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A study of the quality of behavioral change in learners when a system model is used for the instructional design
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A study of the quality of behavioral change in learners when a system model is used for the instructional design
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Content
A STUDY OF THE QUALITY OF BEHAVIORAL CHANGE IN
LEARNERS WHEN A SYSTEM MODEL IS USED
FOR THE INSTRUCTIONAL DESIGN
by
Joan Tagliere Cobin
A Dissertation Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(Education)
September 1973
UMI Number: DP24086
All rights reserved
INFORMATION TO ALL USERS
The quality of this reproduction is dependent upon the quality of the copy submitted.
In the unlikely event that the author did not send a complete manuscript
and there are missing pages, these will be noted. Also, if material had to be removed,
a note will indicate the deletion.
Publishing
UMI DP24086
Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author.
Microform Edition © ProQuest LLC.
All rights reserved. This work is protected against
unauthorized copying under Title 17, United States Code
ProQuest LLC.
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UNIVERSITY OF SOUTHERN CALIFORNIA
THE GRADUATE SCHOOL
UNIVERSITY PARK
LOS ANGELES, CALIFORNIA 90 0 0 7
Pk.D, .
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C é > b é>
T h is dissertation, w ritte n by
Joan T a g lie re Cobin
und er the d ire c tio n o f h.^^... D isse rta tio n C om
m ittee, and a p p ro ve d by a ll its m embers, has
been presented to and accepted by T h e G raduate
School, in p a rtia l fu lfillm e n t o f requirem ents o f
the degree o f
D O C T O R O F P H IL O S O P H Y
Dean
Date.ÛAÀJi^iAjL..okA^j3..73.
DISSERTATION C O M M IT T E E
Chairman
TABLE OF CONTENTS
Chapter
I. INTRODUCTION
Background
Statement of the Problem Situation
Purpose of the Study
Theoretical Framework
Hypotheses
Scope
Organization of the Remaining Chapters
II. SURVEY OF RELATED LITERATURE............................ 10
Introduction
Growth of the Systems Approach
Application of the Systems Approach to
Educational Methodology
Application of the Systems Approach to
the Design of Instructional Systems
Summary
III. METHODOLOGY .......................................... 23
Introduction
Design
Subjects
Procedure
Ins trumentation
Data Collection and Recording
Statistical Analysis
Methodological Assumptions
Potential Effect of Uncontrolled Factors
Factors Affecting Internal Validity
Factors Affecting External Validity
Hyp o theses
Summary
IV. FINDINGS AND DISCUSSION................................ 40
Introduction
Main Findings
Secondary Findings
Interpretation
11
Chapter
V. SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS............. 53
Summary
Conclusions
Recommendations
APPENDIX A ............................. 62
APPENDIX B ....................................................... 64
APPENDIX C ....................................................... 74
BIBLIOGRAPHY ..................................................... 76
111
CHAPTER I
INTRODUCTION
Background
One correlate of colonization is the adoption of the coloniz-
nation’s system of education. That system then, regardless of its
appropriateness, tends to remain after independence* Evidence of this
phenomenon is abundant in the emerging African nations as their edu
cational systems continue to be modeled, for the most part, after
those in France or England. This is true for professional schools as
well; thus, it is unfortunately true that in these countries, as in
most Western nations, curricula are organized around bodies of knowl
edge without particular regard to the tasks needed by the given so
ciety in terms of health-care practices or the needs of the learners
who enter the educational system. The inappropriateness of the con
tent, or body-of-knowledge, approach to curriculum planning becomes
grossly apparent in emerging nations such as those in Africa when one
realizes the vast difference in health-care needs from those of highly
industrialized Western nations.
Central to the problem is the extremely low ratio of health
professionals to the population. This extreme shortage of trained
personnel, which is compounded by the dispersion of the population
over vast areas, has forced nurses into a broader role than has been
traditionally accepted in Western nations.
African nurses must be able to take the primary initiative and
responsibility in managing medical emergencies in a variety of situa
tions, To do this they need to be skilled in a wide range of diag
nostic and therapeutic practices and decision-making abilities. As
the primary health officer in many areas, African nurses find that,
along with caring for the acutely ill, their tasks include public
health functions like health education and sanitation control as well
as all aspects of maternal-child care. For the nurse to function
effectively in this multivalent role it is imperative that she under
stand that she is working with a population that has established
tribal health-care practices with indigenous health-care providers
(e.g., witch doctors). The effective nurse will work to recruit,
train, and supervise these indigenous personnel to upgrade health
practices while keeping cultural patterns intact. The performance of
these widely varied tasks requires specialized training programs which
are designed to meet the unique needs of the society.
The assumption of this investigator is that educators in the
health-care professions trained in the application of a systems model
will be more capable of designing programs to meet these training
needs.
Statement of the Problem Situation
The Director of the World Health Organization (WHO) Regional
Office for Africa, recognizing the need for every country to develop
educational programs for the health professions that will train
practitioners who are responsive to the unique health-care needs of
that country, has made consultation and training in educational me
thodology available to member nations upon request.
Responding to the request for assistance in the generation of
an African-based educational methodology for professional schools, the
WHO Regional Director for Africa invited the directors of nursing
schools from twenty-six African nations to the Regional Office in
Brazzaville, People’s Republic of the Congo, for a week-long meeting
in July of 1970 entitled, "The Scientific Approach to Program Plan
ning." The objectives of this meeting were to promulgate the accep
tance of a scientific approach to curriculum design.
During the joint meeting of French- and English-speaking
African nurse educators, to which this investigator was invited to
serve as a program consultant, a series of theoretical papers dealing
with the scientific approach to educational planning, was presented.
The participants were also involved in bilingual workshops around
selected common problems. The participants concluded at the end of
the meeting that the "scientific method" was the most useful approach
to curriculum design and expressed the need for support from WHO in
training key faculty in this approach.
Responding to this request, the African Regional Office autho
rized a two-week educational methodology workshop for WHO nurse edu
cators which was conducted in Brazzaville in July, 1972, by this in
vestigator, which is herein reported. The participants received
training in the use of a systems model for instructional design. The
goals of this workshop were to enable the participants to (1) train
their counterparts in the use of the systems model for instructional
design; (2) hold workshops and seminars to train other faculty members
in the use of this model; and (3) use the model when designing their
own teaching activities.
Traditionally, professional education has had a very strong
emphasis on content. This methodology has typically stimulated "cram
ming" behaviors, in which the information is learned immediately prior
to an examination and all too often immediately forgotten. This style
is inherently unsuitable for a workshop after which learners may be
expected to implement the skills they have achieved in situations
virtually devoid of supervision.
It was therefore central to the achievement of the goals of
this workshop that the participants not only manifest a cognitive un
derstanding of the material but develop a high level of positive
affect relating to the use of systems models in instructional design.
Without this affect, it is doubtful that the ongoing performance of
the skills taught would ever be realized. It is assumed that WHO
staff achieving a high level of enthusiasm for and competence in the
use of this methodology could design programs to more effectively
train African health-care professionals to meet the needs of their
people.
Purpose of the Study
The purpose of the study was to test a systems model for in
structional design by determining the nature of the behavioral changes.
in the learners exposed to that design. It was assumed that motivated
health-care professionals could achieve the relevant cognitive behav
ioral objectives. Achievement of positive affect which would reflect
attitudes and values relating to education may not be so easily
assumed. It was hypothesized that learners who have had instructional
experiences resulting from the application of a systems model for in
structional design would gain a high level of positive affect related
to the topic.
Theoretical Framework
The systems concept was developed during the second World War
by planners searching for a framework within which they could consider
numerous interacting factors simultaneously. Originating as a method
for the handling of complex design problems, it was readily adapted
during the postwar years by many businesses and industries, especially
those in aerospace (Banathy, 1968).
With the recent attention given by systems engineers to social
problems, the value of this technical problem-solving process has be
come increasingly apparent. While many of the efforts to apply the
systems model to educational problems have centered around immediate
planning functions (Kaufman, 1972), long-term revisions of overall
educational strategies have also been posited (Silber, 1972). De
scribing a system he calls the "Learning-Objectives-Resources-
Inf ormation-Network, " Silber examines the heuristic potential of
educational technology. Systems models have also been utilized in
the exploration of the psychology of instruction (Atkinson and
Paulson, 1972) and the experimental validation of computer-based
instructional plans (Atkinson, 1972) as well as the evaluation of
instructional design plans (Blaney, 1970).
The most useful application of this model to instructional
design is that of Jerrold Kemp (1971). His model provides a means
for the examination and solution of instructional problems by generat
ing tentative answers to questions concerning goals and topic areas,
specific content matter and procedures, and evaluation, Kemp divides
the instructional system into eight interrelated components depicted
in Figure 1. While the components of this model are chronologically
Evaluation Pre-test
Assessment
Support
Service
Subject Content
Learning Objectives
Student Characteristics
Topics
General Purpose
Teaching/Learning
Activities and Resources
Fig. 1.— Instructional design model developed by Jerrold Kemp
conceptualized, the model is not strictly linear. The designer may
enter the schema at any point, working back and forth from any one
component to another.
The systems concept has been described by Banathy (1968) as
serving a dual function within education. Used education, the
model offers a powerful tool for decision-making and design develop
ment, When applied Jtn education, Banathy feels the systems approach
may help to clarify the goals of the educational system, clear defini
tion of purpose being essential to such an approach.
