Like it or loathe it, combining work and study is becoming a feature of modern life. Learning on the job is no longer enough; you need postgraduate training and education to develop your skills.
But it can be hard to find the funding for a traditional college-based course lasting a year or more, and harder still to commit to a regular "day off" , particularly in community practice, where there are often not enough locums around to provide cover. Even if you can find the time and the money, for many people, there is not a course within feasible travelling distance.
Paper-based distance learning courses are one tried and tested answer to this dilemma. But at the University of Derby they have taken a different road: their postgraduate pharmacy students do their learning by computer.
Computer-based learning packages are definitely not just "potted electronic books", says Professor Mike Allwood, who heads Derby's pharmacy postgraduate distance learning programme. A CAL (computer assisted learning) programme acts like a teacher would in a tutorial, giving feedback according to how the students do. The advantage over printed course material is that students have to do something - press a button, drag and drop text, or type in a response. Their keyboard actions can link directly to a "good, you got it right" or "go back and try again" screen, or to more information, depending on their answers. This keeps up attention, and research has shown people do learn better this way.

Professor Mike Allwood, head of Derby's pharmacy postgraduate distance learning programme

A multimedia program takes this structured pathway concept a stage further, building video and sound into the program storyboard. Students can watch a film segment, hear someone speak, and then type in free text responses, or check boxes on a multiple choice questionnaire.
Multimedia is useful for teaching a range of topics, particularly if these involve practical demonstrations, and many education centres are developing it as a teaching tool. But at Derby it was pharmacists who were the driving force behind the university's move to this new IT method.
The story began in the early 1990s, when Mr Mike Cullen, then dean of the school of health and community studies, got funding to develop the idea of computer-based postgraduate distance learning. Dr Dave Gerrett, now senior research fellow in the pharmacy academic practice unit, recalls: "It was physically difficult to get pharmacists to university settings because they lived too far away. But they generally have computers. So it was a matter of putting these together."

Ms Elaine O'Neill (distance learning administrator). Students are able to contact staff by telephone, e-mail or via the programme's website

The money they got allowed staff to develop new skills and specialise in IT. Mr Alan Hopcraft, a radiographer, became director of the university's multimedia teaching and learning unit (see Panel, p412). Soon afterwards, Ms Christine Owen, a software developer, joined the team, which quickly grew in size and skills.
The first course they developed aimed to fill a gap which the Nuffield report had highlighted: not enough social and behavioural sciences in the undergraduate pharmacy curriculum. American "pharmacy administration" courses were not suitable for the British market. New material had to be written, and it had to be presented in some sort of computer format.
At that time, multimedia was a new idea and there were many "authoring tools", which integrated text, images, sound and video for delivery by a computer. Authorware software was eventually chosen to put the whole learning package together. Fortunately, the university chose what is now an industry standard.
The start-up costs were considerable: staff time, computers and software set them back £250,000. Dr Gerrett says the university bought the idea because the method of delivery held great promise for all other courses.
"We were the guinea pigs," he says. "We told them that we will bench test the method and provide the university with the experienced members of staff who can take other courses through."

Derby's multimedia development unit

Derby university's multimedia development unit is specifically devoted to the production of learning courses, using a range of commercial software packages to integrate video clips, graphics, sound and text. The unit started in a small way as the multimedia teaching and learning unit in 1991. Now it has around eight staff and produces multimedia programs for the university and external clients on a whole range of subjects from Shakespeare to the solar system or hand surgery. Computing students often do a stint in the unit as work experience. The unit provides technical support and, in return, students can feed back comments on the new course materials.
Each project it takes on begins with the production of a "story board" which defines how the lessons will flow, and where any graphics or videos will slot in. This is designed with the author, who will be asked for minor changes every year. The program draft will be reviewed by academics, and then go through a quality control process to make sure that all the buttons and pathways work as planned. The finished compact disc goes back to authors for a final check. The unit then makes multiple copies for general release.
Complementing the unit is the University of Derby on-line project, which uses the Lotus suite of programs to provide administrative support and access to learning material over the internet. This includes multimedia, which can be downloaded or accessed directly.
Derby is a new university and learning there is strongly IT-based. Undergraduate campus study bedrooms have computer terminals and a good deal of work is done electronically with timetables and course materials accessible via the internet.

