Higher Education for Medicine, using VLE

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Review of Virtual Learning

Environments in UKMedical, Dental andVeterinary Education

Special Report 6

ISBN 0 7017 0186 2

Julian Cook August 2005


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Institute for Learning and Research Technology Review of Virtual Learning Environments in UK Medical, Dental and Veterinary Education

Julian Cook ISBN 0 7017 0186 2 Page 2

Review of Virtual Learning Environments in UKMedical, Dental and Veterinary Education

Higher Education Academy Subject Centre for Medicine,Dentistry and Veterinary Medicine: Mini-project Report

1. Document Notes

Author Julian Cook, Institute for Learning and Research Technology, University of Bristol

Date 27 August 2005

Version 2.0

Document Name Higher Education Academy Subject Centre Mini-project Report

2. Summary

This is the report of the Higher Education Academy subject centre for Medicine, Dentistry and VeterinaryMedicine (formerly LTSN-01) Mini-Project Review of Virtual Learning Environments in UK Medical, Dental andVeterinary Education. It is an update of the JTAP-623 report carried out in 2001. It presents responses to twoquestionnaires (targeted at academics and developers) circulated in August / September 2004, as well as somecomments collected at a one-day seminar in May 2004.

A total of 35 medical schools responded, along with 9 Dental Schools and 7 Vet Schools. Responses show thatalmost half of schools are now using a commercial rather than a bespoke VLE, although bespoke systems are still

felt to be more suitable. Overall usage of VLEs has increased greatly. There has been development of VLEstowards personalisation and integration with other systems, mainly through moves towards single-sign-on,although there is still work to do in this respect. A minority of schools are actively involved in sharing content(mainly questions and interactive materials) and to a lesser extent system code and components. This is mainlydone within formal projects and associations. The teams supporting VLEs vary enormously in terms of their sizeand skill sets. Although there has been a broadening in the range of activities carried out with VLEs, their corefunction is still delivery of course and administrative information. There is still insufficient data about how VLEs areaffecting teaching and learning practice, although there is a strong belief that they are important in supportingstudents on placement, mainly by improving contact with central services.


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3. Acknowledgments

The author would like to thank the following for their contributions to, and help with, this report.

Academics Developers

Dr David Byrne Ms Sandy Bostock

Dr G Cannavina Dr David Byrne

Prof Jane Dacre Dr John Couperthwaite

Dr David Davies Dr Peter Dangerfield

Dr Reg Dennick Dr Hazel Derbyshire

Prof Susan Dilly Dr Rachel Ellaway

Dr Tim Dornan Dr Neil M Hamilton

Dr Michael Doherty Dr Joan Kemp

Dr Max Field Dr Tony McDonald

Dr Ross Hobson Dr Colin MelvilleMs Sharon Huttly Dr Malcolm Murray

Dr Andrew Jefferies Dr Anthony Peacock

Prof Sam Leinster Dr Andy Pellow

Prof Stephen May Dr Giles Perryer

Prof Jim McKillop Mr Peter Rayment

Dr Jacinta McLoughlin Mr Ash Self

Dr Kieran McGlade Mr Nick Short

Dr Jean McKendree Ms Vivien Sieber

Prof Stewart Petersen Prof Michael Ward

Dr Patricia Reynolds Mr Kim Whittlestone

Prof Trudie Roberts Dr Simon Wilkinson

Dr Susan Rhind Dr Jane Williams

Dr Anita Sengupta

Prof John Simpson Academy Subject Centre

Dr Patsy Stark Dr Megan Quentin-Baxter

Prof David Stirrups

Prof Martin Sullivan ILRT, University of Bristol

Dr Frank Taylor Mr Mike Cameron

Prof Richard Vincent Mr Andy Ramsden

Prof Damien Walmsley Mrs Sue Timmis

Dr Diana Williams

Mr WM Williamson

Mr Jeff Wilson

Thanks also to those who contributed anonymously, and to the reviewers of the text drafts including: RachelEllaway (University of Edinburgh), David Davies (University of Birmingham), Megan Quentin-Baxter (AcademySubject Centre), and all those who responded to the consultation on the final draft in May 2005.

Thanks to the Higher Education Academy subject centre for Medicine, Dentistry and Veterinary Medicine, and theTeaching and Learning Technology Programme Facilitated Network Learning in Medicine and Health Sciences

transferability project (project number 86) for financial support of this study.


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4. Contents

Institute for Learning and Research Technology Review of Virtual Learning

Environments in UK Medical, Dental and Veterinary Education Higher Education

Academy Subject Centre for Medicine, Dentistry and Veterinary Medicine: Mini-project

Report....................................................................................................................................................21. Document Notes.........................................................................................................................................................................22. Summary ............... ................ ................. ................ ................ ................ ................ ................ ................ ................ ................ ........23. Acknowledgments .............. ................. ................ ................ ................ ................ ................ ................ ................ ................ ........34. Contents........................................................................................................................................................................................4 5. Foreword.......................................................................................................................................................................................5 6. Introduction ............... ................ ................ ................ ................ ................ ................ ................. ................ ................ ................ ..67. Aims ............... ................ ................. ................ ................ ................ ................ ................ ................ ................ ................ ................68. Methods ................ ................ ................. ................ ................ ................ ................ ................ ................ ................ ................ ........69. Summary of results .....................................................................................................................................................................710. Discussion............... ................ ................ ................ ................ ................. ................ ................ ................ ................ ................ .. 1111. Recommendations ................................................................................................................................................................... 13Introduction....................................................................................................................................... 15

Aims.................................................................................................................................................... 16Methods.............................................................................................................................................. 17

12. Data collection .........................................................................................................................................................................1713. Responses ..................................................................................................................................................................................18

Results................................................................................................................................................ 2114. Case for Medical VLEs............................................................................................................................................................2115. Pressure to standardise..........................................................................................................................................................2716. Changes to VLEs since 2001................................................................................................................................................. 3017. Growth of VLE usage ............................................................................................................................................................. 3418. IT and support infrastructure...............................................................................................................................................3819. Sharing of system components and content..................................................................................................................... 4220. Role of VLEs in supporting student placements .............................................................................................................. 4821. How VLEs are used................................................................................................................................................................. 5022. Effect of VLEs on learning and teaching practice............................................................................................................. 53

Discussion........................................................................................................................................... 5423. Limitations of this survey.......................................................................................................................................................60

Recommendations ............................................................................................................................ 6224. Hosting institutions .................................................................................................................................................................6225. Medical, dental and veterinary schools .............................................................................................................................. 6226. All developers...........................................................................................................................................................................6227. Developers of bespoke systems .......................................................................................................................................... 6228. Funders / stakeholders ........................................................................................................................................................... 62

Appendices......................................................................................................................................... 6429. Appendix One: VLE types used by individual schools as main VLE............................................................................ 6430. Appendix Two: How bespoke VLEs have developed since 2001 ............................................................................... 6531. Appendix Three: Full system usage data - 2004 .............................................................................................................. 6732. Appendix Four: Server Descriptions ..................................................................................................................................6833. Appendix Five: Interoperability technologies implemented in VLEs ..........................................................................6934. Appendix Six: Breakdown of e-learning activities undertaken to any significant extent at UK medical,

dental and veterinary schools ...............................................................................................................................................7035. Appendix Seven: On-line academics survey ..................................................................................................................... 7236.

