Building an EMS Curriculum from Scratch: The ADDIE Process

By Mike Touchstone

Instructional Design (ID), sometimes also referred to as Instructional Systems Design (ISD), is a strategic and systematic methodology for planning new training, educational programs, courses and classes. Instructional design is a learner-centered rather than the traditional teacher-centered approach to instruction (McGriff, 2000).

The most common popular ID model is a five-phase process referred to as ADDIE — Analysis, Design, Development, Implementation and Evaluation. The ADDIE model is simple and easy to use and is the foundation for numerous variations. According to McGriff (2000), the ADDIE Model is an iterative instructional design process where the results of the formative evaluation of each phase may lead the instructional designer back to any previous phase.

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The first and arguably most important phase of the ADDIE process is analysis. You begin this phase by comparing current performance to performance expectations, and then identify performance deficiencies and gaps in knowledge and skill.

You can collect the relevant information and data from a variety of sources. These include but are not limited to the following:

• Direct observation of provider performance by field training officers (FTOs) and field supervisors. Example: Are the providers selecting and following appropriate protocols? Are they using correct technique for skills?

• Outcome and performance data from quality improvement initiatives and ongoing performance improvement assessments. Example: Are practitioners providing oxygen for all patients complaining of chest pain? Are patient care reports (PCR) complete? Are at least two sets of vital signs recorded for every patient?

• The medical director, medical command physicians, and medical command communications. Example: Are medical command reports on radio or telephone complete, and concise? Has the medical director identified areas that need improvement?

• The certifying or licensure agency regarding regulatory changes such as protocol updates. Example: Have there been protocol changes, continuing education changes, new protocols, or legislation?

• Vendors and manufacturers when the logistics or supply unit rolls out new equipment. Example: What new education do practitioners need related to new equipment such as EZ-IO, new ECG device, wave form capnography, glucometer, or others?

• The providers. The field personnel know what they need and what they want regarding potential education programs. They know where weaknesses exist and can help to identify system issues.

• Others?

You can utilize task, needs, and job analysis techniques to identify the existing knowledge and skill levels of practitioners. Compare the results of these processes to the expected performance and performance standards. You can then begin to ascertain performance deficiencies.

There are a series of questions you must answer during the analysis phase.

• Who is the target audience and what are their characteristics?
     o What do they already know?
     o What do they need to learn?

• What are the instructional goals, learning objectives, and behavioral outcomes?

• What types of learning constraints exist?

• What are the delivery options?

• What are the Adult Learning Theory considerations?

• What is the timeline for the project?

• Who else needs to be or should be involved in the ID process?
(Strickland n.d., Wikipedia 2009)

A critical step in the analysis phase of ID is considering the learning objectives. Determining the general learning outcomes helps you to answer many of the other important analysis phase questions. Once you have the learning outcomes identified, you can begin considering the delivery methodology, identifying needed resources, and considering the aspects of adult learning theory that will impact the rest of the ID process. You will set the foundation and direction for the rest of the process during the analysis phase.

In the next phase, Design, you will go into greater depth and more detail generating the specific components for each unit of instruction within the course. The outcomes of analysis become the inputs for the design phase.


During the design phase, you use the outputs from the analysis phase to begin developing the overall structure and content of your course. Some of the elements of this phase are writing specific learning objectives and test items, selecting delivery methodology, and sequencing the delivery of the instruction. Your efforts are directed at systematic and specific subject matter analysis, lesson planning, and media selection (Malachowski, 2002).

Systematic means an orderly, logical method of identifying, developing and evaluating a set of strategies aimed at attaining a particular instructional goal. Specific means each element of the plan must be applied with attention to detail. By applying systematic procedures and being attentive to specific details, one can design effective instruction.
(Strickland, n.d.)

To begin lesson planning, you must continue to articulate in general terms the goal of the instruction already started during analysis. Then specifically determine the following:

• Program learning objectives in terms of observable, measurable behaviors

• Skills, knowledge, and attitudes to be developed

• Resources and strategies you will use

• Structuring sequencing, presentation and reinforcement of the content

• Assessment methods matched to the learning objectives to ensure agreement between intended outcomes and assessments
(Malachowski, 2002)

When considering structure and sequencing, you may choose to group similar or related topics into units or modules. After determining the groupings, the next step is to decide upon sequencing both within units or modules and amongst the groups to form the overall course structure.
There are many sequencing options; below are a few.

• Step-by-step

• Part-to-whole

• Whole-to-part

• Known-to-unknown

• General-to-specific
(Intuology, 2008)

Instructional designers often create storyboards and prototypes will assist in the sequencing and structuring processes. During this phase you will also create the overall "feel" of the course, the graphic design, and the user interface, if the program is electronic.

The output of the design phase is a course blueprint.

Next month we will continue the discussion of the ADDIE instructional design process with the development stage.

References and Resources

Business Performance Pty Ltd (2008). Addie Model – Training Project Phases. Retrieved from the World Wide Web May 21, 2009 from

Castagnolo, C. (2007). The ADDIE Model; Why Use It? Retrieved from the World Wide Web May 21, 2009 from

Culatta, R. (2009). Weaknesses of the ADDIE Model. Retrieved from the World Wide Web May 21, 2009 from

Instructional Design (n.d.) Instructional Design Using the ADDIE Model. Retrieved from the World Wide Web May 21, 2009 from

Malachowski, M. (2002). ADDIE Based Five-Step Method Towards Instructional Design. Retrieved from the World Wide Web May 21, 2009 from

McGriff, S. (2000). Instructional System Design (ISD): Using the ADDIE Model. Retrieved from the World Wide Web May 21, 2009 from

Wikipedia (2009). ADDIE Model. Retrieved from the World Wide Web May 21, 2009 from

Wikipedia (2009). Instructional Design. Retrieved from the World Wide Web May 21, 2009 from


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