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Strategic decisions for public health education
Stephen W. Draper
I was invited to give a talk at a seminar about public health education
on 25 June 1999, at the IPH
in Cambridge. Although I know nothing of public health, this is a particular
case of the questions for reorganising higher education in the light of
possibilities for collaboration over teaching and of new technology. Here is
my current view of the space of decisions, based partly on my general views
and partly on issues explicitly raised at the meeting by various
Department of Psychology
University of Glasgow
Glasgow G12 8QQ U.K.
In this paper, I am NOT (unlike many) presupposing that CAL or other use of
modern information and communications technology is desirable, but I AM arguing
that collaboration among teachers is likely to be part of the solution.
I have organised the issues into groups: the basic motivation for reorganising
teaching, the need for a theory and the place of CAL, slow pre-planned vs. fast
iterative development of materials, collaboration, and more detailed planning
The organisation for learning and teaching (L&T) that I shall here
call "conventional" for convenience consists of running annual courses in full
time, residential mode (i.e. teachers and learners work in the same place),
based on face to face meetings. The most important constraint here is that of
having the teachers and learners in the same place at the same time for
extended periods. There are many reasons for wanting to remove that
constraint: requests for covering similar material for many different courses
and sets of students (wasteful of teacher contact time), serving students who
cannot make the place requirement (distance learning), part time students
(avoiding the time requirement), students who don't want the whole course
("open learning": where the learner chooses the set of topics they study).
The most important move to make, then, is to "resource based learning" (RBL):
where students learn primarily from resources such as books in a time and place
unconstrained by the teacher's diary. Story-telling first allowed us to learn
from those remote from us in time and space; the invention of writing was a
great leap forward in this; modern ICT (information and communications
technology) including CAL offers still more capabilities in both communication
modes and distribution convenience. Furthermore RBL has one big pedagogical
advantage (besides the logistical ones): it is self-paced, while any monologue
must pick one pace and that will match at most one of the audience.
The solution to the basic problems, then, is a move away from conventional
teaching to RBL. It is more work to write a book or booklet or piece of
software than to make private notes and slides sufficient to support the
lectures that the resources would replace, but probably not as much work as
repeating those lectures many times. If that is done, it will also facilitate
other things it may then be worth taking up: offering more flexible courses,
for a wider range of types of learner, in a wider range of delivery modes (part
time, distance, and open learning), and collaborative teaching (sharing out the
work of authoring and delivery).
In considering RBL, it may be helpful to remember two opposing things. On the
one hand, some subjects have always relied and continue to rely mainly on RBL
without calling it that: for instance philosophy and literature are often
taught mainly in that mode. Weekly tutorials may structure that learning in
conventional courses, and lectures may be offered as side shows, but the great
majority of learning hours are unsupervised, using say a library. On the other
hand, changing a traditional way of doing anything -- in this case L&T --
at first throws up many failures when things that used to work without our
being aware of them suddenly don't work because they didn't automatically
translate into the new mode.
We need a theory of L&T in order to have a way of checking that the
new delivery mode covers all the functions that conventional teaching performed
tacitly (and of course ones it should have performed but may have been
deficient in). It is fashionable (many participants at the seminar did this)
to say that lectures are ineffective for L&T. But if you replace them, you
(unlike most of their critics) have first to have a list of all the functions
they perform and secondly an alternative implementation for each of them.
