School`s Out: The Pros and Cons of Distance Education in EMS

You are considering advancing your education and want to take some courses toward your paramedic degree. You look into various paramedic educational programs in your area and find there are prerequisites to all allied health and nursing programs. However, the prospect of committing 4-5 days a week leaves you undecided. How can you attend college courses while working and raising a family at the same time? Then a colleague tells you about some college courses he's taking online. You had never considered distance learning. After thinking about it, you decide you want to investigate this form of education to find out if it is for you.

What Is Distance Learning?

Distance learning (DL) is an educational delivery option in which a person can take a course via the Internet (World Wide Web) using their home computer. Distance technologies allow learners who might not otherwise pursue courses because of time and family constraints the flexibility of taking a college course in the comfort of their own home or at any location that provides Internet access. DL courses are available 24 hours a day, seven days a week.

DL has existed for more than a century, originally consisting of correspondence courses and materials. Information and assignments were mailed to students, and students mailed their work back to the instructor, who would analyze and grade it and return comments by mail. This system was slow and not particularly interactive; however, it worked for soldiers and rural Americans, and is still operating today at places such as Penn State and Washington State Universities.

Correspondence courses were followed by video-based DL, using the technology of television to deliver content and course information. The mail system was utilized for assignments and written communications. As technology progressed, two-way video was developed, allowing interaction between multiple sites. Video courses were usually synchronous, with students and teachers being in different places while learning and communicating at the same time. The invention of the VCR made taped materials available for private viewing.

Today, the term distance learning (or distance education) has come to mean online learning, employing the World Wide Web for content, delivery and communication. Online courses include traditional educational materials such as books, journals, videos and any digitized content (text, pictures, video, simulations, journals, library materials, specialty websites), as well as articles authored by publishers, instructors and students. Communication tools include e-mail, threaded discussions (online conferences), chats (synchronous online conversations using text, audio or even video), white boards and videoconferencing, as well as faxes and phones. Assignments can be delivered over the Web, students can collaborate with each other, and the instructor can provide feedback, all using the same set of communication tools.

Online courses are commonly delivered using a course management system (CMS). This is an application (software) that integrates all the learning tools (Web pages, tests, threaded discussions, chats, etc.), offers both students and instructors a consistent interface, and even supplies administrative tools to track grades, attendance and course access.

In higher education, some of the more common CMS products include BlackBoard and WebCT, among others (see www.edutools.info/course/productinfo/index.jsp for additional listings).

The key element of online distance learning is the convenience of learning anytime. This allows students who have varying work schedules and family responsibilities to learn at any hour during the day. In Web-delivered courses, students may not interact directly with the instructor; instead, they can access course materials, assignments and, most important, other students from wherever they are and at a time convenient to them. Many courses use cohorts of students and move those cohorts through the curriculum at roughly the same rate, but with sufficient flexibility that students feel they are working at a pace that works within their lifestyle.

Technological Requirements

Online DL requires a late-model computer that can access the Web. You do not need the latest and greatest computer, just a recent model running an operating system (e.g., Windows 98, Windows Millennium, Mac OS X) with sufficient internal resources (RAM, open hard drive space) to permit the uploading of new software and the operation of software programs like Microsoft Office. Most course providers offer potential students detailed information about the technical requirements for their courses, including details on system requirements. For an example of such information, see www.ctdlc.org/help/requirements.html.

Online learners will also need an Internet service provider. As part of that service, a subscriber will get an e-mail account that will be the communication center for online activity.

Internet access can be obtained through a variety of technologies: phone modems, DSL modems, cable modems, local area networks, wireless network cards (home, work or public-access sites), libraries or community colleges. The key element to access is the transfer rate of your connection. For example, phone modems have an upper speed limit of 56Kb/sec., while DSL or a cable modem can increase that rate to 1.5Mb/sec. (an increase of roughly 500%). DSL, cable modems and network connections are all referred to as broadband because they provide sufficient bandwidth to support the transmission of high-quality video. The magic number for such a robust connection is 375Kb/sec., but even with a phone modem operating at 56Kb/sec., it is possible to take an online course, exchange e-mail, post to the course conference, view Web pages and attach assignments to e-mail messages and forward them to fellow students or the instructor.

The software required to take a course depends upon what special tasks and requirements are associated with the course. Generally, a learner needs a late-model browser (e.g., Internet Explorer Version 6 or Netscape Version 6 or higher) and a word-processing program like Microsoft Word. Often, a course requires that your browser be equipped with certain "plug-ins" that extend its capabilities (e.g., Adobe Acrobat Reader, RealOne Player, Windows Media or Macromedia Flash), but these will be identified by the course provider, and learners will be instructed on how to download (usually for free) and install them in their personal computers.

