Helen Osborne: Welcome to Health Literacy Out Loud. I’m Helen Osborne, President of Health Literacy Consulting, founder of Health Literacy Month and author of the book Health Literacy from A to Z: Practical Ways to Communicate Your Health Message. I also produce and host this podcast series, Health Literacy Out Loud.

Today, I’m talking with Mark Haggerty, who is an instructional designer, learning specialist and a medical writer and editor. Mark has built online training programs that are used for teaching thousands of students in many disciplines. A lot of these programs focus on science and medicine.

Mark and I are both members of the American Medical Writers Association, or AMWA. We first met when he and I posted comments on AMWA’s online discussion board to a question about creating presentation slides. I was so intrigued by Mark’s response that we continued this conversation offline.

I’m delighted that he agreed to be a guest on Health Literacy Out Loud. Now you can hear from Mark, too.

Welcome to Health Literacy Out Loud.

Mark Haggerty: Thank you, Helen. I’m honored to speak with you today.

Helen Osborne: You’ve got many titles. You are an instructional designer, a learning specialist, and you focus on online instruction. Let’s take it from the top. What is an instructional designer?

Mark Haggerty: An instructional designer is a profession for creating training courses.

Helen Osborne: I’d like to think that my podcasts are always evergreen and timeless. However, we have to acknowledge reality. We are still in the throes of COVID as we are recording this. Few things are happening in person and most everything is happening online.

Are you new to this? Just in the last six months when we’re dealing with this? Or is this something that’s been going on a long time, this online instruction?

Mark Haggerty: Online instruction has been a part of my work for the past 20 years at least.

Helen Osborne: Oh, really?

Mark Haggerty: But you’re right, in the past six months it’s sort of come into its own and I’ve been very busy to say the least.

Helen Osborne: Mark, I think that’s why I connected with you. Everyone I know is trying to punt, I’ll use a sports metaphor even though I’m not a sports person, and trying to figure out what to do on-the-fly.

We’ve got this content. I know a lot of my in-person presentations are canceled. We have to figure out Plan B, C or D, but we don’t really know how to do it. There’s a special art to doing that online teaching, isn’t there?

Mark Haggerty: There is. I think a lot of the online stuff comes from the fact that you don’t have those breathing human beings in front of you to get all of that nuanced, non-verbal communication while you’re teaching or presenting. Dealing with that takes a whole different skill set.

Helen Osborne: I was very disappointed when I didn’t get to do my in-person presentations. I love doing them. It’s fun to get dressed up. More than that, it’s fun to see people relate to my information, to tell my stories, and engage the audience. And they engage me by their reaction.

That’s why I wanted you to talk with us on Health Literacy Out Loud. I am hoping you can share those hints, tips and all that how-to stuff, because I’m not the only one who’s having to come up with a whole new way of teaching.

Mark Haggerty: No, certainly you’re not. One of the first things I would like to talk about is the fact that there is a layer of technology between you and your audience, you and your students.

It’s important to have another person when you’re trying to do webinars or online training. To have what we call the producer role, someone who can watch over the technology while you are concentrating on the content you’re trying to present.

If you have that, then you have a person who can be watching for technical issues as well as monitoring the chat windows as people are making comments. They become your partner in developing it and getting past that technology layer.

Helen Osborne: Thanks. That’s useful to have support and not do this all alone. Boy, even for these podcasts, I am my own tech support when it comes time to record. That’s pretty scary sometimes.

I want to dial it back just a little bit. You’re not the subject matter expert teaching all those thousands of students. You’re the instructional expert, right?

Mark Haggerty: That’s correct. I remember way back when I was starting in this, my mother would ask, “What do you do for a living?” I’d say, “I create the training courses, all those things you have to do when you go to work.” She’d say, “How do you know what to tell them?”

Helen Osborne: Yes, how do you know? I agree with your mother. Tell us how you know what to do if you’re designing this.

Mark Haggerty: I sit down with the subject matter expert. They say, “I know this topic from A to Z.” I say, “Good. I know how to make topics instructionally sound and educationally helpful. We’ll work together. Why don’t you just tell me about it?”

The person sort of talks me through what they want, and we come up with a structure, an outline usually, of what this ought to be and what people need to know.