These functions include: primary exposition (the one function everyone
notices), a chance for learners to ask content questions, a way for learners to
judge their understanding against other learners' (am I the only one who hasn't
a clue?, is this a stupid question?, ....), a place for administrative
announcements, a place for learners to ask admin. questions, a channel for
teachers to see what is wrong with the teaching and to modify what they are
doing, an occasion for learners to get acquainted and arrange for meetings with
each other (peer interaction and "collaborative learning" is important), an
occasion for teaching by demonstration and learning by imitation (learners see
the "style", the forms of language, how a teacher works on an unprepared
problem posed by a question i.e. their process, not just the product of their
expertise). This is not a complete list. We do not have a complete theory of
the lecture. Still less do we have a complete and adequate theory of the
However we do have useful contributions. In my opinion, the best theory
published so far is the Laurillard model
It is probably not complete (one extension to it is
However it has been turned into a design method for educational materials,
including CAL materials, by Michelle Montgomery in PhD work now reaching
Such theories, or checklists of essential issues, are particularly important in
considering the role and design of CAL or any teaching innovation, for the
reason given above that innovation disrupts implicit successes. Should we use
CAL? My view is adopted from Laurillard (1993), and could be summarised as:
- All the necessary functions can each be implemented in ICT in some way to
- This does not mean that the best implementation (for a particular function
in a particular context or case) is an ICT one. This must be assessed case by
case, function by function.
- Laurillard says she has never seen nor ever expects to see a case where all
the functions are implemented together in ICT. In other words, a piece of CAL
is only ever one element in an ensemble of delivery methods. If you deploy a
piece of CAL, you have to have a plan for delivering all the elements it omits
in some other way.
- In Draper (1998a) I argue, as John Naughton did in the seminar,
that most CAL is no better than the non-CAL methods it replaces, but the few
shining exceptions are the cases where the design was driven by identifying the
thing that former methods did worst, and focussing the software effort on
solving that pedagogic problem. In other words, design must be pedagogy-led,
not technology-led or unsurprisingly it will succeed in technological terms but
fail in pedgogical terms.
Thus in designing a piece of teching you need a checklist of all the
pedagogical functions to be covered (taken frm a theory); a plan for how you
will provide for each of these functions; "materials" will probably only be
part of this provision (others may be services e.g. tutor feedback on
assignments); and software at most will be only a part of the materials.
There is a spectrum of approaches to the design of teaching materials:
from carefully pre-planned to iteratively improved. The OU
represents the pre-planned extreme. The other extreme is "conventional"
university teaching, where lectures may be prepared in a few hours by a single
person with no quality control at all; but are often modified during delivery
in the light of audience reaction and questions, and also from year to year in
the light of reflection on those reactions and of further feedback from exams,
course feedback etc.
There are two aspects to the pre-planned end:
- The slowness of the design process (how long from start of design to
deploying the material, and hence how out of date they necessarily are)
- The "pace" or lifecycle time of the distribution medium: CDs are
unmodifiable once "burned"; books take time to produce, even after the author
has finalised the words; OHP slides can be modified on the spot by hand or
Powerpoint, and in half an hour by computer and printer; the words of a
lecture can be changed on the spot in response to the audience.
Software is usually as impossible to modify as CDs or a book (though there are
exceptions where provision is made for modification). It is usually as
expensive and lengthy to produce as a video. Even worse, though, it depends
upon platforms (hardware, operating systems, window systems) that change fairly
fast. So while a book remains readable indefinitely, CAL may require expensive
conversion every 3 years or so even if its content remains unchanged.
If a medium's cycle time is long, and slow to produce in, it makes sense to use
a careful, expensive, slow pre-planned design process.
If a teaching delivery method is new, we can expect surprises, and it makes
some sense to use a careful design process to minimise failure. On the other
hand, some surprises are inevitable i.e. foresight will be fallible here, and a
slow redesign time will perpetuate the failures that got through.
The amount of human quality control (reviews etc.) should be in proportion to
the number of learners served.
Thus pre-planned design processes are not simply about quality. In fact they
are about trying to cope with inflexible delivery media, and they do so at the
price of being slow to change: thus their content is more out of date, they
take years to respond to learner feedback, and they are not well suited for
teaching innovation of any kind. The recent quiet revolution in printing means
that a book can now be manufactured (printed and bound) within a (very) few
weeks of content being finalised, and for web documents the production and
distribution time is zero: authoring is the only time delay. Thus there is an
important choice to make in creating teaching materials today, particularly for
small learner numbers or for advanced subjects where being up to date is
important. Long pre-planning processes and slow quality control may not be
appropriate, nor in fact lead to greater quality since they must be traded off
against the time cost. It may be better to develop processes that concentrate
on fast authoring and rapid update. Such processes might involve delivering a
unit to a succession of fairly small groups of students, with immediate
revision of material after or even during each delivery, with the author
devoting a lot of time to delivery (including monitoring and feedback) in early
deliveries but tapering off.