Goal clarification, however, is the one value-laden procedure
in an otherwise technological undertaking and fraught, therefore,
with numerous political implications. Some systems theorists have
sought to minimize these problems through the development of elaborate
information-seeking mechanisms through which all interested parties
may contribute their concerns (Kaufman, 1972). The problem, however,
remains unresolved, as is shown by Corwin and Nagi*s (1972) study of
the partisan functions of research within the U.S. Office of Educa
tion, and Williams * (1971) cogent analysis of the controversy over
the evaluation of the Headstart program.
Hypotheses
Students who participate in a learning experience where the
model for instructional design is a systems approach will:
1, manifest higher positive affect towards the topic as mea
sured by pre- and post-test scores on the Osgood Semantic Differen
tial;
8
2, manifest higher achievement in the cognitive domain as
measured by pre- and post-test scores on (a) test writing tasks,
(b) multiple-choice questions, and (c) the writing of behavioral ob
jectives ;
3. "be able to apply the systems approach to instructional
design in planning a training program for African nurse educators:
use the acquired knowledge, skills, and attitudes related to educa
tional methodology to implement and evaluate a training program for
African nurse educators at the end of the workshop (WHO Report, 1972,
p. 8)."
Scope
The study was confined to the testing of one specific systems
model for instructional design for a population of twenty nurse edu
cators employed by WHO. Extrapolation was limited by the use of a
quasi-experimental design that failed to control for (1) the selection
of the learners, (2) the length of training, and (3) interaction be
tween pre- and post-testing.
The workshop, organized under the auspices of the World Health
Organization, operated under certain constraints defined by the sup
porting agency. The participants were not randomly selected from the
population of WHO nurse educators in Africa, but were appointed by
the Director of the African Regional Office, who selected those per
sonnel he considered most capable of benefiting from the workshop.
The data were also subject to bias due to the investigator’s inability
to control such factors as age, experience, and mean time since last
education, all of which could interact with the experimental variable.
The other major delimiting factor was the time available for
the workshop, also defined by the African Regional Director, The
participants all had pressing duties and the time allotted for the
workshop was only somewhat greater than the workshop for directors of
nursing schools (VJUO Report, 1970), Yet the task at the first work
shop had been to achieve acceptance of the systems approach; the task
at the second, to both gain acceptance and develop mastery.
Organization of the Remaining Chapters
Chapter II is a review of the literature with special emphasis
on (1) the systems approach as a process, (2) the systems approach
applied to educational methodolofy, and (3) instructional design as a
process. Chapter III describes the methodology followed during the
investigation: (1) the experimental design, (2) the subjects, (3) the
workshop design, (4) the instrumentation, (5) the statistical anal
ysis, (6) the methodological assumptions, (7) the factors affecting
internal and external validity, and (8) the predictions. Chapter IV
discusses the findings, presenting a tabular analysis of findings
related to primary and secondary predictions and interpreting the main
and secondary findings. Chapter V gives a summary of the investiga
tion, the conclusions drawn from the analysis and interpretation of
the data collected, and the recommendations for implementation and
further research.
CHAPTER II
SURVEY OF RELATED LITERATURE
Introduction
The generation and elaboration of the systems concept and its
utilization within the social sciences is relatively recent. That
this approach has great promise despite its novelty may be attested
to by the fact that the proponents of the systems approach spend most
of their time applying rather than propagandizing it— a development
Kuhn (1962) takes to mean that a usable paradigm has been agreed upon.
This chapter attempts to describe the theoretical background and gen
eral characteristics of the systems approach, and the utility of this
model for educational methodology in general and instructional design
in particular. While concrete examples are delineated wherever appro
priate, the general direction of this section moves from a fairly high
level of abstraction to a highly specific model designed to elucidate
and operationalize the approach.
Growth of the Systems Approach
The increasing sophistication of research strategies in both
the basic and applied sciences in the twentieth century, with the con
sequent proliferation of "facts” with multi-level theories to account
for them, brought about a crisis point in Western scientific en
deavors. At the same time that researchers became cognizant of the
10
11
complex interfaces between different disciplines, the disciplines
began advancing their own technical vocabularies and conceptual frame
works. To enhance the degree to which concepts from one field could
inform workers in another, metatheorists sought to create a unified
theory of science. Such a theory needed to be able to support a suf
ficient level of abstraction to bridge the gulf between disciplines
and.also be empirically based so that its heuristic value might be
subjected to verification.
Taking advances in cybernetics as its starting point, the
general systems theory (Boulding, 1956) offered a mediation between
highly esoteric abstract theoretical frameworks on the one hand and
hyper-empiricism on the other. This approach offered two immediate
advantages to research: (1) a framework in which diverse subjects
could be brought into perspective for comparison, and (2) the effi
cient management of research tasks with multiple interacting vari
ables .
It soon became apparent that the general systems theory not
only facilitated the planning of basic research but also had relevance
for applied research in general and the logistics of wartime planning
in particular. A more specific systems approach designed to aid in
the efficient management of complex endeavors with multiple variables
began to be elaborated. This approach has been defined by
Kaufman (1972) as:
A process by which needs are identified, problems selected,
requirements for problem solution identified, solutions
chosen from alternatives, methods and means are obtained and
12
implemented, results are evaluated, and required revisions
to all or part of the system are made so that the needs
are eliminated [p. 125].
The tremendous power of this approach lies in its ability to depict
the specific nature of the inter-relationships of discrete system
components and to evaluate the effects of altering any of these com
ponents within a simulated model.
Initially developing planning procedures for man-machine sys
tems, systems analysts broke out of this limited field in the decade
after the second world war and generalized the technology to include
application of the systems approach to human problems (Hall, 1956).
The method has proven attractive to policy makers because of its
encouragement of the rational integration of planning, implementation,
and evaluation in numerous settings. This integration has been accel
erated because of the skill of systems analysts in specifying outcome
in quantifiable terms, making "feedback" a reality.
The twofold nature of the systems approach, while providing
the foundation of the model * s strength, also places certain con
straints upon its operation. Kaufman (1972) makes the point that the
applicability of the systems approach is limited by the same condi
tions that affect any scientific endeavor; namely, the validity of
the data used to identify and resolve problems (Mager, 1972), and the
objectivity of the personnel using the systems approach. While this
latter problem frequently takes on political implications when deal
ing with social systems (Williams, 1971), the approach contains within
itself a mechanism for the independent assessment of the analyst.
13
Applications of the Systems Approach
to Educational Methodology
The most comprehensive adaptation of the systems approach to
education has been in the field of planning. In a highly detailed
presentation, which is already gaining recognition as a major contri
bution to the field, Kaufman (1972) enumerated the specific steps
necessary for effective planning and clarified each step with specific
examples. These steps are (1) identification and documentation of
needs, (2) selection of high priority needs, (3) definition of objec
tives which will satisfy those needs, (4) specification of the re
quirements for meeting the objectives, and (5) identification and
evaluation of alternative strategies and tools.^
This process moves from the general, broad definition of prob
lem areas to the specific measures taken in response to the problems
in such a way that a careful definition of the characteristics of one
level flows directly from the immediately preceding step. This thrust
leads directly to the successful management of the educational process
through implementation of the following procedure:
1. Identification of the problem based upon documented needs,
2. Determination of solution requirements and solution alter
natives .
3. Selection of strategies from among the alternatives.
^The early and precise treatment of questions about the pur
poses of a system is fundamental to the entire systems approach and
helps in the building of evaluative criteria— the degree to which the
stated purposes are realized— into the system at an early stage
(Banathy, 1968).
14
4. Implementation of these strategies.
5. Evaluation of the outcome.
6. Revision of any step in the process as needed.
Unequivocal recognition of the need for continual monitoring and revi
sion of the system fosters a high degree of adaptability for the cor
rection of errors in the system and of responsiveness to new conditions
external to the system which may affect any of the components, and
helps to optimize the system’s effectiveness (Banathy, 1968).
The first step in this process— the needs assessment— begins
with an exploration of discrepancy between the present state of affairs
and the ultimately desired outcome. Defending systems planning against
charges that it is politically insensitive to the problems of value
analysis, Kaufman argues that good planning can facilitate a more hu
manistic education by building in a procedure for input from all the
parties involved in the educational process— the learners, the parents
and community members, and the educators— with specific safeguards for
the identification and reconciliation of substantive disagreements be
tween the parties. To achieve a high order of clarity, the needs
assessment or discrepancy analysis must formulate the discrepancy in
terms of the actual products and behaviors of the learners and must be
subject to continual scrutiny and revision. Mager (1972), describing
a similar procedure applied to goals analysis, observes that the degree
of operational specification generated helps to cast goals in a new
light in which their importance may be critically re-evaluated. This
process assists in the discovery of previously covert needs and the
15
exposure of superfluous "needs" which accumulate in systems because of
tradition or political considerations.
The confusion inherent in the contemplation of abstractions
such as "what is" and "what is desired," is eliminated through the re-
introduction of the empirical level in the discrepancy analysis in
terms of the three primary variables; namely, the nature of the so
ciety, the nature of the learner, and the nature of the educator. This
refines the analysis to the consideration of "what is possible" and to
the means for achieving these possibilities.
The procedure by which these means are identified has been
termed a "mission analysis" by Kaufman (1972) and it treats the-ques
tion, "what is to be done?" The primary components of this analysis
involve a specification of the mission objectives and the generation
of a profile defining the steps necessary for the achievement of these
objectives.
The highly problematic nature of the clarification of objec
tives is attested to by the extensive treatment it has received in the
literature, especially by such authors as Mager (1962, 1972), Banathy
(1968), and Kaufman (1972). Mager (1972) suggests, as a preliminary
step to the solution of this problem, that the nature of instruction
be continually determined by the previously identified needs for in
struction. By defining the objectives of instruction in terms of the
specific outcome requirements, it becomes possible to enumerate the
specific components of the objectives. Kaufman holds that mission ob
jectives must precisely state (1) what is to be done, (2) by whom.
