Featured article: Inker et al, Journal of Applied Gerontology 2021, Virginia Commonwealth University, Center for Excellence in Aging and Lifelong Health, Williamsburg, Virginia.

Pragmatic trials are designed to evaluate the effectiveness of interventions in real-life routine practice conditions and produce results that can be generalized and applied in routine practice settings. For example, let’s take a look at how a recent pragmatic microlearning trial performed in a nursing home setting.

A 52-week microlearning intervention was conducted among 250 staff members at nine nursing homes. The microlearning lessons administered averaged six minutes each in length, contained both video and audio elements and consisted of an introduction, brief content with summary points and a two-question quiz to assess learning.

The lessons were released each Monday via an email notification to participants. Qualitative outcomes data were obtained via focus groups and feedback from a post-survey and exit interview. Quantitative data were obtained from two validated instruments (the Dementia Attitudes Scale and the Nursing Home Nurse Aide Job Satisfaction Questionnaire) administered both before and after the intervention.

Due to a technical problem, only 26 pairs of pre- and post-surveys could be linked with one another, thus significantly limiting their ability to demonstrate measurable impacts of the microlearning. On the other hand, their qualitative data were quite rich and generated some interesting themes. Here are three learnings uncovered with supporting feedback from participants.

• Microlearning is an easy and enjoyable way to learn: “It was a nice way to get the information to people without talking them to death.”
• Microlearning is an effective way to learn: "I’ve seen our team members use the tools and resources that were offered in the dementia training with our residents.”
• Microlearning overcomes implementation challenges: “A particular risk was falling behind and having unwatched lessons piling up.”

In spite of the technical problems that limited their quantitative outcome assessment, I would like to tip my hat to these authors and applaud the enormous work they did to plan and implement this impressive pragmatic trial.

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