this project, I may need to refer to my old marketing research textbook for some of those rules on survey creation. All I remembered to do was to not make the feelings about HR a double-barreled question.

After receiving feedback from Dr. Hirumi about version 2.2 of the instructional treatment plan, it was easier to see just how much the WebQuest instructional strategy was being modified to fit the objectives of the instructional unit. Tracy gave an example of a WebQuest she had used before. The task was to research George Washington. The process was to visit a website, read about George, answer some questions, and write an essay. The resources were the initial links provided to the learner, and the evaluation was over the essay. In the case of the client for this project, much of the "questing" is just browsing documentation prepared specifically to guide the learner through filling out their new hire paperwork.

As a result of the feedback from Dr. Hirumi, each part of the plan received some sort of significant modification. Initially, the plan included content to teach some attitudinal content, but that was removed in the final version, because we thought it would be better to allow hospice culture subject matter experts to develop a face-to-face presentation on what they wanted new employees to know. The initial objectives were choppy, and didn't follow 2c's ABCD rule for objectives. The instructional plan also lacked some sort of activity to reinforce the information in the readings. What I imagine for the Accident/Incident Report lesson is to present the new employee with three scenarios. They will need to identify which one requires an Accident/Incident report, then take information from the scenario to fill out a practice form.

The important thing to monitor as revisions were made to the plan is continuity from one part to another. At one point during the revision process, the objective for the learning about the employee assistance program only required learners to identify uses of the program, when in fact the learner also needed to know it was free, voluntary, and confidential.

The other continuity problem surfaced during revisions when we added scenario activities to the process. The objectives only accounted for making choices based on the Hepatitis B information sheet. Since the learners should know from the objectives they will have to apply information from a scenario in addition to the Hepatitis B information page, it was necessary to go back and amend the objectives. There was some discussion during the revision that adding all that information to the objectives "isn't how things are normally done". That was the problem though, the way people normally write objectives is incomplete and/or doesn't align the instruction and evaluation. At this point, the one bit of knowledge of aligning objectives is a reoccurring issue that will probably be one of the educational highlights of this Ph.D. program.

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EME6613_HOTC_Instructional_Treatment_Plan_2.2_blacked_out.html14.64 KB
EME6613_Instructional_Plan_Final_Feedback.doc90.5 KB
EME6613_Instructional_Plan_Preliminary_Feedback.doc76 KB

Sample instructional treatment plan

Unit Descriptors

Designer's Notes: The objectives listed in this instructional treatment plan are based on the subordinate skills analysis conducted on [removed]'s new employee orientation. This treatment plan focuses on the goal analysis item 1.0, "Follow policy and procedures mandated by Human Resources." Proof to work in the United States should include a link to valid forms of identification on a website such as IRS.gov or an internal webpage.

Course title: Orientation for New Employees of [removed]

Unit Number and Title: Unit 1.0 - Human Resources Pre-orientation

Terminal Objective: Given new employee materials, complete all tasks assigned by Human Resources.

Enabling Objectives: When provided instructional resources, scenarios, and job aids, you should be able to:

  • Choose to receive or decline a Hepatitis B vaccination.
  • Identify characteristics of the Employee Assistance Program on a quiz with 100% accuracy.
  • File a sample incident report with 100% accuracy.
  • Prepare and submit all completed personnel file paperwork and supporting documentation.

Prerequisites: Present an original of the following items to a Human Resources representative, who will visually verify and copy all items:

  • government issued identification
  • social security card or other proof to work in United States as stated in the instructions of IRS form W-7, USCIS Form I-9, and/or the USCIS Handbook for Employers, M-274.

 

  • Entry behaviors
    • minimum 6th grade ability in reading and comprehension
    • minimum 6th grade ability in mathematics
    • ability to navigate and print websites on the Internet
  • Optional:
    • voided personal check
    • Hepatitis B vaccination records

Time Requirements: Approximately 1 hour

Instructional Strategy and Media Selection

Designer's Notes: WebQuest

This unit does not cover attitudinal parts of the orientation to give the [removed] culture subject matter experts an opportunity to develop a face-to-face presentation on [removed] culture. The WebQuest grounded instructional strategy has been modified to meet the needs of [removed] pre-orientation paperwork requirements. WebQuests are an inquiry-based strategy in which most or all of the information used by the learners is electronic. They focus learners' time and attention on using rather than looking for information. They are also used to support learners' effort to analyze, synthesize, and evaluate. The critical attributes are pulled from the WebQuest template. This portion of the training is intended to be completely web-based.

Unit 1 Instructional Strategy

Instructional Events Description Media & Tool Selection
Introduction

Prepare and hook the reader and provide a short overview. Stress the importance of completing this unit and illustrate to new employees how this unit will enable employees to start work. Learners will be provided with an overview of each unit that clearly notes benefits and importance of each unit as well as identifies problems and limitations associated with failing to address related skills and/or knowledge.