Quality control could and should be done differently for fast and slow media.
With slow media, QA can sensibly focus on the product. With fast media it may
be more appropriate to focus on the process, since the material products should
This approach would be easier with collaborative teaching, where many authors
were involved, each concentrating on a relatively small amount of material.
Thus a suitable general strategy for the Public Health area might be to focus
above all on the quality of the subject matter delivered, with constant
iteration of the materials (or at least of those parts delivered by text), and
at higher levels by the constant update and change in the selection of elements
included. In the long term this may put such a consortium in a dominating
position; but not because of having a master plan that eventually produced a
single great product whose pre-eminence then steadily decayed, but more by
having a process that at any time offers current high quality backed by a
collective expertise that is unbeatable in aggregate.
For an individual, this would mean authoring an amount much smaller than a
textbook, but maintaining it up to date in both content, delivery medium (e.g.
updating to new versions of Powerpoint, HTML, etc.), and pedagogically
(revising in the light of each new set of students) over a prolonged period.
(I.e. not producing a film or book that immediately goes into history, but a
bit more like providing a service.) For the rest, they might expect to base
much of their teaching on other such units authored by others.
Collaborating on teaching is not an inevitable consequence of the above
considerations, but it is attractive. I will not repeat the arguments here.
The OHPs of my seminar talk are available
Papers arguing this in connected prose are also available
You might also be interested in a paper developing a cost effectiveness analysis
The simplest notion of a text or resource is just exposition. If you
look at an OU textbook you will see a set of additional pedagogically motivated
features such as self-assessment questions (for readers to use to test whether
they are following), summaries, etc. If you look at the best best-selling USA
textbooks, typically aimed at the huge first year course market, you will see
these devices and others such as really large and very up to date
bibliographies which can make such a book a useful starting reference for
fourth year students and indeed staff, even though the text is aimed at first
years. However you will also discover (on enquiry) that such books come with
very extensive companion materials: banks of SAQs, revision materials and CAL
companion software for students, and especially materials for teachers e.g. a
set of fancy colour OHPs (particularly useful when they reproduce important but
intricate illustrations). If materials are for sharing, the latter are very
important, and most CAL is particularly deficient in these: in any attention to
what teachers need. When you author teaching materials, you are not just
authoring for learners, but also for teachers. Failure to address this, will
make your materials less useful to teachers, and so less often adopted.
In summary, in authoring teaching materials you have two sets of users:
learners, and teachers. Each set has multiple needs, not just a single need.
A theory like Laurillard's lists what is needed for learning as a set of
activities, and advanced textbooks show techniques that can be thought of as
ways of addressing more than just one such need in the medium of text. CAL is
full of more such techniques. To address teachers' needs we also need a set of
techniques, some of which can be seen in the teacher materials available in
association with the best textbooks. My attempt, mentioned in my talk, to
document teaching ATOMs to make them easier for teachers to adopt (and to make
decisions about whether to adopt) is another attempt to address this. Two
examples are available on the web
The above are probably the most important strategic issues, and
decisions. Others may include:
To get things rolling, you need people to volunteer. Get people to come
to a bidding meeting ready to volunteer to create, say, two ATOMs each.
They should come with six suggestions they will
offer, but will only actually commit to the two that the most people say they
want to deliver. Only volunteer stuff you feel keen to deliver: this is
important for everyone. As important as volunteering for authoring, is
committing to deliver others' materials. The sooner people do this, the sooner
they start to get experience of what this feels like, whether or not there are
local obstacles, what they want to demand of the authors. Demand needs to be
nurtured as much as supply. Reciprocation means balancing demand and supply.