Very frequently, I have to dial the subject matter expert back because they want to do a data dump of 20 years of experience on this topic. I say, “We just want to do this part, so how do we meet these objectives?”

We get to that part, and then it’s put into a package that can be delivered either online, in a classroom or any other way.

Helen Osborne: You already identified several people either right in the moment or behind the scenes. We have your content expert, the person who knows the key points. I don’t know if you’re the on-the-spot producer, but you’re the designer, creating the bones of this.

Mark Haggerty: Instructional design, yes. That’s what that means.

Helen Osborne: Are there any times you do this when someone else will be presenting the course and it won’t be the content expert?

Mark Haggerty: Absolutely.

Helen Osborne: Is it a third person, or several people?

Mark Haggerty: Yes. You might have a delivery team or someone who is assigned to deliver this. It might be within the training department.

At the end, you have implementation where you give the person a chance to pilot the course and practice it before what we call the debut of the course, which is when you have real students.

Helen Osborne: Can you give us an example of some of these courses? A lot is buzzing through my brain. I might be able to speak for maybe some interests of our listeners. When you talk about a course, can you describe what scale that is on?

Mark Haggerty: It can be really anything. It can be a 20-minute summary of concussion prevention tips and tricks. A lot of the webinars I’m doing right now are COVID-related, where we’re trying to teach various populations safety aspects and things like that. It can be anything that you might think of in terms of training, like leadership skills or technical skills.

As I’ve said, I’ve worked in a lot of different disciplines. I’ve worked in consumer goods and gas and electric utilities, as well as the government.

Helen Osborne: My guess is that anyone who can bring in an instructional designer is probably doing this on a somewhat big scale. They need a budget to be bringing in other people like that and bringing in someone with your expertise.

Mark Haggerty: It’s a corporate scale. Currently working with CME corporations.

Helen Osborne: Continuing Medical Education.

Mark Haggerty: They’re companies that bring in Continuing Medical Education. Those are the people who would use instructional designers.

Helen Osborne: You used the term webinars. Is that what you’re talking about? Are they all webinars? Or is there another format these could be?

Mark Haggerty: If you learn that on Thursday at 11:00 a.m. you tune in through your computer, you listen live to a speaker, watch slides and that kind of thing, that’s what we call a webinar.

It could also be prerecorded and done on-demand. That would be more of a web-based training piece.

A webinar can also be recorded so that people who missed it can watch it later on.

A lot of my work involves taking those live webinars and dressing them up so they’re more presentable without any gaps in timing and that kind of thing.

Helen Osborne: So kind of post-editing?

Mark Haggerty: I do a lot of post-production right now, yes.

Helen Osborne: When I think of webinars, it feels like I’ve been at too many of them these days.

Mark Haggerty: I know.

Helen Osborne: It also addresses a question you and I both responded to on that AMWA discussion board. Somebody got hired to create slides for someone else’s presentation. She was asking, “How should I charge for this? It’s a 60-minute presentation and I’m going to do 60 slides.” I just thought, “Oh, no. I never want to be in your audience.”

I think that’s why I liked you, because you almost reacted the same way. We were both polite, but said, “Sixty slides in 60 minutes? Oh, no.”

Mark Haggerty: Yes, unless you’re playing them as a video and they go by very quickly. Most slides have way more text than they need.

Helen Osborne: In a webinar, is it slide-dependent? Do you always have to be showing something?

Mark Haggerty: Not at all. Think of all the things you’ve been seeing about Zoom and all those other platforms. You’re looking at people looking into their cameras.

There are times, especially during Q&A in the webinars, where we switch off the slides and let the people talk. Usually it’s the presenter who has the camera and the participants either speak or type the questions into a chat window.

Helen Osborne: Now it’s all about me. But not really, just me.

Mark Haggerty: It is about you, Helen.

Helen Osborne: I have a few minutes of your expertise here, Mark. Help us all. I do my own talks, I make my own talks, I get my slides designed by a graphic designer, I show up and I do my thing. Now I can’t do that. It’s not an option anymore.

I would think that for many listeners, they know their subject. They’re clinicians, public health specialists and librarians. They want to get out their important message, but don’t have a great big budget to bring in somebody like you before, during, and post-production.

What can we be doing on a budget to get our message out there in an instructive and informative way when we need to do it online?

