THE EXPLOSION OF EDUCATIONAL technology and the race to develop Internet-based learning have forced educators to create new educational programs and change traditional ones to new learning models. In health care, much of the writing on distance education is in the medical and nursing literature. Less appears in the allied health literature, and the literature contains little research comparing formats; the articles that do appear simply provide a description of courses that have been offered. English et al.1 described a distance learning model in a physical therapy curriculum at the University of Kentucky. Ware et al.2 discussed the challenges of teaching at a distance using interactive video and made recommendations for how to overcome these challenges. Muma and Mayta3 discussed how to develop CD-ROM applications for students at remote sites, and Glacken and Baylen4 described crucial issues in designing an on-line health professions program at Florida Gulf Coast University.
The Medical University of South Carolina (MUSC) has begun the transition from an evening hours and weekend site-based undergraduate health professional curriculum to a web-based delivery format. The Bachelor of Health Sciences (BHS) undergraduate program provides access to postprofessional education for health professionals to enhance their nonclinical competencies. For many years, the existing BHS program has offered courses in five cities throughout South Carolina: Charleston, Greenville, Columbia, Myrtle Beach/Conway, and Rock Hill. The BHS program is relying increasingly on distance delivery using Internet, CD-ROM, satellite, compressed video, videotape, independent learning modules, fax, voice-mail, e-mail, and other electronic means.
For several years, the BHS program has offered one of its core courses, "Interpersonal and Team Communication in Health Care," using a weekend format. The course has three segments, each of which is presented on a separate weekend. The first two segments cover interpersonal skills and team communication. The third segment focuses on customer service in health care and originally was presented during an 8-hour Saturday session. We considered the customer service segment suitable for conversion to an interactive CD-ROM and weh-based course because the content was in a self-contained modular format. Because we wanted to maintain the highly interactive format of the face-to-face session, a new approach had to be taken in planning for interaction, developing activities, and providing support. Would the changes in delivery affect student achievement and would students perceive the course as effective?
This study had two purposes. The first purpose was to determine if there was a statistically significant difference in students' final grades. The second purpose was to determine students' perceptions about the CD-ROM, workbook, and Internet format. Students and faculty were involved in answering two research questions: ( 1 ) Is there a significant difference in student final examination scores using two different course formats, face-to-face format and interactive CD-ROM with workbook and Internet format? (2) What are the students' perceptions of learning through an interactive technology-based course format?
To incorporate as much interaction as possible and to encourage students to reflect on their learning, multiple tools and methods were used. The CD-ROM contained video vignettes for discussion; the instructor included a video introduction to the course; and web-based tools were used, such as e-mail, a bulletin board, and online evaluation. These factors (i.e., integration of web-based tools and a built-in presence of the faculty into a course delivered via technology) are recommended by Horton5 and Winfield et al.6 The question was whether these changes would affect student achievement.
The design is a retrospective, post hoc study. Consequently, all the concerns with retrospective studies apply. …