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Epidemiological Bulletin
      Vol. 17, No. 2
 July 1996  


E-MAIL: A VIABLE TECHNOLOGY FOR DISTANCE TRAINING

IN DEVELOPING COUNTRIES

Introduction

In the 1990s, Electronic Mail (E-Mail), audioconferencing, videoconferencing and docuconferencing distance training technologies became available in the most up-to-date communication systems. Educators remarked that these innovations are the precursor of a paradigm shift in education from classroom to distance training. One educator wrote, Those of us who are traditional classroom instructors may be the last of a breed, at least at the postsecondary level.(1) As early as 1990, the General Assembly of the United Nations in Resolution 45/191 recognized the importance of distance training in the context of human resource development. However, educators emphasized that choices in approaches to education and types of technologies used should be evaluated in terms of available communications links, course content and objectives, student and tutor interests, work experience, academic background, and computer literacy, as well as participants experience with distance training.(1-3) This article discusses important factors that affect the choice of distance training approaches and technologies, excluding correspondence distance training where student-teacher interactions are limited.

Notably, in 1989 Dr. Truls Ostbye, a medical epidemiologist, then at Dalhousie University in Halifax Canada, successfully tested a distance training E-Mail course in epidemiology and medical statistics for health personnel in sites across Canada and one in Norway.(4) The decision to use E-Mail was driven by the need for a less expensive and more convenient form of training than possible in a standard classroom setting. E-Mail could reach government health workers not able to leave jobs or homes for extended periods of time. It allowed them to interact with each other in a timely fashion independent of geographic location or time.(4-5) Again, in 1989, E-Mail training was used successfully by the health authorities in Manitoba, Canada to provide nurses with access to courses necessary for them to qualify for certain jobs.(6) By 1994, the magnitude of distance training courses in the United States was remarkable. The Distance Education and Training Council in Washington D.C., estimated that three million students were registered in accredited programs and that half of the 230 surveyed colleges and universities offered cybercourses (7).

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Determining Factors for Consideration of E-Mail Distance Training

Three factors, convenience, cost, and quality characterize effective training approaches and technologies. With respect to convenience, E-Mail communication with the instructor or among students is possible where there is hardware and software network link between them. Individuals do not have to leave their place of work or families to receive training. An instructor may communicate directly with one student independently or with all students. Students have the flexibility to complete assignments within a wider time frame than permitted by traditional classroom courses. E-Mail Distance Training promotes equity of access by offering opportunities to those unable to attend traditional education settings.(3) This type of distance training is maximized when used to reach students who are separated geographically. It also permits instructors from distant points to reach students working in the traditional classroom setting.

E-Mail Distance Training is often inconvenient where it is needed most. In many areas of developing countries, there is no access to networks from health institutions. Appreciating this constraint, a telemedicine expert, the President of Applied Communications Concepts, (ACC), Mr. Sarkis Zartarian urged the Pan American Health Organization in March 1996 to promote up-to-date communication links within countries as a high priority for health planning. However, some argue this the delivery mode of distance training lacks face-to-face interaction between student and instructor, contributing to higher drop-out rates than with traditional classroom education.(8)

Cost is a major factor in education. E-Mail Distance Training cuts costs related to travel, room and board, providing substantial savings. Corporations, such as IBM, state that distance training has cut their training costs by half.(9) However, distance training logistics problems can be expensive and frustrating to solve, where problems expand in direct proportion to the number of training sites.(1) In comparison to logistics problems, designing distance training curricula is relatively easy. Nevertheless, traditional curricula must be modified to suit evolving technologies and the challenges these technologies present to students.

Although it might be assumed that new technologies automatically enhance the quality of distance training making it more effective than instruction in a classroom setting, available research indicates that there is no significant difference in knowledge transfer between classroom and distance learning approaches.(10) Quality of learning can also be evaluated from a different perspective. Students and teachers in an E-Mail course may begin to communicate intramurally as well as extramurally more with each other and learn more about network bulletin boards and information sources in the World Wide Web.(11) Also, where distance learning extends beyond countries, international understanding, cultural development and links with other institutions of higher learning are encouraged.(11) The decision to select distance or classroom training requires careful study of available human and physical resources, technologies, convenience, cost, and quality as determining factors.

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Strategies for Implementing E-Mail Distance Training

A first step in the planning process is the creation of a distance education capability within a cooperating educational institution or government agency. It is logical to select a training environment that minimizes logistics problems. Other steps include the strengthening of a resource group of trainers and support staff who understand or can learn the use of new technologies around which the new curricula will be designed. Although not necessarily the long term site of choice for in-service government training, a university setting will possibly provide the best chance of success in the early development of an E-Mail Distance Training program. A university has needed physical and human resources and very likely has institutional experience with other types of distance training. Once trained, university staff could provide a valuable base of expertise to institute future E-Mail training in primary target areas, such as health establishments of rural or isolated towns and villages. In addition to the availability of computers, the planning process must also include the connection of dedicated lines to health establishments in secured rooms.