Setting up the first course - a diploma/MSc in social and administrative pharmacy (see Panel, p413) - took two years. It was not so much the technology that slowed things down, but the university's approval process for new courses. Flexibility was the whole idea, and the first distance learning students had multiple choice question tests, which they could do where and when they chose. Not having a "proper exam" was one of the objections raised, but the Derby team did finally win the day.
"We swung it basically because the students we are targeting are professional people. If they were found to be cheating the system the repercussions in terms of registration would be quite severe," Dr Gerrett explains. (Attitudes have now softened and the multiple choice question examination has gone. However, one aspect of the traditional approach has been retained - assessed course work for all the postgraduate courses must still be submitted on paper to the university office, where it gets logged in.)
Professor Allwood and his team finally launched their new postgraduate pharmacy course in the spring of 1994. Over 70 people applied, suggesting that Derby had spotted a gap in the distance learning market. Only 12 were accepted and, as they agreed to pilot both the technology and the course, the fees were reduced.

Ms Karen Rosenbloom - now a Derby tutor and studying for a PhD - was in that first intake. "I'd finished the curtains, painted the house and I was looking for something more challenging. But with three young kids there was no way I could get a day off a week to study," she reminisces. This new course looked to be the answer - she could study when and where she chose. To apply, she had to submit a 2,000-word essay outlining her vision for pharmacy's future.
"I hadn't written an essay for 20 years! But it's really important. You need to understand where the person is and what past experience they've had."
With students from outside the UK registering (Derby currently has students from Israel, Belgium and Ireland), these essays also provide tutors with useful insights on policies and practice in other countries.
As a "beta tester", Ms Rosenbloom got her MSc in social and administrative pharmacy at a cut price in exchange for development feedback.
One interactive technique the computer-based course employs is to invite students to type in comments on what they have read. These are then displayed on the screen, alongside the course author's views. Ms Rosenbloom remembers how inhibited she felt, because she knew all her keystrokes were written to a special feedback disk which went back to the university for analysis. "I wrote gobbledegook and hoped the university would think there was something wrong with my file," Ms Rosenbloom recalls. "I can remember I was too scared to input my ideas, to be read by someone I didn't know. Now we show past students' input too."

About the courses

Derby university offers two main course pathways: social and administrative pharmacy and community pharmacy. In both areas, teaching material is divided into stand-alone modules, each worth a certain number of credits.
Each module is on a compact disc, which a student loads into a computer at home or at work. There are six to 10 lessons per module, and a fair amount of reading.The university's library handles e-mail requests for books, which it posts to students.
Each module has a course leader who keeps in regular contact with students, usually via e-mail or telephone. There is also an optional weekend school each year.
To gain a certificate, pharmacists must complete four separate modules, each taking around 120 hours. To go on to a diploma, they must add on four more modules, with a practice research project on top if they want a master's degree. After that, they can work for a DPharm award. There is also a new "associate student" route for people wanting to do specific modules.
Students can start any time during the year, and assessment is on course work.
The social and administrative pharmacy course, which was launched first, was originally designed for hospital pharmacists who wanted a broader, less clinical postgraduate course.
Dr Ruth Goldstein, who was doing her PhD at the time, suggested that community practice needed something like this too. Now she leads the community pharmacy course. The two courses share several modules, notably the first one, on pharmacy and health policy, which is compulsory.
"It was a deliberate choice to put this first, but it does cause some students heartache," says Dr Goldstein. "But it gives the backdrop to everything else. Once you understand you can move on."
MSc student Mr Hassan Hajat, now on his last module, agrees with that: he opted for Derby precisely because the practice content was not quite like other courses. Now he says he would recommend it to Royal Pharmaceutical Society Council members: "We need to look at pharmacy in a different light."
The portability of course materials is another advantage. "You and your house don't become swamped in paper!" points out health authority facilitator Ms Liz Taylor. Equipped with a laptop, students can study anywhere they choose - one pharmacist is rumoured to take modules on holiday and study in the sun.

The feedback disk is still a key feature of Derby's distance learning approach. Students are asked to put this in the "a:" drive while they are working and it records not only their responses to questions, but how long they spend on particular sections and which ones they skip.
This information is immensely valuable to teachers as it can help spot problems: "You can tell from feedback disks how long they've spent on a section. Then you can ask why they got stuck," explains Ms Rosenbloom. The data recorded on the feedback disks also pick up exercises which are obviously not working, and need to be changed.

Computing technicians in the multimedia unit working on new teaching packs