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Strategic decisions for public health education

Stephen W. Draper
Department of Psychology
University of Glasgow
Glasgow G12 8QQ U.K.

Contents (click to jump to a section)


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 participants.

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 decisions.

The basic motivation:
Conventional vs. other ways of organising learning & teaching

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.

Organising theories of L&T; and the role of CAL

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 L&T process.

However we do have useful contributions. In my opinion, the best theory published so far is the Laurillard model (Laurillard, 1993). It is probably not complete (one extension to it is Draper, 1997). However it has been turned into a design method for educational materials, including CAL materials, by Michelle Montgomery in PhD work now reaching completion.

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:

  1. All the necessary functions can each be implemented in ICT in some way to some extent.
  2. 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.
  3. 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.
  4. 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.

Pre-planned vs. iterative design

There is a spectrum of approaches to the design of teaching materials: from carefully pre-planned to iteratively improved. The OU (Open University) 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:

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 change rapidly.

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.

Reciprocal collaborative teaching

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 (Draper 1999). Papers arguing this in connected prose are also available (Draper 1998b). You might also be interested in a paper developing a cost effectiveness analysis (Draper & Foubister 1998).

A fuller sense of "authoring"

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 (1, and 2).

More detailed planning decisions

The above are probably the most important strategic issues, and decisions. Others may include:

A suggestion for starting a collaboration

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.


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 document]. URL:

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 and

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