Appendix Eight: On-line developers survey ..................................................................................................................... 75

37. Appendix Nine: Glossary....................................................................................................................................................... 82


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5. Foreword

Few will doubt that e-learning has now become part of the core business of universities playing an increasinglyimportant role in the learning and teaching process. In the UK, Medicine, Dentistry and Veterinary Science haveoften been at the forefront of e-learning innovation and in learning environment development in particular. Virtual

learning environments (VLEs) provide an overarching context for e-learning materials: the widespread creation ofsophisticated electronic curricula shows that this has been recognised. Continued development of the electroniccurriculum lies at the heart of this innovation and provides an opportunity to strengthen collaboration betweeninstitutions. A whole new generation of learners is benefiting from the integration of e-learning using moretraditional pedagogical techniques. VLEs are a space in which students can engage with course content in a waythat maps onto their own learning style. For Years 1 and 2 of Medical, Dental and Veterinary courses, VLEs arevery popular and provide a means to inspire and enthuse students in the early stages of their degree. While thepicture is more complex for students out on placements, VLEs make access to more resources easier and thishelps to consolidate knowledge which complements the development of their clinical skills. The integration ofplacement students into an on-line community may take longer to achieve, despite the rise of discussion boardsand the like, as this report suggests. Further research into this area would make an important contribution to thefuture development of VLEs in relation to their use and impact on learners. The report examines the progressmade in the personalisation of systems and recommends that this area should be prioritised. This will further tailor

the electronic curriculum to the needs of individual learners and presents a real opportunity to engage many morestudents more effectively. e-learning then becomes a means for delivering a blended learning experience thatintegrates a range of materials and formats across the curriculum.

The 2001 predecessor of this review, the JTAP-623 report, came at a time when Medical, Dental and Veterinaryschools were exploring how VLEs could be made to support the learning and teaching process by using newtechnologies, particularly the internet and broadband networks. A pattern emerged of investment in localizedinfrastructure and technical staff to develop systems and content to support local needs. While innovation hasbeen driven by a few champions, a much more systematic approach is required, as this report suggests. Such achange to the delivery of the electronic curriculum will enable universities to meet the demands of increasedstudent numbers, and capitalise on their familiarity with new technology.

The present report reflects the change in emphasis in institutions from local to central support for VLEs, fromadoption by individual champions to wider staff uptake, and from locally developed bespoke solutions to the

integration of local systems with commercial tools. We live at a time where it is increasingly difficult for any oneschool to develop all the systems and content it needs to support the curriculum. The importance of sharingexperiences, ideas and good practice remains high while VLE innovation is still diverse and rapidly evolving. TheVLE community will be strengthened by this and as progress continues, a more integrated system will emerge. Thechallenge however, remains for individual schools to maintain high standards and to invest in the technicalinfrastructure necessary to meet the changing needs of the curriculum, teachers, and students. I welcome thisreport as a much-needed review of current good practice across our sector and hope that it will be used toinform the exciting challenges that face us in the future.

Professor William Doe

Dean of the Medical SchoolUniversity of Birmingham


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6. Introduction

The JTAP-623 report, completed in 2001, was a survey of the use of VLEs in UK medical education 1. It highlightedsome of the key issues relating to the development of VLEs, and acted as a focal point for the sharing ofexperiences, ideas and good practice between those who had already been working in this area for some time and

others who were just beginning. This report updates that work by reporting the results of a more recent survey ofmedical, dental and veterinary academics, clinicians and curriculum developers. The term medical VLEs usedthroughout this report refers to the use ofVLEs in medical, dental and veterinary education. A fullglossary is provided in Appendix Nine: Glossary on page 72 below.

7. Aims

The overall aim was to see how much the overall findings of JTAP-623 still applies in 2004 and to see how thesector has moved on during the intervening 3 years.

8. MethodsData was collected on the use of VLEs in medical, dental and veterinary education in the UK. The main datacollection methods and the results are outlined below.

8.1. Participation at face-to-face event. Attendance at the Academy event Twenty-Twenty Vision in Manchester on 6 May 2004.

Data was gathered through:

Informal discussions.

A short paper-based questionnaire for the participants of a focus group.

Notes from a themed group discussion.

8.2. On-line questionnaires.

An academics questionnaire Forty five responses were received during August / September 2004from 9 dental schools, 23 medical schools, and 7 veterinary schools. Six anonymous responses were received.

A developers questionnaire Twenty nine replies were received during August / September 2004,including 25 medical schools, 1 dental school and 3 veterinary schools.

1http://www.ltss.bris.ac.uk/interact/23/in23p14.html


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9. Summary of results

9.1. Although more schools are now using commercial VLEs (rather than bespoke

systems) than in 2001, mainly because of institutional pressures, there is greatersatisfaction among developers of bespoke systems.

Around half of the responding schools are using a commercial VLE, while the remainder use a bespoke system oropen source system.

Main VLE - Source: Developers Survey (n=28).

The sector is now much more mixed in terms of VLE type used, with 12 respondents using a commercial system,11 using their own bespoke systems, 2 using a system modified from another institution, and 2 using the Bodingtonopen source system.

2nd VLE - Source: Developers Survey (n=28).

A few schools are using a second VLE, in some cases where the main institutional VLE supplements the bespoke

system used in the school, and in others bespoke components are retained to supplement the institutions systemwhere this has supplanted the schools original bespoke VLE.

Commercial systems in use - Source: Developers Survey (n=12).

The main commercial system in use is Blackboard, used by 9 responding schools, with another 2 using WebCT,and 1 using FD Learnings Learning Environment (now Tribal Technology).

How has the situation changed since 2001? - Source: Developers Survey (n=28).

For 14 of the respondents there had been no change. A quarter (7) had adopted a VLE since 2001 (of these 3were bespoke or open source systems, and 4 were commercial. Three have changed from using 1 VLE to using 2.

Are the VLEs sufficient in themselves or do they need supplementing with other applications. Source: Developers Survey

(n=25).

The main supplementary applications being used with VLEs are a dedicated assessment system (mostlyQuestionMark Perception), an Optical Mark Reader and an e-portfolio, all used by just under a half of respondents.There were no statistically significant difference between the bespoke and commercial users.

Users of bespoke systems clearly believe that only these can represent the curriculum adequately, while users ofcommercial systems are more ambivalent.

Reasons for choice of VLE - Source: Developers Survey (n=14).

The main reasons selected by users of bespoke systems for not using a commercial system were a) that their ownsystems remain the best way of representing the curriculum and b) because of the deficiencies of commercial

systems.

Source: Developers Survey (n=12).

The main reasons selected for their choice by those using commercial systems were: pressure from the hostinginstitution; that they were not given a choice in the decision; had insufficient resources to develop their ownsystem; or that the commercial system met their needs.

Suitability of commercial systems - Source: Developers Survey (n=26).

All but 2 of the bespoke users agreed that the complexity of medical curricula made commercial VLEs unsuitable,whereas half of the commercial users disagreed. However 5 of the 11 commercial users agreed, suggesting somedissatisfaction with their commercial systems.


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Satisfaction with VLEs reflection of curriculum - Source: Developers Survey (n=26).

Bespoke users expressed more satisfaction than commercial users with their own systems ability to represent thecurriculum. Only 2 bespoke users were less than mostly satisfied, and both represent schools using an off-the-shelf open source system rather than a truly bespoke VLE.

Supplementary tools in commercial systems for managing the curriculum - Source: Developers Survey (n=8).