Some other technical requirements include a printer, anti-virus software (e.g., Norton AntiVirus or McAfee) to protect your system from unwanted damage, and a good computer service contract. It is important to have a plan if your primary system crashes. Serious computer problems in the middle of a course can be catastrophic if you are unable to repair your system quickly or do not have an alternative system available. It is also a good idea to store course-related files-assignments, e-mail, bookmarks-to external media (e.g., floppy disks, a zip disk or a CD-ROM).

Skills and Requirements

Students in online courses are required to do lots of reading and writing. Most of the course material and communication is through text. In addition, students should be comfortable with e-mail (including attaching files and organizing saved messages into folders), word processing (including pasting text from the word processor into an e-mail message), and Web searching.

Online education requires a certain individual who is able to commit to this type of learning. It takes self-discipline, self-assessment and understanding in order to read and process the written word. Most knowledge is new to the learner, and computer-based course knowledge is voluminous. Information has to be processed by the learner, making the learner completely responsible for his or her educational actions and outcomes.

Effective use of time and resources can assist students in obtaining maximum benefit from their efforts. Anytime-access is a benefit of online education, but it must still be scheduled around household responsibilities. Family support with use of the Internet is important for success. Students should set aside a time for distance learning, preferably two times during the week in the event of scheduling changes or unforeseen problems.

Stress management is a beneficial skill for Internet learners. Many students become frustrated by not having quiet time to do their work. Most are tired after a long day at their job. Stress-reduction techniques are weapons of defense and should be established early so that frustrations are minimized. Students should take frequent breaks from the computer to avoid eye fatigue. Additionally, a good chair allows the student to be comfortable while maintaining back support. Playing soft music in the background sometimes helps to keep you awake. Most fire and EMS departments now have Internet access, so if the day is slow in terms of call volume, you may be able to do some online learning in the station.

Reading and comprehension skills are a plus, but even slow readers can benefit from online learning. EMS personnel are frequently tired after a shift and sometimes need to review materials more than once to properly understand the concepts. Lecture materials can be printed, saved or merely read over and over again. Repetition and rereading is a plus of distance education.

Most online programs have an orientation segment that introduces students to the course. In addition, these orientations usually acquaint the learner with the course management system. For several examples, visit www.ctdlc.org/sample/index.html.

Programs and Classes

The use of online delivery for EMS education is growing across the higher-education landscape. Below is a list of Web addresses for some of the programs and certificates currently offered in the U.S.

Online BS in Emergency Health Services from George Washington University-www.gwumc.edu/healthsci/ Programs/EHS/ehs_bs.htm.

Online certificate from George Washington University-www.gwumc. edu/healthsci/Programs/EHS/ehs_cert.htm.

EMS Certificate from Richmond School of Continuing Studies-https://oncampus.richmond.edu/academics/scs/credit/esm/em_cert.htm.

Online BS in Fire and Emergency Services from the University of Florida-www.fcd.ufl.edu/programs.asp?id=2&ProgramType=Bachelors.

Online certificate from the University of Florida-www.fcd.ufl.edu/programs. asp?id=23&ProgramType=Certificate.

Continuing Education-www.world widelearn.com/continuing-education/emer gency-medical-services.htm.

To give readers a sense of what these online programs and certificates cover, here is the course of study for the George Washington University BS degree in Emergency Health Services.

Core courses: Psychosocial Aspects of Health & Illness; Pathophysiology; Health Policy & the Healthcare System; Management of Health Science Services; Ethics for the Health Professional.

Courses in EHS major: EMS Systems Design; EMS Operations & Management; Leadership in EMS; Special Operations; EMS Development & Strategic Planning; Foundations in Management Information Systems; Management of Human Resources in Health Sciences; Organizations; Planning & Marketing in Health Sciences; Financial Management in Health Sciences; Current Issues in Health Sciences Management; Seminar in Health Science Leadership.

DL paramedic and EMT courses are currently under development in Connecticut. A pilot paramedic certificate program was completed this past year at Naugatuck Valley Community College in Waterbury. Several educators are expanding the paramedic DL concept in the state and hope to have additional programs in the future. Potential students can view a sampling of a DL course by visiting the Connecticut distance learning website (www.ctdlc.org/sample/guest.html) and logging into one of the course management systems.

Video Options

Although this article specifically targets Internet DL, learners can also take courses at a distance by registering and receiving videotapes of lectures and accompanying notes and assignments. Tests are submitted back to the learning institution via a proctor, and credit is received. Students can also participate in discussion groups, e-mail sessions, instant-messaging arrangements and course reviews. Washington State is an example of a university offering courses this way.

The best way to find out about DL courses in your state is to seek information using a search engine. Type in "colleges and universities" and go to the distance learning course section.

DL Positives

Most DL students choose this format because it fits within their life demands. The most positive aspect of distance learning is that it allows the student to manage learning in the time he or she has available.

Distance learning actively engages both the learner and teacher with multiple types of interactive strategies. It need not have any face-to-face components. Future resources will most likely include teleconferences, interactive visual conferences, video- and audioconferencing and wireless Internet access.

