1. Introduction

The Master of Public Health (MPH) and Graduate Health Studies (GHS) Programs within the Department of Social and Preventive Medicine are delivering courses in flexible delivery mode for the first time in 1997. Concurrently with development and delivery of printed course material, we are investigating and developing ways to effectively communicate with our students. We need to know how accessible and practical various communication technologies are to our students, how to use the technologies confidently, and what impact their use has on enhanced learning for our students.

2. Context and Objectives

Our programs target mid-career health professionals who bring to the course their life skills, expertise in their profession and knowledge of the health industry. However, they have constraints to their study, such as competing priorities from family, work and community commitments and a considerable time lapse since their previous study. Our primary medium for teaching in 1997 is a set of printed study guides, readings and practice questions for each subject with support from a residential, telephone calls, teleconferences, some limited use of email and local support to students in north Queensland.

Flexible delivery of teaching can be defined as the provision of learning and assessment opportunities in modes which serve to increase the students control over when, where, how and at what pace they learn. It is related to student-centred learning, which emphasises the teachers role as a facilitator in empowering students to take significant, but not total, responsibility for their own learning (Rogers, 1951). This also implies a shift away from the traditional transmission model of teaching towards a social constructivist approach (Ramsden, 1992), and encouragement of deep learning, where the learner is searching for meaning and structure in the material.

The use of computer-based technologies has an obvious requirement of student access. In 1994, Black et al reported that 77 percent of distance education students in Canada had convenient access to a computer for study purposes. Three years later, Venables (1997) reported that, among US science undergraduates, 95 percent of distance students had access to email and 90 percent had access to the Web. If our students follow this pattern, they will traverse the web learning curve within two years. The reports of Lundin (1993) from overseas experiences and of Tinkler et al (1994) in Australia indicate a large amount of activity with use of communication technologies but there are few reports of their effectiveness.

This paper reports our experiences during 1997 of experimentation with newer technologies and evaluation of traditional modes of communication, and concludes with an implementation plan for flexible delivery subjects in 1998. While it would be ideal to evaluate enhanced learning directly, measurement techniques are not yet available for this, so that indicators, such as assessment grades, satisfaction and perceived benefits, must suffice.

3. Evaluations

The evaluation of communication strategies for students studying at a distance comprises two components. Whilst investigating new ways or modes of communication is the fundamental aim of this project, it is also important to evaluate or examine the effectiveness of communication strategies already in place.

Current teaching methods:
An evaluation of the current teaching media used for one subject (SM801) in the MPH and GHS programs in first semester was conducted amongst students undertaking flexible delivery courses in these programs.

Print-based media
Students reported having some trouble with the printed material arriving late and even made some recommendations about putting mechanisms in place that would indicate sooner that a student had not received their material. Other than this, students reported having no problems with the printed material finding it clear and relatively easy to follow.

Residentials
A weekend residential was held in Brisbane at the start of semester for all students studying in the GHSP. This involved both lectures and tutorials and was very well accepted by the students giving them an opportunity to meet the teaching staff and to gain a brief introduction to the subject. In general, students considered residentials to be very important and even recommended having a second session later in the semester. Residentials were considered essential for establishing contact and rapport between the teaching staff and the students.

Telephone calls
In the first semester subject, SM801, students were given telephone numbers for tutors and proscribed times that were set aside for contact both within and outside of normal office hours. Approximately 4 to 5 weeks into the first semester staff realised that this technique for communicating with students was not working. There was a high drop out rate for students who were finding the subject difficult but had not contacted any of the tutors for help. The tutors then started to actively contact as many of the students still enrolled as possible. This active communication strategy was highly appreciated by the students and opened the lines of communication between teachers and students for the rest of the semester.

Students themselves considered telephone calls to be a good means of communication once contact had been established. However, they also reported having trouble getting hold of teaching staff when they required them and needed the lecturer to make the first contact before feeling comfortable enough to initiate contact themselves.

