Institute for Occupational and Environmental Medicine • Ziemssenstrasse 1 • 80336 MunichUnit for Occupational and Environmental Epidemiology & Net Teaching • http://aumento.web.med.uni-muenchen.de/

The Pros and Cons of distance learning

-An example from Germany-

Katja Radon, Stefanie Kolb, Jörg Reichert, Martin Fischer

Definitions-1

• Distance learningLearning via radio, TV, phone, Internet (E-learning

dictionary)

• e-learning Providing computer instruction online, e.g. over the

Internet (The free dictionary)

Definitions-2• Blended learning

Combination of different kinds of learning always

including e-learning (E-learning dictionary)

+

In the following talk…

….distance learning is defined as

case-based e-learning via the Internet

Distance learning or learning in the classroom?

Advantages of distance learning

• Available at any time (evenings, weekends, nights),

independent of time zone

• Material can easily be kept up-to-date

• Available at any place (Computer + high speed Internet connectionnecessary)

• World population 2005: 6.5 billion (US Census Bureau)

• Worldwide Internet Population 2005: 1.1 billion (Computer Industry Almanac)

69 Countries with Internet Coverage <1%Fiji, Faroe Islands, Democratic Republic of the Congo, Burma, Ethiopia, Turkmenistan, Chad, Iraq, Central African Republic, Tajikistan, Cambodia, Nigeria, Yemen, Burundi, Niger, Bangladesh, Bhutan, Mozambique, Sudan, Guinea, Laos, Equatorial Guinea, Burkina Faso, Madagascar, Nepal, Eritrea, Uganda, Zambia, Rwanda, Mauritania, Mali, Lesotho, Cameroon, Guinea-Bissau, Malawi, The Gambia, Paraguay, Azerbaijan, Syria, Sierra Leone, Benin, Moldova, Albania, Libya, Nicaragua, Haiti, Uzbekistan, Comoros, Cote d'Ivoire, Vietnam, Georgia, Angola, Algeria, Honduras, El Salvador, Sri Lanka, Iran, Kazakhstan, Djibouti, Pakistan, Zimbabwe, Tanzania, Togo, Bolivia, Tonga, Guadeloupe, Senegal, Netherlands Antilles, Ghana, Kiribati33 Countries with Internet Coverage >30%

Chile, Spain, Aruba, Czech Republic, Andorra, United Arab Emirates, Greenland, Taiwan, Malaysia, France, Italy, Ireland, Slovenia, Estonia, Belgium, Israel, Germany, United Kingdom, Portugal, New Zealand, The Netherlands, Japan, Switzerland, Singapore, Canada, Finland, United States, Australia, South Korea, Norway, Hong Kong, Iceland, Sweden, Denmark

CIA Worlds’ Fact Book 2004

Advantages of distance learning for specialists in occupational health

• Might be used around current job

• Might be used by mums/dadstaking care of kids

Advantages of distance learning for specialists in occupational health

• Might be used at distant,remote places

• Might be used by health-careprofessionals with certainhealth conditions

Disadvantages of distance learningStudents’ perspective

• No direct contact to teacher

• No face-to-face interaction to other students

• Might take time until students’ questionsare answered

Disadvantages of distance learningTeachers’ perspective

• It takes a lot of time to prepare AND update goodteaching material provided in the web

• You get a lot of questions outside your “business hours”

• You do not know your students

Computer-oriented case based e-learning

Story

Chief complaint

History taking, Occupational history

Medical and technical examinations

Background information:Workplaces, legal aspects

Medical estimate

Implementation in the curriculum:1. Class room teaching

1999-2003

• Lectures

• 1 out of 6 seminars in the PC lab

• 2-3 students work on one of the cases

• Tutor assistants

• Feedback and students’ evaluation at the end

Evaluation results – Class room teachingOverall rating by case

N=864 5th year medical students

Excellent

Poor

Evaluation results – Class room teachingHow many lessons should be in the lab

N=864 5th year medical students

1

2

3

4

5

6

0

Evaluation results – Class room teachingUse and availability of computers

Daily use of computers 60%

Internet access at home 86%

I enjoy learning at the PC (1=a lot, 6=not at all)

3.0 (2.8; 3.3)

I would prefer distance learning overworking on the cases in class

38%

N=173 5th year medical students winter 2002

Evaluation results – Class room teachingSummary

• Students generally like working on the cases,

• Internet coverage high, however,

• Content does matter!!!

• Blended learning is preferred

Implementation in the curriculum:2. Distance learning + Class room

seminars (“Blended learning”) 2004+

• Lectures

• Two 2-hour seminars with a tutor +

• Working on ≥2 of the cases via the Internet(at home, at university, …)

• Students’ evaluation at the end

Implementation in the curriculum:2. Distance learning + Class room

seminars (“Blended learning”) 2004+

Feedback features

• Implemented in the system: -Immediate feedback on the answer given-Overall result (% of correct answers) in theend

-Answer comments

• “Hand operated”:-Protest button to authors-Email contact for problems

Evaluation results – Distance learning“Used e-learning before”

0

10

20

30

40

50

60

70

80

90

%

LMU Munich TU Munich Regensburg

Evaluation results – Distance learning“The cases can easily be handled”

Frequent users

1st time usersE-learning:

Agree

Disagree

Evaluation results – Distance learning“Cases useful complement to lecture”

Frequent users

1st time usersE-learning:

Agree

Disagree

Classroom vs. distance learning “Working with the case was fun”

18

31

52

37

25

14

1

9

36

13

0

10

20

30

40

50

60

%

Agree 2 3 4 5 Disagree

Classroom (n=157)

Distance (n=94) Mean (95%CI): 2.2 (2.1; 2.3)

Mean (95% CI): 2.3 (2.1; 2.5)

Needle stick injury

Evaluation results – Distance learning

Poor

Excellentn=54

Summary• Case-based distance learning for OM is

feasible

• Students well accept distance learning but need feedback

• The motivation of physicians in training to use distance learning might even be higher

• There is no optimal way of teaching that suits

everyone

• Blended learning is preferred