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The use of advanced learning technologies in health sciences education

Allan Christie
University of South Australia

A review of computer based interactive instructional media that have been used in the School of Physiotherapy over the last five years. This includes the use of videodisc and videotape and studies of their educational effectiveness using the decision oriented model of educational evaluation. Probable future developments based around digitisation of data in its various forms (video, still images, audio, text) and "in house" CD-ROM mastering are outlined.

Advanced learning technologies hold great promise for student paced and student directed learning. In the health sciences area, "real life" still images as well as video and auditory input are needed for the teaching of various techniques and assessment skills. Over the last three to five years the author has combined the interactive capability of the computer with videodisc and videotape in an effort to provide realistic learning situations for student. The results from studies undertaken on these methods of learning have been very encouraging with student attitudes being very positive towards these forms of learning and pre-test/post-test knowledge scores invariably showing a significant increase in understanding of the content after students have worked through the interactive lessons (Christie, 1988,1992).


A videodisc on the topic of Orthopaedics was produced by the author in 1987 and software was written at the time using a DOS authoring language called PC-PILOT. A Videologic video overlay board and software was used to overlay the video image onto a computer screen thereby providing a single screen interactive videodisc workstation.

The decision oriented model of educational evaluation was to used to provide a broad conceptualisation of the use of interactive videodisc in the undergraduate physiotherapy curriculum. The results of this evaluation can be found in the unpublished Master's thesis entitled Interactive videodisc in physiotherapy education (Christie, 1989).

This innovative educational approach has worked well with the City campus library of the University of South Australia now having six videodisc workstations with a number of different videodiscs which supplement, and in some cases, replace traditional teaching methods.


The use of interactive videotape was also evaluated by the author in 1990-91 as it had the advantage of being easily edited and less costly than a videodisc. Although not having the random access capability of a videodisc a well planned instructional lesson can still provide student interactivity which is not compromised by slow response times resulting from the linear nature of the videotape system.

Students who used the interactive videotape lesson on Movement Diagrams had an overall positive response with the mean score of the attitudinal questionnaire being nearly three standard deviations above the mid point of the scale. Not only was the use of the interactive videotape system a positive experience but it was also effective in terms of knowledge gained. There was an average increase in post-test scores of 15% when compared with the pre-test scores.

Factors which will affect wider adoption of this instructional medium include the complexity of linking analogue and digital systems (viz. videotape player and microcomputer). Indeed it proved to be more difficult than computer control of a videodisc player. As with the videodisc workstation the need for personal computers dedicated to this one function is a drawback and industrial quality videotape players capable of writing and reading time code are very expensive.

Ongoing development

A decision has been made not to develop further the use of interactive videotape because of the reasons give above, however, continued development of the interactive videodisc is presently been undertaken with a move from the present DOS based courseware to Windows. This is being done for a number of reasons including the apparent widespread adoption of Windows on DOS machines and the ease of programming using "object oriented like" software.

When reviewing the available application development tools for Windows there were a number of choices to make. Apart from programming languages for Windows 3.x such as Turbo Pascal for Windows and Visual Basic there were also Asymetrix ToolBook 1.5, Spinnaker Plus 2.5, IconAuthor 4.0, Guide 3.0, and Authorware Professional 1.0. Clearly academic productivity could be enhanced by these tools as quite complex graphics based applications linking text, sound and video were able to be created much more easily than was previously possible using DOS based authoring tools. In reviewing the above application software a decision was made to use Asymetrix ToolBook with the following considerations in mind:

  1. The author's level of programming expertise.

  2. What software development tools existed in the Windows environment which provided multimedia support?

  3. Was there any one application development tool which seemed to have a critical mass of developers so that support and resources (routines, etc.) could be obtained if necessary?

  4. How expensive were these tools - were there Academic editions?

  5. Was I going to develop just for the Windows environment or perhaps multiple platforms (eg., Macintosh, OS/2, Unix)?

  6. Was there potentially a commercial market for the courseware I was writing?

  7. Could the courseware be easily modified to work with different types of video overlay boards?
As the author was already familiar with authoring languages, Turbo Pascal for Windows and Visual Basic were quickly excluded. This left five other development tools with Asymetrix ToolBook and Authorware Professional quickly emerging as front runners because of the apparently large installed base and their support for multimedia. A detailed review of these application development tools is provided by Christie (1991) with an overview of ToolBook and Authorware Professional following:

Asymetrix ToolBook 1.5

A runtime license of version 1.0 of this software was packaged with Windows 3.0 for the first nine months and with the tremendous popularity of Windows there was, potentially, a large pool of users which had used, or was aware of, ToolBook. However, treacle ran faster than ToolBook 1.0 but its execution speed was improved greatly with version 1.5 and included support for 256 colours, larger scripts, improved Dynamic Data Exchange (DDE) support, enhanced printing capabilities and network awareness for file protection. OpenScript is the native scripting language of ToolBook and is functionally similar to HyperTalk for HyperCard (HC) so having some familiarity with HC meant little difficulty in using ToolBook. So similar are they that Heizer Software released a utility called ConvertIt! which converts HyperCard (HC) stacks to ToolBook books; something which is particularly useful when one considers the large number of public domain HC stacks available. Multimedia ToolBook 1.0 is also available which provides a set of extensions, through a DLL, to OpenScript, the native scripting language of ToolBook. Together with Microsoft's Multimedia Extensions for Windows and the Media Control Interface (MCI) of Windows 3.1 a powerful front end for multimedia hardware can be developed.

Authorware Professional 1.0

This authoring language had its origins in PLATO which was principally a text based authoring program on mainframe computers. It has developed through Course of Action to its current iteration called Authorware Professional. It has three main attributes; With both packages having similar capabilities albeit using different approaches to development (ToolBook - "English like" programming language; Authorware Professional - icon based, flow chart design), the final decision to use Asymetrix ToolBook came down to price and distribution policy. ToolBook (Academic Edition - AE) costs $325 with a 10 pack (AE) costing $2,395. A Multimedia ToolBook 10 pack costs $3,600. For both versions the runtime software can be distributed freely. With Authorware Professional the educational pricing is $1,985 for a single license with a 10 pack AE costing $12,500. A commercial license of Authorware Professional is $9,900 plus a royalty between 2 and 7% depending on volume of sales.

In addition to the updating of the Orthopaedic courseware to run under Windows 3.x using Asymetrix ToolBook 1.5 a new video overlay board called SuperVideoWindows from NewMediaGraphics is being trialed as it is a much cheaper option than the Videologic DVA-4000 board. More recent software for the SuperVideoWindows board uses MCI drivers, however, the author has yet to receive these so control of the videodisc player and configuration of the video overlay window relies on Dynamic Link Library (DLL) calls from within ToolBook. With ToolBook being an "object oriented like" programming language it is envisaged that modification of the scripts to use the courseware with the Videologic DVA-4000 board should not be difficult.


The analogue technology of the videotape and videodisc is inherently self limiting in that each workstation requires a videotape or videodisc player and an add on video overlay board to mix the video and computer signals. Future development plans in the next 12 to 18 months include digitising the video clips and still images that are on the videodisc and producing a CD-ROM using an in house CD-ROM mastering device (eg., JVC RomMaker, Philip CDD 521 or similar device). This will allow delivery across networks and enable all student PC computer pools to be potential delivery sites of the courseware. Students will also be able to borrow the CD-ROM as they might a VHS videotape and play the CD at home on their own personal computer.


Christie, A. D. (1988). Evaluation of an educational innovation - interactive videodisc in the health sciences. Proceedings of the 6th Annual Computer Assisted Learning in Tertiary Education Conference, Dec. 4th - 7th, Canberra, 47-63.

Christie, A. D. (1989). Interactive videodisc in physiotherapy education: a study of the role of interactive videodisc in the teaching of orthopaedics in physiotherapy. Unpublished Masters thesis, University of South Australia, Adelaide.

Christie, A. D. (1991). Multiplatform authoring systems. Proceedings of the 9th Annual Computer Assisted Learning in Tertiary Education Conference, Dec. 8th - 13th, Launceston, 111-116.

Christie, A. D. (1992). Computer based interactive videotape in physiotherapy education. Paper presented at the National Australian Physiotherapy Association Conference, Adelaide, July 8th.

Author: Allan Christie is presently employed as a senior lecturer in the School of Physiotherapy teaching in the areas of orthopaedics and sports physiotherapy in the undergraduate and postgraduate courses. He is the chair of the Advanced Learning Technologies Subcommittee and a member of the Australia Health Informatics Association and the Australian Society for Computers in Learning in Tertiary Education. His current research interests include computer and optical technologies and their possible roles in both administration and education, user interface design issues in advanced learning technologies and evaluation models of educational innovations. His address is University of South Australia, GPO Box 2471, ADELAIDE SA 5001 or AARNet:

Please cite as: Christie, A. (1992). The use of advanced learning technologies in health sciences education. In J. G. Hedberg and J. Steele (eds), Educational Technology for the Clever Country: Selected papers from EdTech'92, 49-52. Canberra: AJET Publications.

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