Mark Haggerty: I would say to do it yourself, become very friendly and good with programs like PowerPoint or Prezi.

Helen Osborne: Or Keynote. I’m an Apple kind of gal.

Mark Haggerty: Or Keynote on the Apple.

If you just go onto YouTube and ask, “How do I do this in . . .” I’m going to use PowerPoint. That’s my go-to application. If you ask how to do this, there are tons of great tutorials on how to do it better than just putting up all words.

Most people will just do a dump of their topic. They think about what they want to do, and they basically outline it on all the slides and present that. If you’re thinking about it, you might add a couple of pieces of ClipArt or something like that or a picture of your dog.

Helen Osborne: I’ve got to tell you I hate those things. My brain goes elsewhere.

Mark Haggerty: It doesn’t help with the context, right? It doesn’t help you learn in the way that the brain is set up to learn.

If you just have to do it yourself, that would be my first piece of advice.

Helen Osborne: Learn how to do it and learn some of the good software.

Mark Haggerty: Learn how to do it. Go to YouTube and find out some of the specific skills you need to remove some of the text, or at least make it a little more consumable or digestible instead of a whole slide that people have to read.

When you have all that text on the slide, what are you going to do? You have to make a choice between listening to the presenter speak and reading the text on the slide. You really can’t do both at the same time.

Helen Osborne: If I’m in the audience and the presenter says, “I know this is too tiny a font, you can’t read it, there are too many words and we don’t have time, but I’m going to rush through it,” my brain is out the door.

Our listeners probably already get it, where our biases are as far as slides. In the few minutes we have left, can you give some pointers that we can all do? Getting the right software and going to YouTube to watch those free tutorials is good. What else?

Let’s say you’re a nurse and you need to teach people about diabetes. That’s your specialty. You’re a great nurse, but this is what you’re charged with doing right now. How can that nurse go about doing a pretty good online instructional program?

Mark Haggerty: If I were a nurse doing that, I would first outline all my thoughts on what I wanted to do and say, “What do I want to get across to the people? What do I want them to learn? What do I want them to be able to do at the end of my talk that they can’t do now or I’m not sure that they can do it?”

Then look for appropriate pictures to fill in those gaps. Visuals communicate so much better than just text. Look for pictures that can communicate the ideas in your words.

Then summarize things in small tables and things. No big spreadsheets going across to show all the results. Just tell what the idea is you want to get from those results. “I want you to see that diabetes rates are going up here and down here. That’s what I want you to get.” That’s what you should put on your slide.

Helen Osborne: Actually breaking this down, you said, “Outline your thoughts.” You didn’t quite say it, but I think part of this is knowing your audience.

Are you giving this to people who are newly diagnosed with diabetes? Are you speaking this to people who have had it for many years? Are there special learning considerations you need to take into account? Know your audience.

Also, you talked about the goals. What are the outcomes you hope will happen? Right?

Mark Haggerty: Absolutely. Another best practice is adjusting your language. I know that you had several episodes of your podcast on plain language. That’s a perfect area. I’d say adjust the language to the audience.

I use three different areas, either public, patient or professional, when I’m doing that. I’ll ask who the audience is and that’s exactly the point to make.

Am I adjusting the language so that anyone in the public should be able to understand it? Patients who are already familiar with diabetes in our example, maybe we can use different language with them. Of course, if it’s a professional audience, you’re going to speak in different terms as well.

Helen Osborne: Of course. It sounds like know your audience and articulate those goals.

The content expert has a ton of content. Is there time to do that outlining? Be looking at the flow. What are you going to say first? What are you going to do in the middle? What are you going to do at the end? When do you tell a story? When do you show a slide? Mark, do you do all that stuff too?

Mark Haggerty: Absolutely. And tell them, “Make sure you practice this before you deliver it.”

Helen Osborne: It sounds like you really go through those paces. The content expert knows what he or she is talking about. That’s not the issue. It’s a matter of whittling it down to what is relevant to that audience.

Mark Haggerty: That’s usually the course that you take, whittling it down. People who are just going into it cold will tend to go down rabbit holes, to use the Alice in Wonderland metaphor. They’ll think, “Oh, yes, I had this fantastic . . .” and they go off and talk about that for five minutes instead of staying on topic.

