Transform Healthcare

:Transgender individuals (TGI), who identify their gender as different from their sex assigned at birth, continue to face pervasive discrimination in social and healthcare settings (Shukla, Asp, Dwyer, Georgescu, & Duggan, 2014).

To tackle this issue, Dr. Lelutiu-Weinberger at Hunter College conducted transgender cultural competency training for staff at NYU Lutheran Family Health Centers in 2015.


  • Analyzed target learners and researched existing tools.
  • Designed a blended learning model including a role-playing simulation based on the learner analysis.
  • Constructed scenarios of simulations with subject matter experts.
  • Designed an evaluation plan to measure effectiveness of the media.
  • Designed a digital prototype and revised it based on the feedback from experts and users.
  • Imported the revised learning content into Articulate Storyline 2.

Target learner analysis

  • 25~39 years old
  • 71%  Hispanic/Latino
  • 97% have a college or advanced degree
  • 71% identified themselves as female
  • 87% identified themselves as straight
  • 89% own a computer 
  • 91% answered they access the internet from smartphones and tablets

Landscape audit

  1. Vanessa goes to the doctor
  2. Improving health care for transgender people 
  3. LGBTQ online, interactive training simulations

Why did I add an online simulation module?

Because, given the complexity of barriers faced by transgender individuals,  6 hours of training could not cover healthcare practitioners’ needs, and it was challenging to convene repeated training sessions in a busy urban clinical setting. Providing a web-based simulation in the form of “personalized online instruction” not only solves this logistical issue, it also offers the opportunity for trainees to reinforce what they  learned in the instructor-led training.



Design rationale

Social Cognitive Theory argues we have a vicarious capability to learn a behavior from observing others’ actions and the consequences.

The simulations provide modeled experience to enhance trainees’ social learning.

Learners act as a registrar, and choose the best communication options to provide respectful healthcare services to a transgender patient.

This design also provides on-demand hints as Scaffolding. There are several decision-making points, and the story branches out depending on the option learners select.

The platform navigates learners back to the main story after providing feedback for any inappropriate choice they made. This simulation aims to help participants understand a transgender individual’s perspective and increase their empathy. They will be encouraged to explore “what if” scenarios and learn actively. 

Instructional strategies and learning theories

  • Story-based learning
  • Simulation
  • Situated Cognition
  • Blended learning
  • Social Cognitive Theory
  • Adult Learning
  • Cognitive Theory of Multimedia Learning
  • Modeling, coaching and scaffolding


1st Iteration  – Brainstorm, sketch, and script

2nd Iteration – Wireframe, and prototype


3rd Iteration – Revise script based on the feedback.


4th Iteration – Revise design for user testing


5th Iteration – Revise design based on the user test result








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