A Proposal for the Development of an Indigenous Health and Family Planning Training System for Village Health Workers in India

Item

Title
A Proposal for the Development of an
Indigenous Health and Family Planning Training System
for Village Health Workers
in India
extracted text
i

I

CHRISTIAN MEDICAL COLLEGE
VELLORE, INDIA
■f-

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A Proposal for the Development of an

Indigenous Health and Family Planning Training System
for Village Health Workers

in India

i
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May 1979

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PURPOSE
The purpose of this protocol is to:

1- State the problem, objectives, procedure, design and evaluation analysis
methods for developing a village-level Health Education Training System in
India.
2- Describe the process whereby pilot projects in programmed learning already
underway will activate broad scale programs for training community-based
health workers in India.

This project will utilize U.S. Agency for International Development, Inter­
national Committee for Applied Research in Population, and Church World Ser­
vice supported studies which prepared and tested pilot materials and identified
factors affecting learning among community health workers using programmed
learning materials in six (6) Asian training programs. Through village level
applications, and careful analyses of their effectiveness, these simplified
indigenously-prepared materials will be continuously improved in contemplation
of large scale reproduction (hundreds of thousands) and utilization by para­
professionals and sub-professionals at the village level. The effectiveness
criterion for this health education project is demonstrated know-how of
trainees in their local environment.

SYSTEM

s a i E N C E S.

I N C.
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INTRODUCTION

Continuing education in health programs requires the periodic upgrading

of skills.

The need is even more apparent among widely-dispersed health

workers.

This project seeks to build on the response of health workers in

South Asia and specifically in India to the use of self-instructional mater­

ials among rural health workers in need of in-service training which has been
conducted by Dr. Charles Ausherman in pilot projects in India, the Philippines,

Taiwan, Bangladesh and in Calcutta-Bombay-New Delhi, India, and Sri Lanka.
.________ 4
.V________________________________ _
Particular
emphasis
was given in those studies to those who for various

reasons, such as expense and inconvenience of travel to training centers can­

not return to formal classroom settings to receive additional educational
training.

It is suggested that this problem relates to a wide variety of

related workers, nationwide, who seek to upgrade their skills as new knowledge
in their respective field expands exponentially.

A specific concern of these

studies was the relationship of learner attitudes on curriculum content and

w format to learning achievement.

The focus of this research increasingly

became centered on the application of indigenous self-instructional training

systems for village level health workers.
RELATED RESEARCH

To meet in-service training needs, self-instructional approaches have

been utilized in a wide variety of settings.

It has been asserted that self­

instruction is just as effective as traditional teaching.

Self-instructional

teaching in certain situations has been shown to be both effective and effici­
ent by several users and researchers.

Xerox Basic Systems, Inc. estimates

that programmed instruction can reduce learning time by 30% to 50%.

The

University of Florida School of Medicine documents a 50% reduction in acqui­

sition time and no reduction in retention using self-instruction.*
*Stevens, C. B., Enzor, M., Phillips, T., Small, P. A., "An Evaluation of Self­
Instructional Package on Amino Acid Chemistry," Journal of Medical Education,
^8:276-279, 1973.

SYSTEM

S C I E N C E S.

I

N C.

Some researchers have measured the effectiveness of initial uses of self­

instruction in the population field.

Mullins and Perkin found that among

Nurses in Thailand engaged in programmed learning about contraceptive tech­
nology, scores for units on the Loop showed an average of 36% comprehension on

the pretest and 80% on the post-test while midwives scored 20% of the pre-test

and 70% on the post-test.

In a unit on oral pills, the nurses improved from

37% on the pre-test to 85% on the post-test and midwives from 17% on the pre­
test to 81% on the post-test.*

Until recently programmed instruction in the Philippines has primarily

been for remedial purposes and generally limited to undergraduate courses at
the college level.

There was skepticism among some educators concerning (1)

the adaptability of self-instructional materials to biomedical topics and (2)

the acceptability of self-instructional materials by professsional and para­
subprofessionals.

Some questioned the acceptability of self-instruction

in a group-oriented culture.

A nationwide study on the use of programmed

learning in the health sciences conducted in the Philippines by the Population

Center Foundation and the University of North Carolina revealed that programmed
learning can save up to 50% in learning time and costs with almost all subjects
preferring this method of training.
The purpose of this project is to apply the findings of research in six

A-sAan studies which tested the relative effectiveness and efficiency of self­

instruction in village^level worker training programs in Asia.

Three findings

have been identified as specifically beneficial for large-scale training pro­
grams for village-level health workers in India.

(1)

Indigenously produced self-instructional materials enable novices

in a particular content area to become masters of that specific con­

tent area in a variety of settings (for example, rural settings as
compared with those learners working in urban settings).

(2)

Self—instructional learning modules cut time and costs of training
programs by over 50% among rural health workers.

(3)

Village health workers consistently state a preference for indige­

nously produced self-instruction materials over previously used
training programs using lectures as the sole or dominant method of

training.
^Mullins, C. and Perkin, G.W., "The
The Use of Programmed Instruction in Family
Planning Training Programs: A Preliminary Report," Studies in Family Planning,
The Population Council, 1969).
SYSTEM
S C I E N C El S.
I n c.
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OTHER RESEARCH FINDINGS

1.

2.

Programmed lei

modules increased the level of information among

novices such f

i.hey can perform at a satisfactory level on a knowledge

recall test in

’.ven subject area.

There was no

sj

' Lficant difference in total achievement scores between

learners from rural and urban areas.

3.

There was no significant difference between learners with positive and
negative attidues on learning content.

4.

There was no significant difference between learners with positive and
negative attitudes on programmed learning format.

5.

There was no significant difference in total achievement scores between
groups, i.e. professionals and para-professionals in specific health
content areas.

RESEARCH DESIGN

The logistics of training large numbers of persons through training
sessions is a formidable problem anywhere, particularly for health worker

trainees.

Hence, knowing what can be expected for indigenously produced self-

instructional materials is of crucial importance.

It was necessary to con­

sider as separate those personnel who could be relatively easily reached by
training sessions and may perform differently than persons who could not be

reached readily by training sessions.
The study population was provided by actual training programs from
government and several private organizations in each country,

It was, of

course, recognized that this training was likely to provide samples that are

less than completely r

^sentative of all health workers working in Asia,

practice, however, th

lining was inclusive of all rural health workers who

could be reasonably ,

d by any form of training program.

of the test groups wc

•signed in a manner which assured equality on such

variables as educati­

.^graphic location of practice, prior training, and

number of years of c

Lice.*

*The selection critc
Ministry of Health
worker candidates

those eligible for training was established by the
etically our sample was representative of all health
ning in a typical training program.

S Y S

i

In

Subjects in each

Thus, the possible effects of these variables

-3SCI E N C E S.

!

N

c.

were controlled and verified through use of analysis of covariance procedures.
The total sample size in each country was 200.
The testing site for those groups receiving self-instruction in a train­
ing setting was under the auspices of local or regional organizations involved

with training of rural health workers.
It is to be noted that some of these organizations did not have their own

training facilities, and it was necessary to utilize a variety of different
training settings as expedients.

Only organizations which were approved as

training sites by the national government were contacted and requested to
participate in these studies.

SYSTEM

-4S C I E N C E S.

I N c.

*

DETAILED WORK PLAN ON IMPLEMENTATION OF HEALTH EDUCATION
AND LOCALIZED TRAINING SYSTEMS (HEALTS)

Instrument Construction
A needs assessment of the learners will be conducted and carefully
analyzed, in order to define clearly the specific needs of the home area(s) of

the class.

Objectives for each needs-responsive self-instructional package

will be drawn from the assessment.

Each package (module) will be designed by

professionals in collaboration with the educational programmers to assure and

to test learning gains and effectiveness of the materials in relationship to

the objectives of each self-instructional module.

The self-instructional

packages and- testing instruments will be pre-tested to check for validity.
Necessary changes will be made prior to reproduction of the modules.

(The

previously referenced pilot work has yielded extensive products/experience.
Sample instruments and sample modules are available from System Sciences, Inc.)

Test instruments will be constructed with the assistance of faculty who

are experienced trainers in the fields of sanitation, nutrition, communicable
diseases, and minor medical care, and other health education subjects.*

Following a judgemental approach to content validity, the faculty and the
investigator will measure specific outcomes of instruction as defined by

instructional objectives.

These objectives will be measured against criterion

tasks performed by operational staff in health programs.

will be conducted.

test.

An item analysis

Test instruments will be tested for reliability in a field

Pre-test and post-tests will be administered by designated staff trained

for this project.

Evaluation Data Analysis

The analysis can be more easily grasped with reference to Table 1 which
summarizes in a schematic way the kinds of data collection envisioned.

The

methodology for analysis of data will be analysis of variance, correlation
analysis, or where appropriate, non-parametric equivalents.

*The subject area content of the modules is described in the World Health
Organization’s Primary Health Worker Working Guide, WHO, 1977, Geneva,
Switzerland.

-5S Y S T E M

S C I E N C E S.

I N C.

Essentially, the evaluation design devolves itself into a test of effec­
tiveness of the modules with rural health workers having secondary school

education and of the modules with rural health workers having primary school
education.

It will also be possible to examine the effectiveness of self­

administered self-instruction as enrichment for existing training programs
among those for whom training sessions are feasible.
Evaluation Method

The minimum number of subjects to be used in this evaluation will consist
of approximately 200 trainees.

THE FOLLOWING EVALUATION GUIDE-OUTLINE AND INSTRUCTIONS WILL BE ADAPTED
TO EACH LOCAL PROJECT SITUATION.

THIS MATERIAL, PAGES 8-56, IS OFFERED AS AN

EXAMPLE OF ONE SPECIFIC NATIONAL EVALUATION AND MAY BE TOO EXTENSIVE FOR A
STATE-WIDE PROGRAM OR ANOTHER LOCALE.

A TYPICAL PROVINCE-WIDE PROGRAM WILL

UTILIZE CAREFULLY SELECTED VARIABLES WHICH ARE REPRESENTED IN THIS EVALUATION
GUIDE.

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SYSTEM

S C I e: n C E S.

I

N

C.

IJ
c

PREMISES CONCERNING THIS EVALUATION

It is anticipated that this evaluation will find that:

1.

Locale of practice makes no significant difference to knowledge ac­

quisition.

2.

Difference in attitudes will not be due to locale or educational

level.
3.

Scores will be related to interest, length, understanding, appli­

cability (of content) and characteristics of programmed learning.

TABLE I
Rural

Urban

50

50

S.I.

ESTIMATED
DISTRIBUTION
OF SUBJECTS

Primary

Total

Total

(01 X o2)

S.I.

50

50

Secondary

Total

Total

N= 100 (4 X 50 = 200)
Estimated distribution at
test sites
Test Sites:

A

= 100 (Location 1.)

B

c 100 (Location 2.)

Total N

= 200

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INSTRUCTIONS FOR TRAINERS

How to Administer the Module
STEP 1.

Before you distribute a module, read Card A.

STEP 2.

Distribute the envelopes with the modules and tell them to bring the
module
out but
- -------- not
-J to
open them until you give the signal.

STEP 3.

When everybody has the module in front of them, say n”0.K., you can
begin. When you have finished reading the module, submit them to me. H

STEP 4.

Record starting time.

STEP 5.

Record time upon submission.

Card A

Pre-Test

This is a programmed instruction module on J
(TITLE)
|
*
(Get one and show it to the trainees.) This module is self-instructional.
material. This material on
(TITLE)
has a review questionnaire. The
purpose of this questionnaire is to assess your learning needs. We wish to know
the level of your expertise. This will greatly help us in organizing a better
training program to upgrade your skills.
Further , your responses will give us an idea on how we can enhance
your
learning.
When you’re through answering the review questionnaire, go on to the next
page and continue reading. You must read every page of this material.
Follow what it tells you to do. Happy learning!

Card B

Post-Test

CONGRATULATIONS

You have just finished going through your modules.
Now we would like to evaluate the effectiveness of the modules, Again,
you will receive the same

set of review questionnaires. J'
May I remind you that
you are not the one being tested.. The modules are the ones being tested and
tried. We wish to know whether
---- these
--- e programmed instruction materials enhanced
your learning.

-8-

Ii
GENERAL INSTRUCTIONS FOR INTERVIEWING
Interviewing is the ’’pivotal point of the survey sequence.” It is the
phase when data for the study are gathered. The quality of data, validity and
reliability that is monitored during the field work phase will determine the
quality and validity of findings and the importance of the research undertaking.
It is for this reason that general instructions for interviewing based on the
three cardinal rules, i.e., asking questions exactly as they are worded, fol­
lowing the sequence of the questions, and asking every applicable question on
the schedule should be followed:

1.