Other advantages are the wide range of networking and community building that accompanies DL experiences.

DL Pitfalls

Students may not always have their questions answered immediately, unlike in the classroom setting. In addition, any sense of community is built from the class conference and e-mail, not from face-to-face interactions. For learners who enjoy physically meeting new people, this change may be daunting. Following are some additional pitfalls a learner may encounter in a DL program.

Technical Ability Problems:

• Learners may not always be available for designated instructor chat times.
• Learners may have difficulty taking timed quizzes and examinations.
• Learners may not have good organizational skills and thus may have difficulty keeping up with the time frames established for the course.

Cost Factors:

• Internet service provider monthly fees.
• Cost of ink cartridges for printing.
• Home phone numbers may be tied up for hours at a time.
• Many colleges have activation fees for DL courses.

Instructional Pitfalls:

• Resource personnel may not be available to answer immediate questions.
• Class size may be large, thus decreasing teacher feedback time.
• DL courses are 24/7, thus there is no room for absenteeism.
• Technology opens up more areas for learning, thus requiring more teacher and student preparation time.

Every educational endeavor requires a commitment to the learning process. DL courses offer a wide variety of learning possibilities but do require time and a long-term commitment, especially if one desires to complete a program or degree. DL courses are not easier than other college courses, but certainly offer more convenience while still maintaining educational integrity.

Conclusion

People learn in a variety of ways. Some do it better with the spoken word, some like to work independently, and others profit from working in groups. Some prefer the independence of taking a course online, especially because they can go to class at a time that they choose and not be obligated to fit into a specific schedule.

Online learning takes commitment and perseverance. The key is having a positive attitude and staying active with the course. Become engaged in learning and competitive with tests and quizzes. Information is always available for review. It is never too late to learn.

Bibliography

• Blais K, Brooten D, Youngblut JM. Educating students isn't the same as selling shoes? Nursing Outlook 50(4): 152-153, July-Aug. 2002.
• Hanna DE, et al. 147 Practical Tips for Teaching Online Groups. Atwood Publishing, 2000.
• May, et al. Generic abilities. J Phys Ther Ed 9:1, Spring 1995.

Distance Learning Mnemonic

The authors summarize distance learning with this mnemonic:
D-Distance learning courses can be taken from anywhere in the U.S. or abroad.
I-Instructors may be located at various colleges.
S-Students may live anywhere.
T-Time frames are established for each course.
A-Asynchronous learning offers 24/7 availability.
N-Never be late for class again.
C-Collaborate with students from all over.
E-Enroll in the courses you need regardless of where they are offered.
L-Learn at your own pace.
E-Evaluate your quizzes and tests online.
A-Arrange your schedule to fit your needs.
R-Review can be completed over and over again.
N-Notes are always available for review.
I-Instructors can set aside designated times for chat discussions.
N-No designated class sessions and no class cancellations.
G-Grades are submitted electronically.

Ingredients for Success

The following skills may be beneficial to students taking online courses.

• Personal commitment, motivation and discipline
• Written communication skills
• Problem-solving skills
• Critical-thinking skills
• Responsibility for outcomes
• Ability to accept constructive feedback
• Stress management
• Reading and comprehension abilities
• Technical skills (typing, etc.)
• Good visual skills
• Good posture and back strength
• Computer skills.

Strategies for Success

• Establishing a time frame for distance learning
• Reaching a mutual agreement with other family members who use the Internet
• Designating a quiet space for studying and maintaining a computer work station
• Obtaining permission from your company to study while on the job, if possible
• Maintaining a computer system with appropriate technical and software capabilities
• Finding a reliable Internet service
• Taking a course with a fellow EMS person can be a plus
• Having the desire to seek tutoring from peers if falling behind in class.

Glossary

Adobe Acrobat Reader-Software that turns a document into a picture so that its formatting is preserved. It is free and downloadable from www.adobe.com.

Asynchronous-Online activity that occurs in different places and different times. In other words, anytime/anywhere learning.

Broadband-An Internet connection that supports data downloads at 375Kb/sec. This is a faster connection that will open Web pages, download large files and even stream video without delays.

Browser-An application that will display Web pages. The major versions are Internet Explorer and Netscape.

Distance learning (DL)-Taking a course via the Internet or lecture videos away from the college/university location.

Internet service provider-A company that provides access to the Internet. This is the service/company that your modem dials.

Macromedia Flash-This is software that permits multimedia to be displayed within a browser like Internet Explorer. Multimedia is interactive and includes sounds and motion.

RealOne Player-Software that will play sound files and videos through your browser. Formerly known as RealPlayer; its competitors include Microsoft Media Player and QuickTime.

Web-based-Accessible through your browser.

Windows Media Player-Software that will play sound files and videos through your browser (supplied by Microsoft). Its competitors include RealOne Player and QuickTime.