16
(3) the conditions under which the outcome is to be demonstrated, and
(4) the criteria to be used in evaluating the outcome.
Once the objectives have been satisfactorily determined, it is
possible to proceed with the mission profile, which is a systematic
identification of the procedures required to realize the objectives.
By stating each necessary procedure in behavioral terms and by ordering
the steps sequentially, a logically ordered plan of the implementation
phase may be achieved. The subsequent planning steps— the functional,
task, and methods-means analyses-— are progressive refinements of the
profile, at ever-higher degrees of specificity.
The strength of the systems approach has led to its application
in such varied educational settings as planning, evaluation, computer-
based instruction, etc. Increasing use of the systems model has led
to its concentrated application to the problem formulated by Mager;
namely, the problem of linking the need for instruction with the actual
instructional practices.
Application of the Systems Approach to the
Design of Instructional Systems
Educational theorists, using the systems approach in the anal
ysis of education, have identified the purpose of education as the
facilitation of learning (Banathy, 1968). Continuing the analysis, it
becomes clear that a system with learning as its goal must center it
self around the learners. The discrepancy between this conclusion and
the actual state of educational practices (Rogers, 1967) is of suffi
cient magnitude to make it apparent that a complete overhaul of
17
instructional systems is necessary. Recognition of the importance of
the instructional design has resulted in a thoroughgoing application
of the systems approach to curriculum problems (Kemp, 1971). The ob
jective of this approach is the development of answers to three spe
cific questions:
1, What must be learned?
2, What procedures and materials will work best to reach
the desired learning levels?
3, How will we know when the required learning has taken
place?
Banathy*s (1968) prescription for answering these questions
included the formulation of learning objectives, development of pre
tests, analysis of student characteristics, identification of subject
content, selection of appropriate learning activities and resources
from relevant alternatives, implementation, and evaluation. Kemp
(1971) revised this prescription into the model depicted in Figure 1
on page 6.
While Kemp makes the point that it is possible to enter the
model at any of the stages and work from one component to another, it
must be remembered that Kemp^s model for instructional design shares
many of the characteristics of other systems models, including the
sequential arrangement of procedures. The higher in the model one
begins, the easier the subsequent analytic tasks become.
Study of the topics and general purposes of an instructional
system is very similar to the discrepancy analysis described by
18
Kaufman (1972) and the initial aspects of Mager * s (1972) goal anal
ysis. Clarity about the nature of the nature of the general purpose,
no matter how vaguely the purpose itself is phrased, both facilitates
the operational specification of learning objectives and aids in the
early identification of evaluative criteria.
The second stage in the process is the analysis of the student
characteristics such as age, maturity, socioeconomic status, environ
mental limitations, and scores on achievement and aptitude tests.
Correct assessments of these variables is essential to determining the
most productive role the learners are to take in the instructional ex
perience (Hedegard, 1967) as well as the selection and presentation of
the most appropriate learning experiences (Banathy, 1968),
Based on the information gleaned from completion of the first
two steps, it is possible to begin to identify and characterize the
learning objectives. The importance of this procedure has been
stressed by Mager (1972), who has demonstrated that highly ambiguous
affective processes may be operationally specified through a consider
ation of the overt behaviors that lead to the inferred presence of
that process. Operational definition of the objectives may be
achieved through use of the procedure outlined below:
1, Write down the goal.
2, Define performance criteria.
3, Examine criteria for duplications, abstractions, and
tautologies,
4, Specify outcome behaviors to be achieved.
19
5, Evaluate the procedure by determining whether performances
enumerated in Step 4 would lead to agreement that the stated goal has
been achieved.
As the objectives gain sufficient precision, they may be for
mulated into different frameworks. Banathy (1966) suggests that ob
jectives may be quantified in terms of the length of time and the
amount of content required to achieve them.
A more highly differentiated typology has been developed by
Gagne (1965) who placed objectives on a continuum ranging from signal
learning, response learning, motor and verbal chaining, to principle
learning and problem solving. This framework was modified by Kemp
(1971) to emphasize the learning of facts, concepts, principles, and
problem solving. Utilization of this framework involves a rank order
ing of objectives, the performance of each objective being dependent
upon successful achievement of the objectives preceding it. Such a
model greatly facilitates the sequential development of subject
content.
Precise definition of the learning objectives represents the
key criteria by which the effectiveness or adequacy of the performance
of a system can be evaluated (Banathy, 1968), This evaluation serves
the dual function of providing feedback to the learner about his pro
gress within the system as well as providing data for the continuous
monitoring of the system. Once objectives have h'eén specified (Mager,
1972), and the conditions under which the outcome behaviors are to be.
performed (Kaufman, 1972), the evaluative process is de-mystified and
20
and the workings of the instructional system are enhanced,
Kemp^s treatment, of subject content is drawn heavily from the
mission profile model. Such content is generated by performing task
analysis on the outcome behaviors which will identify the human capa
bilities— skills, knowledge, and attitudes that the individual needs
to have in order to carry out the specified output- performance
(Banathy, 1968).
The next stage is the introduction of a pre-test, which Kemp
(1971) identifies as serving two functions. The first is the assess
ment of the level of input competence. Banathy (1968) observes that
it is the job of the system designer to assess the capabilities the
student has already acquired relative to the learning inventory. The
second function is the determination of the degree to which some of
the students have already achieved the stated objectives. The impor
tance of the pre-test becomes clear when one considers the dangers of
confusing and demoralizing students through the presentation of mate
rial which they are unprepared to receive, or the likelihood of boring
students with subject content they have already mastered.
Kemp conceptualizes the final component as the "Teaching/
Learning Activities and Resources." Traditional organization of these
activities and resources has centered around teacher-presentations in
which material is organized and presented while the student maintains
an inactive role. Kemp^s (1971) spirited criticism of the shortcom
ings of this approach has been supported by Hedegard^s account (1967)
of how this methodology systematically discourages student creativity
21
and participation. Rogers (1967) depicts the demoralizing effect this
instructional style has on students and suggests that they are more
likely to achieve a high degree of distaste for learning than achieve
any of the cognitive and affective achievements hoped for.
To facilitate the development of alternative strategies,
Banathy (1968) recommends the introduction of a functions analysis at
this point for the purpose of identifying everything that has to be
done by the system in order to facilitate the attainment of the spe
cified learning tasks. He goes on to recommend that learning expe
riences be selected and organized so as to provide the greatest flex
ibility to accommodate the variations between individual students.
In keeping with these recommendations, Kemp (1971) favorably
reviews the attributes of independent study, which, if properly man
aged, provides not only the flexibility and opportunity for active
participation but prompt feedback as well, especially when the inde
pendent study methods include small group discussion. Emphasizing the
importance of the interaction between learners within such discus
sions, he cautions teachers to pay close heed to the group dynamics
involved, facilitating rather than dominating the group process.
Summary
While general systems theorists continue to make gains in
their pursuit of a unified theory of science, the elucidation of these
constructs for educational practitioners has made possible the con
tinued advancement of educational designs and programs. The charac
teristics of such an approach (rational and empirical determination
22
of needs, careful delineation of appropriate strategies, and the re
quirement of adequate criteria in constant reference to previously
defined needs) are especially well adapted to rational planning of
major and far-reaching changes within a system. It is for these
reasons that the systems approach to instructional design seemed an
apt tool for the comprehensive development of nursing education in
Africa.
CHAPTER III
METHODOLOGY
Introduction
Fundamental to the systems approach is the recognition that
not even the most thoroughgoing simulation can be a fully adequate
test of the system, actual implementation being the most effective
method through which evaluative data may be obtained. Accordingly, a
field research program was planned. The One Group, Pre-test, Post
test design was determined to be best suited to the field situation at
hand. While the paradigm does not fully control all relevant vari
ables, the study was begun in the spirit of Kaplan (1964) who held
that many of psychology’s fundamental laws were so fragile that they
could not survive beyond the sterile walls of a laboratory.
Design
The One Group, Pre-test, Post-test design was used. The sub
jects received a multi-form pre-test which measured both cognitive and
affective aspects of their behavior relevant to the systems approach
to instructional design. Then they participated in an intensive two-
week workshop, and were retested on the final day of the program.
The independent variable consisted of all of the elements of
Kemp’s methodology which were applied to the workshop. Primary among
them were the following:
23
24
1. Explicitly defined daily learning objectives and tasks.
2. Intensive small-group practicums.
3. Feedback channels to facilitate learner input into the
instructional process,
4. Clearly formulated behavioral objectives for the overall
workshop.
The dependent variables were the measures of cognitive and af
fective achievement described below.
Subjects
The subjects were twenty female African nurse educators em
ployed by WHO. These nurse educators ranged in age from 35 years to
38 years with a mean age of 45.11 years and a standard deviation of
-4.06. All subjects held bachelor's degrees and thirty-three percent
of them had advanced graduate training. Mean time since the subjects'
last formal education was 9.28 years with a standard deviation of
-3.85. Eight of the subjects spoke English as their second language.
Three of the subjects had "team leading" rather than teaching respon
sibilities at the time of the workshop. Two of the subjects had to be
excluded from the study, as one declined to take the pre-test and ano
ther had to leave the workshop before the post-tests were administered,
Procedure
Jerrold Kemp's systems model served as both the core of the
curriculum and the instructional model for the workshop. Each day of
the workshop was devoted to one step in Kemp's model. A syllabus was
25
provided which, when completed by the participants, became a workbook
for further study and review.