Be sure to establish rapport as soon as you enter a dwelling unit. The
success of the interview and the reliability of the data depend to a large
extent on the quality of rapport established the moment you knock at the
door of your prospective respondent. Always try to affect a friendly
face.

2.

Be thoroughly familiar with the research instrument to avoid interviewing
errors and on-the-spot embarrassment. Familiarity with how the questions
are worded means ability to ask questions in a conversational manner.

3.

Try to preserve a balance between stiff, formal questioning and gabfest.
The earlier entails reading off questions and methodologically checking
answers, while the latter involves time waste due to long, irrelevant
responses.

4.

Ask stimulus questions exactly as they are worded. Be absolutely neutral
in asking them. Do not elaborate, neither do you suggest an answer or
give analogies or examples. It takes very little to encourage a respondent
to answer you the way he thinks will please you.

5.

Be on the look out for underscored words in the interview schedule,
need to be emphasized.

6.

Do not leave an applicable question unanswered. Proceed to the next only
when the respondent gives you an adequate answer.

7.

Guard against respondent talkativeness,
interview.

8.

Off-tangent responses may lengthen the time of interview. T**
Wherever possible.
keep R on the track without necessarily cutting him off abruptly.

9.

Do not accept a DK or NA answer unless 100 percent certain,
stems from a number of things:

They

This is not a measure of a good

The DK answer

a.

The respondent may not understand the question asked of him.

b.

The respondent, while thinking over the question, says DK to fill in
the silence.

c.

The respondent may be trying to evade the issue either because he
feels it as too personal, he fears a wrong answer, or he feels he is
uninformed.

-9-

IJ
d.

The respondent may not really know the subject asked. It is the
interviewer’s responsibility to make sure that such is the case.

If the respondent does not want to commit himself, the interviewer should
assure him that there are no right or wrong answers and that all answers
are confidential.

10.

Never give your opinion even when asked to.

11.

Try to never interview in the presence of an audience, This could affect
the privacy of the interview and lead to data contamination, It may be
necessary to resort to techniques such as diverting and side-tracking the
outsider, satisfying his curiosity, or getting your respondent to dismiss
him.

12.

Never interview when you feel very tired,
cause ’’leading temptations.’’

13.

Go over the protocol at the end of each interview to ensure that all
applicable questions had been asked.

-10-

Resultant impatience might

ii
FIELD EDITING
Pointers in interviewer editing:

1.

All questions must be accounted for, Each item must be answered even if
answers are of the NAP, NA, or DK sort.
NAP-not applicable. The question need not be asked.
NA—no answer, The question may have been asked but responses appear
irrelevant.
DK—don’t know.

Skip particular

2.

Check skip questions. Follow instructions carefully,
questions when asked to do so.

3.

For open-ended questions like questions on attitudes, opinions, judgment,
and the like, probe for responses that fall under generalizations.

4.

As much as possible, take time to go over your interview schedule at the
end of each interview session to check that all pertinent questions have
been asked and answered. A return call may prove difficult if not im­
possible, not to mention the bias which may set in.

5.

Edit each interview schedule immediately,
easier.

6.

Avoid erasures. If at all possible, just cross out faulty responses and
enter responses on the margin or somewhere in the page.

7.

Always aim for accurate, unbiased, valid responses,
cially on attitude questions.

In this way, recall will be

Avoid recalls espe-

Pointers in team leader editing:
1.

Check that all pertinent questions have answer, be they symbols or notes.

2.

Check skip questions.

3.

Watch out for irrelevant responses.

Callbacks may be needed.

4.

Look out for open-ended questions.

All such questions require probing.

5.

If there occurs a pattern of same responses or more than the expected
number of DKs and NAs, check on the interviewer’s personality. Unless
explained otherwise, the interviewer factor may prove harmful to the data.
A persistent DK or NA response could mean no probing was exerted by the
interviewer. The challenge is to get a reaction.

6.

Make comments in pencil on questions that need to be done again due to
incomplete answers, lack of sufficient probing, or inconsistency with
related questions. Do not erase.

They should be marked NAP.

-11-

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7.

Write all numbers that need to be done again on top of the first page of the
interview schedule so that the interviewer can locate them.

8.

Re-edit and cross out numbers one by one after answers are corrected.

9.

If answers are still unsatisfactory, repeat procedure without erasing.

10.

Make sure identification codes are written legibly and correctly on the
right hand corner of each page of the interview schedule.

11.

Initial last page of the interview schedule only after all corrections have
been made.

SPOTCHECKING

Pointers in team leader spotchecking:

1.

Randomly select a schedule accomplished by each interviewer.

2.

Choose five objective questions for each schedule.
(Keep them confidential.)

3.

Go back to the person interviewed and ask these five questions,
write down the answers so there will be basis for comparison.

4.

Compare the answers you got with the responses in the completed interview
schedule.

5.

If these answers are not the same, find out why!

-12-

Be sure to

Ii
A Study of Programmed Learning for Continuing Education

An Interview Guide

Background
This project is testing the feasibility of using self-instruction for
the training of rural level health educators.

As a means of upgrading

knowledge, attitudes, and skills, providing for uniformity of training and

reducing training costs.

It involves two phases, namely:

the development

and production of prototype self-instructional training units and the
evaluation of self-instructional modules on such subjects as:

family planning,

ecommunicable diseases and sanitation.

The Evaluation Study

This project of programmed learning for continuing education in village

health is the second phase of the pilot self-instruction project.

A.

B.

Objectives

1.

To explore the effect of programmed learning among groups in a
formal learning situation and among groups in a nonformal
learning situation.

2.

To explore the influence of demographic and attitudinal vari­
ables on the learning effect of the programmed learning modules.

3.

To explore the influence of the self-concept variable on the
learning ability of the rural health workers in the use of
programmed learning materials.

Operational Definitions

1.

Self-instruction, programmed instruction, programmed learning
(these t ms can be used interchangeably). This is instruc­
tional material which utilizes the techniques of programmed
instruction.

-13-

2.

Programmed instruction. This is an instructional method which
is learner-centered. This method programs the learning of the
learner. It consists of a series of learning steps referred to
as frames. A frame is a unit of a program that requires a
response of the learner. The learner interacts with the pro­
grammed instructional material. The material, in turn, conThis
tains a built-in feedback of the learner’s responses,
maximizes the probability of success in learning.

3.

In this study, this refers to the
Formal learning situation.
inservice training program of the Ministry of Health.

Nonformal learning situation. Tliis refers to the area of work
of the rural health worker trainees who are not in a training
program.

C.

5.

Primary school level trainees are those who have attended
primary school but have not graduated from secondary school.

6.

Trainers. These are training-officers who are most actively
involved in supervising the training of the trainees during the
training course.

7.

Trainees.

8.

Training personnel. The supervising health personnel who are
most involved in training the trainees.

9.

Secondary school rural health workers are those trainees who
have attended secondary schools (and have graduate from primary
schools).

10.

Training program. This refers to the training courses offered by
the Ministry of Health.

Rural health workers in this training program study.

Methodology

1.

Sample Size. Total N-200
- 100 Site 1.
- 100 Site 2.

2.

Procedure

Treatment

This project follows up the pilot study of the West Bengal State
Government which investigated the effectiveness of self-instructional
training materials in baby weighing, sanitation and communicable
diseases, for rural health workers at the village level.
Modules produced for this project by health and medical educators
will be administered by trainers according to specified guidelines
which are found in this document.
Interviews will be taken after
the subjects complete the last p^sttest by trained personnel accord­
ing to guidelines attached. The questionnaire includes demographic
and attitudinal data.

-14-

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Time Table
The demographic and attitudinal data collection should be:
Inclusive dates

Site

No. of types of respondents

1.
2.

- 100
100

The above schedule includes the training of interviewers.
Interview Schedule

Language

The schedule for the trainees should be translated into local dialects.

A.

The Trainee’s Interview Schedule

Block One

Interview Situation

Enter the necessary data. For the clinic code under question 5 the
respondents ’ codes of their home base clinics (place of work assign­
ment). All will have been assigned codes.
ps. 12 and 13 cover interview attempts made, This refer to the
effort to contact the respondent and to interview him/her. This does
not include appointment visits with the respondents.

Block Two - Demographic Data

This block identifies the respondent in terms of age, civil status,
religion, education, and similar other demographic characteristics.
Q. 21 deals with R’s propensity to attend religious services, Re­
ligious services here does not include attendance to baptism, cou­
firmation, wedding, and other such religious rites.
Q. 23b - Do not fail to ask this question just because R has already
obtained a degree as shown in his/her answers to Q.23a. An earlier
overall assessment of the respondents demographic characteristics
shows that some of them still go to school.

Block Three - Training

This block looks into the background training of the respondents.
The results can serve as a possible explanation for certain attitudes
they have aside from being able to check on the adequacy of their
training form implementing the program. Respondents’ attitude for
their training certainly affect their attitudes toward the methods
used during the training, one of which is the use of self—instructional
materials.
Q. 27 - Show Card One

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Block Five - World Outlook
This block is intended to tap the worldliness of the respondents by
asking their cosmopoliteness (exposure to the urban setting) and
their exposure to mass media. It seeks to determine any difference
between rural and urban learners particularly in the use of programmed
instruction.
Block Seven - Attitude Toward Subject

This block assesses the respondents’ interest, motivation, and en­
couragement levels. From this, we will be able to find whether or
not there is a significant difference between learners with positive
and negative attitudes on content and programmed learning format.
Qs. 37 and 38 - Show Card Two to R.
Block Eight - Attitude Toward Modules

This block asks a great deal about the modules used by the trainee
respondents during their training. ’ Their activities toward the
modules affect their total achievement scores.
Q. 42 a - Show Card Three.
Q. 42 c - Read Categories
Block Nine - Application of New Knowledge

Q. 43 a - Show Card Three

Block Ten - Interview Evaluation
This block contains your reactions to the interview situation and
your impressions of your respondent.
B.

The Trainer’s Interview Schedule

Block 1 ~ Interview Situation
Follow instructions under Block 1 of Trainees’ schedule.
Block 2 - Demographic Data
Follow instruction under Block 2 of Trainees’ schedule.
Block 3 - Training

Follow instructions under Block 3 of Trainees’ schedule.
Block 5 - Attitude Toward Programmed Instruction
Q. 30 - Ask to accomplish pages 10 - 11.
“16-

Give card two to R.

Ii
Block 6 - Attitude Toward Modules
Q. 31 - Note instructions in the interview schedule.
Q. 31 f - Ask R to accomplish page 14.
after he/she has answered all items.

Get back the questionnaire

Q. 32 - Show the modules one by one. Let R refer to the pages and/or
frame which he/she thinks contain irrelevant material.

Q. 34 c and d - Show Card Three.
Q. 36 - Show Card Four.

Block 7 - Training Center Evaluation
Q. 37 - Ask R to accomplish the checklist.

Block 8 - Interview Schedule
Follow instructions under Block 10 of Trainers’ schedule.

-17-

Answer Cards

CARD ONE

1.

Very insufficient

2.

Insufficient

3.

Sufficient

4.

Very sufficient

CARD TWO
1.

Strongly disagree

2.

Disagree

3.

Agree

4.

Strongly agree

CARD THREE
1.

Not at all useful

2.

Not useful

3.

Useful

4.

Very useful

CARD FOUR
1.

Not at all satisfied

2.

Somewhat satisfied

3.

Satisfied

4.

Very much satisfied

-18-

WORK PLAN AND TIMETABLE

I

Stage One
(Six Months)
HEALTH EDUCATION AND LOCALIZED TRAINING SYSTEMS

Programmed Learning Training Project
Activities
(See separate Agenda)

Time

Key Manpower Direction

1.

Pre-Workshop Planning Initial Activity

3 months

Full Staff

2.

Workshop

3 days

Full Staff

3.

Revision

11 days

Project Associate
Consultants

a) revising and reviewing of pre-tested
SI materials
b) pre-testing revised SI materials
d) final revision
d) final editing
e) typing final copies

Project Assistant
Project Associate
Editor
Clerk-Typist

i

f—*

KO

I

4.

5.

Printing

21 days

a) typesetting, proof reading, typing
b) -paste-up, insert proof corrections
c) camera work, blue print, printing,
binding

(not needed if
mimeographed)

Editor
Typesetter
Typist
Artist

Distribution and utilization

a) deliver to treatment groups
b) use of PI modules

6.

Evaluation and revision

a) QN construction (including pre-testing
revision)
b) contract evaluation
b.l. training interviewers
b.2. data gathering
b.3. data processing

c) data analysis and writing of quarterly reports

Project Associate
Project Assistant

Programmer
Coders
Clerk-typist Secretary

Stage Two
(First Six Months After Workshop)
HEALTH EDUCATION AND LOCALIZED TRAINING SYSTEMS

Work Plan for Programmed Instruction Training Project

d)
e)

f)

s)
h)
i)

J)

i
O
I

k)

1)

m)
n)

7.