- Course "level": undergraduate, postgraduate, CPD (continuing professional
development). Having said that, it may be surprisingly easy to use the same
material for all, and accommodate the differences in the surrounding structure
of what is expected of the learner, pacing, feedback opportunities, assessment
pressures etc. Remember too that although it is very boring to be trapped in a
lecture that repeats familiar material, in any self-paced medium e.g. text it
is only a small penalty to skip over familiar stuff. Furthermore it is
reassuring to find you do know material, while a quick refresher is a great
help for most topics other than those you used during the last month.
- Unit size. There is a huge range of sizes of "unit" -- of something you
author -- from a whole textbook down to Euromet's attempted standard of 15
minutes of learner time. Traditionally, academics can only write a textbook,
not anything smaller, which means that they do this perhaps once in a career,
while failing to publish anything else of the extensive teaching material they
in fact create. This is wasteful, and just an artifact of how the book
industry was organised. There is a tendency to think CAL must be in big lumps
like that. Carey however
et al., 1998) has pioneered "nicheware": much smaller software
units. You could do the same, provided you organise a distribution system to
get it from authors to interested deliverers, and just as important feedback
from the learners to the authors to keep standards high and software
- "Teaching" duties in fact have three different functions that do not have to
be done or divided among people in one lump: authoring, delivery, and
accreditation. Collaboration or not can be chosen separately for each of
these. Accreditation, for instance, will be done by a mixture of
university level and possibly a professional body influencing curricula or
running exams themselves. Authoring (both writing and editing i.e.
coordination, QA, and larger scale intellectual design) may be done by
individuals (cf. textbook writers, creating a lecture course) or groups.
Groups may find it sensible to keep their materials private (though they will
leak through students), or make them available for free, or for money. But
note that uptake and so acclaim is maximised by making them free, while joining
the group may be mainly rewarded by getting a voice in what others will write,
and so influencing the body of material on which your courses can draw (and for
which you then don't have to design material of your own). Delivery is
more labour intensive: the amount of work rises with the number of students.
It is the locus for customising for different groups of students. It is
intimately linked with assessment, and hence accreditation. Don't forget that
authors need to do some of this to improve their product.
- Quality assurance on materials. Some alternatives are:
My personal choice would be to leave ultimate QA responsibility with each
course coordinator, but have a consortium or professional body organise review
by anonymous peers AND the public, and for this public evidence to be a major
source of evidence used by course coordinators.
- simply share materials now (QA by recipient only),
- some peer QA review leading to accept/reject by an editor for a virtual
journal or textbook,
- more open peer review where nothing is rejected, but reviews both anonymous
official ones and signed ones by all and any users are available online,
- passed by a professional body.
Carey,T., Harrigan,K. Palmer,A. & Swallow,J. (1998)
"A learner-centered design idea kit for student/faculty teams: Scaling up a
learning technology strategy" URL:
Draper, S.W. (1997, 18 April) "Adding (negotiated) management to models of
learning and teaching" Itforum (email list: invited paper) [also WWW
Draper, S.W. (1998a) "Niche-based success in CAL" Computers and
Education vol.30, pp.5-8 [also WWW document]. URL:
Draper (1998b) "Reciprocal Collaborative Teaching" [WWW document] URL
Draper (1999) "Models for Collaborative Teaching" [WWW document] URL
Draper, S.W. & Foubister,S.P. (1998)
"A cost-benefit analysis of remote collaborative tutorial teaching"
in M.Oliver (ed.) Innovation in the evaluation of learning technology
(London: University of North London) and [WWW document] URL
EUROMET (1998) EUROMET project pages [WWW document] URL
See also the related National Learning Network for remote sensing
and Charles Duncan.
Laurillard, D. (1993) Rethinking university teaching: A framework for the
effective use of educational technology p.103 London: Routledge.
Additionally a diagram of the Laurillard model is at:
MANTCHI (1998) MANTCHI project pages [WWW document] URL
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