Each morning session began with a formal presentation, includ
ing both a lecture and a session with visual materials, covering one
aspect of the systems model. The learning objectives for the day were
clearly stated along with a definition of tasks and assignments. Fol
lowing this presentation, the subjects assembled in four work groups
to which they had been randomly assigned. Two of the work groups had
six participants and the other two had four participants. These groups
worked on the assignment given them that morning, met with the other
groups after lunch for a review, and completed reading assignments in
the evening. The assigned reading material is listed in Appendix A.
Daily learning objectives
The following statements were the objectives given at the be
ginning of each day respectively (WHO, 1972);
First day
Using the national health-care plan as a reference, at
the end of today's session you will be able to list five of
the major tasks of the nurse practitioner in the country to
which you are assigned [p. 4].
Second day
After today's session you will be able to: (a) explain
in a written paragraph the need to identify pre-requisite
knowledge, skills, and attitudes of the students who enter the
basic nursing programme in the school to which you are assigned;
(b) list four possible criteria to apply in the selection of
students into the nursing school to which you are assigned [p. 7].
26
Third day
You will be able, at the end of today’s session, to:
(a) write a learning objective and evaluate it according to
Mager’s criteria; (b) classify learner behaviors into the
cognitive, affective, and psychomotor domain [p. 8].
Fourth day
When you have completed the activities for today,
you will be able to explain in a written paragraph the rela
tionship of behavioral objectives to the choice of subject
content for instruction [p. 11].
Fifth day
When you have completed the activities for today, you
will be able to: (a) explain briefly the use of pre-tests
for instructional planning; (b) construct true-false, multiple-
choice, and matching test items which are evaluated as useful
by your peers [p. 12].
Sixth and seventh days
When you have completed the activities for the next
two days, you will be able to: (a) define teaching, using
Rath’s criteria; (b) list the broad categories of teaching/
learning activities; (c) discuss the role of the teacher as
described by Abrahamson; (d) select teaching/Iearning activ
ities appropriate to objectives; (e) list two advantages and
two disadvantages for each category of teaching/learning
activity [p. 18].
Eighth day
After you have completed the day’s activities, you
will be able to: (a) critically review multiple-choice,
matching, and true-false test items; (b) construct rating
scales that measure learner performance related to specific
learning objectives; (c) list criteria to assess the problem
solving activity of a group [pp. 35-36].
Ninth day
You will demonstrate: (a) comprehension of the sys
tems approach to instructional design today when you evaluate
the workshop; (b) an ability to assist one another within the
group with strategies which will promote change in the method
of instructional planning for their respective settings [p. 39],
27
Ins trumenta tion
The application of Kemp's model over the course of a two-week
workshop represented a number of interdependent variables, necessitat
ing a multiform evaluation utilizing strictly quantitative measures as
well as measures in which subjective judgment was required. The mea
sures described below were exactly the same for both the pre-test and
the post-test except where otherwise stated.
Cognitive measures
A thirty-item multiple-choice examination developed from that
used in the Kampala workshop (WHO, 1970) was administered on the first
and ninth days of the workshop. This examination included items on
educational objectives, measurement and evaluation, curriculum planning
and techniques of instruction. A copy of the examination is given in
Appendix B.
On the first and last days of the workshop, participants were
also asked to construct examination items to test recall, interpreta
tion of data, and problem solving. These items were independently
rated by both the principal investigator and Dr. Stephen Abrahamson*
utilizing the following criteria:
1. Does the item as a whole deal with an important and useful
aspect of the subject?
2. Is the item as a whole phrased in the working language of
the subject?
3. Does the item as a whole ask a question which demands
knowledge of the subject?
28
4. Is each item independent of every other item in the test?
5. Is the central problem clear?
6. Is the problem stated accurately?
7. Is the problem stated briefly but completely?
8. Does the problem contain only material relevant to its
solution?
9. Are the distractors important, plausible answers rather
than obvious distractors?
10. Does the item avoid the fault of giving away the best
response by irrelevant details or extraneous clues?
11. Do the alternatives deal with similar ideas or data ex
pressed in similar form?
Each participant was asked at the outset to write her own
learning objectives for her participation in the workshop. These ob
jectives were re-written as part of the post-test and were reviewed
independently by both consultants for content and style, on the basis
of the following criteria:
1. The specific learner was identified.
2. The desired behavior was indicated in terms not open to
many interpretations.
3. The conditions for when and where the learner would per
form the behavior were indicated.
4. The acceptable level of performance for the learned be
havior was specified.
Analysis of pre-test data provided the investigators with a
more detailed understanding of the participants and facilitated the
29
the planning of subsequent learning activities.
Daily assignments were turned in by the participants and were
reviewed to determine the degree to which daily learning objectives
were being achieved.
The core assignment, which took the participants two days to
complete, was to prepare a very small instructional unit including
learning objectives, subject content (with sources), and specific
teaching/learning activities (WHO, 1972), This assignment, for which
there was no pre-test, was subsequently rated by the principal inves
tigator according to the following criteria: (1) interrelatedness of
all instructional design components, (2) clear statement of learner
entry level characteristics, (3) appropriateness of learning objec
tives for level of learners, (4) choice of teaching strategies, and
(5) application of test construction theory to the development of
assessment tools.
Affective measure
The affective measure of achievement was the Osgood Semantic
Differential which provides for the quantification of subjective re
sponses. The Osgood Semantic Differential is based upon the concep
tion of attitude as an evaluative response which may be measured as a
tendency of approach or avoidance (Osgood, Suci, and Tannenbaum,
1957), This model has been stated somewhat more specifically by
Mager (1972):
When someone says, 'He has a favorable attitude toward muk-
luks,' he is suggesting , , , that the mukluk lover will tend
to say favorable things about the object, that he will tend
30
to move toward the object when he sees one rather than away
from it [p. 15] . . .
When this notion is tied to that of bipolar attitudes with a neutral
center point within the continuum, the dimensions of what Osgood and
his associates (1957) call semantic space become more visible. After
assigning a neutral center point, such as 4, on a scale from 1 to 7,
attitudes may be measured for two qualities in terms of this center
point, or origin. It becomes possible to measure both direction from
the origin, or positive and negative attitudes, and distance from the
origin, which represents the intensity of the attitude. The Semantic
Differential is illustrated in Appendix C.
Both the reliability (Tannenbaum, 1953) and the face validity
(Suci, 1952) of the Semantic Differential have long been established.
While originally used in the measurement of political attitudes, the
Semantic Differential has found increasing applications in behavioral
research, Kerlinger (1964) recognized this.
One of the difficulties in communicating about education is
the different interpretations put on educational ideas. . . .
We have here a useful and perhaps sensitive test to help in
the exploration of an extremely important area of psycholo
gical and educational concern: connotative meaning [p. 75].
Through the presentation of a series of varied bipolar adjec
tives, such as good-bad, fair-unfair, valuable-worthless, pessimistic-
optimistic, it was hoped that a fairly precise measurement of the
subjects * attitudes towards instructional design was attained.
Data Collection and Recording
On the first day of the workshop, following the opening re
marks by Alfred Quenum, M.D., African Regional Director of WHO and a
31
brief introduction by Stephen Abrahamson, Ph.D., the principal inves
tigator administered the pre-tests to the participants. The pre-tests
were administered in the following order: (1) writing of learning ob
jectives, (2) test item writing, (3) Osgood Semantic Differential, and
(4) multiple-choice test. The pre-tests were evaluated shortly after
the close of the first day’s session. Daily assignments were checked
each evening. The final assignments and the post-tests, which were
administered in the same sequence as the pre-tests, were evaluated
after the termination of the workshop and the return of the investi
gator to the United States.
Statistical Analysis
The pre-tests and post"-tests given the workshop participants
consisted of four different formats. The data for each format were
analyzed separately, then results were compared within the different
formats. Interaction of the experimental variable with student char
acteristics was assessed where appropriate.
Skill in writing learning objectives
During the pre-test period, each participant was asked to
write her individual learning objective for attending the workshop.
Criteria indicated by Mager were used to judge each of the learning
objectives. After the training and group experience in writing learn
ing objectives, each participant was asked to re-write the learning
objective she had indicated during the pre-test. The same criteria
were used to judge the second set of objectives.
32
Raw scores were used to derive means and standard deviations
for both pre-tests and post-tests. A ^ test was performed to deter
mine statistical significance. Subjects were also ranked by post-test
scores.
Skill in writing test items
The participants were asked to write three test items during
the pre-test period. One item was to test recall; a second, interpre
tation of data; and a third, problem-solving skills. After the train
ing and group experience, the participants were asked once again to
write several test items. The pre-training and post-training test
items were judged against criteria for several types of test items
given during the workshop. Raw scores were used to derive means and
standard deviations for both pre-tests and post-tests. A _t test was
performed to determine statistical significance. Subjects were also
ranked by post-test scores.
Semantic Differential
A mean and standard deviation for the group Semantic Differ
ential were subjected to several statistical tests to determine their
significance. Each subject’s raw scores for evaluation, potency, and
action, the three scales of the Semantic Differential— all these were
converted to derived scores for each concept on both pre- and post
tests. Subjects were also ranked by pre-test scores, post-test
scores, and the amount of change between tests. These "gain” scores
were converted to percentile scores for comparison.