Revise Module &
Revise Questionnaire
Site Orientation­
listing - Sampling
Pretest 4 Modules &
Questionnaires
Revise Module &
Questionnaire
Printing Module &
Questionnaire
Training Supervisor

1st month

2nd month

3rd month 4th month

xxxx

xxxx

xxxx

Recruit & Train
Interviewers
Administration of
the 4 Modules
Interviewing &
Data Gathering
Data Processing )
) edit:
)
Data Analysis
) coding:

Preparation of Final Draft
Annual Report
a) Planning for a
2-3 Year Larger Project
b) One-Day Conference to
Disseminate Results of
Pilot Project

xxxx

xxxx

5th month

6th month

xxxx

xxxx

xxxx

xxxx

xxxx

xxxx

xxxx
xxxx

xxxx
xxxx

xxx
XX
XX

xxx
X

XX

x
XX

X

xx

X
X

x

x

Repeat first stage for new content areas.
NOTE:

Each nx” indicates one calendar week.

I i

Suggested
LIST OF TABLES FOR EVALUATION REPORT
Table

1.

Respondents According to Organization

2.

Subjects According to Locale of Work and Type of Professions.

3.

Geographic Distribution of Subjects According to Region and
Training Center ....................... ••

4.

Subjects According to Training Area, Professional Type, Place of
Work (Rural or Urban)

5.

Age at Last Birthday of Trainees

6.

Length of Service of Trainees

7.

Distribution of Ethnolinguistic Groups

8.

Frequencies of Learning Gain on Module #1

9.

Frequencies of Learning Gain on Module #2

10.

Frequencies of Learning Gain on Module #3
Module #4
...........

11.

Pretest and Post test Mean Scores for Ed. level A and Ed. level B. on
Module #1
.............................

12.

Pretest and Post test Mean Scores for Ed. Level A and Ed. Level B. on
Module #2

13.

Pretest and Post test Mean Scores for Ed. Level A and Ed. Level B. on
Module #3

14.

Frequencies of Total Learning Gain:

15.

Pre- and Post-test Mean Scores for Ed. Level A and Ed. Level B. on
Modules #1, 2, 3, 4

16.

Scattergram of Total Learning Gain (down) and Total Time to Complete
Modules in Minutes (across) .
...................

17.

Analysis of Variance of Module Scores by Total Learning Gain

18.

Analysis of Variance of Total Learning Gain by Location of Work

19.

Analysis of Variance of Total Self-Concept Scores by Location of
Work
•••••• ...................

-21-

Total of all Modules

20.

Scattergram of Total Learning Gain on Module (down) by Total Reaction
Score to Module Content (across) .

21.

Analysis of Variance of Module Scores by Total Learning Gain on

22.

Analysis of Variance of Agreement with Contents of Module by Total
Learning Gain on Module
................... . . . .

23.

Scattergram of Module Learning Gain (down) by Total Reaction Score to
Modules Content (across)
. .............

24.

Scattergram of Module Learning Gain (down) by Total Reaction to Module
Content (across)

25.

Analysis of Variance of Reaction to Modules, Length by Learning Gain . .

26.

Analysis of Variance of Reaction to Modules, Readibility of Learning
Gain
...................

27.

Analysis of Variance of Reaction to Modules, Clarity of Learning
Gain....................................’

,

28.

Analysis of Variance of Reaction to Modules, Length by Learning Gain . .

29.

Analysis of Variance of Reaction to Modules, Readibility by Learning
Gain
.................. .

30.

Analysis of Variance of Reaction to Modules, Clarity by Learning Gain. .

31.

Analysis of Variance of Reaction to Module, Interest by Learning Gain. .

32.

Analysis of Variance of Reaction to Module, Length by Learning Gain. .

33.

Analysis of Variance of Reaction to Module, Readibility by Learning
Gain

34.

Analysis of Variance of Reaction to Module, Clarity, by Learning Gain. . .

35.

Analysis of Variance of Attitudes Regarding Future Usefulness of Learning
Modules by Total Learning Gain on All Modules

36.

Analysis of Variance of How Useful the Module Would be to the Respondent
in the Future by Total Learning Gain on All Modules

37.

Analysis of Variance of Total Learning Gain by Classification of
Respondent
d,...........................

38.

Analysis of Variance of Total Learning Gain on All Modules by All
Groups
.

39.

Scattergram of Total Learning Gain on All Modules (down) by Total
Combined Scores on All Self-Concept Measures (across)

-22-

Table I.
Years of Education /

I
to

w

/

Rural

/

Urban

Distribution of subjects ( 0^ X 02 )

I

n

Table 2.
Distribution at Test Sites
Test Site

1.
2.
3.
4.
1.

2.
i
to
I

3.
4.

Years of Education A. / Years of Education B. /

Total

Table 3.

Test Site

Locational 1
Urban/Rural

2

3

5

Location 2.
Urban/Rural

Tears of Ed. A.
Years of Ed. B.

Distribution of Subjects According to Years of Education
i
Ui

I

and Locale of Work.

1

2

3

4

Table 4.
Age

Percent

Number of Respondents

100%

200

20-24

25-29
30-34
35-39

40-44

45-50

i
I

Total

Subjects According to Age

4

Table 5.
Group

Indonesian
Balinese

Makassar

i
to
I

Subjects According to Ethnolinguistic Groups

Ethnolinguistic Group

Table 6.
Frequencies of Learning Gain

Test item improvement

i
NJ
OO

I

(1 table for each Module)

Frequenct

Percent

Table 7.
Years of Ed A.

66

Pre test (score X)

Post test

(X Score)

Number of Correct test items
i
VO

I

Pre and Post Test Mean Scores in each Module.

Years of Ed. B.

Table 8.
Test items improvement

i
O
I

Frequency

Percent

IJ

(HEALTS)
The Development of Indigenous Health Training
Systems for Village Workers
Interview Schedule for Trainee Respondents

R#___
Page 1

BLOCK 1
INTERVIEW
SITUATION

1* .Respondent type:

2.

1 Primary School graduate
2 Secondary
3 Other

Respondent/s name:

Family Name

Given

3» - B/ s address (residential):

Town

Town/City

Province

4.

Institutional affiliation:

1 Ministry of Health
2 Other
3 Government hospital/clinic
4 Private hospital/clinic
5 (Specify)
_____

5. .Clin i c /o ffj c e address:
Town

Town/City

Province

Region

Clinic code;

6. R* s posi tion/designation
7.

Length of service in present position:

PLEASE NOTE THIS QUESTIONNAIRE IS NOT TO BE USED IN ITS ENTIRETY
BUT IS TO GUIDE THE PROJECT DIRECTOR CONCERNING TYPES OF DATA
WHICH MAY BE USEFUL IN THE EVALUATION.

-31-

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Interview Schedule for Trainee Respondents

8.

Interviewer:

9.

pate of jnterv1ew:

10.

Place of interview:

11.

Lanp;uage(s) of interview:

12.

Number of interview attempts made:

13.

Reason for each attempt:

BLOCK 2
DEMOGRAPHIC DATA

U.

Date of birth:

When were you born?
DERIVE:

15.

Age in years

Place of birth:
Where were you born?

Town
16.

FILL IN ALL THAT APPLY.

District

City

Civil status:

What is your civil status?
1.
2.

3.
4.

single
married
widowed
separated

-32-

CROSS OUT NAP CATEGORIES

Province

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Interview Schedule for Trainee Respondents

17.

N umber of chiId re n:

a.

(If single) when you have a family of your own, how many children
would you want?
Girl(s)
Boy(s)
Total

FOR MARRIED R’s ONLY
b.

When you married, how many children did you wish to have?
Boy (s)
Gi rl (s)
To tai

c.

How many pregnancies did you/your wife have?

(PROBE FOR LIVE BIRTHS & STILLBIRTHS)
d.

18.

How many living children do you have?

at marriage;
FOR MARRIED R’s ONLY

a.

How old were you when you got married?

FOR RESPONDENTS WHO WERE MARRIED MORE THAN ONCE, ASK:
Age at first marriage
Age at second marriage
Other (specify)

FOR SINGLE R’s ONLY:
b.

19.

If you decide to get married, at what age would you like to get mar­
ried?

Length of marriage: FOR MARRIED R’s only.
RIAGE(S), ASK LENGTH OF EACH MARRIAGE.

IF R HAS HAD PREVIOUS MAR-

How long have you been married?
1st/

20.

Religion:

-33-

2nd/

3rd

I1EALTS

Y(0____
Page 4

Interview Schedule for Trainee Respondents

What is your religious affiliation?
1.
2.
3.
4.
5.

DO NOT READ CATEGORIES.

Hindu
Muslim
Buddist
Jain
Other (specify)

21. J^ropensity .to attend religious services:
Bow often do you attend religious services?
1.

2.
3.
4.
5.
6.
7.
8.
9.
22.

Never
Once a year
Once a month
Twice a month
Three times a mo’nth
Four times a month
Five or more times ;a month but less than daily
Daily
Other (specify) __

JEthnolinguistic grouping:
What language do you speak most of the time?
1.
2.
3.
4.
5.

23.

Hindu
Tamil
Bengal
English
Other (specify)

Educational attainment?
a.

What is your highest educational attainment?
experiences in addition to formal schooling.

-34- •

List all other training

I i

HEALTS

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Interview Schedule for Trainee Respondents

1.
2.

3.
4.
5.
6.
7.
8.
b.

Other (Specify)

Are you studying at present?

1. Yes
2. .No
c.

IF YES, ASK:

What are you taking up now?

d.

IF NO, ASK:

How long ago did you complete your last degree?

e.

Where and when did you obtain your highest education?

School/College/University

Municipality/City

Year Graduated
Block 3
TRAINING

24.

QB-GYN Training:
Please enumerate all in-service or other specialized training in OB-GYN.
PROBE FOR PLACE, DATE, AND TYPE OF TRAINING. ENTER IN TABULATED FORM.

-35-

i1
HEALTS

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Interview Schedule for Trainee Respondents

R1a c e/Institution

25.

Dates Inc1usive

Type of Training

Sponsoring Agency

Family planning training:

Where and when did you participate in a family planning training course?
What type of training did you receive?
ENTER RESPONSES IN TABLE BELOW:
Place/Institution

Dates Inclusive

Type of Training

a.
b.
c.

d.

e.
f.
g.

26.

Scope of FP training:
Were you formally trained for:
ENCIRCLE CATEGORIES WHICH BEAR AFFIRMATIVE RESPONSE.

-36-

Sponsoring Agency

ii
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Interview Schedule for Trainee Respondents

27.

perceived training sufficiency:
EXPLAIN TO THE RESPONDENT THAT ALL RESPONSES WILL BE TREATED IN THE
STRICTEST CONFIDENCE.

What do you think about the training methods or approaches used in
MENTION EACH TYPE OF TRAINING ENUMERATED IN 025, THEN ASK WHETHER EACH
ITEM IS VERY INSUFFICIENT, INSUFFICIENT, SUFFICIENT, OR VERY SUFFICIENT
AND WRITE CORRESPONDING CODE UNDER COLUMN TWO. SHOW CARD ONE.

Were they....

1.
2.

3.
4.

Very insufficient
Insufficient
Sufficient
Very sufficient

If insufficient, ask:
Why?

Write reasons under column three.

Col. 1
Formal training
(cf. Q. 25)

Col. 2
Perceived sufficiency

Col. 3
Reason for insufficiency

a.

b.
c.
d.

e.
f.
g.

28.

Motivation to attend last training;
a.

How willing were you when you took the course?

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HEAI/l’S

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Page 8

Interview Schedule for Trainee Respondents

1.
2.

3.
4.
b.

Not at all willing
Not willing
•Willing
Very willing

Please explain your answer.

BLOCK *4
SELF-ESTEEM •

29.

Ask respondent to accomplish Block

-38-

ii
HEALTS

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Interview Schedule for Trainee Respondents

Below is a list of statements with which you may agree or disagree, Please
indicate on the blank beside the statement your opinion by writing down the
appropriate code of the categories shown in CARD TWO.
1. I feel that I’m a person of worth, at least on an equal plane with
others.
2. I feel that I have a number of good qualities.

3. All in all, I am inclined to feel that I am a failure.
4. I am able to do things as well as most other people.

5. I feel I do not have much to be proud of.
6. I take a positive attitude toward myself.
7. On the whole, I am satisfied with myself.

8. I wish I could have more respect for myself.
9. I certainly feel useless at times.
,10. At times, I think I am no good at all.