Investigating new technologies:
The investigation of new modes of communication with distance students is a very important component of this project. As part of this investigation, the team has trialed two specific technologies within the group videoconferencing and email list server groups.

Videoconferencing
Videoconferencing technology was trialed in the context of a team meeting. It was generally thought that the use of the videoconference facility resulted in a more efficient meeting with more discussed and covered in less time. No one had any trouble hearing and the equipment itself was relatively easy to use. No one reported that they found the technology distracting. Videoconferencing was found to be an excellent way to communicate at a distance, simulating well face-to-face teaching. It was noted, however, that a training session is essential before using this technology with students. Cost and equipment constraints must also be taken into consideration when selecting this mode of communication. Videoconferencing is an expensive way to communicate.

Email list server groups
The team found that this was an excellent way to communicate if you knew how to use, and were comfortable with, using the equipment. The email list server was considered to be a useful tool for discussion if an individual was prepared to participate. While the list server kept team members minds on the subject, it also provided a forum for contribution without interruption and allowed a discussion to take place over a period of time without every person having to be there at the same time. It was noted that it is essential to keep to salient points when using this technology since the saturation of information is potentially overwhelming and it can be tiresome wading through superfluous information. Since most students today have access to email, discussion groups provide a useful and practical mode for communication over a distance.

4. Student based Experiments

The lessons learned in first semester were used in the planning and implementation of the delivery of a second semester subject (SM818). Again print-based material formed the main thrust of the subject course work. In addition, all students were sent a set of disks which contained a freely available computer program (EpiInfo) that can aid students with their calculations. A number of additional forms of communication with students were also utilised.

• World Wide Web
  A web page was established which contained a copy of the study material, details on how to contact tutors, a link and instructions to download EpiInfo from an appropriate site, and a link to a page from where the students could download copies of assignments. This web page provided an excellent means of distributing material to students who had access (which was over 80% of the students enrolled). To print, photocopy and send out all the material required for the subject over the whole semester was a very time consuming, costly and inconvenient process. Posting relevant material on the web page was, however, instantaneous, inexpensive and convenient. Additionally, students could have access to the material much faster because of the time saved through avoiding the copying and mailing process. This is important for material such as assignments, which have strict deadlines.
• Email and telephone calls
  The students were also put into three tutorial groups, with three students in each group, and assigned a tutor. The tutor contacted each of the students in their group in the first few weeks of the semester, introduced themselves, and gave out the telephone numbers and email addresses of the other students in their tutorial group (with their permission). This opened the lines of communication between the students and the tutors and amongst the students themselves.
• The email addresses of all the tutors were contained within the printed notes, as well as being provided on the web page. In addition, tutors mentioned to students that they had the option to contact the tutors by email if they so desired. Many of the students found this option most convenient as some of the tutors are part-time staff and difficult to contact by phone. This also gave students the opportunity to think about their problem and clarify the question, and gave tutors the time to formulate a response. Another advantage of email is that for international students in a different time zone, contact with tutors will be more convenient.

5. Implementation in 1998

During 1997 it became clear that communication between students was as important as the communication between staff and students. The external students, who did not have a line of communication with fellow students, tended to assume that they were alone in having difficulties and were reluctant to ask questions for fear of appearing stupid. Therefore, plans for communication with students in 1998 will be discussed in two parts: firstly, the communication of educational material from staff to students and, secondly, discussion of this material both between staff and students and between students.

Communication of Material from Staff to Student:
It is anticipated that the majority of students will have access to the Web and email in 1998 and that this will increase in future years (Venables, 1997). Electronic communication will, therefore, play a major role in communication with students. Traditional communication methods (post, fax and telephone) will be used for those students without email access. The experiences of both staff and students who have used the various technologies being trialed this year will be considered when finalising the plans for 1998.

Print and mail
As in 1997, the main medium for the communication of resource material to external students will be print, as this is currently the only format that is equally available to all students.