33
Rankings of subjects on all measures were compared for inter
relationships. Subjects were also categorized according to their
ages, time since last formal education, teaching experience, present
responsibilities, whether or not English was their primary language,
and the work groups to which they were randomly assigned. The inter
action of these variables with both cognitive and affective achieve
ment was analyzed by comparison of raw and derived scores and ranking.
Multiple-choice test
Raw scores were used to derive means and standard deviations
for both pre- and post-tests, A _t test was performed to determine if
there were a statistically significant difference between the means of
the two tests. Subjects were also ranked both by post-test scores and
by the amount of improvement between tests. These "difference" or
"gain" scores were converted to percentile scores for comparability.
Methodological Assumptions
1, A positive correlation exists between high achievement as
determined by the cognitive measures and the ability to independently
implement the systems model.
2, A positive correlation exists between high positive affect
as measured by the Osgood Semantic Differential and the commitment to
engage in further study and implementation of the systems approach to
instructional design.
3, The changes in affect measured by the Osgood Semantic Dif
ferential will persist over time and are relatively "fade-resistant,"
34
4. Changes in both the cognitive and affective domains are
due to the experimental variable and not to extraneous interaction
among the workshop participants.
Potential Effect of Uncontrolled Factors
The application of a systems approach to the workshop design
created an experimental variable with numerous interreactive compo
nents which cannot be effectively differentiated for purposes of eval
uation, As a consequence, data from this study cannot be used to in
dicate which components of the workshop were successful or unsuc
cessful, but only whether the workshop as a whole was successful or
not in meeting its objectives.
Factors Affecting Internal Validity
History is perhaps the most salient variable which must be
considered here. The length of time between pre-test and post-test,
twelve days, as well as the fact that the participants shared common
quarters and facilities during the course of the workshop made pos
sible a number of extraneous interactions which affect the evaluation
of the experimental treatment. These interactions could have been
oriented towards the content of the workshop or merely given rise to
positive or negative effects of social interaction between the parti
cipants, who frequently had to work with one another on group projects
to meet daily workshop objectives.
Maturation may also have been a significant factor since some
of the participants described themselves as extremely fatigued by the
35
end of the workshop. It is also possible that there was some "fade"
in the Semantic Differential once the novelty of the subject under
consideration wore off. It is doubtful that fatigue could have af
fected the pre-tests, which were administered at the same time of day
as the post-tests; furthermore, the participants had ample opportunity
for a good night’s rest prior to the pre-test.
Pre-testing may have affected the quality of learning for the
participants, but this is somewhat unlikely as the objectives of the
workshop were stated more clearly by the investigator in her presenta
tion than could have been inferred from perusal of the tests. The
indirect nature of the Semantic Differential is such that sensitiza
tion concerning affect is also unlikely.
Instrumental decay may have been a factor if the investigator
and the independent judge felt themselves to be under any time pres
sure while rating the pre-test or if their implementation of evalua
tive criteria for the development of items and the formulation of be
havioral objectives in the post-tests were in any way altered as a
consequence of having led the workshop,
Statistical'regression towards the mean may be suspect because
the pre-test scores on the Semantic Differential were positive to the
extreme.
Selection was not done on a random basis using the population
of all nurse educators employed by WHO in the African Region, Rather,
the Regional Director selected those who he felt could benefit most
from the workshop, a factor which definitely limits internal validity.
36
Mortality is an issue for only one of the participants who was
unable to make travel arrangements which would have allowed her to
stay for the post-test.
Selection-maturation interaction is not a problem in the One
Group, Pre-test, Post-test design, as the subjects serve as their own
controls.
Factors Affecting External Validity
Interaction effects of testing is not a likely source of bias
in this experiment as so much emphasis was placed upon a highly ex
plicit statement of objectives during the course of the workshop.
Even if this were a factor, the effect on the ability to extrapolate
from the data would be negligible since use of the pre-test is an
integral part of the systems approach to instructional design and
would probably be a component of any such program.
Interaction of subject selection, and the experimental variable
is viewed from three aspects.
1. While the participants did manifest a very high initial
level of interest in the topic, this is not uncommon for work at the
professional level, so generalizability to similar settings was not
probably impaired.
2. There may have been some residual resistance to the system
approach to instructional design due to the implicit criticism of the
traditional teaching methods the workshop participants had been using.
This effect might have been most serious for participants with lengthy
teaching experience.
37
3. The possibility of interaction between the experimental
variable and particular learner characteristics, such as age, whether
English is a primary or secondary language, time since last formal
education, is considered below.
Effects of multiple treatment have no bearing on external
validity in this experiment, for the results being evaluated are the
cumulative effects of the entire workshop and not the effect of any
individual lesson.
Rater bias, while not a factor in the multiple-choice test or
the Osgood Semantic Differential which were strictly quantitative
measures, may have been a factor in the other more subjective mea
sures .
Reactive effects of the learning environment may also have
been a problem due to the presence of WHO supervisors throughout the
workshop, which may have affected the behavior of the participants.
Hypotheses
Primary hypotheses
1. Learners who participate in an instructional experience
where the model for instructional design is a systems approach will
manifest higher positive affect towards the topic as measured by the
pre- and post-test scores on the Osgood Semantic Differential.
2. They will manifest higher achievement in the cognitive
domain as measured by pre- and post-test scores on (a) test item
writing tasks, (b) multiple-choice questions, and (c) the writing of
behavioral objectives.
38
3. These same learners will
. . . be able to apply the systems approach to instructional
design in planning a training program for African nurse edu
cators: use the acquired knowledge, skills, and attitudes re
lated to educational methodology to implement and evaluate a
training program for African nurse educators at the end of the
workshop [WHO, 1972, p. 8],
Secondary hypotheses
1. The experimental effect will be greater (i.e., the degree
of score gains in both domains will be higher) for the younger parti
cipants .
2. The experimental effect will be greater (i.e., the degree
of score gains will be higher in both domains) for those participants
with the most recent formal educational experiences.
3. The English-as-a-second-language group (hereinafter re
ferred to as the ESL group) will have lower pre-test scores on both
the multiple-choice test and the Semantic Differential.
4. The ESL group will have greater improvement in both do
mains than the English-as-a-native-language group (hereinafter re
ferred to as the English group).
5. Post-test scores for the ESL group will more closely ap
proximate scores for the rest of the participants than the pre-test
scores did.
6. There will be a positive correlation between each work
group’s overall change on the Semantic Differential and on their spe
cific attitude towards group work.
39
Summary
The One Group, Pre-test, Post-test research design was se
lected for a field research program to test the application of the
systems approach to the instructional design of a workshop for WHO
nurse educators. A series of test formats used for both pre- and
post-testing have been described indicating possible effects of un
controlled factors due to the limitations of the research design.
CHAPTER IV
FINDINGS AND DISCUSSION
Introduction
The results of this study will be presented in three major
sections. In the first section, data bearing on the primary hypo
theses will be presented in terms of the effect the workshop had on
the cognitive and affective behavior of the participants. In the se
cond section, data bearing on the secondary hypotheses relating to
the specific characteristics of the learners will be presented. The
third and final section will contain additional findings concerning
the interrelationships of the various cognitive measures for which no
specific predictions were made. Following this, a theoretical inter
pretation of the data will be presented.
Main Findings
Hypothesis 1
Learners who participate in an instructional experience where
the model for instructional design is a systems approach will manifest
higher positive affect towards the topic as measured by the pre-test
and post-test scores on the Osgood Semantic Differential,
Findings. Although seventy-two percent of the participants
indicated a positive change in attitude toward concepts related to
educational methodology upon completion of the workshop, this did not
40
41
prove to be statistically significant. Several statistical tests were
employed to make this determination. A mean and standard deviation
were derived for the group of participants in each concept. A jt test
for correlated samples was run for each concept using the group means.
A sign test was performed on each of the three scales for all ten con
cepts. Significance at the .05 level was obtained in very few in
stances .
Hypothesis 2
These learners will manifest higher achievement in the cogni
tive domain as measured by pre-test and post-test scores on (a) test
item writing tasks, (b) multiple-choice questions, and (c) the writing
of behavioral objectives.
Findings on (a) test item writing tasks
Pre-test Post-test
Mean 6.78 11.27
Standard deviation 2.87 3.23
Jt = 1.37 .05^ p<[ .10 for one-tailed test of
significance
Findings on (b) multiple-choice questions
Pre-test Post-test
Mean 16.50 19.00
Standard deviation 2.87 2.98
_t = 3.168 p ^ .005 for one-tailed test of
significance
42
Findings on (c) the writing of behavioral objectives
Pre-test Post-test
Mean 1.88 3.94
Standard deviation .55 .90
Jt = 1.279
The results of the Jt test on (c) the writing of behavioral objectives,
although tending to point in the same direction as the findings on (a)
and (b), are not statistically significant. Despite this, it is in
teresting to note that forty-four percent of the participants met
fully all the evaluative criteria for behavioral objectives on the
post-test and another thirty-nine percent of the participants met
eighty percent of the criteria.
Hypothesis 3
The participants will be able to apply the systems approach to
instructional design in planning a training program for African nurse
educators: use the knowledge, skills, and attitudes related to edu
cational methodology to implement and evaluate a training program for
African nurse educators at the end of the workshop.
Findings. Despite the fact that
. . . each participant was asked to submit, six months after
the termination of the workshop, an instructional design pre
pared for the nursing faculty of the country to which the
participant is assigned on the topic of educational methodo
logy [WHO, 1972, p. 2] . . .
the African Regional Office of WHO was unable to fulfill its commit
ment to collect these "instructional designs" from the participants.