11. I can be comfortable with all varieties of people — from the highest
to the lowest.
,12. When I’m in a group, I usually don’t say much for fear of saying the
wrong thing.
.13• I don’t approve of spending time and energy in doing things for other
people.

14. Because of other people, I haven’t been able to achieve as much as I
should have.

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Interview Schedule for Trainee Respondents

,15. I don’t approve of doing favors for people,
they’ll take advantage of you.

If you1re too agreeable,

16. I enjoy doing little favors for people even if I don’t know them
well.
17* I usually ignore the feelings of others when I’m accomplishing some
important end.
18. I’m very sensitive. People say things and I have a tendency to think •'
they’re criticizing me or insulting me in some way and later when I
think of it, they may not have meant anything like that at all.
19. I try to get people to do what I want them to do, in one way or
another.

20. I have a tendency to sidestep my problems.
21. I enjoy myself most when I’m alone, away from other people.
22. I don’t feel very normal, but I want to feel normal.
23. I feel neither above nor below the people I meet.

2^. I do not worry or condemn myself if other people pass judgment
against me.

25* When someone asks for advice about some personal problem, _I’m most
likely to say, ”It’s up to you to decide,” rather than tell him what
he should do.
26. I feel confident that I can do something about the problems that may
arise in the future.

-40-

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Interview Schedule for Trainee Respondents

27. I believe that people should get credit for their accomplishments,
but I very seldom come across work that deserves praise.

28. I’m not afraid of meeting new people. I feel that I’m a worthwhile
person and there’s no reason why they should dislike me.
29. There are very few times when I compliment people for their talents
or jobs they’ve done.

30. I look on most of the feelings and impulses I have toward people as
being quite natural and acceptable.
31. I would rather decide things when they come up than always try to
plan ahead.

32. I never have any trouble making up my mind about important decisions.
33. I have always felt that I have more will power than most people have.
34. I seem to be the kind of person that has more bad luck than good
luck.

35. There’s not much use for me to plan ahead because there’s usually
something that makes me change my plans.
36. I nearly always feel pretty sure of myself even when people disagree
with me.

-41-

u
JIEALTS

R#____
Page 12

Interview Schedule for Trainee Respondents

30.

QccupatIona1 sati s fa c t ion:
How satisfied are you with your Job as a FP worker?
Would you say you are not satisfied, satisfied, or very satisfied?
1.
2.

3.

Not satisfied
Satisfied
Very satisfied

BLOCK 5
WORLD
OUTLOOK

31.

Cosmopoliteness:
a. Is your home in an urban or rural setting?
1.
2.
b.

Is your work in an urban or rural setting?
1.
2.

c.

Rural area
Urban area

Rural area
Urban area

IF R LIVES AND WORKS IN AN URBAN AREA, ASK:

Do you go out to the villages to extend your services?

1.
2.

Yes
No

If no, ask:

d.

Why not?

IF R LIVES AND WORKS IN A RURAL AREA, ASK:
Do you move around to extend your services?
EXTENT OF AREA)

How often do you go to the city?

-42-

Where?

(PROBE FOR

ii
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Interview Schedule for Trainee Respondents

1.
2.

3.
4.
5.
6.
7.
8.
9.
32.

Less than once a year
Once a year
More than once a year but less than once a month
Once a month
Twice a month
Three times a month
Four times a month
Five or more times a month but less than daily
Daily

Mass media exposure:

a.

How often do you read a:
1) Newspaper? DO NOT READ CATEGORIES.

3.
4.
5.
6.
7.
8.
9.

Less than once a year
Once a year
More than once a year but less than once a month
Once a month
Twice a month
Three times a month
Four times a month
Five or more times a month but less than daily
Daily

2)

Magazine?

1.

Less than once a year
Once a year
More than once a year but less than once a month
Once a month
Twice a month
Three times a month
Four times a month
Five or more times a month but less than daily
Daily

1.
2.

2.
3.
4.
5.
6.
7.
8.
9.
b.

DO NOT READ CATEGORIES.

How often do you obtain news or information from the:
1) Radio? DO NOT READ CATEGORIES.
!•
2.

3.

Less than once a year
Once a year
More than once a year but less than once a month

-43-

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HEALTS

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Interview Schedule for Trainee Respondents

4.
5.
6.
7.
8.
9.

Once a month
Twice a jnonth
Three times a month
Four times a month
Five or more times a month but less than daily
Daily

2)

Television?

1.
2.

Less than once a year
Once a year
More than once a year but less than once a month
Once a month
Twice a month
Three times a month
Four times a month
Five or more times a month but less than daily
Daily

3.
4.
5.
6.
7.
8.
9.

DO NOT READ CATEGORIES.

BLOCK 6
ATTITUDE
TOWARD
FP

33.

.Utilization of FP methods:
a.

Are you/Is your spouse using any contraceptive method?
PROBE FOR CONTRACEPTIVE METHOD(S) PRESENTLY USED.

1.
2.
b.

What is it?

Yes
No

Why do yo prefer (mention contraceptive method used)
ods?

to other meth-

11
HEALTS

R#____
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Interview Schedule for Trainee Respondents

3^.

Attitude toward FP strategies:
FOR NURSES AND MIDWIVES ONLY
ASK RESPONDENT TO ACCOMPLISH PAGE 15

‘-45-

GIVE CARD TWO.

Ii
HEALTS

R#_____
Page 16

Interview Schedule for Trainee Respondents

Below is a list of statements with which you may agree or disagree, Please
indicate whether you strongly disagree, disagree, agree, or strongly agree in
each of these statements by writing down appropriate code of the categories
shown in CARD TWO.
1*

Nurses should be trained to prescribe pills to new acceptors.

2.

Nurses should be trained to insert IUDs.

o

Nurses should be trained to remove IUDs,

4.

Midwives should be trained to prescribe pills to new acceptors.

5.

Midwives should be trained to insert IUDs.

6.

Midwives should be trained to remove-IUDs,

.7-

Non Allopathic workers should be trained to prescribe pills to new
acceptors.

8.

Non Allopathic workers should be trained to insert IUDs.

9.

Non Allopathic workers should be trained to remove IUDs.

-46-

Ii
HEALTS

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Interview Schedule for Trainee Respondents

35.

Attitude toward role in FP:
a.

Do you think that extending FP services is a load on your regular
work?
1.
2.

b.

Yes
No

Please explain your answer.

BLOCK 7
ATTITUDE
TOWARD
SUBJECT

36.

Interest/motiyation/en.loyiDent level:

ASK RESPONDENT TO ACCOMPLISH PAGE 17,

-47*-

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HEALTS

Interview Schedule for Trainee Respondents

Please indicate how you reacted to the module as a whole in terms of your gen­
eral interest and agreement toward the content of the module by encircling the
number that closely corresponds to your opinion.

1.

2.

3.

What can you say about the content of the module?
a.

Not substantial

1

2

3

4

5

6

Substantial

b.

Agree with content

1

2

3

4

5

6

Do not agree w/content

c.

Not interesting

1

2

3

4

5

6

Interesting

d.

Not long

1

2

3

4

5

6

Long

e.

Easy to read

1

2

3

4

5

6

Hard to read

f.

Confusing

1

2

3

4

5

6

Not confusing

What can you say about the content of the modules?
a.

Not substantial

1

2

3

4

5

6

Substantial

b.

Agree with content

1

2

3

4

5

6

Do not agree w/content

c.

Not interesting

1

2

3

4

5

6

Interesting

d.

Not long

1

2

3

4

5

6

Long

e.

Easy to read

1

2

3

4

5

6

Hard to read

f.

Confusing

1

2

3

4

5

6

Not confusing

What more do you want to learn about family planning?
1.
2.

3.
4.
37.

Conception process
Contraceptive method
Both of the above
Other (specify)

Attitude toward the pill:

a.

Do you feel oral contraceptives are dangerous to most women’s health?
SHOW CARD TWO.

-48-

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Interview Schedule for Trainee Respondents

1.
2.

3.
4.
b.

38.

Please explain your answer.

Do you feel IUD is a potential risk to most women’s health?
SHOW CARD TWO.

1.
2.

3.
4.

39.

Strongly disagree
Disagree
Agree
Strongly agree

Strongly disagree
Disagree
Agree
Strongly agree

Among the different FP methods, enumerate three which you most likely
encourage/recommend your acceptor to adopt, Please rank them accordingly.

1st 2nd -

3rd BLOCK 8
ATTITUDE TOWARDS
MODULES

40.

What impressed you most when you were reading a module?
1.

2.
3.

Illustrations
Series of learning steps
Knowing how you fared immediately after answering the questions.

-49-

IJ
R#____

HEATLS

Page 20
Interview Schedule for Trainee Respondents

41.

Readability and clarity of modules:

a.

How many times did you have to read the module before you could
understand it?
1.
2.

34.
b.

How many times did you have to read the module on
could understand it?

1.
2.

3.
4.
c.

3.
4.

before you

Once
Twice
Three times
More than three times

Hoy; many times did you have to read the module on
could understand it?

1.
2.

42.

Once
Twice
Three times
More than three times

before you

Once
Twice
Three times
More than three times

Initial usefulness:
a.

Did you find the modules useful during your field-training/practicum?
SHOW CARD THREE.
1.
2.

34.
b.

Not at all useful
Somewhat useful
Useful
Very useful

What particular problems did you encounter during your fieldtraining/practicum which made you refer to your modules?

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Interview Schedule for Trainee Respondents

c.

Do you want to keep the modules with you?

Do you

READ CATEGORIES AND ENCIRCLE THAT WHICH APPLIES.
Want to have one copy of each module?
Want to have two copies of each module?
Want to have several copies of each module?
Not read it?
Not have intentions of keeping it?

1.
2.

3.
4.
5.
d.

Why?

e.

Have you ever seen any other self-instructional module before you
attended the training course in comprehensive family planning
services/physician’s course?
1. Yes
2. No

If Yes, ask where?
f.

Would you recommend the three modules to your co-workers?
!•

2.

Yes
No

g.

Why?

h.

In a training program, what do you think would be best for you?
1.
2.

3.
4.
5.
6.
i.

the lecture method alone
the lecture method followed by group discussions
the module alone
the module followed by group discussions
the module followed by a lecture followed by group discussions
the module followed by a lecture followed by group discussions

Do you think that receiving self-instructional modules to learn new
information on contraceptive methods is sufficient to upgrade your
level of expertise?

LIBRARY
(

*
v

AND

A

oocumentatio

V

unit

)

' V

u
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HEALTS
Interview Schedule for Trainee Respondents

1.
2.
3.
4.

strongly.disagree
disagree
agree
strongly disagree

Please explain your answer?


J.

Do you think that family planning training seminars conflict with
your clinic services?

1.
2.

yes
no

Why?

k.

Would you recommend limiting the training seminars on family planning
provided the modules are sent to the clinics?
1.
2.

yes
no

Why?

BLOCK 9
APPLICATION
OF NEW KNOWLEDGE

43.

Field app1ication;

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Interview Schedule for Trainee Respondents

a,

Do you believe that what you have learned from your modules would be
useful in your future performance as a FP worker?
SHOW CARD THREE

1.
2.
3.
4.
b.

What you have learned from the modules was... READ CATEGORIES.

1.
2.
3.
4.
c.

What you had strongly been eager to learn.
What you somewhat wanted to know.
What you had not been quite interested in at all.
What you had no interest in at all.

Do you think the module on the pill will be useful to you when you
teach others about oral contraceptives? SHOW CARD THREE.

1.
2.
3.
4.
d.

Not at all useful
Somewhat useful
Useful
Very useful

Not at all useful
Somewhat useful
Useful
Very useful

Do you think the modules on the IUD will be useful to you when you
teach others about the IUD? SHOW CARD THREE.

1.
2.
3.
4.

Not at all useful
Somewhat useful
Useful
Very useful

BLOCK 10
INTERVIEW
EVALUATION

(To be accomplished by the interviewer after the interview.)

-5 3-

ii
R#____
Page 24

HEALTS

Interview Schedule for Trainee Respondents

*14.

Respondent*s attitude toward the interview:

1.
2.
3.
4.
5.
6.
7.
8.

45.

Interested
Indifferent
Hesitant
Frightened
Inquisitive
Suspicious
Antagonistic
Other (specify)

Establ.i shment of rapport:
1.
2.
3.
4.

Easily established
Established but with some difficulty
Established despite great difficulty ‘
Never established

46.

Respondent1s pre-interview activity:

47.

Other persons present during the interv.new:

48.

Interview conditions:

1.
2.
3.

49.

Very noisy and/or with many distractions
Some noise and/or distractions
Quiet and/or with a minimum of distraction

Respondents* health and energy level:

1.
2.
3.

Very healthy and energetic
Adequately healthy and energetic
Sickly and/or lethargic

-54-

Li
HEALTS

R#_____
Page 25

Interview Schedule for Trainee Respondents

50.