Overview: Many of you may have some experience filling out Human Resources paperwork. This paperwork is important for starting work. This unit will provide an overview of Hepatitis B, the Employee Assistance Program (EAP), and Accident/Incident Reports. Human Resources paperwork provides [removed] with information to pay you. This unit is relatively short and should take you approximately one hour to complete.

Web page
Task

Describe the end result of what the learners' activities will be. This section should list the aforementioned enabling objectives included in this design document. Prerequisites should also be listed here, including what materials learners will need.

  • Given information and a practice scenario about Hepatitis B, you should be able to choose to receive or decline a Hepatitis B vaccination.
  • Given information and a practice scenario about the Employee Assistance Program, you should be able to identify characteristics of the Employee Assistance Program in a quiz with 100% accuracy.
  • Given information and a practice accident scenario, you should be able to accurately file an incident report with 100% accuracy.
  • Given job aids, you should be able to accurately complete and submit all personnel file paperwork and supporting documentation.

For this unit you will need:

  • government issued identification
  • social security card or other proof to work in United States as stated in the instructions of IRS form W-7, USCIS Form I-9, and/or the USCIS Handbook for Employers, M-274.
  • minimum 6th grade ability in reading and comprehension
  • minimum 6th grade ability in mathematics
  • ability to navigate and print websites on the Internet
  • Optional:
    • voided personal check
    • Hepatitis B vaccination records

 

Web page
Process

What steps should the learners go through? Use a numbered list here to show the flow of the instruction. Providing the checklist here is recommended in the WebQuest template. Learners will be prompted with links to resources about Hepatitis B, the Employee Assistance Program, Accident/Incident Report, and job aids.

You will be provided with instructional resources, scenarios, and job aids. During this pre-orientation you will complete the following processes:

  1. You will read about Hepatitis B
  2. Once you have read the Hepatitis B information, you will be presented with a scenario
  3. You will answer a question about the scenario
  4. Using information learned in the scenario, you will complete the Hepatitis B vaccination form
  5. Next, you will read about the Employee Assistance Program
  6. Once you have read about the Employee Assistance Program, you will be presented with a scenario
  7. You will answer questions about the scenario
  8. Using information learned from the scenario, you will identify uses of the Employee Assistance Program
  9. Next, you will read about filing an Accident/Incident Report
  10. Once you have read about the Accident/Incident Report, you will be presented with a scenario
  11. You will answer a question about the scenario
  12. Using information learned from the scenario, you will identify the correct sample scenario from a list and use the scenario information to fill out an Accident/Incident Report
  13. You will then be directed to a list of required paperwork and identification for starting work
  14. You will complete the required paperwork for your personnel file.

 

New Employee Checklist

Use this checklist as a guide for which documents must be completed, signed, and submitted to the Human Resources office.

Criteria Yes No Comments
W-4 boxes 1-7 completed      
W-4 signed and dated      
Affidavit of Good Moral Character county blank says "Seminole"      
Affidavit of Good Moral Character employee name in second blank      
Affidavit of Good Moral Character employment blank says "[removed]"      
Affidavit of Good Moral Character signed by new employee in AFFIANT blank      
Criminal Activity Policy is signed and dated      
Receipt and Acknowledgement of Understanding of the Sexual Abuse Policy has employee name printed and signed      
Notice of Privacy Practices Acknowledgement form is signed, name is printed, and dated in the "[removed] Employee/Volunteer/Other Signature" blank      
Notice of Privacy Practices Acknowledgement form reads "[removed]" in the "Company Name" area of the signature line      
Statement of Privacy/Confidentiality is signed, name is printed, and dated      
Authorization for Media Use/Publication has employee name printed in the "Print Name of Person Giving Authorization" blank      
Authorization for Media Use/Publication has a check for "may" or "may not" to authorize media rep      
Authorization for Media Use/Publication is signed and dated by employee      

Conflict of Interest form lists new employee name in the blank after "I"

     
Conflict of Interest employee, volunteer, or member checkbox is checked      
Conflict of Interest form has checks in the check blanks in items 1-3      
Conflict of Interest form is signed, dated, and name is printed      
Consent for Drug Testing is dated, signed, and name is printed      
Full, Part-Time, Temporary, and Per-Diem Compliance Form has initial assignment date, employee name, social security number, signature, and date      
Acceptance/Declination Hepatitis B Virus Vaccine name and department are completed      
Acceptance/Declination Hepatitis B Virus Vaccine contraindications paragraph is initialed      
Acceptance/Declination Hepatitis B Virus Vaccine agreement is signed and dated three times OR vaccination refusal agreement is initialed, signed, and dated      
Electronic Authentication Policy Acknowledgement Form name is printed, signed and dated.      
When to complete an Accident/Incident Form is signed and dated      
Electronic Communications Systems Employee Acknowledgement Form is printed, signed and dated.      
OPTIONAL: Direct Deposit Form is filled out with name and social security number submitted with a voided check      
OPTIONAL: Employee Charitable Fund Donation Form is signed with an election for charitable donation amount.      