These include applications to support specific activities (e.g. Special Study unit and placement allocations); linkageto non-VLE hosted materials, timetable, a bespoke CMS and various VLE-controlled bespoke tools.

9.2. Almost all hosting institutions are using commercial VLEs, but only a minority ofsurveyed schools were experiencing pressure to fall into line.

Relationship between school and institutional VLEs - Source: Developers Survey (n=14).

For almost all bespoke users, the hosting institution is using a commercial VLE either exclusively or in conjunctionwith a bespoke system. The exceptions are 2 institutions that are using the same open-source VLE as their medicalschool.

Institutional attitudes to bespoke medical VLEs - Source: Developers Survey (n=12).Most bespoke users said their institutions were happy for the two systems to coexist, but 5 schools said thatpressure to adopt the hosting institutions VLE was either already present or was likely in the future. There arealso moves to make the school and institutional systems more interoperable.

Likely future relationship - Source: Developers Survey (n=12).

Nine bespoke users said the two systems would continue to co-exist though one or two were unsure, and someagain mentioned a trend towards greater interoperability between systems rather than mutual exclusion.

9.3. There has been progress towards personalisation of systems and data integration,particularly various forms of single-sign-on.

There has been considerable progress towards individualised user portals, and implementation of survey tools hasalso increased.

The 2004 survey asked the bespoke developers how far the intended developments mentioned in the 2001 surveyhad actually taken place.

Personalisation features - Source: Developers Survey (n=14).

There is quite a mixed picture, with considerable progress towards user specific portals into the VLE, but otherfeatures, particularly intelligent recommendation of resources and user specified pathways, have not been widelyadopted.

Other features - Source: Developers Survey (n=14).Author uploading tools, assessment tools and 2-way communication were already established features of mostsystems, and survey tools are a newer but very popular feature, while the use of MeSH and RSS feeds is neitherwidely adopted nor planned.

Most schools now have some level of integration between the VLE and other systems - Source: Developers Survey (n=24).

At least 24 out of 28 schools have or are planning some level of integration. The most common is a single-sign-onwhere the same user details have to be entered separately to login to each system, while a smaller number havemore sophisticated integration such as true single-sign-on (where authentication information is passed betweensystems) or linking to student record systems. The 11 other responses emphasised that fuller integration is onits way even if it is not present yet in most cases.


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9.4. Use of VLEs has increased significantly across the sector.

Most schools now use a VLE - Source: Academics Survey (n=38).

Use of a VLE is underway to some extent in 31 of the 38 schools who responded to the relevant question in theAcademics Survey.

In the majority of schools, the VLE is now used by most or all staff and students - Source: Academics Survey (n=38).

Twenty four out of the 38 believe that the VLE is used widely across the school, either by many but not yet all, orby all as a matter of course.

Broken down into subject disciplines, the greatest level of embeddness appears to be in Medicine, where 9 schools(almost half of the 19 that responded) see their VLEs used as a matter of course by staff and students. Thisrepresents a step onwards from 2001, where the impression was that in most school VLE uptake was moresporadic and patchy.

9.5. Levels of use by students and staff have increased significantly.

For 20 out of the 23 schools responding, usage has increased either significantly or massively 2. No respondents

said that usage had remained stable or decreased.

Usage statistics - Source: Developers Survey (n=10).

Only 10 respondents were able to give detailed usage figures, and such figures are notoriously unreliable. Howeverfigures given by Edinburgh, Nottingham and Cambridge indicate at least a ten-fold increase in use since 2001.

Years using most heavily (e.g. 1st, 2nd etc.) - Source: Developers Survey (n=19).

The overall picture suggests that usage is heaviest in the first 2 years of the curriculum, although there are schoolswhere use is heaviest towards the end of the curriculum.

9.6. VLEs are hosted on a mix of Microsoft and Unix platforms; support teams are

mainly small and of mixed composition.

The results presented below represent survey questions that were not directly or systematically addressed in the2001 survey. It is not possible to link them directly to growth in VLE usage. The results presented simply indicatethe level of IT and support infrastructure in place at the time of the survey.

IT infrastructure

Server descriptions - Source: Developers Survey (n=21).

a) Nine of the schools use Microsoft based set-ups mostly using a combination of Win 2000 / 2003, IIS, SQLServer, and ASP.

b) Six use what could broadly described as Unix set-ups, including Linux, OSX, and Solaris with Apache, My

SQL, Zope or PHP.Few of the responses gave much indication of the hardware power they use to run their VLE, although 8 of therespondents mentioned that they run their VLE on multiple machines.

Support teams - Source: Developers Survey (n= 22).

Many schools have less than 1 FTE in each support role, except for the roles of Server / site maintenance, VLEadministration, educational development and e-learning development where at least half of the schools have morethan one FTE3.

A small number of institutions (c. 6) have large development teams (up to 20 people), where another 11 havearound 6 or 7 staff, and the remaining 4 have fewer than this.

2 Acknowledging of course that these terms are very imprecise.3 However it must be acknowledged that these roles are not very clearly defined and that there may considerable overlap

between them.


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As a whole most of the support staff are located within the school rather than provided by the institutioncentrally, although less so for the roles of server maintenance, VLE administration and user training. For bespokeusers support is much more likely to be provided locally, and in particular all their web development staff areprovided within the schools.

9.7. Although sharing of code and content is only a priority for a few schools, mostschools have shared at least some content, mainly interactive materials and

questions.

The 2001 report recommended that further efforts be made to facilitate the sharing of both VLE components andcontent across the sector.

The case for a single medical VLE - Source: Developers Survey (n=14).

There is broad agreement that there is not a justification for a single standard VLE specifically for medicinebecause of variations in curricula between schools.

Interoperability technologies - Source: Developers Survey (n=21).

By far the most common interoperability technology is XML, implemented by a small majority of schools, with

Learning Object metadata and the IMS QTI specification also implemented by a sizeable minority.

Sharing system code and components - Source: Developers Survey (n=23).

Sharing system code and components is only a high priority for 5 out of the schools represented, and for 11 it islow priority or not on their agenda at all. Eight had shared code either a great deal or somewhat, showing thatsome schools have done this even when it is not a high priority.

This is done using a variety of approaches: for example Blackboard users within the sector are beginning tocollaborate (by sharing Blackboard Building Blocks) and there are number of other collaborative projects workingtowards code / component sharing.

Sharing content - Source: Developers Survey (n=24).

The level of priority for making content readable by systems at other institutions is about the same as it is forsharing system code and components and the same schools are enthusiasts for both activities, with one or twoexceptions.

Results suggest rather more actual sharing of content than of system code, with 16 schools having shared somekind of content somewhat or a great deal. Interactive materials seem to have been shared rather more andreusable learning objects (RLOs) rather less, despite the relatively large number of schools implementing astandard for this.

9.8. Although delivery of VLEs to hospital sites is somewhat constrained by IT

infrastructure limitations, VLEs have been successful in facilitating support for andcommunication with staff and students at remote sites, and for delivering learning

activities.

Effective uses of VLEs to support students on placements Source: Paper-based questionnaire (n=7).

Responses included: providing equity across placements; creating a community of learning; allowing rapidcommunication; stimulating student / tutor dialogue; improving contact with tutors; facilitating curriculumcoherence; facilitating activities such as e-CPD, formative Computer Assisted Assessment (CAA), video lecturessynchronised with slides.

Limitations of VLE use at remote sites: the effect of hospital IT infrastructure on VLE use - Source: Developers Survey(n=23).