Respondents verbal skills:
1.
2.

3.
51.

Respondents comprehension of interview questions:
1.
2.
3.

52.

More than adequate
Adequate
Inadequate

Understood immediately
Some elaboration was necessary
Had great difficulty in understanding

Interviewing pace:

1.
2.
3.

Leisurely
Moderate
Under considerable time pressure

53.

Other impressions:

54.

Edited by:

55.

Spotchecked by:

-55-

1 i
CARD ORE
1.

Very insufficient

2.

Insufficient

3.

Sufficient

4.

Very sufficient

CARD TWO
1.

Strongly disagree

2.

Disagree

3.

Agree

1U

Strongly agree

CARD THREE
1.

Not at all useful

2.

Not useful

3.

Useful

4.

Very useful

CARD FOUR
1.

Not at all satisfied

2.

Somewhat satisfied

3.

Satisified

4.

Very much satisfied

-56-

HEALTH EDUCATION AND LOCALIZED TRAINING SYSTEMS

Seminar/Workshop on
Programmed Learning for Rural Health Workers
REGISTRATION

Name:

Title or Position:

School, Faculty or Department:

Field of Special Interest:

Educational Background:

Postal Address:

THE ATTACHED REPRESENTS SAMPLES OF MATERIALS USED IN THE PROGRAMMED INSTRUC TION PORTION OF THE WORKSHOP.

u
THE AGE OF DISCONTINUITY

by:

Peter F. Drucker

Teaching is the only traditional craft in which we have not yet fash­
ioned the tools that make an ordinary person capable of superior perform-

ance.

In this respect, teaching is far behind medicine where the tools

first became available a century or more ago.

It is, of course, infinitely

behind the mechanical crafts where we have had effective apprenticeship for

thousands and thousands of years.
The development of self-instructional, self-testing, easily-understood

materials of instruction can be revolutionary.

They can break the grip

which inflexible requirements of time and place of instruction now hold on
schools and colleges.

Our present focus of attention is often on the

teaching and not on the learner,
and teaching without learning.

There can be learning without teaching

If students learn well, they have been

taught well—no matter who taught them or what instructional materials were
used.
—Edgar Dale, Editor
The News Letter
March, 1970

i1
HANDOUT #1

Review of Characteristics of Programmed Learning As
Compared with Traditional Teaching
Programmed Learning:

1 - Is learner centered NOT teacher dominated.
2 - Contains a clear statement of objectives.
3 - Uses criterion referenced post-tested as
evidence of results.

4 - Provides information in sequential-logical
small steps which are easier to assimilate.
5 - Is concise (takes less time).

6 - Is individually paced.
7 - Uses any educational method(s) as
appropriate to content.

8 - Gives frequent feedback - knowledge of results.

9 - Allows response by students.
10 - Gives reinforcement to learners.

11 - Assures uniform quality control in educational
programs.
12 - Is useful when learners are geographically
dispersed (no classroom necessary).
13 - Allows teacher time to give to individual
learner needs and thus, is more interesting
from teacher’s point of view.

1

11

HANDOUT #1-B
SEMINAR-WORKSHOP ON PROGRAMMED INSTRUCTION
AN OVERVIEW OF PROGRAMMED INSTRUCTION

Intro­
duction

Varied
Forms

Programmed instruction is the innovation which
within the span of only ten years from its formal
inception by B. F. Skinner in 195^ spread quickly
throughout the world and is predicted to stay.
From the original linear program of Skinner and
the branching program of Crowder were born several
concepts of programs such as:
£

a
&
£

self-learning units
self-learning kits
learning packages
Unipacs (short for unit packages)

A self-learning unit is a program based on a unit
of subject matter.

A self-learning kit is similar to the self-learning
unit.
Learning packages are more comprehensive in nature
as they include not only programmed units but also
slides, filmstrips, and other materials needed to
develop a segment of subject matter—all in one
package.

Use in
New
Settings

The rapid adoption of programmed instruction in its
varied forms is clearly related to new school
organizational set ups or systems such as:
6
£
S
£
C
6

II - individualized instruction
IPI - individually prescribed instruction
CAI - computer progression scheme
Project IMPACT - instruction managed by parents,
adults, community and teachers
Non-graded school
Open university
Mastery learning

2

IJ

Use in
several
subject
fields

Programmed instruction is now utilized in many
subject areas. The APLET (Association for
Programmed Learning and Educational Technology)
Yearbook of Educational and Instructional
Technology of 1972-73 lists 52 subject fields
among which are:

©
©
©

e

Trends

£

education
industry
medicine
economics
carpentry
shoe making
veterinary practice

&

e
c

religion
electricity and
electronics
engineering
geography
geometry
mathematics
languages

Programmed instruction in its varied forms has been
introduced in many parts of the.world. The schools of England
use it extensively, not only individually but in consortium
among institutions. The Association for Programmed Learning
and Educational Technology based in London which includes mem­
bers from other nations has done a lot to promote programmed
learning not only in Great Britain but also in other parts of
the world. (A Philippine Chapter was organized in Manila in
197*1 after the seminar on Programmed Instruction and Technology
sponsored by the German Government and the Carl Duisberg
Gesselachaft, Philippines.)

In the United States, II, IPI, and CAI have spread to many
schools and the use of self-learning units, packages and
unipacs has likewise increased.

s

In the Philippines, the experimental use of self-learning kits
has widened from the few pilot schools in Naga, Cebu, Iloilo,
Manila, and Bulacan to several schools/divisions . More
teachers have been trained to make programs after the first
seminar on programmed instruction jointly sponsored by the
UNESCO and the Department of Education in 1971. The Philippine
Normal College has conducted four similar seminar-workshops
since 1971, aside from offering regular courses in programmed
instruction. The U.P. has also been offering the same course
although not in every semester.

a

There is a general trend to combine the basic forms of
programming or to modify them.

3

IJ

Nature
and
character­
istics

Programmed instruction is a method by which a learner learns by
himself from carefully sequenced materials, These self­
instructional materials:
ft
£
ft

&

What PI
is not

are presented in small steps
are logically sequenced
require active responding
give immediate feedback to inform the learner the correctness of his answer, thus giving reinforcement
involve constant evaluation, since most frames contain
test question aside from the post-test
follow the process of learning as they are constructed
from the simple to the complex or from the easy to the
difficult.

A programmed material is not a test. It is a teaching
material in which a bit of information is given which the
learner is asked to apply in a new situation.
&

Programmed instruction is not a cure-all. It is not the
only method but should be used with other methods, A
teacher is still needed although in a different role—that
of a director or manager of learning.

Programmed instruction is not an audio-visual aid. Pro­
grammed learning is an effort to complete the educational
model—that is:
Stimulus —Response

Reinforcement

An audio-visual aid is only a stimulus.

Values of
Programmed
Learning

ft

A good programmed material focuses on just the essentials.

5

More material is covered in a short time, hence helps solve
the problem of knowledge explosion.

£

Makes mastery learning possible even for the dull pupils.

ft

There is satisfaction resulting from the knowledge Of
achieving the correct answers.

4

Ii
<*

The expertise of subject matter specialists can be shared by
an infinite number of students and teachers.

&

High Standards of performance are maintained through good
quality programs.

&

Absent students could easily catch up with their peers.

Creative talents of educators and trainers are tapped.
Limi­
tations

Types
of
Programmmed

ft

It takes great technical skills to make a good program.

ft

Very few programs are available in the market.

ft

It is costly to produce the materials at the beginning.
There are two basic types of.programs:

ft

The Skinner program which is also called:
- Linear because it follows one line of thought, i.e. ,
the learner proceeds from one frame to the next.

- Constructed-response because the learner constructs or
thinks out his answers.
- Extrinsic because the path of the learner is predeter­
mined by the programmer.
ft

The Crowder program which is also called:

- Multiple-choice program since it presents multiple­
choice questions after the given information.
- Branching program because the learner does not follow
one line of thought but detours to other lines of
thought, depending on his choice.
- ’’Scrambled book” because for every choice of answer the
learner is told to turn to a different page.

5

11
- Intrinsic program because the path of the learner is
determined by his own choice of answer

Examples

{J

The Handbook on Programmed Instruction by Dr. Millan is
written in linear form.

Attached is Crowder’s branching program.

Steps in
Program­
ming

1st Step

There are five basic steps in preparing a programmed material:

State the objectives:
- in behavioral (observable) terms
- with the condition or conditions under
which the learner must perform
- with the quality of performance expected
The objectives should also consider the outcomes of learning
expected such as:
- The cognitive (knowledge, comprehension, application,
analysis, synthesis, and evaluation)

- The affective (attitudes, values, interests, apprecia­
tions)

- The psychomoter (skills, abilities habits)
2nd Step

Write the post-test
- Each objective should have a corresponding test item or
items.

- Questions should be of varied types.
- Questions should be constructed according to the
principles of test construction.

6

ir

3rd Step

Write the program

- Present material in several ways (linear, branching, or
a combination or modified form).
-Use illustrations, charts, slides, when necessary.
- Provide enough practice frames for the learner to apply
what he had learned.
- Check for adequacy, grammar, etc.
4th Step

it

Try out the program
- First on a one-to-one basis,
on difficult parts.

Observe reactions specially

- Next to a small group

- Then to a big group
5th Step

&

Revise the program
- Consider the observations made during the try out.

- More frames may have to be constructed.

7

11
HANDOUT #1-C
SYSTEMATIC INSTRUCTION

The model for systematic instruction is similar in most instances to the

process for planning programmed learning.
analyzing the problem.

The first step involves

What does the learner want to know, do or feel?

Next a consideration of the context involves an inventory of the setting
with its resources as well as constraints.

In order to understand what

needs to be done in the learning experience it is important to subtract

where the learners are now from where they should be.

This equation pro-

duces what needs to be done in the instructional process.

A statement of

what they will be able to do in terms of performance is the next step which
comes about as objectives are formulated.

These are evaluated by col­

leagues who are recognized and certified for their competence in the specific subject areas.

When the objectives have been validated by these

professionals the tests, pre and post-tests are created. The next step is

to choose a -format as to how the curriculum should be organized.
commonly five major instructional formats:
method.

2- Individualized instruction.

this category.)

There are

1- The lecture-discussion

(Programmed learning falls into

3- Small group instruction.

^4- Seminars.

5- Experimental

learning.

hedia is the next important consideration.

How instruction is communicated

is often a question with more than one. answer.

Just one medium is seldom

adequate to reach all of the learners in any one group.
Evaluation is answering how successful the learning experience was to the

learner and also to the teacher and educational designers.

The response in

the form of an orderly collection of data is the basis of the revision

which is the final essential step to systematic instruction.

8

iI

HANDOUT #1~D

SYSTEMATIC INSTRUCTION (SUMMARY)

The model for systematic instruction is similar in most instances to the
process for planning programmed learning.

The first step involves analyzing

t^ie Pr°bWhat does the learner want/need to know, do or feel?

Next a
consideration of the context involves an inventory of the setting with its

resources as well as constraints.

In order to understand what needs to be done

m the learning experience it is important to subtract where the learners are
now from where they should be. This equation produces what needs to be done in
the instructional process.
A statement of what they will be able to. do in terms of performance is the

next step which comes about as obj ectives are formulated,

These are evaluated

by colleagues who are recognized and certified for their competence in the
specific subject areas, When the objectives have been validated by these
professionals the tests, pre- and post-tests, are created.

The next step is to choose a format as to how the curriculum should be
organized.

There are commonly five major instructional formats:

1)

The lecture-discussion method.

2)

Individualized instruction.

3)

Small group instruction.

4)

Seminars.

5)

Experiential learning.

(Programmed learning falls into
this category)

Media is the next important consideration,
is often a question with more than one answer,

How instruction is communicated
Just one medium is seldom

adequate to reach all of the learners in any one group.

Eyaluation is answering how successful the learning experience was to the
learner and also to the teacher and educational designers.

The response in the

form of an orderly collection of data is the basis of the revision which is

the final essential step to systematic instruction.

9

HANDOUT #2

Programmed Instruction Project

1.

Goal:

2.

Constraints

3.

4.

Prepare a mixed format learning package using the principles of
programmed instruction.

a.

Use both linear and branching formats

b.

Select appropriate medium (appropriate for learning
characteristics identified)

c.

Show evidence of field testing

a.

The program should use to the best advantage the
(P.I.) principles presented in class.

b.

The program should attend to the constraints listed
above.

c.