43
The only indirect measure available to this investigator is
the fact that five African nations, which were represented at the
workshop, have requested substantial amounts of literature pertaining
to Kemp^s model for instructional design from the African Regional
Office and have expressed an active interest in pursuing this approach
further.
Secondary Findings
The total sample studied was N = 18, consequently any attempt
to divide this sample into subgroups immediately renders subgroup N*s
too small to perform _t tests or even chi squares. While it is pos
sible to identify certain trends, nothing in this section should be
taken as conclusive. It is merely hoped that the data presented here
will help to identify fruitful avenues for further study.
Hypothesis 1
The experimental effect will be greater (i.e., the degree of
score gains in both domains will be higher) for the younger partici
pants ,
Findings, As seen from the data tabulated below, the findings
are consistent with the hypothesis,
(a) on Semantic Differential
Mean Mean
Percentage Ranked
Age Change Change
> 1 s,d, above mean ,94 10.33
y 1 s,d. below mean 1.38 10,16
44
(b) on multiple-choice test
Age
Post- Mean Mean
test Percentage Ranked
Score Change Change
>1 s.d. above mean
y 1 s,d. below mean
17.33
20.00
6.33
21.16
14.67
6.16
Hypothesis 2
The experimental effect will be greater (i.e., the degree of
score gains will be higher in both domains) for those participants
with the most recent formal educational experiences.
Findings. Despite the raw post-test scores, all findings are
consistent with the hypothesized gains.
(a) on Semantic Differential
Age
Mean
Percentage
Change
>1 s . d. above mean
■>1 s. d. below mean
1.16
3.24
Mean
Ranked
Change
10.0
8.5
(b) on multiple-choice test
Age
Post
test
Score
Mean
Percentage
Change
Mean
Ranked
Change
>1 s . d. above mean
>1 s. d. below mean
18.75
17.50
18.5
32.5
8.5
5.5
Hypothesis 3
The ESL group will have lower pre-test scores on both the
multiple-choice test and the Semantic Differential.
45
Findings. The data shown below clearly support the hypothesis
for the multiple-choice test but not for the Semantic Differential,
where the difference is hardly noticeable.
Raw Mean Pre-test Scores
Group
Semantic
Differential
Multiple-
Choice
ESL
English
16.39
16.66
15.12
17.15
Hypothesis 4
The ESL group will have greater improvement in both domains
than the English group.
Findings. The hypothesis is accepted on the basis of the data
shown below.
(a) on Semantic Differential
Group
Mean
Percentage
Change
Mean
Ranked
Change
ESL
English
2.57
1.18
9.75
10.20
(b) on multiple-choice test
Group
Mean
Percentage
Change
Mean
Ranked
Change
ESL
English
31.1
7.3
6.5
11.9
Hypothesis 5
Post-test scores of the ESL group will more closely approxi
mate scores for the rest of the participants than the pre-test scores
46
of the same group did.
Findings. The data tabulated below clearly support the hypo
thesis for both the Semantic Differential and the multiple-choice
test.
(a) comparison on the basis of raw scores
Semantic Differential Means Multiple-choice Means
Group Pre-test Post-test Pre-test Post-test
ESL 16.39 16.81 15.12 19.00
English 16.66 16.79 17.15 18.70
(b) comparison on the basis of mean difference in scores
Semantic Differential Multiple-choice
Pre-test 1.65% 13.04%
Post-test .012% 1.50%
Hypothesis 6
There will be a positive correlation between each work group's
overall change on the Semantic Differential and on their specific at
titude towards group work.
It must be noted that work group JD had to be excluded from
consideration in this part of the study as the two subjects who had
been dropped from the statistical analysis (one for refusal to take
the pre-test and the other for inability to take the post-test) were
both members of group ]D, leaving it with only two subjects.
Findings. As shown by the data tabulated on the top of the
next page, the hypothesis is supported by the findings.
Work Group
A
B
C
Percentage
of Change
Regarding
Group Work
Percentage
of Change in
Standard
Deviation
-17.26
-3.52
5.09
-.79
.56
7.95
Mean
Rank
Change
10.86
10.30
4.50
47
Interpretation
Main findings
Hypothesis 1. A number of factors may have combined to de
crease the likelihood of statistical significance for changes in the
Semantic Differential despite a strong trend in the predicted direc
tion. When the three scales were converted to derived scores for each
concept, it became possible to assign scores from 1.0 to 21.0 to each
subject for each concept, and a mean score from 1.0 to 21.0 for each
subject's overall attitude. Despite the wide range of potential
scores, the mean pre-test score of 16.54 was extremely high.
Given this highly positive valence, it becomes reasonable to
anticipate a degree of regression toward the mean on the post-test.
Of the four participants who scored the highest on the pre-test, three
scored lower on the post-test.- Two of the five participants who
scored lower on the post-test still scored above the workshop mean on
this measure. Were the N large enough to permit statistical manipula
tion to control for this regression, a positive determination of sig
nificance would have been much more likely.
48
Hypothesis 2. While the post-test mean for test item writing
represented a 69.9 percent increase over the pre-test mean, variance
remained relatively constant, increasing by only 12.5 percent. Most
instructional systems fail to make allowance for students on the lower
end of the scale, with the consequent loss of these students to the
educational process as they fall farther and farther "behind." The
data at hand attest to the fact that adherence to Kemp^s recommenda
tions about consideration of student characteristics can lead to a re
integration of this subgroup.
While the data did not achieve the .05 level of significance,
rankings, based on post-test raw scores for this measure, correlate
very highly with rankings for the other cognitive measures.
The mean increase of 16,1 percent on the multiple-choice post
test, with an attendant increase of only 3.8 percent in the variance,
lends further credence to the suggestion of convergence developed
above.
The failure of the jt ratio, resulting from the comparison of
pre- and post-test scores on the writing of behavioral objectives, to
achieve significance despite a 109.5 percent improvement in the post
test and the excellent performance of eighty-three percent of the
subjects noted in the findings, suggests a small number of subjects
who made gains for the other two cognitive measures. The post-test
procedure (presenting the subjects with their pre-test objectives)
may have alienated some of the participants or in some way reenforced
their pre-test response sets relative to behavioral objectives.
49
Rankings based on this measure also correlated highly with rankings
based on the other two cognitive measures.
Secondary findings
Hypothesis 1. While all the findings are in the predicted
direction, those for the multiple-choice test are much clearer and
more unequivocal than those for the Semantic Differential. A number
of plausible explanations may be put forward to account for this.
They shall be enumerated here and evaluated in the light of further
findings.
1. The younger participants may have matured in a more "hu
manistic" environment and may have developed a distorted image of, and
bias against, any terminology using the word "systems" as sounding
vaguely computerized.
2. The younger participants may be lower on the career lad
der, and consequently more willing to learn about a new methodology
which their supervisors favor despite their own misgivings.
3. The multiple-choice test may have been more sensitive to
the differences produced by individual variables than the Semantic
Differential.
4. The interaction of age with the independent variable may
have somehow become confounded with the length of time since last
formal education, as the younger participants were more likely to have
had recent instructional experiences.
Hypothesis 2. While all of the findings were in the predicted
direction, they were somewhat at variance with those findings for the
50
first hypothesis. The improvement in attitude for the below-mean
group was more distinct; its gains in cognition, though impressive,
were less striking than for the group treated in the first hypothesis
There are a number of possible interactions here.
1. Those participants who were students more recently may
have more vivid recollections of the drawbacks of traditional educa
tional methodology, and, as a consequence, be more favorably disposed
to alternatives.
2. Those participants who were students more recently may
have less actual teaching experience and consequently feel less iden
tification with the traditional model. This is indirectly supported
by the multiple-choice post-test scores. The below-mean group, de
spite great improvement, was unable to match the scores of the above
mean group. It is possible that a certain sophistication about the
areas touched on by the multiple-choice test is achieved through pro
longed practical experience.
As there were several older participants in the below-mean
group and no younger ones who had not recently been students, time
since education would seem to be a better indicator of both affective
and cognitive gain than age. These factors argue against the "anti
systems" and "career-ladder" theories based upon the interpretation
of the first hypothesis.
Hypothesis 3. While the ESL group scored lower on both mea
sures, the difference was nearly twelve times greater for the
multiple-choice test than it was for the Semantic Differential. Two
51
reasonable explanations may be put forward at this point.
1. The multiple-choice test is more sensitive to learner
characteristics than the Semantic Differential,
2. It may be more difficult for non-native speakers to think
analytically in English than it is for them to offer their subjective
feelings in English.
Hypothesis 4. Again the cognitive change is more apparent
than the improvement in attitude. This may be partly due to the
higher initial scores on the Semantic Differential. A major factor
in the reputed success of instructional systems is the attention they
pay to the characteristics of the learners. The advantages to this
approach are quite evident in the cognitive gains the ESL group made
as they became more comfortable with the terminology.
Hypothesis 5. The near-total convergence of the post-test
scores for both language groups indicates the high degree to which
the supportive aspects of the workshop design were operative.
Hypothesis 6. While the correlation between attitude towards
group work and overall attitude within the work groups may in some
part reflect the general trends of each group, the strength of the
responses to group work make it seem more likely that the attitude
represents an outgrowth of the group experience. This is consistent
with the contention of systems theorists that the learning process
may be as significant as the content.
52
Two potentially valuable indicators— the participants* present
positions and their past teaching experiences— had to be excluded from
the analysis, as three of the participants did not have current
teaching responsibilities and two had no prior teaching experience.