A considerable majority (16) agree that their user group's ability to take full advantage of their VLE is constrainedby IT infrastructure in hospitals where their students and teachers are located.

Only a minority (4) provide and support IT infrastructure for teaching areas in hospitals, while the majority eithersimply make recommendations or have little or no involvement.


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9.9. While the single most common use of VLEs remains to deliver programmeinformation and course documentation, many schools are also using them as aplatform for on-line learning activities despite some doubts about the efficacy ofthese.

The JTAP-623 2001 report found that most schools were using VLEs heavily to i) deliver information about theprogramme and less as ii) a platform for on-line learning.

Relative importance of information delivery vs. on-line learning Source: Paper-based questionnaire (n=7).

Overall respondents see i) as less demanding and consequently it has in many cases been emphasised, but thatthere is interest in and in some cases a recognition of the potential for ii) but also some concerns about the costand validity of such materials and activities.

How e-learning is used - Source: Academics Survey (n=44).

The single most common use of e-learning selected (mainly but not exclusively delivered via a VLE) is for on-linemanagement of course literature such as programme / module / study guides, with 41 respondents choosing thisactivity. Thus the heaviest use of VLEs is still as a means of delivering information about the programme. Howevermany schools are engaged in on-line learning activities, the most common of which are formative assessment andasynchronous discussion.

The continued emphasis on i) is reprised in the response from the Academics who were asked to choose andprioritise the four main drivers for using a VLE in their school; the two highest scoring drivers were both relatedto curriculum management a result very similar to the 2001 survey.

9.10. Little data is available yet on the impact of VLEs upon learning, teaching and

assessment practices, however there is some evidence that it can release staff timeand facilitate a review of practice.

Source: Paper-based questionnaire (n=7).

Respondents to the paper-based questionnaire describe the effect their VMLE has started to have upon learning,

teaching and assessment practices in their institution. Answers show a mixed picture of schools where use of VLEshas already had a significant impact (releasing staff time, facilitating review of practice) and where it is too early tosay.

10. Discussion

10.1. Which of the planned developments have actually been implemented and howsuccessful have they been?

Developing beyond what we understood them to be 3 years ago, VLEs seem to be evolving into aggregations of a

wider set of e-learning tools, for example e-portfolios and assessment tools. Applications such as e-portfolios leadmedical VLEs towards becoming truly personalised. However a limit on this has been placed by the difficulties ofseamless integration between systems. The gradual implementation of true single-sign-on may represent a first steptowards this at least from the users perspective, and ultimately towards replacing the single jack-of-all-trades VLEwith more modular suites of integrated applications. However the modular approach risks losing the cohesion andsense of orientation experienced by users of a well-designed unified on-line environment.

10.2. How much collaboration and sharing of system components and/or content has

there been between institutions developing medical VLEs?

Medical schools seem unlikely to collaborate to the extent of creating a single VLE or even a smaller number ofVLEs for UK medical education. There has been some sharing of system code and components, and of content.

There has been rather more of the latter, perhaps in part due to the high value of good quality content and theimproved interoperability between systems which means that content can be more easily shared across a range ofplatforms thus reducing the imperative for sharing of code.


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Most sharing has been done between groups of schools brought together through formal collaborative projects,membership of specific national and international associations or through using the same commercial VLE. Thereseems to be some inconsistency between reports of content sharing and implementation of standards andspecifications required to enable this, suggesting standards implementation is motivated by local rather than inter-institutional considerations.

10.3. Given the rapid evolution of commercial VLEs, is there still an overriding case for

the continued use and development of bespoke VLEs?

The answer to this is more mixed than it was in 2001. Many (but not all) schools using commercial VLEs aresatisfied with them, but there is greater satisfaction among bespoke developers. Open source VLEs present a newrival to bespoke systems as they appear both economical and amenable to local adaptation. However, thesuitability of both commercial and institution-wide open source systems may depend as much on how flexibly theyare implemented institutionally as on their inherent flexibility. With greater integration of systems it will becomeeasier to assemble VLEs from a range of tools seamlessly joined together. The case for continued dedicatedmedical VLEs will depend on their offering unique facilities.

10.4. As institutions have begun to adopt VLEs centrally, has there been any pressure on

schools to fall into line with institution-wide VLE strategies, and how have schools

responded to this?

This has only occurred in a minority of cases and most bespoke developers are optimistic about their futureprospects. However it is worth considering that pressure may come from within schools as well as from thecentre as the facilities and potential benefits of centralised VLEs become more widely known about. Bespoke VLEdevelopers can add value to their own systems through medicine specific tools and features such as assessmenttools, e-portfolios, case-logging tools.

10.5. How has usage of VLEs by staff and students grown and developed? How muchdemand does this place on IT infrastructure?

The growth of VLE use both numerically and in terms of embeddedness indicates that VLEs have been a success

and have an important place in medical education.

The staff teams who support this increased usage vary widely both in terms of size, mix of skills and how they aredistributed. This raises the question of what is really necessary, and which model works best, requiring furtherresearch before a recommendation could made. There seems to be some correspondence between thecomposition of the support team according to the type of VLE (bespoke or commercial) and whether the medicalschool is new or more established.

10.6. In what ways are VLEs most successful in supporting students and teacherslocated at disparate clinical and educational sites?

The limited control exercised by most schools over the IT infrastructure at the sites where many of their users

are located restricts to some extent what they are able to deliver via the VLE. One possible solution is the use ofthin client technology as adopted by the University of Bristol, although this has limitations in its support fordelivering video.

The main benefit of the VLE for students on placement and their teachers was said to be that it improved contactbetween remote sites and the central school but interpretations vary as to whether this means one-way deliveryof information or a multi-way conversation between learners and their teachers. There are suggestions of somemovement towards the latter, although some respondents have reservations.

10.7. Has there been any shift towards using VLEs as a platform for on-line learningrather than as a means of delivering more traditional documentation?

Is such a shift actually desirable? The key role of VLEs in medicine remains the delivery of traditional course

documentation. While some respondents embrace e-learning activities with enthusiasm others doubt their valueand are mindful of the cost and effort involved. Arguably while on campus students learn via face-to-face contactand on-line activities constitute a supplement to this rather than core learning. For students on placement there


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may be a greater case for providing on-line learning activities if the intention is to teach them underpinningknowledge during this time in addition to clinical skills.

10.8. Have the VLEs started to have any effect on learning, teaching and assessmentpractices?

Little evidence was collected during this survey but this question is believed to constitute an important area forresearch. Since VLEs are now becoming firmly embedded into the curriculum as well as representing significantongoing investment by both developers and teaching staff it seems vital to understand their influence upon thekinds of doctor, dentist or vet that are graduating from these institutions.

11. Recommendations

11.1. Hosting institutions

Where an institutions medical / dental / veterinary school is using the main institutional VLE, control of the VLEstructure should be devolved as far as possible to the schools to allow schools to modify the VLE for their needs.

11.2. Medical schools

Schools (or hosting institutions) should audit their local support teams and evaluate their suitability forimplementing their e-learning / VLE strategy. Results should be published in order for the community as a whole todevelop models of effective support.

Schools relying on single individuals to develop / support their VLE should consider an expansion of their supportteams and acquiring staff with relevant specialist skills.

Schools are able to share developments and some sharing and exchanging good practice has taken place,particularly when collaboration is facilitated by external funding such as FDTL or JISC. Sharing can be as effectivebetween same-course in different institutions, or different-courses in the same institution.