The program should include display formats (i.e.,
visual, verbal) which are appropriate for the
learning task identified.

a

Select topic to be programmed

b

Assessment of the audience characteristics

c

Objectives specified unambiguously

d

Subobjectives are expressed

e

Criterion Test is constructed

f

Paradigm is selected

g
h

Sequences are ordered

i

Sequences are tested

J
k

Revisions are made
Program is validated

1

Revisions are made

Requirements:

Procedures:

Frames are constructed

10

11

i i

HANDOUT #3

Task Description

The student will take a driver’s training course to learn to drive a
car safely. The course is administered by an instructor in a car with an
automatic transmission. Some of the tasks he will be expected to perform
correctly are the following: When approaching a stop sign, press down on
the brake peddle. Having stopped the car, check to see that no cars are
approaching. Then accelerate smoothly. When desirous of turning left at
an intersection, turn on to do so, operate the switches that turn on and
off the lights, windshield wipers, and defroster.

11

ii
Task Analysis
Objectives
1.

When approaching a stop sign, the student will correctly and safely
press down on the brake pedal and come to a stop.

2.

Having, stopped the car, the student will visually check cross traffic
before proceeding, then accelerate smoothly.

3.

When approaching an intersection intending to make a left turn, the
student will turn on the left-hand turn signal.

4.

Having reached the intersection, the student will correctly and safely
turn left.

5.

When told to turn lights on, the student will operate the light
switch.

6.

When told to turn the wipers on the student will operate the wiper
switch.

7.

When told to turn on the defroster, the student will operate the
defroster.

12

11
HANDOUT //4

Task Description

The student will conduct an experiment in order to identify the basic
structures of a leaf and will record his findings. He will be provided
with a microscope and other necessary equipment. First, the student will
turn the leaf over in order to expose the underside. Second, he will locate
the breathing pores (or stomata) and the two guard cells on either side.
Then he will draw a simple diagram and label the stomata and the two guard
cells showing what he observed.

Next, the student will cut a thin cross section of the leaf with a razor
blade. Then, he will place the cross section under the microscope so that
he can examine the edge. The next task is to locate the plaisade layer,
the epidermis, and the spongy layer. And finally, the student will draw a
simple diagram and label the plaisade layer, and epidermis, and the spongy
layer showing what he observed under the microscope.
Objective

Given the necessary equipment and instructions, the student will conduct an
experiment in order to identify the basic structures of a leaf and will
record his findings.
Subobjectives
1.

Given a leaf, the student will turn it over to expose the underside.

2.

The student will locate the stomata and guard cells.

3.

The student will draw a simple diagram of a leaf, including stomata
and guard cell.

4.
5.

The student will label the stomata and guard cells on his diagram.
Given a leaf and a razor blade, the student will cut a thin cross section.

6.

The student will place the cross section under a microscope and adjust
the microscope.

7.

The student will use a microscope to locate the palisade layer, epi­

dermis, and spongy layer in the cross section of a leaf.
8.

The student will draw a simple diagram of the cross section, including
the palisade layer, epidermis, and spongy Iyer.

9.

The student will label the palisade layer, epidermis, and spongy layer
on his diagram.

13

IJ
HANDOUT #5

EXAMPLES OF THEMATIC PROMPTS

1.

Goru is a sacred animal.

Goru is also called

in the Hindu

rel J.gion,

2.

The brain ’’makes sense” out of the impulses carried from the cochlea
by the
nerve.

3.

Learning usually occurs when an individual’s response is promptly
rewarded or

Reinforcement which consists of presenting south-after stimuli is
called positive reinforcement, reinforcement which consists of
terminating unpleasant stimuli (e.g., loud noise) is called

reinforcement.

5.

It is easy to learn about the metric system when one thinks of the

money system in relation to it.

A dollar has

cents

(pennies).

1

6.

100 Rupia

7.

Thus, a centimeter works somewhat like a cent.
taka, 100 centimeters is

8.

Centigrade and Fahrenheit are both scales of temperature •
also a

9.

Knowing that most metals expand when heated, and remembering that the

A meter has

centimeters.

Just as 100 paisa is 1

Kalvin is

period of a pendulum depends on the length of the rod, we would expect
that a pendulum clock would
time on a cold day,
10.

The Indonesian Flag is colored

and

14

I i
HANDOUT #6

BIBLIOGRAPHY
Cram, David, Explaining Teaching Machines and Programming, Fearon Publishers,
Palo Alto, California, 1970.

Crowder, N.A., ’’The Rationale of Intrinsic Programming,” Programmed Instruction,
No. 5, April 3-6, 1962.
Davis, Robert, Learning System Design, McGraw Hill, 1974.

Espich, J.E., Williams, B., Developing Programmed Instruction Materials,
Fearon Publishers, Palo Alto, California, 1967
Kibler, Robert J., Objectives for Instruction and Evaluation, Allyn and
Bacon Inc., 1974.

Lunsdaine, A.A.., Glaser, R.E. (editors). Teaching Machines and Programmed
Learning, NEW, 1960.
Lysaught, J.P., Williams, C.M., A Guide to Programmed Instruction.
Sons, New York, 1963.

Wiley and

Mager, K.F., Preparing Objectives for Programmed Instruction, Fearon Pub­
lishers, San Franciso, 1962.

Markle, Susan M. , Good Frames and Bad, John Wiley and Sons, Nev; York, 1964.
O’Day, E.F., Programmed Instruction and How to Use it in Educational Applica­
tions , Prentice-Hall, Englewood Cliffs, 1968.
O’Day, .E.F., Julhavy, R.W., Anderson, W., Malczyski, R.J., Programmed
Instruction: Techniques and Trends, Merideth Corporation, 1971.

Pipe, P., Practical Programming, Holt, Rinehart and Winston, Inc., New
York, 1966.

Rowntree, D., Basically Branching, Fearon Publishers, Palo Alto, California, 1970.

Schramm, W., Programmed Instruction, Fund for the Advancement of Education,
1964.
Segall, Ashar, Vander Schmidt, Burglass and Frostman, Systematic Course
Design for the Health Fields, John Wiley and Sons, Inc., New York, 1975.

Skinner, B.F., The Technology of Teaching, Appleton-Century, Crofts, 1968.

Vargas, Julie S., Writing Worthwhile Behavioral Objectives, Harper and Row,
New York, 1972.

J5

HANDOUT #7

I j

TERMINOLOGY RELATED TO PROGRAMMED INSTRUCTION
1.

'eaching machine - The vehicle that carries or presents programmed instruction,
vehicle may be a printed page, film or computer based.

2.

Thematic prompt - A cue to response that takes into account the knowledge the reader
already possesses.

3.

Linear program - A program in which each frame follows in order one after the other. hj_1
users of the program must follow this sequence.

The

■0
4.

Panel - A diagram, chart or visual material that is referred to in a program but is st
arate from the frames in a program, It can be tipped into the pages of a program or- t_t
up outside. The program is used as a visual referent while the reader is going through
the program.

5.

Branching program - A program in which frames are sequenced in several orders and the
user of the program tracks and program according to his response. Branching is an
attempt to take into consideration individual differences.

1

^—>271
6.

-•H2z

Formal prompt - A cue to response that is based on the Form of the response.
i.e. - number of letters -letter cues
PAR
or rhymes

S

7.

Scramble book - An example of Branching program technique. The reader progresses
through the pages according to his responses rather than page by page in usual book US"'
technique.

8.

Constructed response - User is called upon to respond by manufacturing his response as
opposed to being a multiple number of responses from which to choose.

9. . Fading - The gradual withdrawal of cues to response.

10.

Frame - Within a linear program each nbit” of information and its accompanying call fc
response is called a frame.

11.

Step - The planning decision regarding how much or how little to incorporate in a fran .

12.

Terminal behavior - What is expected of the learner after the program.

13.

Criterion behavior - The quantity, quality, and time expectations applied to specific
activities called for a behavioral objectives.

1H.

Feedback - That information provided the learner that tells him if his response is
appropriate or not.
16

u.

HA^BDUT #8

VISUALS

Visual:

A symbolic or pictorial representation.

Visuals can aid your teaching objectives in the following ways:
1. Attract and hold the student’s attention
2. Clarify information
3. Provide a common reference for instructor and student
4. Overcome .limitations of time and space (e.g. clinical cases).
In order to determine whether or not your self-instructional unit can benefit from the
use of visual:

A.
' B.

Examine your instructional objectives
Look at the characteristics of the available media (see chart).

Ask these questions:
1. Do I need visuals to complete this objective? (Will visuals add to my objective or will they distract from my teaching?)
2. Do I need more than one visual for this objective? (i.e. a series or a combination of different visual media.)
How
close to real life does the visual have to be? (Can it be a graph or
3.
line drawing, or should it be a black and white or color photograph?)
4. Does the visual have to have color? (Color is particularly important for
"recognition" or "diagnosis" objectives.)

SELECTIVE VISUALS CHART FOR SELF-INSTRUCTIONAL UNITS
sorAwi

ro miuwaraaisw’wwjw v-w ••» rr.

efi

Variety of Presentation
More
Symbolic
A
PRINT
GRAPHS
OR
CHARTS

1

FT I UlfTlLlK—< ZILKlIWl ~ WlTl mil fl II11

Sample Verbs

capitals, underlining, boxing, separating "define", "list",
from text, different lettering, numbering "explain", "discuss"
pictures, words, numbers,
bar or broken line graph
color or black and white

"relate", "assess"
"recall", "select"

simple line drawings with or without
;
LINE
labels shaded line drawings with or without
DRAW­ labels realistic or graphic, comparison
"locate", "recog­
INGS
drawings series of drawings, cartoons
: nize" , "identify",
"compare"

BLACK & printed with the text, added to appendix
WHITE
variety of sizes, comparison photographs
PHOTOS series of photographs '-

"recognize,
"identify", "dem­
onstrate" "compare"

COLOR
SLIDES

"distinguish",
"diagnose" /’ident­
ify" /’compare"

Attached to back of unit, realistic or
graphic, close-up and distant shots
comparison slides, series of slides

More
Realis­
tic
Rnr.':

K8fi«fr

Marjorie L. Kupper, Jane W. May
17

1 j

HANDOUT #9

EXAMPLES OF FORMAL PROMPTS
1.

Number of Letters:
In the knee jerk or petellar-rendon reflex, the kick of the leg is the
r

2.

to the tap on the knee.

Number of Words in A Response:

To express action which was completed at an indefinite past time or

which is still going on, we use the

3.

tense.

Serial responses:
Like the

Flag, the Flags of

and

are

and

4.

Sound Patterns (rhyming):
Nine times seven and just one more is eight time eight, or

5.

Syntax:

We say that the form BOY is singular but that the form BOYS is
singular/plural

Understand is a more complex behavior and therefore the learner will

be expected to behave differently than he would for just knowledge of
the subject. If the learner can explain the function of the parts of
the projector, and can explain how the projector works, we can say he

has an

of projectors.

18

u
HANDOUT #10

TECHNIQUES OF INTRODUCING

CONTENT IN FRAMES
1.

By definition:
a.

Use a common sense definition.

Follow in the same frame

with an example part of which pupil can formulate.

A noun is the name of something.

Ex:

Chair is a noun because it is the

b.

of a thing.

Follow in another frame, with an example requiring the pupil

to use the word define.

Ex:
c.

because it is the name of a thing.

Tree is a

Show what the concept is not and point

Introduce contrast.

out concepts easily confused which are not the same as the

focal concept.

Ex:

because it is

Sing is not a

the

name of something.

In "Lita has a beautiful dress’*, dress is a
but beautiful is
2.

, the name of something.

By example:
Ball, hat, dog, house—all these are names of things. They
are called nouns.

3.

The name airplane is also called a

By anticipation:
The subject of a sentence is a noun and sometimes a verb

form called a gerund which means doing something.
Ex:

In ’’The pupils study their lessons well1*, the subject
19

Ii
is

• Pupils is a

In "Swimming is a good exercise”, the subject is
Swimming is a verb form used as a noun and it is called a

4.

By prompts:
a.

Thru similarity
(1)

of ideas:

Just as the sun rises in the morning,

in the evening.

the full moon

(2)

of signals:

"Naturally” signals a common sense

answer.
The roads were impassable after the floods

Naturally, many pupils were
(3)

in class.

of grammatical construction:
The higher the altitude of a place the colder is

the climate the lower is the place, the

b.

Thru constraint
(1)

of ideas:

(2)

of signals:

Warm air rises; cold air

+8 is greater than -2 and

+3 is greater than -10, but
9 is
(3)

than -1.

if grammatical construction

Same constructions limit the range of response.
The thicker the clouds, the (lighter, heavier) is

the rain that falls.

20

u.
c.

Through echoic devices (imitative)

Bright pupils love to be challenged in their thinking,
hence they should be asked

d.

Hints:

questions.

Reference to earlier learnings.

The term "principle” means "fundamental truth” or

"basic law".

The principles of teaching then means

of teaching.

0535E

4 >

21

5
. A. OOC°*H«

>

1)
A TEST ON PROGRAMMED INSTRUCTION
Direction:

Write the letter of the item which best completes the meaning
of the statement.