World Wide Web
In addition, all of the printed material will also be made available through a dedicated Web page. Initially, this will simply duplicate the printed material with the addition of electronic cross-referencing to help students move through the material. Tutorial solutions and notes will be posted on the Web site on a weekly basis and assignment questions, solutions and explanatory notes will also be posted at appropriate times. The main advantage to students at this stage will be that of time-saving in that they will no longer have to wait for material to arrive in the mail. This resource will also benefit internal students who wish to revisit, or were unable to attend a lecture or tutorial session.

Guest Lectures: Video
For the internal students, the semester starts and ends with a talk from an expert in the field of epidemiology. These serve to introduce the subject in the first week and then to pull together the threads in the final week and are always enthusiastically received. In 1998 we will also make these sessions available to external students. All students will be invited to attend these presentations, although this will clearly only be possible for those who live close to Brisbane. Other students will have the opportunity of hearing the speakers through some form of video-link. Possibilities include videoconferencing to a few regional centres (Cairns, Rockhampton, Townsville) in real time or the preparation of videos of the sessions that could then be played back to groups of students and a tutor through regional centres or sent individually to the more isolated students.

Discussion between Staff and Students and between Students:

Breaking the ice: Residentials
The first contact with the students will be through residential weekends held in the first weeks of semester. During this time, when students are introduced to their course of study and the process of distance learning in general, we will form virtual tutorial groups (see below).

Starting the ball rolling: Telephone
In 1998 we will establish telephone contact with all of the students during the first two weeks of semester to break down the initial communication barrier mentioned previously.

Keeping it rolling: Email
Internal students are kept up-to-date with regular announcements at the start of each lecture session. To ensure that external students are kept informed in the same way, the same information will be sent to them in a weekly email communication.

Virtual Tutorial Groups
External students are at a disadvantage because they do not have the traditional tutorial environment in which to get to know their fellow-students and teachers. To recreate this tutorial environment, students will be divided into groups of 6-10 and each group will be assigned a tutor. Ideally all members of a group would have email and the group would meet via an email list-server which would be set up especially for that group. Students would be encouraged to use this to discuss issues with both their tutor and the other members of the group. Tutors would monitor communication within the group and could contribute as necessary providing not only clarification of issues and answers to questions, but also questions to stimulate discussion. This ongoing contact with students would enable tutors to identify quiet students who could then be contacted privately to check on their progress.

Teleconferencing and videoconferencing
To facilitate communication within the tutorial groups, two or three teleconferences will be scheduled during the semester. These would take place a week or so before each assignment was due and would be centred around a particular tutorial exercise as well as providing a forum for students to ask more general questions.

6. Conclusion

Overall, the lessons learnt this year have motivated the teaching staff to create the beginnings of an effective and efficient means of communication with and between students. This is resulting in positive responses from students and is, hopefully, providing a better environment for them to learn. An aspect of this communication that should not be ignored is staff training to develop confidence and competence with the use of these new technologies. This will be the focus of the final stage of our Action Learning Project.

REFERENCES

Black, D., Bischoff, P. and Bates, A. (1994). Further Information on Open Learning Agency Distance Education Students. Burnaby, BC: The Open Learning Agency.

Lundin, R. (1993). Overseas Experience in Non-traditional Modes of Delivery in Higher Education using State-of-the-art Technologies: Best Practice. Canberra: Australian Government Publishing Service.

Ramsden, P. (1992). Learning to Teach in Higher Education. London: Routledge.

Rogers, C. (1951). Client-Centred Therapy. Boston: Houghton-Mifflin.

Tinkler, D., Smith, T., Ellyard, P. and Cohen, D. (1994). Effectiveness and Potential of State-of-the-art Technologies in the Delivery of Higher Education. Canberra: Australian Government Publishing Service.

Venables, J. (1997). Rebirth of the Cool. Times Higher Education Supplement, 14 March.