Within the dietetics profession, students are required to complete 20 weeks of placement, with half of that time spent in developing and demonstrating competence in individual case management [1]. The assessment of the clinical competence of student dietitians is a shared responsibility between the university and the health sector [1], with the assessments made by site supervisors during clinical placements providing a key source of evidence of student competence [2]. The difficulties faced by site supervisors in assessing student performances during clinical placements are clearly reported in the literature [3,4]. Clinicians therefore need to be supported by universities to use credible and defensible assessment practices [5]; however, the geographical distribution of placement sites prohibits face-to-face education of all supervisors.

Web-based delivery of education to support clinical supervisors has been successfully used by the professions of medicine, nursing, and physiotherapy [6-9]. The Web-based mode transcends geographical and time constraints [10] and may be more accessible to clinicians, particularly those in rural or community-based settings who may be sole practitioners within a multidisciplinary team [11]. Web-based delivery provides an efficient means to share resources and avoid duplication [12]. Professional development delivered via the Web has been shown to achieve equivalent outcomes (satisfaction, knowledge retention, and change in practice) when compared to face-to-face delivery [13,14].

When developing a Web-based learning program, both the discipline-specific content and the learning process need to be considered. Constructivist pedagogy, in which learners construct their own meaning by forming connections through collaboration and reflection between their prior knowledge and new experiences (authentic real-world problems), has been recommended for Web-based delivery [15,16]. Collaboration can be supported within a virtual community using a central online discussion forum [17]. This learner-centered approach to Web-based education allows participants to be independent self-paced learners and to select learning content in a way that meets their learning style [16,17]. Rowe and Rafferty [18] have demonstrated improved user engagement with Web-based learning by self-regulated learning strategies such as activation of prior knowledge, self-monitoring, and reflections. There is evidence to suggest video-based learning material may improve learner engagement [9,19-21]. Effective Web-based delivery must also consider the usability and accessibility of the program [22,23].

Programs to educate supervisors in the use of more credible and defensible assessment practices are currently non-existent. This paper explores the potential for a Web- and video-based constructivist tool to support clinical supervisors to use credible and defensible assessment practices during clinical placements. The program aims to use authentic video-based learning material and metacognitive activities such as self-monitoring and reflection to support clinical supervisors to transform their assessment practices. The study also considers the interdependence between pedagogy, usability, and accessibility.

The Web-based program “Feed our Future” was developed using a design-based research approach adapted from Wang and Hannifin [24]. This approach has been used in the design of technology-enhanced learning environments for the way in which it advances design, research, and practice concurrently [25]. Design-based research addresses a practical problem in context, is informed by theory, and is refined through an iterative process of formative feedback and reflection in consultation with participants [25]. In the final stage of product development in design-based research, the intervention is pilot-tested and evaluated. This stage is then used to inform final revisions of the program [24].

In October 2012, research consultation and initial development of the program commenced concurrently.

Table 7 presents the final learning content for Feed our Future. Figures 2-4 present screenshots of the final interface.

This paper describes the development of the first research- and Web-based learning program to support clinical supervisors in their assessments of student dietitian competence during clinical placements. This case example demonstrates the value of a design-based research and consultative approach to developing a program. The use of a Web-based mode has the potential to disseminate expertise and research findings nationally, overcoming geographical and time boundaries, in the provision of continuing professional development to health practitioners who assess student performance.

The results of the pilot test supported the pedagogical design of Feed our Future. The program encouraged independent self-paced learning and catered to different learning styles as recommended by Ng’ambi and Lombe [16]. Participants demonstrated new understandings that aligned with the programs’ learning objectives of the program through the use of authentic student-client consultations, problem-based learning activities, and reflections. Kyeong-Ju Seo and Engelhard [9] achieved similar results with their constructivist Web-based continuing education program for physiotherapy supervisors with their participants perceiving improvements in the quality of their clinical education skills and practices. The approach used in this study highlights the interdependence of pedagogical, usability, and accessibility considerations [22] with the iterative process and the end-user involvement facilitating the identification of barriers to effective educational outcomes.

Participants in the pilot test found the video recordings of student-client consultations to be helpful in learning about competency-assessment practices. Clinical vignettes in traditional face-to-face learning programs have been used to assist supervisors to gain a shared understanding of entry-level competence in physiotherapy [37]. When used in Web-based delivery, videos have been shown to help engage students and improve learning outcomes [20,21,40]. Maloney and colleagues [19] found learners preferred videos in comparison to other learning materials made available through a Web-based resource repository. Developing a Web-based program with a large number of videos (n=20) in Feed our Future was technically challenging. The decision to edit and divide the videos was driven by network capacity limitations, but Guo’s research [41] suggests that short (6-9 minute) videos also have pedagogical advantages.

Consistent with the findings of Cook and Steinert [14], users appreciated material that was relevant, well-organized, and had clear expectations including time commitments. The participation rates for the discussion forum in this study were low despite the fact that other studies have identified conversational discussion and social bonding as key factors for successful Web-based education [14]. This feature is also key to constructivist pedagogy [16] and aligns with the notion of an interpretive community of assessors [33]. Possible solutions to address the lack of engagement with discussions may include more active moderation on the forum, blended Web-based learning with face-to-face contact, a social media approach that conforms to workplace security restrictions, or more assistance with technical problems [14].

Technical barriers experienced in the pilot-testing of Feed our Future such as IT incompatibilities between organizations’ infrastructure, software and Internet browsers, security restrictions, and bandwidth limitations are not unique [42]. Universities have very few security restrictions and are able to use programs such as YouTube to achieve positive learning outcomes [43]. Awareness that this freedom may not be available in some health settings is required if effective Web-based programs are to be available for use by clinical supervisors working in these settings.

Feed our Future, like many programs [44,45], was developed on a limited budget. Lack of IT expertise, infrastructure, and associated software, were limitations to the development of this program. Two years was required to complete the design-based research approach. Despite the advantages, the development requirements for Web-based programs are more labor intensive than face-to-face delivery [44,45].

The research-based design and national consultation used for the development of this program was robust. The sample size and the qualitative design of the pilot test and evaluation, although consistent with similar studies [46,47], does not support generalization of the results. Rather, these findings have been used to inform and improve the innovative product. Due to the lack of comparison with other modes of delivery, conclusions cannot be drawn as to whether Web-based delivery was the preferred option by clinical supervisors. The design-based research approach, however, offers supporting evidence for Web-based pedagogical approaches [25]. Further research is required to measure whether the learning of participants translated into actual changes in their competency-based assessment practices, and to determine the uptake of the program nationally.

Web-based programs, such as Feed our Future, offer a viable solution for universities to provide professional development to geographically dispersed clinical supervisors in preparation for their students’ clinical placements. A design-based research approach offers a practical process for Web-based tool development.