Schools considering their future VLE strategy should keep an eye on developments towards integration andinteroperability and consider the potential benefits of a hybrid solution rather than a single all-encompassing VLE.

11.3. All developers

Developers (particularly those working with or considering hybrid solutions) should prioritise the implementationof true single-sign-on where this is available locally.

Continue to work to allow modular integration between applications rather than development of all-encompassingVLEs.

Systems should be developed so that they are linkable at quite a deep level and integrated so that the user isunaware that they are using a different system.

Developers should analyse the tool integration models that are effective and be willing to share these with thedevelopment community.

11.4. Developers of bespoke systems

Continue to add value to medical VLEs through development of health-education specific applications and tools.

Work towards further development of personalised learning environments.

Demonstrate in detail how bespoke VLEs represent the curriculum better than a commercial or open source VLEcould.


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11.5. Funders / stakeholders

Evaluation work should be funded into:

How successful sharing of content has been in terms of how shared content is used and which kind of contentis most popular.

More specifically, how are RLOs used by different institutions. To what extent are RLOs used across

institutions? How far can they be designed to facilitate local modification? Furthermore feasibility studies should be carried out into sharing of learning processes.

Further research should be funded into:

How communication tools have helped to support students on placement and engender an on-line community.This would best be done as a set of case studies.

Give further consideration to the type of RLOs that could be shared.

Developing models of VLE / e-learning support in medical schools and their hosting institutions, and evaluatingthe effectiveness of these.

Further projects should be funded to support and encourage sharing of content.

Finally and most importantly, research is urgently needed into the true impact of VLEs on the practice of healtheducation and on the experience of students and staff.


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Introduction

The early adoption of VLEs by medical schools was a response to a) curriculum changes which had resulted in theblurring of the preclinical / clinical divide and b) to a need to manage larger numbers of students who now spendan increased proportion of their study time based away from the host institution engaged in clinical experiential

learning at clinical sites. They were developed to facilitate communication between sites, between students andteachers, and to find ways to represent and explain an ever more complex curriculum; and in response to qualityassurance requirements particularly as measured in the England / NI 1998-2000 round of QAA visitations.

The JISC JTAP-623 report1, completed in 2001, was a survey of the use of VLEs in UK medical education. Ithighlighted some of the key issues relating to the development of VLEs, and acted as a focal point for the sharing ofexperiences, ideas and good practice between those who had already been working in this area for some time andothers who were just beginning.

JTAP-623 found that:

Seventeen out of 21 UK medical schools surveyed were using a VLE, but of these 15 had either developed theirown or adopted / adapted one developed at another UK medical school, rather than commercial VLEs.

This was mainly because a) it was felt that the latter were unable to represent the complexity of the medicalcurriculum, but also b) because commercial systems were in their infancy when development of many of themedical VLEs began.

The result was some 12 largely separate developments, representing a considerable replication of effort.

The main use of VLEs was as a way of providing information about the curriculum and for providing supportinginformation rather than to facilitate on-line learning.

It was too early to get a clear sense of how the VLEs were affecting teaching and learning practices across thesector.

All of the developers interviewed intended to continue development of their system, in particular to addfeatures such as greater personalisation and delivery to mobile devices.


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Aims

As this is a new and very fast developing field, by late 2003 it was considered that JTAP-623 was in need ofupdating. The overall aim of the project was to see how much the overall findings of JTAP-623 still applied and tosee how the sector had moved on during this time. In the meantime several new medical schools had started up,

and it was considered necessary to include them.

The project initially set out to address the following:

1. Given the rapid evolution of commercial VLEs, is there still an overriding case for the continued use anddevelopment of bespoke medical VLEs?

2. As institutions have begun to adopt VLEs centrally, has there been any pressure on medical, dental andveterinary schools to fall into line with institution-wide VLE strategies, and how have schools responded?

3. Which of the planned developments have actually been implemented and how successful have they been?

4. How has usage of VLEs by staff and students grown and developed? How much demand does this place onIT infrastructure?

5. How much collaboration and sharing of system components and/or content has there been betweeninstitutions developing VLEs in clinical subjects?

6. In what ways are VLEs most successful in supporting students and teachers located at disparate clinical andeducational sites?

7. Has there been any shift towards using VLEs as a platform for on-line learning rather than as a means ofdelivering more traditional documentation?

8. Have the VLEs started to have any effect on learning, teaching and assessment practices?

It was decided that questions 6, 7 and 8 would be difficult to answer reliably and may therefore be beyond thescope of this study. However ultimately it was decided that 1-5 would be addressed by on-line questionnaire, andan attempt to get at least some data on questions 6, 7 and 8 would be made through attendance at a SubjectCentre event at which many of their nominated primary contacts (NPCs) would be present.


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Methods

12. Data collection

The main data collection methods were participation at face-to-face events and on-line questionnaires.

12.1. Participation at face-to-face events

Attendance at the Subject Centre event Twenty-Twenty Vision in Manchester on 6 May 2004 enabled some datato be gathered addressing questions 5, 6,and 7 (see Aims on page 16 above), as well as individual opinions andexperiences which informed the development of a wider survey (see 12.2 On-line questionnaires below). Althoughthe theme of the meeting was external clinical placements, there was a significant sub-theme of e-learning(including a themed breakout group titled - e-learning: How can e-learning support learning on external clinicalplacements?). This provided three sets of data:

Notes from participation in formal and informal discussions and pick up how people are thinking. A short open-ended paper-based questionnaire addressing questions 5, 6 and 7 circulated to all participants in

the themed breakout group.

Detailed notes of the discussion during the themed group taken by a member of the Subject Centre team.

The main use of the first and third items above was to inform the development of the on-line questionnaires.

12.2. On-line questionnaires4

Two on-line questionnaires were created and circulated during August and September 2004 to 2 separate lists ofinvited respondents. These were:

An academics questionnaire focussing on the strategic implementation of a VMLE, and the context for its usewas circulated to the nominated primary contacts of the Subject Centre.

A developers questionnaire focussing on the technical aspects of the VLEs. This was circulated to a list ofknown VLE developers compiled by the Subject Centre.

While the Academics Survey received responses from 45 of the dental, medical and veterinary schools in the UKand Ireland, the Developers Survey only received responses from 28 of them. The respondents were from alimited, invited list and time was not available during this project to extend the list to cover the whole potentialcommunity, or to personally chase up those who did not respond5.

The on-line surveys were created and made available using the SurveyMonkey survey tool (www.surveymonkey.com).The look and feel of the questionnaire was customised to reflect the look and feel of the Subject Centre website.A copy of the Developers Survey can be viewed at: http://www.surveymonkey.com/s.asp?u=90194782348 and theAcademics Survey at: http://www.surveymonkey.com/s.asp?u=79224782346

The developers questionnaire was structured so that the questions presented to respondents would depend onthe type of VLE they were using (according to their answer to the first question). Thus respondents who said theywere using a bespoke VLE would see questions relating to bespoke developments and to the merits of bespokesystems, while those using a commercial VLE did not see questions about system developments but were askedabout the merits of commercial VLEs.

An email was sent to the invitees from the Subject Centre commending the survey to them. Thereafter reminderswere sent out periodically. A lead time of 7 weeks was given. The reminders were sent automatically via theSurveyMonkey system which enabled reminders to be sent only to those who had not yet responded.

