Overview

I designed Speaking Up: Escalating Concerns as a Leader, a scenario-based eLearning course for onboarding newly hired or promoted middle managers in healthcare. The course helps leaders practice escalating concerns in a way that promotes psychological safety, strengthens team culture, and supports patient care.

In a healthcare setting, practicing these leadership behaviours in real life could be risky. Both team dynamics and patient care outcomes could be negatively affected.

Learners step into the role of Sabrina, a care coordinator navigating a sensitive team issue, and with guidance from a mentor, they make decisions, see outcomes unfold, and reflect on their choices.

This project addresses a common performance gap: new middle managers in healthcare often lack experience formally escalating concerns, even though their actions directly influence team dynamics, communication, and patient safety. Practicing these skills in real life can risk harming trust or compromising care outcomes, so I designed a safe digital alternative.

An interactive eLearning course offered a scalable way to build confidence before learners face these challenges on the job. A scenario-based format worked especially well by placing learners in realistic situations where they make decisions, see outcomes, and reflect on their approach. This method is particularly effective for developing interpersonal skills such as respectful escalation.

To keep the course focused on performance, I created an action map outlining five target behaviours:

1. Identifying concerns requiring escalation.

2. Gathering objective evidence.

3. Selecting an appropriate communication strategy.

4. Communicating concerns clearly and professionally.

5. Reinforcing accountability after the issue is addressed.

I began by researching best practices in communication, psychological safety, and team leadership. Since this was a fictional project, I acted as my own subject matter expert to synthesizing my research. With this foundation, I created a text-based storyboard to map the course flow, define the mentor character’s role, and identify decision points that would drive engagement.

Next, I developed wireframes to explore layout, character placement, and interaction pacing. I aimed for a clean, professional design suited to a clinical environment, ultimately selecting a calming colour palette and minimal art style. Following multimedia learning principles, I focused on simplicity and avoided unnecessary visuals.

Wireframe Mock-Up | MS PowerPoint

Completed Slide | Articulate Storyline

To foster a supportive learning environment, I used a conversational tone for narration and guidance, particularly in the voice of the mentor character. This aligns with research suggesting that learners respond better to friendly and respectful language, especially in emotionally complex learning situations.

Once I had a prototype, I shared it with reviewers and used their feedback to clarify instructions, refine interactions, and improve accessibility. I then made iterative updates to strengthen the overall flow and learner experience.

To build the course, I used ChatGPT to generate cohesive character illustrations and background images that reflected a realistic healthcare workplace. I then developed the module in Articulate Storyline, where learners follow Sabrina, a newly promoted care coordinator, as she navigates a sensitive team issue. Learners make decisions on her behalf, receive targeted feedback, and reflect on how their choices align with leadership expectations. To support immersion, I also added subtle sound effects sourced from Pixabay.

To deepen learning and support generative processing, I incorporated reflection prompts after key decisions and included a review scenario that gives learners the chance to apply what they’ve learned in a new context. I also introduced a “Team Culture Meter” that visually tracks how each decision impacts team dynamics. This element reinforces cause-and-effect relationships and provides ongoing feedback in a simple, intuitive format.

Reflection Prompt

Since this course was developed as a fictional project, it has not been implemented or evaluated in a real-world setting. However, if the course were adopted by a healthcare organization, one opportunity for ongoing evaluation would be to monitor the built-in reflection prompts. User responses could be recorded by the LMS and reviewed by an administrator to identify trends in learner understanding and common challenges, and guide follow-up training or coaching where needed. Adjusting the module to be SCORM compliant would allow it to integrate with a wide range of LMSs and track completion, scenario outcomes, and reflection responses in a standardized way.

To support consistency between training and practice, I recommend that organizations ensure their internal policies align with the strategies modeled in the course. For example, the module encourages learners to consult documentation before escalating a concern, so relevant policies and logs should be easy to access. It also reinforces the importance of directing concerns to the appropriate supervisor, which means that escalation pathways and the chain of command should be clearly documented and visible to all team members.