Helen Osborne: How long are your programs usually? How long should they be?

Mark Haggerty: Mine are usually an hour or less. I wouldn’t do a live webinar for longer than two hours.

That’s another thing between live courses and live online courses. People don’t have the stamina to attend to the screen for as long as they can in a classroom.

Helen Osborne: That’s true. In a classroom, you can stretch, wiggle or go get a cup of something to drink.

Mark Haggerty: Yes. And as an instructor in a classroom, you can notice the non-verbals that are going on in your class and say, “Looks like we might need a break. Let’s take five minutes.”

Helen Osborne: The podcasts are a version of online instruction. It’s audio only. As listeners know, I try to keep them in the 20- to 25-minute range, which we’re nearing that point right now. I try to plan with guests, like, “How can we fit in what’s possible without overwhelming listeners in that amount of time?”

Last part I just want to check with you. You did all the steps, you did all the paces and you’re feeling pretty good about it. How do you when this program works?

Mark Haggerty: You ask people to evaluate it. Usually at the end, if it’s a formal classroom thing, you can still do an evaluation. “How well did it work for you?”

Another part of assessment is to actually give them a little quiz or test. If it’s a skill or a bit of knowledge that you want them to have, then you will give them a quiz question or two to say, “What is this, that and the other?” You measure their performance that way.

Helen Osborne: Is it an upside of using so much technology that we have more interactive tools? I know people are doing quizzes, votes, polls, submitting questions and all that kind of stuff that you might not do in person.

Mark Haggerty: Yes, but I think those technologies are there to try to mimic or replace the interaction you’d have in the classroom. In a classroom, you can also have tabletop exercises and, “Everybody go to a flipchart and create this.” That’s what breakout rooms are for in the webinar technology.

Helen Osborne: Mark, do you see that instruction is going where it’s going to be online most of the time? Or is this just until we can get back to doing things the way they were before?

Mark Haggerty: I think people are discovering that this is a valid way. They were always thinking, “I just can’t see it. I can’t quite do it.” But in the past six months, we’ve been forced to do it this way. Kids in school have been forced to do it this way. We’re all learning as we go.

I think there are going to be pieces of it that stick. We won’t be doing it 100%. I’m sure there will be a lot of people who will be happy to get back to skills-based classes where you have to teach somebody to do something. What if you were trying to teach somebody how to operate a crane? Do you think you could do that online?

There are probably things that are not appropriate for online, because you really want to have them in the driver’s seat to do those things.

But many of the things that we do now will be done online in the future. We’re finding out, “I don’t have to travel across the country to get to this course,” and, “We don’t have to send trainers all over the country to teach the courses.”

We also get the benefit of the diversity of different voices from all around the world in the same class. You get a lot of those benefits by having a mixture of people that you wouldn’t have seen otherwise.

Helen Osborne: Mark, I appreciate your optimism more than anything else, and your how-to information and the context for this. This is something that all of us, whether we’re working at big companies or we’re trying to do it one person at a time, are all trying to figure out.

There will be some resources on your Health Literacy Out Loud web page where people can get more how-to information. For now, I want to put a semicolon in our online conversation on Health Literacy Out Loudand thank you so much for being a guest.

Mark Haggerty: It’s been a pleasure and a privilege, Helen. Thank you for inviting me.

Helen Osborne: As we just heard from Mark Haggerty, it is important to teach our content excellently online as much as it is to do so in person. For many of us, myself included, this is a shift in how we teach. It can be hard.

For help clearly communicating your message online, in person and all the other ways, you might want to look at my book, Health Literacy from A to Z. You might be especially interested in Chapter 32 that is about teaching and learning.

Feel free to also explore my website, www.HealthLiteracy.com, or contact me directly at helen@healthliteracy.com.

Health Literacy Out Loud podcasts come out every few weeks. You can get all the episodes automatically, for free, by subscribing at Health Literacy Out Loud, or find us at Apple Podcasts, Google Play, Spotify, iHeartRadio, RadioPublic, Stitcher or probably all the other places you might find podcasts these days.

Please help spread the word about Health Literacy Out Loud. Together, let’s tell the whole world why health literacy matters.

Until next time, I’m Helen Osborne.

Listen to this podcast