4 Throughout this report the intention is to present all evidence addressing a particular question together under its relevantheading. The report is organised according to the question being addressed rather than the data source. Hence in placesresponses from the different sources are presented side-by-side. Although the report moves back and forth between data

from different sources, the sources are clearly labelled throughout. It is hoped that this is the most illuminating way of givingthe reader an overview of the evidence under each question.

5 See 23 Limitations of this survey on page 60 below for further methodological reflections and caveats.


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SurveyMonkey allows personalised emails to be sent, including a link to the survey which allows the system totrack who has responded. Where respondents accessed the survey using the URL directly, rather than byresponding to the email, this information was not available.

12.3. Methodology notes

Confidentiality noteIn order to avoid sending repeated reminders to people who had already responded, the electronic survey systemtracked who had responded. This also allows the survey authors to map individual responses to specificinstitutions. The questionnaire also included an optional question asking for the respondents identity. There werea number of responses where this information was not filled in by the respondent but where the identify of therespondent was known by the system. In these cases responses will not be identified, either by name or byinstitution. The information was only used to indicate which institutions responded to the survey and to identifyquotes.

Terminology notes

Throughout this report, as in the questionnaire both 'VLE' and 'VMLE' are used which are intended to be readinterchangeably for the purpose of this report.

This report represents a survey of departments / schools / colleges involved in undergraduate medical, dental andveterinary education. It contains instances where the situation in the school is contrasted with that in thehosting institution. However a number of the participating schools are institutions in their own right. Howeverfor the purpose of this report, the term school is used to refer to all participating schools, departments orwhole institutions, and institution is used to represent the hosting University or College.

At various points in this report, medical or medicine is used to refer collectively to medicine, dentistry andveterinary science / medicine. It is hoped that readers will understand that this is for the sake of brevity.

13. Responses

13.1. Paper-based questionnaire

Seven responses were received, representing the following schools:

Peninsula Medical School (PMS).

University of Manchester.

The Royal Veterinary College, London (RVC).

Dental Institute, GKT School of Medicine.

University of East Anglia (UEA).

and a further 2 who responded anonymously.


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13.2. Academics survey

Responses were received from 45 medical, dental and veterinary schools. The following institutions wererepresented:

Medical Schools Dental Schools

University of Aberdeen University of Birmingham (Birmingham Dental School)

University of Bath University of Dublin

University of Birmingham University of Dundee

Brighton & Sussex Medical School (BSMS) Eastman Dental Institute

University of Dundee Dental Institute at Guy's, King's College and StThomas' Hospitals, King's College, London (GKTDental Institute)

University of Durham University of Leeds

University of East Anglia Medical School (UEA) University of Newcastle

University of Glasgow University of Sheffield

Hull York Medical School (HYMS) University of Wales College of Medicine (now CardiffUniversity)

School of Hygiene and Tropical Medicine, Universityof London (LSHTM)

Imperial College School of Medicine, London(Imperial)

Veterinary Schools / Departments

Keele University University of Bristol

Guys, Kings College and St Thomas Hospitals, theKings College School of Medicine, London (GKTSchool of Medicine)

University of Cambridge

University of Leeds University of Dublin

Leicester Warwick Medical School (LWMS) University of Edinburgh

University of Manchester University of Glasgow

University of Nottingham6 University of Liverpool

Queen Marys School of Medicine and Dentistry(QMUL)

The Royal Veterinary College, London (RVC)

Queen's University Belfast (QUB)

University of Sheffield

University of Southampton

University of St Andrews

University College London (UCL)

A further 6 institutions posted responses anonymously.

6 Note that this report relates to the undergraduate programme in Nottingham and does not include reference to theGraduate Entry Programme (Nottingham / Derby).


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13.3. Developers Survey

Responses were received from 29 medical, dental and veterinary schools. The following institutions arerepresented:

Medical Schools Medical Schools (continued)

University of Aberdeen University of Nottingham7

University of Birmingham University of Oxford

University of Bristol Peninsula Medical School (PMS)

University of Cambridge Royal Free and University College Medical School,London (UCL)

University of Durham University of Sheffield

University of East Anglia (UEA) University of Southampton

University of Edinburgh8 St George's University of London (SGUL)

University of Glasgow University of Wales College of Medicine (now CardiffUniversity)

Guys, Kings College and St Thomas Hospitals, theKings College School of Medicine, London (GKTSchool of Medicine)

Hull York Medical School (HYMS)Dental Schools

Keele University University of Birmingham

University of Leeds

Leicester Warwick Medical School (LWMS)Veterinary Schools / Departments

University of Liverpool University of Bristol

University of Manchester University of Edinburgh8

University of Newcastle The Royal Veterinary College, London (RVC)

A further 1 institution responded anonymously

7 These results do not represent the University of Derby.8 The developers response from the University of Edinburgh should be read as also covering Edinburgh Veterinary School.


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Results

Results will be organised according to the 8 key questions identified in the project proposal (see Aim on page 6above).

14. Case for Medical VLEs

Given the rapid evolution of commercial VLEs, is there still an overriding case for the continued use anddevelopment of bespoke medical VLEs?

14.1. What type of VLE are schools using now?

Main VLE

Respondents were asked to indicate which of the following is being used as the main VLE at their school: Commercial VLE (e.g. Blackboard).

Bespoke VLE developed at this institution.

Bespoke VLE developed elsewhere but modified at this institution.

Bespoke VLE developed elsewhere with no significant local modifications.

None.

Other.

Figure 1. Source: Developers Survey (n=28).

As Figure 1 shows, the sector is much more mixed in terms of VLE type used, with just under half using acommercial system and the remainder using either their own bespoke systems, a system modified from anotherinstitution, or the Bodington open source system (Leeds and Oxford). See Appendix One: VLE types used by

individual schools as main VLE on page 64 below for a full list of schools and the VLE they use.


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Using more than one VLE

Figure 1 shows that a few respondents said their schools are using a second VLE. Results indicate that where thefirst VLE is a bespoke system (and the second VLE is a commercial system), the commercial product that has beenadopted by the hosting institution and is being used to supplement the bespoke system used in the school, possiblyfor data exchange purposes, to provide specific functionality (such as CAA), or for specific courses such aspostgraduate programmes (e.g. Newcastle, Aberdeen, GKT School of Medicine). Where the first VLE is commercial(and the second VLE is listed as a bespoke system), the bespoke developments were described as having been

supplanted by another (commercial) system adopted by the hosting institution, and bespoke components areretained to supplement what is offered by the institutions system (e.g. Birmingham Medical School). In both casesthere is some evidence of both VLEs sharing or using common data sources.

Commercial systems in use

VLE No. of schools

Blackboard 9

WebCT 2

FD Learning's LE 1

How has the situation changed since 2001?

Respondents were asked to choose from the following to indicate how their current situation compares to thesituation in 2001.

We weren't using a VMLE in 2001.

No change.

Using a different VMLE.

We were only using one VMLE in 2001 and now we're using more than one.

Don't know / I wasn't here then.

Change in type of VLE used 2001 - 2004

New since

2001, 7

No change, 14

Different VMLE,

1

More than one

VLE now, 3

Don't know, 3


For half the respondents there had been no change. A quarter had adopted a VLE since 2001 (of these 3 werebespoke or open source systems, and four were commercial). See below for a summary of which institutions havechanged or adopted new VLEs since 2001.