 

All checklist items are turned in to Human Resources and accepted as complete

__________ Initials of Human Resources Representative

_____/______/_____ Date

 

 

Web page
Resources

Resources will be internally linked webpage's listing information about Hepatitis B, Employee Assistance Program, Accident/Incident Reports, and help documents for instructions on filling out each personnel file document. Each document for Hepatitis B, Employee Assistance Program, and Accident/Incident Report will have one or more scenarios to give learners practice with each area. Some type of webform will be used to allow users to answer questions about each scenario. Type and features of webform will be determined at a later date. Job aids will need to be designed to explain how to properly complete each form. A webpage describing acceptable Governmental IDs will be provided in this section. A link to IRS form W-7 and USCIS Form I-9 will be provided as a resource of acceptable Governmental IDs.

[contact information removed]

Web page
Evaluation New employees will complete the checklist of items and turn it in to Human Resources. Checklist is included as part of the process of the instructional strategy and in the appendix of this document. Checklist and multiple choice survey
Conclusion A couple sentences here will summarize what the new employees have accomplished during the orientation. Including some rhetorical questions and additional links is recommended by the WebQuest template for extending the experience beyond orientation. Web page

Media Selection Rationale

Webpages were selected o deliver most instructional events for a number of reasons:

  • First and foremost, the context analysis indicated that the material is to be delivered via the Internet. As such, the webpages provide the most accessible means of providing a combination of audio, video, text and graphics.
  • The content and learning objectives for this unit is primarily focused on the acquisition and use of verbal information and filling out of forms. As such, the use of text and graphics are most essential which the webpages support in an effective manner, particularly with the availability of using hypertext links.
  • No face-to-face interaction is necessary for the web based events.
  • Allows for a student centered approach and will allow time for Human Resources to focus on culture and attitudinal goals in a face-to-face meeting.
  • Provides a dynamic environment to present orientation materials and multimedia. No longer will Human Resources need to keep stacks of pre-sorted photocopies and re-arrange prepared packets for information updates.
  • Serves as a job aid for future reference. Employees can refer to it for the most updated information whereas information from the new hire packet in paper form can become outdated.
  • Focuses on the dissemination of information. Hypertext links can be beneficial in communicating extra information.
  • Allows for immediate feedback.
  • Face-to-face time requirements are reduced for Human Resources staff.

Unit 1 Learner Assessment Alignment Table

Designer's Notes: The enabling objectives for Unit 1.0 focus on the acquisition of verbal information, declarative knowledge, and attitudes rather than higher order thinking skills, therefore a checklist is suitable for assessing new employee success in orientation. The terminal objectives for the new hire orientation focus on conceptual, verbal, and attitudinal domains. Each objective addresses the audience, required behavior, condition, and criteria or degree to which the performance will be measured.

Unit 1 Learner Assessment Alignment Table

Skill Objective Domain Method Item/Criteria
Turn in required personnel paperwork to Human Resources Terminal objective: 1.0 - Given new employee materials complete all tasks assigned by Human Resources. Rules Post test: New employee checklist

Checklist item:

___ New employee paperwork complete

Make an informed choice about receiving a Hepatitis B vaccination

Enabling objective: 1.1 - Given information and a practice scenario about Hepatitis B, new employees will choose to receive or decline a Hepatitis B vaccination. Cognitive Post test: Assessment Rubric

Assessment Rubric is listed below

Identify characteristics of the Employee Assistance Program

Enabling objective 1.2 - Given information and a practice scenario about the Employee Assistance Program, you should be able to identify characteristics of the Employee Assistance Program in a quiz with 100% accuracy. Verbal

Post test: true/false quiz

T/F - Family members can participate in EAP
T/F - EAP is voluntary
T/F - EAP is not free
T/F - EAP is not confidential
T/F - EAP may be consulted for any problems an employee encounters

File an Accident/Incident Report

Enabling objective 1.3 - Given information and a practice accident scenario, you should be able to accurately file an incident report with 100% accuracy. Rules Post test: Paperwork checklist

Checklist item:

___ Sample practice Accident/Incident Report

Complete and submit all personnel file paperwork Enabling objective 1.4 - Given job aids, you should be able to accurately complete and submit all personnel file paperwork and supporting documentation. Rules Post test: Paperwork checklist

Checklist item:

___ All checklist items are turned in to Human Resources and accepted as complete

Appendix: Sample Assessment Instruments

Designer's Notes: Sample assessments are a compilation of the assessment items listed in the assessment alignment table. The assessment items specified for enabling objectives 1.1-1.4 were compiled to generate checklists to measure the achievement of the terminal objective 1.0. Contact information on how to submit paperwork to Human Resources could be included in the checklist instructions.