CHAPTER V
SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS
Summary
Western-European-style nursing education has been designed to
meet the needs of heavily industrialized, fully developed, urbanized
societies. African graduates of Western-oriented programs lack many
of the skills and qualities to effectively meet the health-care needs
of African society. Due to the extreme shortage of health profes
sionals, nurses need to be able to perform many functions that would
not be considered nursing tasks in Western nations.
African leaders, recognizing the need for change from colonial
systems of education and recognizing the need for assistance in the
effective planning for change, have become increasingly interested in
the systems approach as a result of WHO activity.
The purpose of this study was to test a systems model for in
structional design with a group of WHO nurse educators in Africa by
determining the nature of the behavioral changes in the learners ex
posed to that design. It was assumed that motivated health-care
professionals could achieve the relevant cognitive behavioral objec
tives. Achievement of positive affect which would reflect attitudes
and values relating to education may not be so easily assumed. It
was hypothesized that learners who have instructional experiences
53
54
resulting from the application of a systems model for instructional
design would gain a high level of positive affect related to that
topic.
It was predicted that learners who participated in an instruc
tional experience where the model for instructional design is a sys
tems approach would :
1. manifest higher positive affect towards the topic as mea
sured by pre- and post-test scores on the Osgood Semantic Differen
tial;
2. manifest higher achievement in the cognitive domain as
measured by pre- and post-test scores on (a) test writing tasks,
(b) multiple-choice questions, and (c) the writing of behavioral ob
jectives;
3. "be able to apply the systems approach to instructional
design in planning a training program for African nurse educators:
use the acquired knowledge, skills, and attitudes related to educa
tional methodology to implement and evaluate a training program for
African nurse educators at the end of the workshop (WHO, 1972, p. 8),"
The systems model is a theoretical framework which facilitates
the simultaneous consideration of numerous interrelated factors. Ori
ginally applied to purely "technical" problems, systems engineers have
paid increasing attention to societal problems in general and educa
tion in particular. "Systems" methodology provides a procedure for
the precise identification of specific needs and lays the foundation
for the generation of appropriate strategies to meet those needs.
55
The present study is an investigation into the applicability
of Kemp * s (1971) model for instructional design, which is based upon
an analysis of the interrelationships of the following components:
(1) general purposes, (2) student characteristics, (3) behaviorally
specified learning objectives, (4) subject content, (5) pre-tests,
(6) teaching/learning activities and resources, (7) post-tests, and
(8) evaluation and revision.
This study utilized the One Group, Pre-test, Post-test design.
While this design has few controls for limiting the effects of experi
mental artifacts and extraneous variables, it was the only model ap
propriate to the field conditions under which the investigation
operated. The principal investigator felt quite strongly that it was
important to examine the model’s operation in as "natural" a setting
as possible.
The independent variable was the workshop— its content and the
actual instructional procedures. The dependent variables were three
cognitive and one affective measures and the ongoing behavior of the
workshop participants some time after the termination of instruction.
Kemp’s systems model served as both the content of the work
shop and the instructional model, providing the participants with a
two-week living laboratory in the theory and practice of systems me
thodology. This may have complicated the analysis of the data to some
extent, for it is difficult to determine which effects were due to the
workshop procedure and which were due to the purely substantive as
pects of the curriculum.
56
Subjects were given a pre-test and a post-test, both of which
included (1) the writing of test items (one item for recall, one item
for interpretation, and one item for problem solving), (2) the formu
lation of behavioral learning objectives, (3) the completion of a
thirty-item multiple-choice test, and (4) the completion of the Osgood
Semantic Differential for concepts related to the systems approach to
instructional design. Data derived from these measures were subjected
to analysis to determine the mean and standard deviation, and Jt tests
were applied where appropriate. The amount of change between tests
was converted into percentile scores for purposes of comparison. Par
ticipants were then ranked according to their gains and losses on the
various measures, and these rankings were compared for cohesiveness
across subgroups for various learner characteristics.
The methodological assumptions of the study were the follow
ing:
1. A positive correlation exists between high achievement as
determined by the cognitive measures and the ability to independently
implement the systems model.
2. A positive correlation exists between high positive affect
as measured by the Osgood Semantic Differential and commitment to en
gage in further study and to implement the systems approach to in
structional design,
3. The changes in affect measured by the Osgood Semantic Dif
ferential will persist over time and be "fade-resistant."
57
4, Changes in scores in both the cognitive and affective do
mains are due to the experimental variable and not to interaction
among the workshop participants.
An analysis of the characteristics of the workshop partici
pants made early in the workshop led to the generation of the follow
ing minor predictions:
1. The experimental effect will be greater (i.e., the degree
of score gains in both domains will be higher) for the younger parti
cipants .
2. The experimental effect will be greater (i.e., the degree
of score gains will be higher in both domains) for those participants
with the most recent formal educational experiences.
3. The ESL group will have lower pre-test scores on both the
multiple-choice test and the Semantic Differential.
4. The ESL group will have greater improvement in both do
mains than the English group.
5. Post-test scores for the ESL group will more closely ap
proximate scores for the rest of the participants than the pre-test
scores of the same group.
6. There will be a positive correlation between each work
group * s overall change on the Semantic Differential and their specific
attitude toward group work.
Conclusions
Hypothesis 1. Learners who participate in an instructional
experience where the model for instructional design is a systems
58
approach will manifest higher positive affect towards the topic as
measured by the pre-test and post-test scores on the Osgood Semantic
Differential,
Seventy-two percent of the participants indicated a positive
change in attitude towards concepts related to educational methodo
logy. The fact that the change was not statistically significant
might have been due to statistical regression toward the mean.
Hypothesis 2. These learners will manifest higher achievement
in the cognitive domain as measured by pre-test and post-test scores
on (a) the writing of test items, (b) multiple-choice questions, and
(c) the writing of behavioral objectives.
Concerning (a) the writing of test items, the results were
significant at the .10 level.
Concerning testing through (b) multiple-choice questions, the
results were significant at the .005 level.
Concerning (c) the writing of behavioral objectives, while
the results were not statistically significant, eighty-three percent
of the subjects met at least eighty percent of the evaluative criteria
on the post-test measure, and rankings based on this measure had a
correlation of +.78 with rankings based on the multiple-choice test.
Hypothesis 3. The participants will be able to apply the
systems approach to instructional design in planning training pro
grams for African nurse educators; namely, to use the knowledge,
skills, and attitudes related to educational methodology to implement
and evaluate a training program for African nurse educators at the
59
end of the workshop,
The African Regional Office of WHO reports that it has re
ceived requests for further assistance with the development of in
structional design systems from ten nations, that it has fulfilled
requests for large amounts of literature relating to this matter, that
it has translated the syllabus and other material used in the workshop
into French, and that it is planning another workshop on the systems
approach in the French language.
The various subgroups of participants were not of sufficient
size to’permit the determination of statistical significance, so the
minor hypotheses which were discussed in the preceding chapter and
the findings based upon them cannot be taken as definitive statements;
however,' they may point out trends worthy of further investigation.
Summary. The subjects made striking gains in both the affec
tive and cognitive domains as a result of the workshop. Comprehensive
application of the systems model can enable students with initial
deficiencies, such as those in the ESL group, to overcome these defi
ciencies and to achieve on the same level as the other participants.
While the workshop had a greater impact upon the younger participants
and those with recent educational experiences, the content may have
complicated the effects of the actual experimental procedure.
Recommendations
Research design
1. For nearly all of the predictions, the multiple-choice
test was a much more potent indicator than the Osgood Semantic
60
Differential. While this may be related to the extremely positive at
titudes registered on the pre-test, the possibility that the multiple-
choice format may be more sensitive to certain kinds of differences
merits further investigation.
2. Any replication of this study, or any similar studies,
would do well to utilize a sample sufficiently large to permit a more
substantive statistical analysis of various subgroups. While this in
some ways interferes with the preferred utilization of small working
groups, appropriate experimental designs may be implemented to permit
both a relatively small student-teacher ratio and an adequately large
sample.
3. When initially small samples are divided into work groups,
it may be more practical to "randomize" the character of the groups by
controlling assignments for characteristics to assure the even distri
bution of variables. This also allows the investigator to control
group membership so as to avoid reviving any long-standing personal
conflicts between or among participants.
4. It must be emphasized that the sole utility of the cogni
tive and affective measures rests upon the assumption that they are
sound indicators of the actual future behavior of the workshop parti
cipants .
The ultimate criteria, of course, remain the subsequent field
performances of the nurse educators who attended the workshop. A
clear and pressing need exists for a study in which the effects of
siich instructional techniques upon the participants may be traced over
61
a period of several years.
Implementation
1. In intensive learning experiences where a significant part
of the interaction is between the different participants and where
this interaction may be given some structure, more detailed knowledge
than age, prior education, and experience would significantly enhance
planning effectiveness.
2. There is a significant difference between cognitive com
prehension of a subject and sufficient mastery to allow the learner
to effectively communicate that subject to another in a teaching situ
ation.
Actual mastery of such a complex skill as full and effective
utilization of the systems approach to instructional design cannot be
effectively developed within two weeks. More instructional time is
required if the participants are to be raised to this level of under
standing. Educators operating within time constraints similar to the
ones imposed on this study might do well to concentrate more energy
on building strongly positive attitudes towards the subject matter.
APPENDIX A
READING LIST FOR WORKSHOP PARTICIPANTS
62
63
WORKSHOP ON EDUCATIONAL METHODOLOGY
NURSING
Brazzaville» 10-21 July 1972
Workshop reading list. The list of assigned reading material
is given below. The reading material is to be read by each partici
pant in the order in which they are listed below.
