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Course Management Software and Other Technologies to Support Collaborative Learning in a Nontraditional Pharm.D. Course
Jayne L. Smith, The University of Georgia
Paul J. Brooks, The University of Georgia
A. Bernie Moore, The University of Georgia
William Ozburn,
The University of Georgia
Jonathan Marquess, Mercer University

Elizabeth Horner, Mercer University

Abstract
Objective: This paper describes a Nontraditional Pharm.D. curriculum put together by the University of Georgia College of Pharmacy (UGA) and Mercer University Southern School of Pharmacy (Mercer). The courses involved use a variety of synchronous and asynchronous delivery methods throughout the 53 semester hour course of study. Each course has an online component using WebCT course management software to deliver content and case studies augmented with graphics and audio/video streaming; to facilitate threaded discussions and email; to administer quizzes and evaluations; and to link to outside web-sites. The curriculum has been evaluated by qualitative and quantitative measures of its success. This evaluation shows that a variety of delivery methods reinforces the application of distance learning skills.

1. Introduction and Purpose of Program
Currently, two degrees can be conferred to undergraduate pharmacy students, the Bachelor of Science in Pharmacy (B.S.Pharm.) and the Doctor of Pharmacy (Pharm.D.). However, because of growing patient care responsibilities of pharmacists, beginning in 2000 the national accrediting body for pharmacy schools will accredit only those programs that lead to the Pharm.D. degree. The overwhelming majority of pharmacists hold only the B.S. Pharm degree; consequently, there is concern of possible disenfranchisement of B.S. trained pharmacists in obtaining promotions and maintaining job security when competing with new Pharm.D. graduates. In response to this concern, national pharmacy practice organizations have encouraged colleges of pharmacy to develop a mechanism by which practicing pharmacists can earn the Pharm.D. using nontraditional, distance-learning formats. (AACP)

The two pharmacy schools in the state of Georgia, the University of Georgia College of Pharmacy (UGA) and Mercer University Southern School of Pharmacy (Mercer), joined forces to create a distance learning based Doctor of Pharmacy curriculum called the Nontraditional Doctor of Pharmacy Pathway Program. The program, which began with its first class in November 1999, is designed for practicing pharmacists in Georgia, who hold the B.S. Pharm. degree and wish to obtain the Pharm.D. in a flexible, part-time curriculum.

2. Curriculum Overview
The 54-semester hour curriculum is designed to "fill-in-the-gaps" between the two degrees and requires mastery of additional competencies expected of a Pharm.D graduate. By restructuring traditional coursework of the in-residence, full-time Pharm.D. program, we are able to offer the advanced degree to adult learners wanting to acquire it on a part-time basis while continuing to work as a pharmacist. Because it is competency based, the program not only provides fundamental levels of learning, but also requires students to attain the highest professional demands of evaluation, synthesis, and problem solving needed in contemporary pharmacy practice.

Early on, the following tenets were considered essential to program design:

  1. Instruction is mostly self-directed and self-paced.
  2. Substantial application of innovative instructional media and distant learning is used for delivery.
  3. A process is available for assessing competency obtained from prior experience.
  4. Substantial portions of the practice experience is conducted at the studentís own practice environment, where a change in practice habits has maximal impact.
  5. The curriculum maintains the same competencies as the traditional program.

To plan for this type of program, we looked to the Southern Regional Education Board's Principles of Good Practice for Electronic Campuses. The Principles of Good Practice offer standards for electronic-based courses and programs to help ensure that the characteristics of good teaching and learning are addressed, that quality and support are built-in at an institutional level, and that the program and courses are evaluated on an on-going basis.

Because of the unique nature of the curriculum, a variety of synchronous and asynchronous delivery methods are used in the program. These delivery methods are introduced to the Nontraditional Pharm.D. students in an initial survey course called Issues in Pharmacy Care. This 2-semester hour course is designed to acquaint students with the curriculum and instructional technology used in the program. The course employs a "learning by doing" approach and forces students to use a variety of technology-assisted instruction through live, hands-on workshops and on-going web-based assignments.

The technologies introduced in this course and subsequently utilized throughout the entire program of study include the following:

  1. Windows 95 and Netscape Communicator
  2. Course Listserves
  3. WebCT Course Tools Software
  4. GSAMS (Georgia Statewide Academic & Medical System) Videoconferencing System.

3. Purpose and Use of Technology Systems
In order to be admitted to the program, each student must have computer hardware and software that meet minimum requirements. In addition, each is expected to have obtained basic computer skills and is required to complete a Windows 95 assignment prior to the "kick-off" weekend workshop. During the introductory workshop, the students are given an overview of Windows95, Netscape Communicator, email etiquette, and listserves. Hands-on training also includes a step-by-step process for downloading and installing programs from the Internet. Moreover, course specific listserves are created for communication and announcements to and amongst the students.