1.

The basic idea of programmed instruction is:

a.

Breaking information into large units of items.

b.

Reinforcement of learning from satisfaction of getting the

correct answer

2.

3.

c.

Following instructions with accuracy

d.

Substituting the teacher with a program

To benefit most from a programmed material, the student:
a.

Reads the material just like a textbook

b.

Recalls the answers to questions mentally

c.

Copies the material

d.

Writes the answers to questions

The most important value of a programmed material is:
a.

The teacher may have a holiday while the students work on the

material

b.

A programmed material can be used for several years without need
of revision

c.

An infinite number of students can benefit from the expertise of

several specialists.
d.

4.

Programmed material are not expensive

Which of these is not found in a good objective?
22

11.

5.

6.

a.

The objective stated in behavioral terms

b.

The conditions under which a student performs

c.

The list of resources needed

d.

The quality of performance expected

Which of these is a properly stated objective?
a.

Knows the value of family planning

b.

Understands the evils of abortion

c.

Appreciates the advantages of a small family

d.

Enumerates three effects of contraceptives

A type of programmed material in which the path of the learner is

determined by the answers he makes is called:

7.

a.

linear

b.

branching

c.

chaining

d.

Ruled

Giving cues to the learner as to the answers to question observes the
principle of:

8.

a.

prompting

b.

fading

c.

reinforcement

d.

shaping

The first step in programming is:

23

iI

9.

10.

a.

Writing the frames

b.

Trying out the frames

c.

Writing the objectives

d.

Evaluating the frames

Who of these is not urgently needed in programming?
a.

A guidance counselor

b.

the subject specialist

c.

language expert

d.

programming expert

A programmed material is considered good if:

a.

Half of the students obtain 50? of the items

b.

60? of the students score 70 in a 100-item test

c.

75? of the students get 75? of the test items

d.

90? of the students get 90? of the test items

24

L J,
11.

In the process of developing a programmed material, the best way to
try it out is on the basis of:

12.

13.

a.

one-to-one

b.

one-to-ten

c.

one-to-one hundred

The Skinner program has the advantage of:
a.

presenting one idea at a time

b.

presenting several ideas in a panel

c.

Asking the student to choose an answer

d.

Asking the student to make several answers

What do you expect to gain from this workshop?
achieved?

25

In your opinion, how best can this be

11

EVALUATION

I.

Title
Author

Target Audience
Estimated Working Time
Materials in Package (worksheets, slides, charts, etc.)

II.

Are there any relevant portions of'the learning module which are
not mentioned in the objectives or sub-objectives?
YES

NO

If YES, please specify the portion.

III.

Is the learning module:

YES

a.

Suitable for intended audience?

b.

Clear, precise, to the point?

c.

Make appropriate use of figures, diagrams,
slides, etc.?

d.

Accurate and authentic?

e.

Organized?

f.

Interesting?

g-

Comprehensive presentation of material
to meet objective?

h.

Contain the information necessary to
answer all the post-test items?

i.

Sequenced from simple

NO

to complex?

If you checked NO to any of the above items, please specify why.

26

11

IV.

Are there clear statements of what the learner can do after
successfully completing the package?
YES

V.

Is frequent practice given?
YES

VI.

NO

Is there an overall review frame?
YES

VII.

NO

NO

Please comment on any other aspects of the learning module,
objectives or post-test items, that you feel might be relevant
for adequate revision, e.g.,
Is the mode of presentation the most appropriate?

THANK YOU.

27

I j

H.ANDOUT #11

Model

Process of P.I.

Selection (topic or body
of knowledge)
Assessment of
Learner

&

Objectives

Pl

Sub-Objectives

2 )

12

Revision

Validation Tes

(What are critical
targets? — not all

Lr

- Does it reach
^.intended audie :e

i.e., tasks with a skill,
(task analysis)

Revision
/

Criterion Test
Cons truction

/
(Do learners have
sufficient skills?)

9

Developmental
Testing—feedb^c'
from sample o
learners

Paradigm Selection

Writing the Program—
constructing of frame*
use of discovery, etc,

a. extrinsic
b. intrinsic
Format—media selection
Ordering—handle objectives
in this or that
way

28

ir

EVALUATION FORM

Programmed Instruction
Title
1.

Does the program confirm the learners1 response?

2.

Is the instruction sequenced from simple to complex?

3.

Is the programming technique appropriate for the learning function being treated?

4.

Is the "critical idea" principle applied to the structuring of program frames?

5.

Is there evidence of over prompting?

If your answer is yes, briefly describe the nature

of the over prompting.

6.

Is the display format suitable from a perceptual point of view?

7.

If panels are used, do they serve a prompting function?

8.

Did the program hold your interest?

On the scale presented below, rate the program by placing a check mark at any point along the

continuum.

Poor

Good

Excellent

Your comments:

29

1J
Evaluation Sheet

It is hoped that you would be willing to evaluate the effectiveness of the instruction, con­
cerning how you liked it, any criticisms you might have, and any suggestions for improveme .

that

ou may have.

Did you find the package boring

, interesting

, easy

, hard

Comments:

Were there any parts or sections that you found irrelevant?

Would you like to’1

Did the illustrations help your understanding, or did you not pay much attentiportant for

Comments:
This package was designed as part of a larger package which is to be used both e?

seas.

Do you have any comments about the cross-cultural aspects of the packag

Comments:

30

1 1 "CRITICAL IDEA" PRINCIPLES

1.

In each frame, a student is held responsible only for that portion of the presented

material to which he has responded correctly.

Frames that follow may be built on such

material.
2.

In a critical program the active responses are integral to the learning process.

3.

A student is held responsible at the minimum level of understanding required for a

correct response to a frame.
4.

Concept formation is dependent upon maximum generalization.

5.

A useful technique which serves to maximize generalization is to require that each
restatement of a concept use new terms and new perspectives.

31

APPENDIX A~3

<I

I. For each statement circle the one response that is the closest to your opinion.

1. The course objectives were:
a. ’ clearly stated or written
b. stated or written; but not all of them were clear to me
c. stated or written; but most of them were not clear to me
d. neither stated or written

______
■ ; was geared to a level that was generally:
2. The course
content
appropriate
for
my background
a. i
b. too elementary
c. too difficult
d. inappropriate for my background
3. I think the organization of the course material was:
a. completely~clear and useful; excellent
b. for the most part, clear and useful; good
c. some topics were organized in a clear and useful manner, while others were not; fair
d. there was little apparent organization in this course; poor
4. After reading the course manual, I think it is:
a. both a well written and useful document
b. a fairly well wTitten document, but nevertheless useful
c. a poorly written document that is of limited utility
d. neither a well written nor useful document
•e. there is no course manual

5. The time required to complete the homework assignments was:
a. reasonable
b. unreasonable
c. wasted; these assignments were "busy work”
•d. there were no homework assignments in this course

6. The amount of time allotted for this course was:
a. sufficient
b. too long
c. too short
number of days
d. this course should last
7. Overall, I think this course was:
a. excellent
b. good
c. fair
d. a waste of time and money

8. Given the objectives of the course and the skills required for a meaningful understanding of the material, I
would:
a. recommend this course to a friend without reservation
b. recommend this course with some possible changes
c. not recommend this course unless there were definite improvements
d. not recommend this course under any circumstances
9. For future courses, there should be:
a. no substantive changes
b. more practical application of the course material
c. more theory presented as a basis for the material taught
d. more of a ‘‘balance* provided between theory and practical application
10. How did you hear about this course?
a. employer
b. friend
c. schedule
d. conference
e. other

NAME

COURSE

DATE

C.

z-

Cd

c

o

GO

<

s

CX) Q

ZQ

5.
5.
5.
5.
5.

4.
4.
4.
4.
4.

3.
3.
3.
3.
3.

2.
2.
2.
2.
2.

1.
1.
1.
1.
1.

6. During the course I felt challenged to learn.
7. Generally, the course materials were presented in an(inte^^ingjn^nnei>
8. The course content was well coordinated among the instructors.
9. The instructors were well prepared for most class sessions.
10. The instructors were quite knowledgeable about their subject area.

5.
5.
5.
5.
5.

4.
4.
4.
4.
4.

3.
3.
3.
3.
3.

2.
2.
2.
2.
2.

1.
1.
1.
1.
1.

7.1. Generally, I understood what I was expected to learn in this course.
12. Throughout the course I received sufficient information on anything I did not
understand.
13. The questions raised during the lectures were usually answered to my satisfaction.
14. My background was adequate for success in this course.
15. The teaching methods used in this course were effective for my learning.

5.

4.

3.

2.

1.

5.
5.
5.
5.

4.
4.
4.
4.

3.
3.
3.
3.

2.
2.
2.
2.

1.
1.
1.
1.

16. This course contained a sufficient amount of practice exercises.
17. The course assignments were useful for my learning.
18. The production quality of the audio-visual materials was technically adequate.
19. The audio-visual materials aided my understanding of the topics presented.
20. The final exam accurately represented the material covered in this course.

5.
5.
5.
5.
5.

4.
4.
4.
4.
4.

3.
3.
3.
3.
3.

2.
2.
2.
2.
2.

1.
1.
1.
1.
1.

21. Overall, I was pleased with this course.
22. I think my technical skills and/or knowledge have been strengthened as a result of
this course.

23. I think I vzill be able to use w’hat I have learned from this course in mv current
position.
'

5.

4.

3.

2.

1.

• 5.

4.

3.

2.

1.

5.

4.

3.

2.

1.

JI. Please circle the one number that represents the extent of vour acement with
each of the following statements. READ EACH ITEM CAREFULLY.
1. The course content was useful for my professional growth.
2. The course content was what I had expected.
3. The course content was too complex.
4. The course content was too simple.
5. The course content was up to date.

24. I consider the most needed improvement in this course to be:

25. The “best” part of this course was: ..

DO NOT WRITE I N T H I S

p a r r

O

GO <C

g<

b!2 OS

11
WORKSHOP ON PROGRAMMED INSTRUCTION

1.

Purpose:
In response to requests for family planning and health training materials,

it is proposed that a workshop be held to produce self-instructional manuals
on contraception, maternity records and related health-nutrition-MCH subjects.'
This 5-day activity will be held at a location in

selected by the

A staff of educational media and pro-

grammed learning experts will assist content specialists to prepare a

complete first draft version on each subject area.

This project will then

continue the field-testing and revision process until a final version is

ready for publication.

An evaluation study will determine the effective-

ness of this method of training in participating country programs.

2.

Duration:

This work will begin on
months.

3.

and continue for a period of six

The workshop will be held

with the assistance of The Committee

on Applied Research in Population will provide local costs and support

staff, Dr. Charles Ausherman, will be the consultant resource for this
project.

11
4.

Outputs:

As a result of this project, programmed instructional packages will be
produced as a means to facilitate family planning training health programs.

Effective dissemination of research through self-instructional modules
introduced into national training programs will be conducted.

The total

number of programmed instructional packages will be approximately 20
(titles).

In addition, participants will be trained in the methods of

programmed instruction.

2 -

5.

WORV’ PTAN AXTn TIM^^BLF

Programmed Learning Training Study.

1.

Workshop

2.

Revision

Activities
(See separate Agenda)

Time
3 days

Manpower
Full Staff

11 days

Research Associate
Consultants

a) revising and reviewing of
pre-tested SI materials
b) pre-testing revised SI materials
c) final revision
d) final editing
e) typing final copies
3.
i

co

r

4.

Printing

21 days

a) typesetting, proof reading,
typing
b) paste-up, insert proof
corrections
c) camera work, blue print,
printing, binding

(not needed if
mimeographed)

Editor
Typesetter
Proofreader
Typist
Artist

Distribution and utilization

a) deliver to treatment groups
b) use of PI modules

5.

Research Assistant
Research Associate
Editor
Clerk-typist

2 months and
2 days

Evaluation
a) QN construction (including
pre-testing revision)
b) contract research

b.l. training interviewers
b.2. data gathering
b.3. data processing
c) Data analysis and writing of study reports

2 months and
20 days

Research Associate
Research Assistant

Programmer
Coders
Clerk-typist
Secretary

i I

SAMPLE LETTER OF INVITATION TO PARTICIPANTS OF WORKSHOP

Dear

is sponsoring a workshop on programmed
learning in Family Planning/Health Training programs at the

We expect this workshop to provide an <exciting opportunity for a select group of '
training specialists to exchange ideas and to explore new instructional training
approaches. The first day will be devoted to presentation on and discussions of
new and significant instructional methodologies for use in your training curri­
culum.
We anticipate that during the workshop, you, as a participant, will design and
create your own programmed learning unit, You will be asked to select an
instructional topic consistent with the theme of
^2 the seminar: that is, the
development of mastery in family planning and research methods, You will then
formulate instructional objectives pertinent to the topic of your choice.
From
these objectives, you will createi an easily replicable, individually paced
programmed-learning unit.