 

New Employee Checklist

Use this checklist as a guide for which documents must be completed, signed, and submitted to the Human Resources office.

Criteria Yes No Comments
W-4 boxes 1-7 completed      
W-4 signed and dated      
Affidavit of Good Moral Character county blank says "Seminole"      
Affidavit of Good Moral Character employee name in second blank      
Affidavit of Good Moral Character employment blank says "[removed]"      
Affidavit of Good Moral Character signed by new employee in AFFIANT blank      
Criminal Activity Policy is signed and dated      
Receipt and Acknowledgement of Understanding of the Sexual Abuse Policy has employee name printed and signed      
Notice of Privacy Practices Acknowledgement form is signed, name is printed, and dated in the "[removed] Employee/Volunteer/Other Signature" blank      
Notice of Privacy Practices Acknowledgement form reads "[removed]" in the "Company Name" area of the signature line      
Statement of Privacy/Confidentiality is signed, name is printed, and dated      
Authorization for Media Use/Publication has employee name printed in the "Print Name of Person Giving Authorization" blank      
Authorization for Media Use/Publication has a check for "may" or "may not" to authorize media rep      
Authorization for Media Use/Publication is signed and dated by employee      

Conflict of Interest form lists new employee name in the blank after "I"

     
Conflict of Interest employee, volunteer, or member checkbox is checked      
Conflict of Interest form has checks in the check blanks in items 1-3      
Conflict of Interest form is signed, dated, and name is printed      
Consent for Drug Testing is dated, signed, and name is printed      
Full, Part-Time, Temporary, and Per-Diem Compliance Form has initial assignment date, employee name, social security number, signature, and date      
Acceptance/Declination Hepatitis B Virus Vaccine name and department are completed      
Acceptance/Declination Hepatitis B Virus Vaccine contraindications paragraph is initialed      
Acceptance/Declination Hepatitis B Virus Vaccine agreement is signed and dated three times OR vaccination refusal agreement is initialed, signed, and dated      
Electronic Authentication Policy Acknowledgement Form name is printed, signed and dated.      
When to complete an Accident/Incident Form is signed and dated      
Electronic Communications Systems Employee Acknowledgement Form is printed, signed and dated.      
OPTIONAL: Direct Deposit Form is filled out with name and social security number submitted with a voided check      
OPTIONAL: Employee Charitable Fund Donation Form is signed with an election for charitable donation amount.      

 

All checklist items are turned in to Human Resources and accepted as complete

__________ Initials of Human Resources Representative

_____/______/_____ Date

 

 

Sample Assessment Rubric for measuring achievement of terminal unit objective Unit 1

Complete success
  • New employee completed all tasks assigned by Human Resources.
  • New employee made an informed decision about electing to receive a Hepatitis B vaccination.
  • New employee correctly identified uses of the Employee Assistance Program.
  • New employee accurately filed a sample incident report.
  • New employee accurately completed and submitted all personnel file paperwork and supporting documentation using job aids.
Marginal success
  • New employee did not complete all tasks assigned by Human Resources.
  • New employee submitted an incomplete Hepatitis B vaccination Acceptance/Declination form.
  • New employee did not correctly identify uses of the Employee Assistance Program.
  • New employee did not accurately fill out a sample incident report.
  • New employee did not accurately complete and submit all personnel file paperwork and supporting documentation.
Incomplete file
  • New employee did not complete any tasks assigned by Human Resources.
  • New employee did not elect or decline the Hepatitis B vaccination.
  • New employee did not submit quiz regarding characteristics of the Employee Assistance Program.
  • New employee did not submit a sample incident report.
  • New employee did not accurately complete and submit any personnel file paperwork and supporting documentation.

 

Sample Assessment Rubric for measuring achievement of Enabling objective: 1.1 - Given information and a practice scenario about Hepatitis B, new employees will choose to receive or decline a Hepatitis B vaccination.

Accepted
  • Having read the information about Hepatitis B, you have decided to protect yourself and get the Hepatitis B vaccine shot series.
Declined
  • Having read the information about Hepatitis B, you have decided to decline the Hepatitis B vaccine shot series. You have been provided with valuable information but still choose to decline the Hepatitis B series and fully understand the risks.
  • Having read the information about Hepatitis B, you have decided to decline the Hepatitis B vaccine shot series. You have already received the complete Hepatitis B series vaccine.
Prohibited
  • Having read the information about Hepatitis B, you see the value of the Hepatitis B vaccine but have decided to decline the series due to existing health conflicts.
Undecided
  • Having read the information about Hepatitis B, you have not made a decision about receiving the Hepatitis B vaccine series.