The students are then introduced to the WebCT course management software. WebCT is a secure environment for organizing and presenting course materials and managing student records. This is the first time most of the students have been exposed to an online course environment, and several hours are spent exploring the tools and options that will be used throughout the program. Some of the features of WebCT that are highlighted during the workshop include:

Course Updates - This link provides a listing of any updates to the course, changes to the WebCT site, and reminders about due dates.

Course Calendar -This color-coded calendar is designed in Calendar Creator 6.0, then captured as a .jpg image before being posted to the course webpage.

Course Content - This icon connects the student to course information. The WebCT Path Editor tool is used to provide access to the course syllabus and all course content-specific information. In addition to text based files, other formats used include image files, streaming video, and links to outside websites.

Student Directory -The directory contains photographs and contact information for all students currently enrolled in the program.

Quizzes & Surveys - Most courses use online quizzes covering specific objectives of the course. WebCT allows many options for releasing the quizzes and results. The WebCT survey tool is also used for course evaluations. Although there is a feature in WebCT to view which students have submitted surveys (a "yes" or "no" by the student's name), the survey results are anonymous.

Communication Tools - This is a link to threaded discussions, private mail and chat rooms. The WebCT bulletin board tool is used to conduct threaded discussions in a majority of our courses. Most courses have specific dates when a facilitator will be online with the student to guide the discussion. At this time, students are not required to participate in synchronous online discussions via the chat room, but that tool is available if the students wish to schedule amongst themselves.

My Record - This is a WebCT tool that allows the students to view their individual grades in the course. When students submit online quizzes for grading, the grade is automatically posted under "my record." The instructor or course developer can enter other grades, such as projects and proctored exams. The final grade can then be calculated electronically and released to the student.

My Progress - This is another WebCT tool that allows the students to keep track of personal progress in the course. Information provided includes the number of times they have "hit" the homepage or other course pages and how many articles they have posted and read.

During the weekend workshop, the students are also given an introduction to the GSAMS videoconferencing system. GSAMS is one of the world's largest two-way interactive video networks with over 400 GSAMS rooms located throughout the state of Georgia. Up to 12 sites can be connected at one time via a T1 phone line. When possible, we use videoconferencing in place of requiring the students to attend onsite sessions. As with proctored exams, every effort is made to reserve a GSAMS room within 1-2 hours driving distance of the student's home. It is important for the students to be familiar with the equipment common to all GSAMS rooms including the control panel and document camera because facilitators are not available in all sites around the state.

4. Experience and Assessment of Specific Aspects of the Technology
An educational program specialist works with faculty on course development and appropriate use of technology. Decisions on the use of technology are made based on the needs of the course, faculty and students. Ongoing course and program evaluation is essential to determine the program's success. As the students progress through the courses, they evaluate the technology used to deliver the course material. Updates to the course or additional training are provided based on these evaluations and informal feedback.

In addition to describing the general characteristics of technology mentioned in the previous section, we offer insight into our experience with specific aspects of technology and provide student assessments.

4.1. Videostreaming
Access to videostreamed instruction is obtained on the WebCT course page. Due to the current low quality of streamed video files (tiling, buffering, small frame size, etc.), we use this type of media on a limited basis and for video that does not require high resolution. We also use streaming audio when the video image is not necessary. We currently use streaming video for faculty and topic introductions and to further explain specific content. Videos are typically 10 minutes or less. We are currently experimenting with streaming PowerPoint slide shows to test the feasibility of streaming these types of presentations to students using a 28.8 Kbps modem.

All of the production work for videostreaming is completed in-house using miroVideo's DC30 plus capture card, Adobe Premiere editing software, and RealProducer G2 conversion software. The program has recently purchased RealProducer Pro G2 to expand the educational opportunities of video streaming. This newly released software allows for batch conversion of audio and video files, and offers SMIL and HTML templates to build multimedia presentations incorporating text and images along with the video. Students must download and install RealPlayer G2 (free) to view the streamed video content.

To assess the effectiveness of streamed video, the students were given an opportunity to provide feedback on this technology. Overall, they felt the use of streamed video was an asset to the course. Video allows students to see and hear a faculty member introduce topics and emphasize important concepts prior to interacting online (a little bit of the touchy-feely stuff that is hard to accomplish at a distance.) In addition, they can view demonstrations and hear faculty explain complex charts and graphs.

Through survey assessments students agreed with course development specialists that streamed video clips for instruction should be no longer than 15 minutes. This is due to the small window available for the video clip on their computer monitor and current low quality (grainy, jerky, slow buffering, etc.) of streamed video. Based on this feedback, we will continue to incorporate video in our courses. However, when quality of the image is essential or when we need to use a larger volume of video, standard videotapes or pressed video on CD-ROM will be employed in lieu of streaming technology.