A team of instructional development specialists and health educators will
assist ;you and your fellow participants in designing and producing your unit.
In
g"
, the
n individual and group
processes of preparing these units, each participant
should be able to discover ways in which programmed learning materialsJ can be
useful in facilitating instruction in his/her own institution. Discussions will
also be oriented towards finding practical means Jfor sharing materials, especially
those programmed-learning units finished in the workshop.
To make the workshop a Ihighly
' productive experience for all.
we urge you to
make the following preparations:

*Please refer to the workshop schedule enclosed herewith

4 -

I/
Page Two

1.

Make a preliminary choice of a topic (relating to the theme of the
seminar/workshop) on which you can develop an instructional unit.
The average learner in your program would take 30-60 minutes to
complete this unit. You may want to relate your topic to any of
the topics suggested on the next page or choose one which you think
relevant to your program.

2.

It is very important that’ you bring with you to the workshop all
the references, books, photographs, 35 mm. slides, or other materials
which you will want to use in producing your progrannned-learning
unit.

3.

Prepare to spend three days of concentrated effort in learning the
various phases of the design, development, and effective use of
materials in programmed-learning form. These phases include clearly
defining instructional objectives, choosing learning strategies
which will help the learner to accomplish those objectives, and
designing a post-test, which will allow the learner to measure bis
learning achievement.

For some workshop participants, this will be a first encounter with a
relatively new but proven instructional approach, and we will make every
effort to assist in your exploration of the potentials of this method.
The overall objective of the workshop is to enable each participant to
(1) master the methodology of an instructional approach for teaching
family planning-related topics to others; and (2) create one unit on a
topic related to the theme of the seminar/workshop.

5 -

6.

SUGGESTED SCHEDULE OF WORKSHOP ON PROGRAMMED-INSTRUCTION

DATE/DAY

TIME

TOPIC ACTIVITY

8:00
8:30

Introduction to Agenda
Programmed Instruction
a) Overview
b) Literature review of research
on the effectivity of Programmed
Instruction

9:00-10:15
(10:0010:15

Discussion/Reactions
Training-Research Consortium
Programmed Learning Model

11:00

Discussion/Reactions

11:30

Selection of Topics

11:45

Summary of Assuring Learning
Guidelines on Designing Programmed
Learning Units

12:15 NOON

Lunch

2:00 PM

Evaluation of sample prototype materials

2:30

Behavorial Objectives

2:45-5:30

Development of Programmed Instruction

(3:30
5:30
7:00
8:00

Free time
Dinner
Educational Media Presentation
Systematic Course Designs for the Health
Sciences
Learning System Designs

- 6 -

Ii
DATE/DAY

TIME

TOPIC ACTIVITY

7:00
8:00

Breakfast t
Designing & Constructing Consistent
Post Tests

8:45

Evaluation

9:45-10:45

Development of programmed learning units
(continuation)

12:30 NOON

Lunch

2:00 PM

Exchanging of Units

3:00-5:30

Revision of Programmed Learning Units

5:30

Free time

7:00

Dinner

8:00

Training System Design and Educational Media
Presentation or Continuing Refinement of the
Programmed Learning Unit

7:00

Breakfast

8:00

Exchanging Units

9:00

Trainer-Learner Interviews

9:30-10:15.

Revision of Programmed Learning Units

10:15

Participant’s Evaluation of Workshop

10:45

Continuing Revision of Programmed Learning
Units

12:30 NOON

Lunch

2:00-4:00

Finalization of Programmed Learning Units
(Tliis process of finishing and testing
the units will last 3 days)

Last Day

Staff Evaluation of Workshop Feedback of
Participant’s Evaluation of Workshop

7 -

I j

7.

P.I. DEFINITIONS

Programmed Learning uses a systems approach which has built-in evaluation.

Cognitive objectives are tested by post-test questions for the students.
Attitudinal objectives are tested by post-test questions and student response.

Programmed learning units are generally revised until 90 percent or more of the
learners using the units achieve at least 90 percent of the objectives, according
to the post-tests in each unit.

8.

A NOTE ON P.I. CHARACTERISTICS:

Characteristically, a Programmed Learning course is comparable to a traditional
semester’s work on a given subject consists of 15 to 30 self-contained learning
modules.

1.

Each module has the following characteristics:

It allows the student to proceed at his/her own learning rate indi-

vidually.

Completion time of each package averages from 30 to 60

minutes.

2.

It has a clear statement of objectives—i.e., the intended learning
objectives or instructional outcomes.

3.

It has a self-administered post-test, enabling the student and others
to measure whether the objectives have been achieved.

4.

It includes frequent practice exercises relevant to the objectives and
to the post-test.

8 -

IJ
5.

It includes feedback, or knowledge of results, which reinforce the
student for correct responses and allow him/her to improve comprehen-

sion and retention.

6.

Programmed Learning places emphasis on the needs of the learner and

allows the trainer or teacher to focus on individual needs of each
Learner.

7.

Programmed Learning breaks down learning tasks into smaller units

easier to assimilate.

8.

Programmed Learning forces creators of instruction to decide what end
behaviors are acceptable and practicable.

Thus, the Learner is the

final arbitrator of how and why a subject is presented.

as such is no longer a master.

The teacher

Recent studies reveal that:

PL is particularly applicable when those to be trained are widely
dispersed.
PL is most economical in programs where many personnel require training.

PL can reduce the number of expert instructors required.
PL can facilitate the rapid introduction of new technical information.

PL permits a quality control of the material presented to the student.
PL is more effective with some groups of personnel.
PL offers an advantage in training personnel whose day-to-day work is
not subject to direct constant supervision.

PI1 is intolerant of airy attitudes and breezy generalities and is a
threat to teachers who rationalize their inadequacies in terms of

"stupid students".
- 9 -

i j
PL can free a teacher for creative inter-action with Learners adding
a whole new dimension to teaching.

9.

REVIEW OF P.I.

Programmed Instruction:

1.

Is learner centered, NOT teacher dominated.

2.

Contains a clear statement of objectives.

3.

Uses criterion referenced post-test as evidence of results.

4.

Provides information in sequential-logical small steps which are easier to
assimilate.

5.

Is concise (takes less time).

6.

Is individually paced.

7.

Uses any educational method(s) as appropriate to content.

8.

Gives frequent feedback - knowledge of results.

9.

Allows response by students.

10.

Gives reinforcement to learners.

11.

Assures uniform quality control in educational programs.

12.

Is useful when learners are geographically dispersed (no classroom necessary)

13.

Allows teacher time to give to individual learner needs and thus, is more
interesting from teacher’s point of view.

10 -

10.

EVALUATION OF THE PI MODULES

The purpose of this research is to test the relative effectiveness and
efficiency of self-instruction in village level worker training programs in

India.

. A.

Four’ problems have been identified as potential areas of study:

PROBLEM STATEMENTS

1.

Do self-instructional materials enable novices in a particular content
area to become masters of that specific content area?

2.

Do self-instructional learners working in rural settings improve in

learning performance as much as compared with those learners working in
urban settings?

3.

Does learning with a self-instructional learning module relate to

their attitudes concerning application of this new knowledge?

4.

How does attitude of a learner toward a particular body of learning
content relate to the total learning gain of the learner?

B.

HYPOTHESIS

1.

Programmed learning modules can increase the level of information among

novices such that they can perform at a satisfactory level on a knowl­
edge recall test in a given subject area.

2.

There will be no significant difference in total achievement scores
between learners from rural and urban areas.

11 -

I/
3.

There will be no significant difference between learners with positive

and negative attitudes on learning content.

C.

EVALUATION PURPOSE

Continuing education in health programs requires the periodic upgrading of
skills.

The need is even more apparent among widely dispersed health workers.

This research seeks to determine the response of health workers to the use
of self-instructional materials in need of in-service training.

Particular emphasis will be given to those who for various reasons, such as
expense and inconvenience of travel to training centers cannot return to

formal classroom settings to receive additional educational training.

It

is suggested that this problem relates to a wide variety of related workers.

world-wide, who seek to upgrade their skills as new knowledge in their

respective field expands exponentially.

A specific concern of this study

is the relationship of learner attitudes on curriculum content and format
to learning achievement.

D.

RELATED RESEARCH

To meet in-service training nneds, self-instructional approaches have been
utilized in a wide variety of settings.

It has been aserted that self­

instruction is just as effective as traditional teaching.

Self-instructional

teaching in certain situations has been shown to be both effective and
efficient by several users and researchers.

Xerox Basic System, Inc.

estimates that programmed instruction can reduce learning time by 30% to

50%.

The University of Florida

School of Medicine documents a 50%

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reduction in acquisition time and no reduction in retention using selfinstruction.

(Stevens, C.B., Enzor, M., Phillips, T., Small, P.A., ”An

Evaluation of Self-Instructional Package on Amino Acid Chemistry”, Journal
of Medical Education, 48:276-279, 1973.)

Some researchers have measured the effectiveness of initial uses of self­
instruction in the population field.

Mullins and Perkin found that among

nurses in Thailand engaged in programmed learning about contraceptive technology,
scores for units on the Loop showed an average of 36% comprehension on the pre­

test and 80% on the post-test while midwives scored 20% on the pre-test and 70%
on the post-test.

In a unit on oral pills, the nurses improved from 37% on the

pre-test to 85% on the post-test and midwives from 17% on the pre-test to 81% on

the post-test.

(Mullins, C. and Perkin, G.W., ”The Use of Programmed Instruction

in Family Planning Training Programs:

A Preliminary Report”, Studies in Family

Planning, The Population Council, 1969.)

Until recently programmed instruction in the Philippines has primarily been
for remedial purposes and generally limited to undergraduate courses at the

college level.

There was skepticism among some educators concerning (1) the

adaptability of self-instructional materials to biomedical topics and (2) the
acceptability of self-instructional materials to biomedical topics and (2) the
acceptability of self-instructional materials by professionals and sub­

professionals.

Some questioned the acceptability of self-instruction in a

group-oriented culture.

A nation-wide study on the use of programmed learning

in the health sciences conducted in the Philippines by the Population Center
Foundation and the University of North Carolina revealed that programmed learning
can save up to 50% in learning time and costs with almost all subjects pre­

ferring this method of training.

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A Study of Programmed Learning for
Continuing Education in Family Planning in
12 Month Budget for Programmed Instruction Study
Workshop:

20 Participants
Paper, supplies, typist
4 modules x 200 each

Project coordinator
(part time) 12 months

Secretary
(part time) 4^ months

Research Assoc.
(full time) 12 months
Transport

per month x 12 months

Consultants, artist
Postage, tel. & tel. Qtly reprts

Overhead & contingency

J

I
PROGRAMMED INSTRUCTION TODAY

By

Dr. Wilbur Schramm
Stanford University

The introduction of programmed instruction to developing countries presents

some delicate problems, and must be accomplished with caution and insight.

The problem is one of sharing skills, findings, and materials in a sensitive
and culturally bound area.

The United States, where most of the work on

programmed instruction has been done, must be prepared to share with the new
How it does so is of the greatest impor-

states, and certainly will do so.
tance.

The new states must be encouraged to resist fast-talking salesmen who

try to sell them programs and machines made in and for the United States.

At

the very least, these programs must be translated culturally as well as lin­

guistically, and purchase of the machines may well be an unnecessary expendi­
ture.

Furthermore, a nation’s education is a precious national possession and

responsibility.

The way to introduce a revolutionary new method like pro­

grammed instruction into a national system is not to introduce materials but

to introduce the method—to build up competence in the new country so that it
can decide what programs it wants made, what use it wants made of the tools,
what it wants to buy, and what teachers it wants trained in the new techniques.

We are not certain how many American programs would be usable in any of these
new cultures; we are not even certain what changes would be required in the

programming method itself.

Therefore, any introduction of programmed instruc­

tion into a developing culture should be combined with development, and the

findings should be shared as widely as possible, not only within the country
but among the developing countries,

Up to this point, we should be concerned

with sharing our knowledge with the new states,

Only after we understand the

requirements of programming for the given culture, and only after the country

has built up competence to make its own decisions about programmed instruc­
tion, should we think of what materials (hardware) of programmed instruction
are appropriate.

The true revolutionary quality of programmed instruction lies in its

potential for helping to free man from inadequate curricula, from inflexible
concepts of ’’readiness ” and abilities, from the poverty of the self-contained
classroom and the lockstep of annual progress, from generations of ignorance
in traditional societies, from inadequate theories of learning and inadequate

use of capacities to learn.

S Y S T E M

S C I E N C E S.

I

N c.

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