1. Etienne, G. The application of systems analysis to education.
Unpublished manuscript. University of Southern California,
1972.
2. Longway, M. Curriculum concepts-— an historical analysis. Nursing
Outlook, 1972, 20, 116-120.
3. Roy, C. Adaptation: A conceptual framework for nursing. Nursing
Outlook, 1970, 18, 42-45.
4. Kemp, J. Instructional design. Belmont, Calif.: Fearon Pub
lishers, 1971.
5. Builough; B., & Bullough, V. A career ladder in nursing: Prob
lems and prospects. American Journal of Nursing, 1971,
71, 1938-1943.
6. Mager, R. F. Preparing instructional objectives. Belmont,
Calif.: Fearon Publishers, 1962.
7. WHO. World Health Organization handbook for educators in the
health professions. Geneva: WHO, 1962.
8. WHO. Implications of Individual and small group learning systems
in medical education. (Technical Report Series #489)
Geneva: WHO, 1972.
9. Abrahamson, S. Methods of teaching. In W. Mendel & P. Solomon
(Eds.), The psychiatric consultation. New York: Grune &
Stratton, 1968.
APPENDIX B
MULTIPLE-CHOICE TEST ADMINISTERED TO WORKSHOP
PARTICIPANTS AT THE BEGINNING AND
AT THE END OF THE WORKSHOP
64
65
WORKSHOP ON EDUCATIONAL METHODOLOGY
NURSING
Brazzaville, 10-21 July 1972
Instructions; In the blank space provided before each item print the
letter corresponding to the correct and/or best answer.
1. One good reason for using explicit objectives rather than
implicit objectives is that the former
A - permit a broad interpretation of educational outcomes;
B - are not as restrictive in the assessment of terminal
performance;
C - describe specific components of behavior;
D - are more concerned with the process of education
rather than the product which results.
2. According to the criteria listed by Mager, which of the fol
lowing choices best completes this statement of objective:
Given the necessary chemicals and equipment the student can
A - identify the elements in unknown compounds;
B - identify the elements in eight out of ten unknown
compounds ;
C - identify eight unknown compounds;
D - identify eighty percent of the elements in unknown
compounds.
3. Which of the following are not observable directly?
A - performances;
B - responses;
C - learnings ;
D - terminal behaviors.
66
4. Achievement measures based on relative standards (norms)
A - reflect the least amount of end-of-course competence;
B - provide explicit information about what the student
can do;
C - indicate the prerequisite condition for further in
struction;
D - may permit students to proceed without really demon
strating minimum competence.
5. Relative standards of achievement are based on
A - specific performance criteria established by the
teacher;
B - minimum acceptable levels of end-of-course achieve
ment (terminal performance);
C - criteria established by comparing the performance
levels of students with each other;
D - response patterns of students to individual test items.
6. A test is said to be valid when it
A - measures consistently whatever it is that it does
measure;
B - discriminates between individuals of varying academic
abilities ;
C - measures the performance it is intended to measure;
D - involves an economical construction and administration,
7. The purpose in using some form of objective test is
A - to meet explicit rather than implicit objectives;
B - to eliminate subjective judgments of the scorer;
C - to provide examinees with a list of alternatives to
choose from; e.g., multiple-choice or true-false;
D - to provide a high reliability to the test.
67
8. One should use a free response test rather than a fixed re
sponse test
A - when Encouraging students to study for command of
knowledge;
B - when testing for ability to think critically;
C - when encouraging skill in written expression;
D - under any of the conditions listed above,
9. An item is said to be a positive discriminator when it
A - gives an advantage to some students over other
students ;
B - is negatively correlated with other items ;
C - differentiates high scorers from low scorers ;
D - contains inherent prejudices built in by the item
writer.
10. Item analysis procedures can help the teacher to
A - establish levels of minimum acceptable performance;
B - determine which students are working at a level com
mensurate with their ability and which are not;
C - improve his examinations by revising individual items;
D - determine how any given class performed in relation
to another class.
11. The usual procedure for establishing test validity is to
A - correlate scores on the test with some other measure;
B - determine how well students score on repeated ad
ministrations of the test itself;
C - determine how well the items on the test correlate
with each other;
D - assess the objectivity of the scoring procedures.
68
12. To compensate effectively for a student*s low level of enter
ing behavior a teacher might
A - provide review exercises;
B - provide more instruction;
C - change the instructional objectives;
D - make use of any of the above procedures.
13. Experimental evidence on learning indicates that
A - rapid learning results in rapid forgetting;
B - meaningful material is more rapidly learned but more
quickly forgotten;
C - meaningful material is more rapidly learned and re
membered for longer periods of time;
D - a student who spreads learning throughout the term
will learn as much as the student who crams.
14. The most critical variable to be considered when evaluating
instruction is
A - student performance;
B - satisfaction of instructor and opinions of colleagues;
C - student opinions;
D - satisfaction of instructor,
15. Most examinations used in medical schools test student
ability to
A - interpret facts and information;
B - recall specific facts;
C - solve problems;
D - apply knowledge to solve a problem.
69
16. Curricular planning decisions are most likely to reflect the
views of the majority in the educational environment when
policy decisions are made by
A - a faculty committee composed of representatives of
several departments in the medical school;
B - a committee representing the school administration,
the faculty, and education specialists;
C - a committee comprised of departmental chairmen and
the dean;
D - a committee representing the school administration,
faculty, students, and education specialists.
17. The learner's anxiety about his education must be considered
by the teacher because
A - learning is facilitated by a student's fear of failure;
B - fright reduces speed, efficiency, and retention of
learning ;
C - keeping students happy is significantly related to
their learning;
D - all of the above are true.
18. The essay examination has an inherent weakness of potential
lack of objectivity. Which of the following suggestions
would be least helpful in combating that weakness?
A - conceal the examinee's identity from the scorer;
B - do not "lift" a statement verbatim from the text
book;
C - prepare in advance a "model" response to each
question;
D - grade a single question on all papers before grading
a second question.
70
19. In designing a curricular segment which is to train students
in the application of creative problem solving skills, the
learning activities and evaluative criteria most consistent
with the objective are
A - lectures and demonstrations by the most creative
problem solvers on the faculty with evaluation
based on student recall of material presented;
B - laboratory or field exercises in which students re
peat classical experiments or problem solving
activities, with evaluation based on student
ability to reproduce classical results ;
C - student placement in an organized sequence of lab
oratory, clinical, and community problem situa
tions, with student solutions clearly identifiable
and evaluation based on expert analysis of the ap
proach and student contribution to solving the
problem;
D - student placement in an organized sequence of lab
oratory, clinical, and community settings, with
difficulty in identifying student contributor of
solution and with evaluation based on the opinions
of other members of the team.
20. The lecture primarily helps students achieve the following
objective
A - acquisition of a body of information;
B - gain of a better understanding of material;
C - achievement of basic clinical or laboratory skills;
D - development of attitudes toward the content.
21. It is postulated that no two (or more) students learn in
exactly the same way. This suggests that
A - group learning activities should be avoided;
B - lectures cannot be expected to facilitate learning;
C - each student needs a preceptor or tutor;
D - a variety of teaching methods is called for.
71
22. Institutional objectives should be defined by cooperative
planning activities involving
A - administration representatives;
B - faculty representatives;
C - student representatives;
D - all of those above.
23. "Terminal behavior" is best defined as how someone acts
A - if he has learned what he was expected to;
B - in the last phases of a fatal illness;
C - when taking an examination at a computer console;
D - in his last weeks of school.
24. Which one of the following is not a familiar error in the
use of rating scales?
A - leniency;
B - central tendency;
C - proximity;
D - ambiguity.
25. Using the criterion of student achievement, a teacher^s
performance is best judged by
A - his students ;
B - his colleagues;
C - his superiors;
D - none of the above.
72
26. Assessment of student achievement of skills
A - requires application of rating scales ;
B - cannot be accomplished without direct observation;
C - can be accomplished by reviewing records;
D - can be inferred from student reports of their own
performance.
27. Kemp^s approach to instructional design is
A - the best available "model" at this time;
B - recommended by the WHO consultants ;
C - a useful tool to help examine educational planning ;
D - particularly appropriate to African nursing edu
cation.
28. Which of the following is not characteristic of grades as
signed to students in courses?
A - arbitrary;
B - meaningless;
C - reliable;
D - threatening.
29. "The greatest advantage of (the blackboard) is . , . its
magnetic effect upon attention." Therefore, it is a good
teaching practice when using the blackboard to
A - draw diagrams or connecting lines while lecturing;
B - print legibly what is supposed to be there before
the teaching session starts ;
C - leave important material on the blackboard;
D - avoid drawing on the blackboard while talking.
73
30. The use of "drill" (repetitive exercise of skill activities)
will be least helpful in promoting the learning of
A - application of knowledge to the solution of a
problem;
B - achievement of science-based clinical skills;
C - development of patient-centered professional be
havior ;
D - professional attitudes toward patient care.
APPENDIX C
SEMANTIC DIFFERENTIAL
74
SEMANTIC DIFFERENTIAL
75
Teaching
Good
Heavy
Boring
Active
Painful
Wise
Simple
Hard
Light
Bad
Light
Interesting
Passive
Pleasurable
Foolish
Complex
Soft
Dark
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Cobin, Joan Tagliere (author)
Core Title
A study of the quality of behavioral change in learners when a system model is used for the instructional design
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Doctor of Philosophy
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Education
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University of Southern California
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education, educational psychology,Education, Instructional Design,OAI-PMH Harvest
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Cobin, Joan Tagliere
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education, educational psychology
Education, Instructional Design