4.2. Asynchronous (Threaded) Discussions
The bulletin board feature within WebCT is an essential instructional tool used in the Nontraditional Doctor of Pharmacy Program. Since it is an asynchronous, threaded discussion format, students and faculty are not tied down to a specific day and time to hold discussions. Moreover, both students and faculty are able to "attend" class even during business trips and vacation. During the orientation course, students are introduced to the concepts of self-directed and cooperative learning. Threaded discussions lend themselves to these student-directed learning strategies, since the discussions are driven by the students and guided by the faculty member. This allows faculty to "observe" interactions to initial posting and to interject and mold discussions to keep the students on task.

In the introductory course, a faculty member engaged the group in dialogue for a period of seven days using the threaded discussion technology. The discussion involved comments, experiences on the job, and reactions to a journal article about self-directed learning. A detailed report of these experiences from the instructor's perspective is found in the Appendix.

Most of the thirty students currently enrolled in the program prefer the use of threaded discussion to a required meeting time. The following student comment is indicative of the general feeling about threaded discussions. "I thoroughly enjoyed using WebCT for communication in this course. The threaded discussions proved to be a neat process to accommodate different work schedules." However, one student voiced concerns about threaded discussions "I did not feel that the threaded discussion was helpful for the following reasons: (1) Itís hard to read on the computer screen (2) The only way to "get the flow" is to print out the whole thing (3) If one does not comment, it can be interpreted as (the student) being disinterested when in fact your comment might be identical to one that had already been made."

4.3. Synchronous Discussions
Synchronous discussions also have an important place in the program. For example, live, contact time during the orientation course occurred during the initial 16-hour on-site workshop. In addition, an optional student-directed chat-room was available for conversations on projects and collaborative support. Also, GSAMS videoconferencing was used during an 8-hour interactive, distance television session to six sites around the state. Having occasional face-to-face interaction between students and faculty builds camaraderie and familiarity that in turn supports open and honest discussions in the asynchronous environment. In addition, on-site and live distance television sessions are ideal for making formal presentations, testing communication skills, holding "help" and brainstorming sessions, and discussing logistical program issues that require give and take.

4.4. Quizzes & Surveys
Although major exams are proctored at official test sites around the state, quizzes posted on WebCT are extremely valuable to the student and faculty. Quizzes are used as formative evaluation opportunities to prepare the student for major exams and are used as a confidence builder. The instructor has several options for quiz development, reporting, and grading. Some of these options include taking the quiz multiple times, averaging grades and gathering other statistics that can be reported to students, and providing immediate or delayed feedback on selected answers and grades. During the initial course workshop, students learn how to use the quiz function in WebCT by taking a "computer quiz" to test their knowledge of the material that was covered earlier in the session. This quiz is only for tutorial purposes and does not count toward the student's grade in the particular course. In other courses, students are given a deadline for submitting quizzes, which can count a significant portion of the course grade.

The same quiz function in WebCT also can be setup as a survey. Surveys collect anonymous comments that are not linked to specific students. End of course evaluations on content and skills are captured using the survey tool in WebCT. Students rate their perceived ability to perform each course objective listed in the syllabus (i.e., do they believe they fully met, partially met, or did not meet the objective) and the level of instruction received for each objective. Open-ended questions allow students to assess the pace of the course, support materials, and technical support. These questions also yield general course comments and identify areas of improvement. For example, after a threaded discussion on self-directed learning, the students were asked to submit an anonymous online survey to evaluate the effectiveness of this asynchronous communication tool. The results, although overwhelmingly positive, did indicate a need for more instruction on proper use of this tool. When the students got together via GSAMS videoconferencing a few weeks later, they were given more instruction on the features and use of the bulletin board tool. Since we use WebCT to post grades as well as capture the evaluations, it is possible to require that students assess the course prior to releasing their grades.

5. Conclusion
We have determined it is important to employ several types of delivery mechanisms in a distance learning program. Since each student learns differently, having both synchronous and asynchronous learning strategies helps assure us that we are responding to different learning styles. Alternating delivery method also appears to minimize "burn-out" with a specific type of instructional technology. There is a tendency to use the newest and most sophisticated technology available. However, from our experience we have concluded that we must strike a balance between technology-based components, ease of use, and self-direction to facilitate mastery of the learning objectives and not detract from learning.

Flexibility and a willingness to change are key to succeeding in this environment. We will continue to improve our courses by evaluating new and existing technologies and incorporate changes in delivery mechanisms that promote learning from a distance. We hope this will lead to the success of this innovative professional degree program.

6. References
Bootman, J., Hunter, R., Kerr, R., Lipton, H., Mauger, J., & Roche, V. (Eds.). (1997). Approaching the millennium: The Report of the AACP Janus Commission. (pp. 1-15). American Associaton of Colleges of Pharmacy.

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IMEJ multimedia team member assigned to this paper: Daniel Pfeifer