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New bespoke: Oxford, Glasgow, Manchester

New commercial: LWMS, PMS, RVC, UCL

1 VLE to 2 VLEs: GKT School of Medicine, Birmingham Medical School, Liverpool

Are the VLEs sufficient in themselves or do they need supplementing with other

applications?

The purpose of this question was to get a sense of how satisfied people were with the facilities offered by theirVLE and how far they needed to supplement it with additional applications.

Respondents were asked which of the following they are using to supplement their VLE where they are NOT anintegral part of the basic VLE:

Content management system.

e-portfolio / personal academic record.

Specialist assessment tool (e.g. QuestionMark Perception).

Courseware authoring tools.

On-line student survey tool for student feedback. Discussion board / chat facilities.

Optical Mark Reader.

Other.


Clearly, while all the other tools are being used to some extent, Optical Mark Readers and Assessment tools arethe most widespread supplement, both being used by a majority of respondents, suggesting that althoughassessment may not be integrated into the VLE it is nevertheless an activity that is increasingly reliant ontechnology.

All of the Blackboard users supplement it with a CAA system, mostly QuestionMark Perception. In general,commercial users supplement their system more than bespoke users - with the exception of Optical MarkReaders.


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14.2. Are bespoke systems still the best way of representing the curriculum or cancommercial systems do this job adequately?

Reasons for choice of VLE

Users of both bespoke and commercial systems were asked to select the reasons for their choice of VLE. Theresults are given in Figure 4 and Figure 5.


Users of bespoke (including open source) systems were asked to choose from:

Legacy.

Still best way of reflecting curriculum.

Cost.

Deficiencies of commercial systems.

Other.

Other reasons given were:

Adaptability.

Extensibility.

Retains local knowledge.

Meets local needs.

The reason given in the case of one school using Bodington was that it was used corporately by the hostinginstitution.


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Users of commercial systems were asked to choose from:

Cost of software.

Cost of staff.

Institutional pressure.

Commercial system met all our needs.

Development skills not available.

Other.

Other responses: We didn't choose to buy anything (or haven't yet). We use Blackboard as it is the one supported institutionally.

It's not ideal and we often fit the learning around the product but we have no alternative at the moment. It'slikely that we will continue to use Blackboard as a means to manage and deliver but will increasingly use othertools for specific things e.g. CAA, content management, etc. (Bristol).

Flexibility of system. Allows for complexity of curriculum (unlike Blackboard, WebCT). Continuity - allowed usto continue using QuestionMark and WebBoard - seamlessly integrate with FD Learning LE (Leicester).

Commercial support, not reliant on developers in house. Ease of academic use ( PMS).

Decision taken at senior management level and we had no say as such ( Liverpool).

Ease of use - after evaluation of products on a TLTP project with Newcastle, we wanted something that staffwould feel confident using, so that they could take ownership of the system. Too small to go it alone, so usedan existing VLE (Durham).

Suitability of commercial systems

The survey asked developers to respond to the statement: Commercial off the shelf VLEs are unsuitable formedical schools because they are unable to represent the complexity of the medical curriculum.


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Figure 6. Source: Developers Survey (n=26; 14 Bespoke users, 12 Commercial).

Figure 6 shows a clear (although given the small numbers, not statistically significant) difference between the viewof bespoke and commercial users, with none of the bespoke users disagreeing and half of the commercial usersdisagreeing with the question. However nearly half (5 out of 12) of the commercial users agree that commercialsystems are unsuitable for medicine, which suggests some dissatisfaction among users of commercial systems.

Satisfaction with VLEs reflection of curriculum

The question was then put another way, with respondents asked to indicate how satisfied they are with the waythat their VLE represents the structure and content of their curriculum.

Figure 7. Source: Developers Survey (n=26; 14 Bespoke users, 12 Commercial).

Figure 7 shows that bespoke users are clearly more satisfied than commercial users in this respect (although againthe small numbers mean that the difference is not statistically significant). Furthermore both of the 2 bespoke

users who were less than mostly satisfied represent schools using an off-the-shelf open source system ratherthan a truly bespoke VLE.


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Users of commercial systems were asked in a free text question to indicate what other tools, if any, they use tohelp manage the complexity of the medical curriculum. Eight of 12 commercial users posted replies to thisquestion.

Responses included:

We are still having the debate as to whether we need any system to manage (or present) the complexity of themedical curriculum in terms of a VLE for delivery of e-learning. Students study one unit at a time and they

know where to get information on that unit and any e-learning materials. I'm not entirely convinced that weneed a VLE to represent the complexity - this is done adequately well via the course handbook and is thenbroken down for each unit. I think those who manage the learning think they need someway to represent thiselectronically, but if you asked the students I suspect they don't really care as long as they can access what theyneed for what they are studying at the time (i.e. a URL). I think what is important for us is for students (andstaff) to be able to move seamlessly between the various tools and systems e.g. single-sign-on betweenBlackboard and our own Intranet (Medici) is really important. Where the complexity requires tools is in thearea of student administration and in particular of placements and assessment. However, it's not thetechnology here that is the issue but the underlying processes and guidelines and standards that have to beagreed and set by consultants / academics i.e. the human / process issues ( Bristol Medical School).

We have had our own in-house system since '97 and since moving to WebCT we have been trying to find waysin which we can still use the power of our own system to enhance WebCT. Our own system was a web-services-based XML content management system and to some extent parts of this are still used (Birmingham

Medical School).

Don't as yet make much use of the CMS - only installed last month . A lot of bespoke Java and MySQL toolswhich are controlled via Blackboard (Durham).

None specifically at present (Liverpool). Currently we also use a sophisticated Intranet development in Cold Fusion to provide linkages to Computer

Aided Learning (CAL) packages which cannot be uploaded into the VLE. We are also using the CMIStimetabling system which is not yet integrated into the VLE (RVC).

The Clinical Log is the main thing outside the VLE, Also we have had to develop applications to support otherareas i.e. Special Study Unit and Placement allocation (PMS).

14.3. Summary

Altogether a rather more mixed picture than in 2001, with 12 out of 28 respondents using a commercial VLE,compared to only 2 out of 21 in 2001. This change in proportion is partly accounted for by schools that either didnot exist in 2001 or were not yet using a VLE. However of the 7 schools that have started using a VLE, only 4 areusing commercial VLEs, so this does not account for the full picture. The remainder are probably accounted for by3 respondents who are currently using a commercial system but didnt know what was happening in 2001, and the2 schools which have switched from a bespoke VLE to a commercial system. A further complicating factor is that 2schools who said they were developing their own system in 2001 have since adopted the open source systemBodington, which could be described as an off-the-shelf non-commercial system. One of these is Leeds, whereBodington was developed (though not specifically for clinical subjects).

15. Pressure to standardise

As institutions have begun to adopt VLEs centrally has there been any pressure on schools to fall into line withinstitution-wide VLE strategies and how have schools responded to this?

15.1. Relationship between school and institutional VLEs

Users of bespoke systems were asked to say how the situation in their school related to that of the hostinginstitution, by indicating whether the hosting institutions was using:

The same bespoke VLE as the school.

A commercial VLE.

A different bespoke VLE to the school.


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Both a commercial and bespoke VLE side by side.


The 2 bespoke users whose hosting institutions are using the same bespoke VLE are the 2 who use Bodington(which should probably be better categorised as a non-commercial off-the-shelf system rather than a truebespoke VLE) (Figure 8). Thus apart from at Leeds where Bodington was developed, there is almost no use oftruly bespoke systems among hosting institutions.

