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A rapidly expanding healthcare system needed an onboarding model that could scale across multiple sites while supporting hybrid work and varied clinical roles.
A rapidly expanding healthcare system needed an onboarding model that could scale across multiple sites while supporting hybrid work and varied clinical roles.
A scalable onboarding architecture designed for ~200 new hires annually across multiple healthcare sites. The solution includes a performance analysis, program blueprint, and implementation plan intended to accelerate time-to-competency, improve retention, and create consistent role readiness across locations.
This project was developed in OPWL 535: Principles of Adult Learning at Boise State University and adapted here for portfolio review. It was completed collaboratively with two classmates — I led video production and served as primary author for Element 2: Behavioral Application, including the shadowing structure, buddy coaching model, and 30-day milestone checkpoint design.
Project Snapshot
Project Snapshot
Context: multi-site healthcare onboarding redesign
Role: performance analysis + program architecture
Deliverables: blueprint, implementation plan, rationale
Scope: conceptual scenario grounded in research
Design Focus: Scalable onboarding architecture for multi-site healthcare systems
Challenge
Challenge
A regional healthcare system planned to open three new hospital sites within 24 months, requiring a scalable onboarding model for physicians, nurses, support staff, and volunteers. Existing onboarding relied primarily on short in-person sessions and lacked the longitudinal structure needed to support hybrid work and rapid expansion.
Leadership requested an onboarding strategy that could scale across locations while maintaining consistency, engagement, and care quality.
Goals
Goals
The primary goal was to design a comprehensive onboarding program that would:
Support the successful integration of 200+ diverse employees annually across multiple sites
Create a scalable system that could accommodate longitudinal learning beyond initial orientation
Address the cognitive, behavioral, and socio-emotional dimensions of adult learning
Reduce early attrition by maintaining engagement and support beyond the critical first 30 days
Establish sustainable learning practices that benefit both individual employees and organizational growth
Solutions
Solutions
The proposed solution was a three-element onboarding ecosystem:
Element 1: Cognitive Foundations
Element 1: Cognitive Foundations
Pre-boarding training for managers and buddies
Structured orientation days
Foundations eLearning hub designed using evidence-based instructional principles including cognitive load theory, Universal Design for Learning (UDL), and andragogy
Element 2: Behavioral Application
Element 2: Behavioral Application
Structured shadowing and guided practice within the zone of proximal development
Buddy coaching
30-day milestone checkpoint to support skill development through deliberate practice and feedback
Element 3: Socio-Emotional Ecology of Learning
Element 3: Socio-Emotional Ecology of Learning
Extended reflection milestones at 60 and 90 days
Peer connection strategies and recognition systems
Sustainable communities of practice to address the documented drop in perceived support and role alignment that occurs after initial onboarding
Approach
Approach
The design approach framed onboarding as a continuous learning ecosystem rather than a one-time orientation event. The model integrates structured learning, guided practice, and social support to sustain capability development beyond the first weeks of employment.
The framework integrates multiple learning science principles, including adult learning theory, cognitive load theory, social learning, deliberate practice, and communities of practice. Examples include:
Social learning theory, situated learning, and deliberate practice research for behavioral application
Transformative learning theory and communities of practice for sustained engagement
Self-determination theory for motivation and recognition systems
Each element was grounded in specific research evidence, with particular attention to recent healthcare retention studies showing dramatic declines in perceived support (90% to 0%) and role alignment (85% to 0%) between 30 and 90 days post-hire.
Results
Results
As a strategic recommendation for a fictional scenario, this project produced two key deliverables:
Written Report (8 pages): A research-grounded proposal explaining the learning science rationale for each program element, designed for non-L&D senior leadership.
Video Presentation (15 minutes): A complementary presentation applying audio-visual design principles to communicate the same recommendations to busy decision-makers.
The ecosystem model successfully demonstrated how cognitive foundations, behavioral application, and socio-emotional support could work together to create scalable, evidence-based onboarding. The framework addressed the specific constraints of hybrid work, multi-site expansion, and diverse role requirements while maintaining theoretical rigor and practical feasibility.
References
References
Jackson, J., Thibeau, E., & Whitfield, J. (2025). Assignment #2: Recommend a solution [Course project]. OPWL 535: Principles of Adult Learning, Boise State University.
Appendices
Appendices
- Appendix A. Assignment #2: Recommend a Solution — Comprehensive written analysis and onboarding solution, detailing performance gaps, system design, and implementation strategy.
- Appendix B. Onboarding Learning Ecosystem for St. Luke’s: OPWL 535 Assignment 2 — Condensed visual walkthrough of the onboarding solution, summarizing the architecture, key components, and implementation approach.
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