It is imperative to select only the most appropriate technologies to support distance training. According to Mr. Zartarian, President of ACC, we ought not promote costly technologies necessary to emulate real time communications when distance training or telemedicine can be effectively provided in developing countries at much less expense. E-Mail is an example of using a time-delayed training methodology instead of a real-time audioconferencing or videoconferencing technology associated with traditional classroom education. This suggestion is particularly true where communications are most difficult. E-Mail works well using older modems with slower baud rates than are required for effective real-time file transfer of voice or video.

Although E-Mail's potential is maximized reaching students at distant geographic points, in the initial phase of distance training, success may be increased by maintaining a semblance of the traditional classroom routine, where E-Mail interactions supplement the expertise of the instructor. This would lessen drop-out problems and limit the need to radically change existing course curricula until trainers have mastered the technologies. Where courses are being transmitted from one country to others, it is of critical importance to have at each site a contact person who can resolve technical or logistics problems. Knowing as much about the target population as possible is extremely important for E-Mail Distance Training. With the target population in mind, every aspect of the reading material must be considered: sequence of presentation, style of writing, organization of content and reading aids employed.(12) Therefore, it is very helpful to have local trainers evaluate the proposed course curriculum and suggest changes. During the initial phase of an E-Mail course, there must be a well designed and implemented evaluation process which assists trainers to meet the special needs and skill levels of students. Through careful research, planning, and evaluation educators can develop E-Mail training strategies including appropriate technologies which match existing budgets with the needs of a target population.

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Conclusion

E-Mail Distance Training is a convenient and cost effective mode of training, that is equal in quality to classroom training. It permits interaction between student and teacher and among students independent of geographic location or time. It has been used successfully by health authorities since 1989 and has an ever-increasing presence in colleges and universities in the United States. Success with E-Mail Distance Training requires students to be more self-motivated, which means accepting responsibility for study tasks, acquiring basic computer skills, and actively interacting with the instructor. At a minimum, students must be able to log on to the network, upload files, and type and transmit simple messages. E-Mail courses are successful when tutors can report that they know students online personalities as well as they would faces and voices.(7) Successful E-Mail courses are characterized by innovation both in the delivery and teaching-learning methodologies.(5) E-Mail Distance Training can be a viable mode of training when careful research, planning, and evaluation form the basis for selection of appropriate strategies and supporting technologies which match existing budgets with the training needs of a target population.

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References

  1. Lytle, Stephen J.,MS, MPH, Lytle, Barbara V., MS, Youmans, Karen, G. MPA, RRA. Learning at a Distance: People, Technology, and Learning Experiments, Journal of AHIMA/July-August,1995;66(7):64-67.

  2. Kailani, Taiseer, Z., PhD.Window on Distance Learning Institutions, Pakistan Journal of Distance Education,1993;X:(I-II):102-124.

  3. Sherwood, PhD, RN; Myrna L. Armstrong, EdD, RN, FAAN; and Mary Lou Bond, PhD, RN. Distance Education Programs:Defining Issues of Assessment, accessibility, and Accommodation, The Journal of Continuing Education in Nursing,1994 November/December;25(6):252.

  4. Ostbye Truls, MD, MPH.An 'Electronic' Extramural Course in Epidemiology and Medical Statistics, International Journal of Epidemiology, 1989;18:275.

  5. Lewis, Judith, M., and Farrell Marlene. Distance Education, A Strategy for Leadership Development,Global,1995 June;16(4):185.6.

  6. Maltby, Hendrika RN, MScn; Drew, Linda, RN, NScN; and Andrusyszyn, RN, MScN. Distance Education:Joing Forces to Meet the Challenge, The Journal of Continuing Education in nursing,1992;22(3):119-122.

  7. Stuart, Anne, Telecomputing, going the distance, CIO, Dec.15, 1995/ Jan 1, 1996, pg. 62-70.

  8. Garrison, D.R. Researching dropout in distance education. Distance Education,1987;8(1):95-101.

  9. Bolwell, Christine, RN, MSN, ed. Distance Learning and Support Through Computers, Microworld, Nursing Educators,1991 December/January;5(2):9-11.

  10. Filipczak, Bob, ed. Putting the Learning into Distance Learning, Training Magazine,1995 October;111-118.

  11. Ostbye, Truls, MD,MPH.The Electronic Medical-Student Exchange: A low-Cost alternative to Overseas Electives, Canada Medical Association; 1995 Novenber 1;153(9):1327.

  12. Minis, John, R.Instructional design principles derived from cognitive psychology: implications for distance training, Pakistan Journal of Distance Education,1993;X,(I-II):29-47.

Source: Division of Health and Human Development, Health Situation Analysis Program, SHA, PAHO.

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