15.2. Institutional attitudes to bespoke VLEs

In the light of reports that some schools who had developed their own VLEs had been put under pressure toadopt the same system as their hosting institutions, bespoke users were asked to indicate their host institutionsattitude to their using a different VLE by choosing from the following:

Applying pressure to adopt main institution VLE.

Happy for two systems to coexist.

Tolerant for now but future pressure to standardise is likely.

Institution interested in adopting an extension of medical school VLE.

Other.


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Attitudes of hosting institutions to school VLEs

Pressure to

adopt main VLE,3

Happy to

coexist, 8

Future pressure

likely, 2

Interested in

adopting school

VLE, 1

Other, 2


Figure 9 shows that 8 of the 12 respondents said their institutions were happy for the two systems to coexist, but5 schools said that pressure to adopt the hosting institutions VLE was either already present or was likely in thefuture. Other answers were that they are looking at what elements can be made interoperable with Universitylevel VLE (Manchester), and that the host institution has no VLE (Glasgow).

15.3. Likely future relationship

Bespoke users were asked what they saw as the future relationship between the schools bespoke system and thehosting institutions system over the next 3 years in their school (Figure 10).

What will happen to host institution and med. school

VLEs which currently exist side by side?

Both will

continue, 9

Commercial

discontinued, 1

Don't know, 1

Other, 2



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The Other answer was that the VLEs would be engineered to allow free movement of data between the 2 systems(Aberdeen).Clearly most of the respondents to this question believe that both systems will be able to exist side byside, and the Other answers to the last 2 questions suggest that this may be facilitated by greater interoperabilitybetween the 2 systems possibly with the outcome that they become complementary rather than mutuallyexclusive. Nevertheless it does seem that some institutions do not share this view, and some schools were, in2004, under pressure to adopt institutional approaches (possibly with some aspects of their own independentsystems remaining).

16. Changes to VLEs since 2001

Which of the planned developments have actually been implemented and how successful have they been?

16.1. Features added since 2001

The 2001 report contained quite a long list of additional features and functionality that developers intended toimplement over the coming 2 years or so. The 2004 survey asked the bespoke developers how far thisdevelopment had actually taken place, to gauge the overall functionality of the current bespoke systems as well as

plans for further development.

This question was divided into 2 sections:

9. Covering a number of features, mentioned in the 2001 survey, that are intended to make the systems morepersonalised: these were sufficient to require a separate dedicated section.

10. Covering other features spanning a range of functions.

Personalisation features

Section i) asked about the following features:

Separate portals for teaching staff management and students with interface relevant to each group.

Personalised tools such as My Timetable My Calculator My Calendar.

Integration of VMLE with a personal academic record system (PARS).

An on-line learning portfolio management system.

Intelligent analysis of user's learning style to recommend further suitable resources in the style of Amazonscustomers who bought book 'A' also bought books 'B' and 'C' and CD-ROM 'D'.

User specified individual pathways through materials9.

For each of these, respondents were asked to say whether this was something they:

Already had in 2001.

Had adopted since 2001.

Planned to adopt.

Had no plans to adopt.

9 This list is not exhaustive and could also have included: annotations, smart book marking, PPD, discussion, but was developedfrom responses to the JTAP-623 2001 survey.


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Figure 11 shows quite a mixed picture, with some progress towards personalisation made since 2001, particularlywith user specific portals into the VLE, but some of the features mentioned in the 2001 report, particularlyintelligent recommendation and user specified pathways have not been widely adopted.

Other features

Section ii) asked about the following:

Author uploading facilities.

Assessment tools. Two-way communication tools (Discussion board / Chat room).

Student survey tool for student feedback.

Separate interfaces for authoring different types of materials such as tutorials and assessment e.g. MCQs.

Use of MeSH headings for indexing and classification of resources10.

Enhanced use of MeSH allowing users to select headings from pull-down list or expandable tree.

Incorporation of RSS feeds.

Increased incorporation of video resources.

10 Other potential purposes for using MeSH, e.g. curriculum mapping, were not specified in the survey.


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Figure 12 shows that author uploading tools, assessment tools and 2-way communication were already anestablished features of most systems, and that survey tools were a newer but very popular feature, while the useof MeSH and RSS feeds was neither widely adopted nor planned.

The open-ended response option appended to these questions elicited some explanatory comments, particularlyabout the use of MeSH11.

We don't use MeSH in the main VLE, however we do use it in conjunction with our Resource DiscoverySystem which catalogues 'raw materials' (images, sounds, videos) for developers to create learning packages forthe main VLE (Nottingham).

We use MeSH in some areas e.g. anatomy but it is not used in e.g. Public Health (Oxford).

MeSH possibly in the future (Aberdeen).

MeSH headings are just too complex. We rely on IIS, which seems largely satisfactory. Students and staff canoptionally customise a wide variety of specialist external search engines from their personalised desktopprovided on our MLE (Southampton).

One school reported that they had implemented RSS feeds but since removed them (Aberdeen).

A full breakdown of the features implemented by each of the 14 schools using bespoke systems is given at 30Appendix Two: How bespoke VLEs have developed since 2001 on page 65 below.

16.2. Integration with other information systems

Another area where developments were ongoing was in the integration of the VLEs with other institutional ITsystems. In 2001 there were few schools that had made much progress in this respect.

The 2004 survey asked all the developers to indicate to what extent their VLE is integrated with other institutionalIT systems, by selecting from the following:

Weak single-sign-on that allows VLE to be accessed with same login details as other institutional systems, butusers have to login separately to each system.

11 The Subject Centre-funded project METRO project also offers a critique of MeSH for education and intends to develop itsown set of subject headings designed for medical education. Seehttp://www.medev.ac.uk/resources/features/docs/metrofinal_report.pdf


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True single-sign-on where login information can be passed between systems so the user only has to loginonce to access all participating systems.

VLE is integrated with Athens systems.

Students and staff can use all features of the library system from within the VLE interface.

Staff can build reading lists etc directly from within the VLE interface.

System integrates with student record system to record assessment scores. Student details can be taken directly from student record system and displayed within the VLE.

Details of student membership of units / modules / groups can be taken from student record system and usedwithin the VLE.

Other.


Other responses were:

Moving towards single-sign-on and passing information between systems - bits of it work e.g. between portaland Blackboard (and can be for Medicines Intranet and Blackboard - just need to do a bit of developmentwork). (Bristol Medical School).

Projects this year will incorporate Shibboleth authentication with bespoke VLE, library sources and institutionalVLE (Blackboard). (Newcastle).

A number of the above are under consideration but have not been integrated yet. IE integration with MIS andLibrary systems (PMS).

Currently piloting Sentient reading list integration for Medical School (Oxford).

Working with our institutional portal team towards true single-sign-on. Athens access currently in testing(Aberdeen).

above in progress (Cambridge).

VLE will be integrated with Athens systems eventually (Manchester).

Athens (and later Shibboleth) authentication will be available later this year. The latter should see SSOimplemented for all University services (Durham).

Separate sign-on for main system & VALE (medical VLE). Data has to be wangled out of student record system.VALE keeps a record of all aspects of the medical course (exam marks / groups etc.) plus student details (homeaddress, term time address etc.). (Glasgow).


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We have a separate bespoke student and staff record system which is informed by the central Universitysystem, but which goes furthe

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Higher Education for Medicine, using VLE

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